The Consequences of Calcium Underconsumption among Children and Adolescents: A Systematic Review and
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The Consequences of Calcium Underconsumption among Children and Adolescents: A Systematic Review
Introduction to Calcium Underconsumption in Children and Adolescents
Calcium is a critical nutrient for the growth and development of children and adolescents. It plays a vital role in bone health, muscle function, and overall metabolic processes. However, underconsumption of calcium during these formative years can lead to significant health issues, both immediate and long-term.
Impact on Bone Health and Fracture Risk
Childhood Fractures and Calcium Intake
Several studies have explored the relationship between calcium intake and the risk of fractures in children. A systematic review and meta-analysis of observational studies found no significant association between mean calcium intake and fracture risk among children. However, other nutritional factors such as milk avoidance, high energy intake, and high intake of sugar-sweetened beverages were associated with increased fracture risk.
Bone Mineral Content and Dairy Consumption
Dairy products, which are rich in calcium, have been shown to significantly increase bone mineral content in children. A systematic review of controlled trials indicated that supplementing the diet with dairy products enhances bone mineral content, although the evidence regarding its effect on linear growth remains inconclusive. This suggests that while dairy products can improve bone health, their role in overall growth needs further investigation.
Calcium Metabolism and Requirements
Calcium Absorption and Retention
Calcium requirements for infants and young children are crucial due to their high needs for growth. Balance studies have shown that calcium intake from human milk leads to greater absorption and retention compared to formula or solid foods. These findings highlight the importance of adequate calcium intake during early childhood to support optimal growth and development.
Fortified Foods and Health Outcomes
Calcium fortification in foods is a common strategy to address calcium deficiency. A systematic review and meta-analysis found that calcium-fortified foods significantly increase calcium intake and improve bone health outcomes, particularly in children. This approach not only enhances calcium intake but also contributes to better bone mineral density and overall growth.
Combined Effects of Physical Activity and Calcium
Synergistic Benefits on Bone Health
The combination of physical activity and adequate calcium intake has been shown to have a synergistic effect on bone health in children and adolescents. Randomized controlled trials have demonstrated that regular physical activity combined with high calcium intake significantly improves bone mineral density, especially during early puberty when bone growth is most rapid . This underscores the importance of a holistic approach to bone health that includes both nutrition and physical activity.
Variability in Guidelines and Recommendations
Inconsistencies in Calcium and Vitamin D Guidelines
There is considerable variability in the guidelines and recommendations for calcium and vitamin D supplementation for children. A review of clinical practice guidelines revealed inconsistencies in the recommended daily intake of calcium and vitamin D, as well as differences in the choice of supplements and sunlight exposure recommendations. This variability highlights the need for standardized guidelines to ensure adequate calcium intake and prevent deficiencies.
Reevaluation of Dairy Products and Bone Health
Questioning the Efficacy of Dairy Products
Despite widespread recommendations for dairy consumption to promote bone health, some studies have questioned its efficacy. A review of existing literature found that increased consumption of dairy products or total dietary calcium did not consistently show benefits for bone health in children and young adults. This suggests that other factors, such as overall diet quality and physical activity, may play a more significant role in bone health than previously thought.
Conclusion
Calcium underconsumption among children and adolescents can have serious consequences for bone health and overall development. While dairy products and fortified foods can help increase calcium intake, the combined effects of physical activity and adequate nutrition are crucial for optimal bone health. However, inconsistencies in guidelines and the efficacy of dairy products highlight the need for further research and standardized recommendations to ensure children receive the necessary nutrients for healthy growth and development.
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Most relevant research papers on this topic
Nutrient and food intakes in early life and risk of childhood fractures: a systematic review and meta-analysis.
Effects of Dairy Product Consumption on Height and Bone Mineral Content in Children: A Systematic Review of Controlled Trials.
Calcium Intake and Metabolism in Infants and Young Children: A Systematic Review of Balance Studies for Supporting the Development of Calcium Requirements
Effect of Calcium Fortified Foods on Health Outcomes: A Systematic Review and Meta-Analysis
Combined effects of physical activity and calcium on bone health in children and adolescents: a systematic review of randomized controlled trials
Evaluation of the clinical practice guidelines and consensuses on calcium and vitamin D supplementation in healthy children using the Appraisal of Guidelines for Research and Evaluation II instrument and Reporting Items for Practice Guidelines in Healthcare statement
Calcium, Dairy Products, and Bone Health in Children and Young Adults: A Reevaluation of the Evidence
Combined effects of interaction between physical activity and nutrition on bone health in children and adolescents: a systematic review.
Vitamin D and Calcium in Children 0-36 Months: A Scoping Review of Health Outcomes
Global Consensus Recommendations on Prevention and Management of Nutritional Rickets
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