The role of the therapeutic team in shaping eating habits and lifestyle in children with dietary calcium deficiency.
OBJECTIVE
Assessment of the effect of low-calcium diet on bone mineral content in children and adolescents.


METHODS
The study involved 89 children (49 girls and 40 boys) aged 5-18 years, in whom diseases affecting bony metabolism had been excluded. Children with a history of dietary calcium content below 500 mg/day were recruited. The study group was divided according to age: group I, age 5-9 years (children before puberty); group II, age 9-15 years (early puberty); group III, 15-18 years (late puberty). Dual energy X-ray absorptiometry (DEXA) was used for densitometric measurements. Bone mineral density (BMD) was assessed in the whole skeleton (total BMD), in vertebrae L2-L4 (spine BMD) in g/cm2 and as Z-score. Concentrations of Ca, Ca2, P, activity of alkaline phosphatase (AP) and its bony isoenzyme were determined in the serum.


RESULTS
Total bone mass below 5th percentile (according to the norm for age and gender) was found in 56.98% of the children involved in the study. A significant reduction was noted in the spine mineral mass in boys (p < 0.01) as compared to girls (0.731 +/- 0.17 g/cm2 and 0.835 +/- 0.19 g/cm2, respectively). The lowest mean Z-score (-1.850) was observed in group III as compared to group I (-1.194) (p < 0.01) and group II (-1.201) (p < 0.05). There were statistically significantly positive correlations between total and spine BMD and BMI. The correlation coefficient was r = 0.56 and r = 0.41 (p < 0.001), respectively.


CONCLUSIONS
In the majority of the children (c. 60%), a reduction in bone mineral content was found. The lowest Z-score (-1.850) was revealed in the oldest children, which may disturb the process of reaching the optimum level of the peak bone mass.
Górska
A
A
Department of Family Medicine and Environmental Nursing, Medical University of Bialystok, Poland. agorska50@wp.pl
Konstantynowicz
J
J
Chlabicz
S
S
Urban
M
M
Kaczmarski
M
M
D000293:Adolescent; D015519:Bone Density / Q000502:physiology*; D001851:Bone Diseases, Metabolic / Q000209:etiology; D002118:Calcium / Q000172:deficiency*; D002136:Calcium, Dietary; D002648:Child; D002675:Child, Preschool; D004032:Diet / Q000009:adverse effects*; D005260:Female; D015438:Health Behavior; D006801:Humans; D008019:Life Style; D008297:Male; D010348:Patient Care Team
D002136:Calcium, Dietary; D002118:Calcium