Prevalence of low dietary calcium intake in patients with epilepsy: a study from South India.
BACKGROUND
The effects of antiepileptic drugs (AED) on bone health are well documented. Inadequate dietary intake of calcium and vitamin D plays a vital role and further compromises the bone health.


OBJECTIVE
To assess the dietary pattern with special reference to calcium and related minerals in people with epilepsy (PWE) on AED.


METHODS
The dietary assessment in PWE was documented by dietary recall method. Patients were categorized according to age: group I: <14 years; group II: between 15-20 years; group III: between 21-45 years; group IV: >46 years. From the raw weights, total energy, dietary calcium, dietary phosphorous intake and phytate calcium ratio was calculated using a food composition table by Indian Council of Medical Research (ICMR) and analyzed statistically.


RESULTS
A total of 362 patients with mean age of 29 + 15 years were studied. There were 190 women. The mean duration of AED treatment was 4 + 3 yrs, 64% on monotherapy 64% and 36% on polytherapy. The mean dietary intake of the total chohort was 2,007 + 211 Kcal/day, carbohydrate 335 + 33 gm/day; protein 31 + 7 gm/day; fat 18+2 gm/day; calcium 294 + 40 mg/day; phosphorus 557 + 102; phytates 179 + 30 mg/day; and phytate/calcium ratio 0.56+0.2. Milk and milk products were consumed by 42% of the total cohort. The daily dietary calcium (301 + 40 mg/day) intake of men was significantly higher than women (287 + 39 mg/day) (P < 0.001). This was more evident in group II (P < 0.01) and group III (P < 0.03). There was a positive correlation between dietary calcium and dietary phytates (P < 0.001), dietary proteins (P < 0.001), dietary fat (P < 0.001), and total energy (P < 0.001).


CONCLUSIONS
The dietary consumption of calcium of all the patients was far below the recommended daily dietary allowance (RDA) by Indian Council of Medical Research (ICMR). Low dietary calcium could have a confounding effect on PWE on AED in all age groups. There is a need to formulate consensus guidelines to supplement dietary calcium to PWE.
Department of Neurology, Sri Venkateswara Institute of Medical Sciences, Tirupati - 517 507, Andhra Pradesh, India. bneuro_5@rediffmail.com
Bindu
B
Menon
Chittari Venkata
CV
Harinarayan
Marella Neelima
MN
Raj
Swapna
S
Vemuri
G
G
Himabindu
T K
TK
Afsana
D000293:Adolescent; D000328:Adult; D000927:Anticonvulsants / Q000009:adverse effects*; D002136:Calcium, Dietary / Q000008:administration & dosage*; D015331:Cohort Studies; D002149:Energy Intake / Q000502:physiology; D004827:Epilepsy / Q000188:drug therapy / Q000453:epidemiology; D005260:Female; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D014808:Vitamin D Deficiency / Q000139:chemically induced / Q000453:epidemiology*; D055815:Young Adult
D000927:Anticonvulsants; D002136:Calcium, Dietary