Dietary Calcium Intake and Food Sources Among Chinese Adults in CNTCS

Overview

Journal PLoS One

Specialties General Medicine
Science

Date 2018 Oct 2

PMID 30273413

Citations 25

Authors

Feifei Huang

Zhihong Wang

Jiguo Zhang

Wenwen Du

Chang Su

Hongru Jiang

XiaoFang Jia

Yifei Ouyang

Yun Wang

Li Li

Bing Zhang

Huijun Wang

Affiliations

Soon will be listed here.

Abstract

Background: Calcium is one of the essential micronutrients in the human body and is well-known for its important role in keeping bones and teeth healthy. However, calcium deficiency is a very common nutritional problem in the world and especially in China. The aim of this research was to determine the dietary calcium intake of Chinese adults and the corresponding food sources based on data from the 2015 China Nutritional Transition Cohort Study.

Methods: We obtained dietary data from Chinese adults ages 18 to 64 years in 15 provinces, autonomous regions, and municipalities using 3 consecutive days combined with the household weighing method. We used the China Food Composition (book 1, 2nd edition) to calculate the calcium intake from each food category. We regarded the percentage of participants with a calcium intake median below the estimated average requirement as the level of calcium inadequacy in the overall population.

Results: We divided the participants into 2 age groups, 18-49 years and 50-64 years, which included 6,630 and 5,307 participants, respectively. The groups' dietary calcium intake medians were 324.8 milligrams per day (mg/d) and 332.7 mg/d, respectively, and the calcium inadequacies were 92.9% and 96.0%, correspondingly. The median calcium intake for the whole study population was 328.3 mg/d, and the inadequacy was 94.3%, which improved with higher education, income, and urbanization levels. The main food sources of dietary calcium among the study population were vegetables, legumes, and cereals, which contributed 30.2%, 16.7%, and 14.6%, respectively. Milk and dairy products contributed 6.7% to the study population but varied with the urbanization level to 15.0%, 6.1%, 6.3%, and 2.0% in urban, suburban, county, and rural areas, respectively.

Conclusion: These findings highlight the importance of nutrition education and intervention for Chinese adults to improve their dietary structures and increase milk and dairy products intake to consume adequate calcium.

Citing Articles

Macroelements Intake in Chinese Adults - 10 PLADs, China, 2022-2023.

Huang F, He Y, Su C, Zhang J, Du W, Jia X China CDC Wkly. 2025; 7(1):1-5.

PMID: 39801825 PMC: 11718374. DOI: 10.46234/ccdcw2025.001.

Calcium deficiency and its implications for cardiovascular disease and cancer: Strategies for resolution via agronomic fortification.

Cheng L, Lian J, Ding Y, Wang X, Munir M, Ullah S Food Sci Nutr. 2024; 12(11):8594-8607.

PMID: 39619946 PMC: 11606831. DOI: 10.1002/fsn3.4464.

Persistent Calcium Inadequacy in Korean Adults over 20 Years: Analysis of the 1998-2018 Korea National Health and Nutrition Examination Survey.

Ju S, Kwon Y, Yeum K Foods. 2024; 13(22).

PMID: 39593984 PMC: 11593063. DOI: 10.3390/foods13223568.

Home Meal Replacement Fortified with Eggshell Powder and Vitamin D Prevents Bone Loss in Postmenopausal Women: A Randomized, Double-Blind, Controlled Study.

Joo N, Shin S, Kim K, Lee S, Jung S, Yeum K Nutrients. 2024; 16(8).

PMID: 38674843 PMC: 11054347. DOI: 10.3390/nu16081152.

Clinical practice of vitamin D screening and supplementation in pregnancy in Asia-pacific countries: A cross-sectional study.

Lee R, Chng A, Tan K Heliyon. 2023; 9(11):e21186.

PMID: 38034721 PMC: 10684368. DOI: 10.1016/j.heliyon.2023.e21186.

References

Oh J, Woo H, Kim M, Lee Y, Shin D, Shin M . Dietary total, animal, vegetable calcium and type 2 diabetes incidence among Korean adults: The Korean Multi-Rural Communities Cohort (MRCohort). Nutr Metab Cardiovasc Dis. 2017; 27(12):1152-1164. DOI: 10.1016/j.numecd.2017.10.005. View

Quann E, Fulgoni 3rd V, Auestad N . Consuming the daily recommended amounts of dairy products would reduce the prevalence of inadequate micronutrient intakes in the United States: diet modeling study based on NHANES 2007-2010. Nutr J. 2015; 14:90. PMC: 4559338. DOI: 10.1186/s12937-015-0057-5. View

Xiao Q, Murphy R, Houston D, Harris T, Chow W, Park Y . Dietary and supplemental calcium intake and cardiovascular disease mortality: the National Institutes of Health-AARP diet and health study. JAMA Intern Med. 2013; 173(8):639-46. PMC: 3756477. DOI: 10.1001/jamainternmed.2013.3283. View

Popkin B, Du S, Zhai F, Zhang B . Cohort Profile: The China Health and Nutrition Survey--monitoring and understanding socio-economic and health change in China, 1989-2011. Int J Epidemiol. 2009; 39(6):1435-40. PMC: 2992625. DOI: 10.1093/ije/dyp322. View

Paik J, Curhan G, Sun Q, Rexrode K, Manson J, Rimm E . Calcium supplement intake and risk of cardiovascular disease in women. Osteoporos Int. 2014; 25(8):2047-56. PMC: 4102630. DOI: 10.1007/s00198-014-2732-3. View

Nicklas T, ONeil C, Fulgoni 3rd V . The role of dairy in meeting the recommendations for shortfall nutrients in the American diet. J Am Coll Nutr. 2009; 28 Suppl 1:73S-81S. DOI: 10.1080/07315724.2009.10719807. View

Bolland M, Grey A, Avenell A, Gamble G, Reid I . Calcium supplements with or without vitamin D and risk of cardiovascular events: reanalysis of the Women's Health Initiative limited access dataset and meta-analysis. BMJ. 2011; 342:d2040. PMC: 3079822. DOI: 10.1136/bmj.d2040. View

Mensink G, Fletcher R, Gurinovic M, Huybrechts I, Lafay L, Serra-Majem L . Mapping low intake of micronutrients across Europe. Br J Nutr. 2013; 110(4):755-73. PMC: 3785176. DOI: 10.1017/S000711451200565X. View

Wang H, Wang D, Ouyang Y, Huang F, Ding G, Zhang B . Do Chinese Children Get Enough Micronutrients?. Nutrients. 2017; 9(4). PMC: 5409736. DOI: 10.3390/nu9040397. View

10.

. Food labeling: health claims; calcium and osteoporosis, and calcium, vitamin D, and osteoporosis. Final rule. Fed Regist. 2008; 73(189):56477-87. View

11.

Barr S . Applications of Dietary Reference Intakes in dietary assessment and planning. Appl Physiol Nutr Metab. 2006; 31(1):66-73. DOI: 10.1139/h05-020. View

12.

ONeil C, Keast D, Fulgoni V, Nicklas T . Food sources of energy and nutrients among adults in the US: NHANES 2003–2006. Nutrients. 2013; 4(12):2097-120. PMC: 3546624. DOI: 10.3390/nu4122097. View

13.

Koyama T, Yoshita K, Okuda N, Saitoh S, Sakata K, Okayama A . Overall nutrient and total fat intake among Japanese people: The INTERLIPID Study Japan. Asia Pac J Clin Nutr. 2017; 26(5):837-848. PMC: 6556773. DOI: 10.6133/apjcn.072016.11. View

14.

Murphy S, Poos M . Dietary Reference Intakes: summary of applications in dietary assessment. Public Health Nutr. 2003; 5(6A):843-9. DOI: 10.1079/PHN2002389. View

15.

Olza J, Aranceta-Bartrina J, Gonzalez-Gross M, Ortega R, Serra-Majem L, Varela-Moreiras G . Reported Dietary Intake, Disparity between the Reported Consumption and the Level Needed for Adequacy and Food Sources of Calcium, Phosphorus, Magnesium and Vitamin D in the Spanish Population: Findings from the ANIBES Study. Nutrients. 2017; 9(2). PMC: 5331599. DOI: 10.3390/nu9020168. View

16.

Manios Y, Moschonis G, Grammatikaki E, Mavrogianni C, van den Heuvel E, Bos R . Food group and micronutrient intake adequacy among children, adults and elderly women in Greece. Nutrients. 2015; 7(3):1841-58. PMC: 4377885. DOI: 10.3390/nu7031841. View

17.

Barr S, Murphy S, Poos M . Interpreting and using the dietary references intakes in dietary assessment of individuals and groups. J Am Diet Assoc. 2002; 102(6):780-8. DOI: 10.1016/s0002-8223(02)90177-x. View

18.

Strohle A, Hadji P, Hahn A . Calcium and bone health--goodbye, calcium supplements?. Climacteric. 2015; 18(5):702-14. DOI: 10.3109/13697137.2015.1016419. View

19.

Murphy S . Using DRIs for dietary assessment. Asia Pac J Clin Nutr. 2008; 17 Suppl 1:299-301. View

20.

Serra-Majem L, Ribas-Barba L, Salvador G, Jover L, Raido B, Ngo J . Trends in energy and nutrient intake and risk of inadequate intakes in Catalonia, Spain (1992-2003). Public Health Nutr. 2007; 10(11A):1354-67. DOI: 10.1017/S1368980007000961. View