Calcium intake by adolescents: a population-based health survey

Assumpção, Daniela de; Dias, Marcia Regina Messaggi Gomes; Barros, Marilisa Berti de Azevedo; Fisberg, Regina Mara; Barros Filho, Antonio de Azevedo

doi:10.1016/j.jped.2015.09.004

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Original article • J. Pediatr. (Rio J.) 92 (3) • May-Jun 2016 • https://doi.org/10.1016/j.jped.2015.09.004 copy

Calcium intake by adolescents: a population-based health survey^☆ ☆ Como citar este artigo: de Assumpção D, Dias MR, de Azevedo Barros MB, Fisberg RM, de Azevedo Barros Filho A. Calcium intake by adolescents: a population-based health survey. J Pediatr (Rio J). 2016;92:251-9.

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective

To analyze calcium intake in adolescents according to sociodemographic variables, health-related behaviors, morbidities, and body mass index.

Methods

This was a cross-sectional population-based study, with a two-stage cluster sampling that used data from a survey conducted in Campinas, São Paulo, Brazil, between 2008 and 2009. Food intake was assessed using a 24-hour dietary recall. The study included 913 adolescents aged 10-19 years.

Results

Average nutrient intake was significantly lower in the segment with lower education of the head of the family and lower per capita family income, in individuals from other cities or states, those who consumed fruit less than four times a week, those who did not drink milk daily, those who were smokers, and those who reported the occurrence of headaches and dizziness. Higher mean calcium intake was found in individuals that slept less than seven hours a day. The prevalence of calcium intake below the recommendation was 88.6% (95% CI: 85.4-91.2).

Conclusion

The results alert to an insufficient calcium intake and suggest that certain subgroups of adolescents need specific strategies to increase the intake of this nutrient.

Keywords
Adolescent; Calcium dietary; Food consumption; Health surveys

Variables and categories	n	Mean (95% CI)	p-Value^a a In bold, p value <0.05.
Gender
Male^b b Reference category used for comparison.	462	692.3 (636.9-747.7)
Female	451	540.7 (436.4-645.0)	0.000
Total	913	618.2 (570.8-665.5)

Age range (in years)
10-14^b b Reference category used for comparison.	504	620.3 (567.0-673.5)
15-19	409	615.5 (496.0-735.0)	0.886

Ethnicity
White^b b Reference category used for comparison.	587	639.7 (595.6-683.8)
Non-white	323	579.0 (461.7-696.4)	0.102

Number of people in household
1-3^b b Reference category used for comparison.	220	646.0 (574.7-717.4)
4-6	579	627.3 (489.6-764.9)	0.572
7 or more	114	515.6 (290.6-740.5)	0.094

Origin
Campinas^b b Reference category used for comparison.	692	633.8 (580.9-686.6)
Another municipality or state	221	569.5 (445.6-693.3)	0.075

Head of family educational level (in years)
0-7	382	528.6 (379.8-677.4)	0.000
8-11	310	625.9 (476.2-775.5)	0.003
12 or more^b b Reference category used for comparison.	210	759.8 (695.5-824.1)

Per capita income (in minimum wages)
<1	578	564.6 (399.4-729.9)	0.000
≥1 to ≤2	193	646.7 (450.5-842.9)	0.021
>2^b b Reference category used for comparison.	142	785.1 (705.5-864.8)

Occupational activity
Works^b b Reference category used for comparison.	148	655.5 (557.8-753.2)
Does not work	754	610.4 (418.5-802.3)	0.341

Has health care insurance
Yes^b b Reference category used for comparison.	307	712.8 (654.6-771.0)
No	601	566.7 (440.7-692.6)	0.000

Attends school
No	143	596.4 (412.9-779.8)	0.019
Yes, public	607	589.7 (437.5-741.8)	0.001
Yes, private^b b Reference category used for comparison.	162	735.0 (666.4-803.5)

Number of appliances in household
0-10	420	538.6 (373.1-704.2)	0.000
11-15	231	643.2 (486.6-799.8)	0.090
16 or more^b b Reference category used for comparison.	261	718.7 (649.5-787.8)

Variables and categories	n	Mean (95% CI)	p-Value^a a In bold, p-value <0.05.
Fruit consumption
7 times a week^b b Reference category used for comparison.	246	675.6 (602.5-748.7)
4-6 times a week	189	671.0 (499.0-842.9)	0.927
≤3 times a week	478	567.4 (413.7-721.1)	0.010

Raw vegetable consumption
7 times a week^b b Reference category used for comparison.	295	658.0 (597.5-718.6)
4-6 times a week	214	581.2 (443.0-719.3)	0.052
≤3 times a week	404	608.2 (480.9-735.5)	0.140

Milk consumption
7 times a week^b b Reference category used for comparison.	552	711.5 (663.8-759.2)
4-6 times a week	94	649.0 (502.5-795.4)	0.209
≤3 times a week	267	413.6 (316.8-510.4)	0.000

Soft drink consumption
7 times a week	207	625.4 (491.1-759.6)	0.581
4-6 times a week	145	668.7 (518.3-819.2)	0.186
≤3 times a week^b b Reference category used for comparison.	561	602.4 (551.1-653.8)

Smoking status
Nonsmoker^b b Reference category used for comparison.	873	624.3 (577.0-671.5)
Ex-smoker	18	591.9 (344.9-838.8)	0.746
Smoker	22	396.1 (255.0-537.2)	0.000

Alcohol consumption
Does not drink alcohol^b b Reference category used for comparison.	764	616.4 (564.5-668.3)
1-4 times a week	118	669.2 (525.6-812.7)	0.253
2 or more times a week	26	476.7 (333.5-620.0)	0.004

Physical activity at leisure
Sedentary	278	566.9 (428.4-705.5)	0.013
Insufficiently active	305	610.0 (474.5-745.6)	0.132
Active^b b Reference category used for comparison.	330	667.7 (607.7-727.7)

Sleep (hours/day)
<7	60	615.3 (443.0-787.5)	0.445
7-8^b b Reference category used for comparison.	450	657.9 (597.0-718.8)
9 or more	393	572.9 (446.6-699.2)	0.012

Computer use (hours/day)
0^b b Reference category used for comparison.	437	563.8 (499.5-628.1)
1-2	298	657.5 (522.0-792.8)	0.011
3 or more	172	688.3 (527.2-849.4)	0.013

Variables and categories	n	Mean (95% CI)	p-value^a a In bold, p value <0.05.
Headache/migraine
Yes	227	543.4 (431.8-655.0)	0.003
No^b b Reference category used for comparison.	686	642.7 (594.3-691.1)

Dizziness
Yes	55	490.8 (349.5-632.2)	0.005
No^b b Reference category used for comparison.	858	626.2 (578.2-674.2)

Number of chronic diseases
0^b b Reference category used for comparison.	739	613.7 (561.5-665.9)
1 or more	170	620.5 (500.6-740.4)	0.840

Number of health complaints
0^b b Reference category used for comparison.	344	638.0 (572.9-703.2)
1	295	627.0 (494.5-759.4)	0.742
2 or more	274	583.9 (443.7-723.9)	0.153

BMI (kg/m²)
Low weight	30	468.2 (260.0-676.4)	0.055
Normal weight^b b Reference category used for comparison.	565	619.8 (566.6-673.0)
Overweight	133	668.5 (521.3-815.6)	0.303
Obesity	81	626.7 (438.3-815.2)	0.918

Variables and categories	First step^a a Adjusted for calories and for demographic and socioeconomic variables. (95% CI)	p-Value^b b In bold, p-value <0.05.	Second step^c c Adjusted for calories and for all the variables of the table. (95% CI)	p-Value^b b In bold, p-value <0.05.
Gender
Male^d d Reference category used for comparison.	328.6 (213.2-443.8)		408.3 (281.3-535.3)
Female	297.5 (148.7-446.5)	0.068	399.8 (229.6-570.0)	0.694

Origin
Campinas^d d Reference category used for comparison.	328.6 (213.2-443.8)		408.3 (281.3-535.3)
Another municipality or state	279.7 (123.6-435.8)	0.020	372.4 (216.1-528.7)	0.017

Educational level of the head of the family (in years)
0-7	173.4 (9.25-337.6)	0.000	300.3 (125.6-475.0)	0.000
8-11	245.7 (68.2-423.2)	0.010	344.3 (158.3-530.2)	0.034
12 or more^d d Reference category used for comparison.	328.6 (213.2-443.8)		408.3 (281.3-535.3)

Per capita income (in minimum wages)
<1	241.2 (52.0-430.5)	0.022	321.7 (117.5-526.0)	0.029
≥ 1 to ≤2	240.3 (44.7-435.8)	0.032	355.6 (145.5-565.8)	0.209
>2^d d Reference category used for comparison.	328.6 (213.2-443.8)		408.3 (281.3-535.3)

Fruit consumption
7 times a week^d d Reference category used for comparison.			408.3 (281.3-535.3)
4-6 times a week			392.8 (210.7-575.0)	0.576
≤3 times a week			355.9 (183.4-527.4)	0.025

Milk consumption
7 times a week^d d Reference category used for comparison.			408.3 (281.3-535.3)
4-6 times a week			328.6 (155.3-502.1)	0.001
≤3 times a week			215.4 (51.0-379.9)	0.000

Smoking status
Nonsmoker^d d Reference category used for comparison.			408.3 (281.3-535.3)
Ex-smoker			453.4 (211.4-695.3)	0.434
Smoker			336.1 (151.2-521.0)	0.016

Sleep (hours/day)
<7			506.7 (297.2-716.2)	0.020
7-8^d d Reference category used for comparison.			408.3 (281.3-535.3)
9 or more			413.6 (255.7-571.5)	0.732

Headache/migraine
Yes			371.5 (218.0-525.0)	0.007
No^d d Reference category used for comparison.			408.3 (281.3-535.3)

Dizziness
Yes			332.3 (153.0-511.6)	0.005
No^d d Reference category used for comparison.			408.3 (281.3-535.3)

Sociedade Brasileira de Pediatria Av. Carlos Gomes, 328 cj. 304, 90480-000 Porto Alegre RS Brazil, Tel.: +55 51 3328-9520 - Porto Alegre - RS - Brazil
E-mail: jped@jped.com.br

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[1] * Corresponding author. E-mail:abarros@fcm.unicamp.br (A. de Azevedo Barros Filho).

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Calcium intake by adolescents: a population-based health survey☆ ☆ Como citar este artigo: de Assumpção D, Dias MR, de Azevedo Barros MB, Fisberg RM, de Azevedo Barros Filho A. Calcium intake by adolescents: a population-based health survey. J Pediatr (Rio J). 2016;92:251-9.

Abstract

Objective

Methods

Results

Conclusion

Calcium intake by adolescents: a population-based health survey^☆ ☆ Como citar este artigo: de Assumpção D, Dias MR, de Azevedo Barros MB, Fisberg RM, de Azevedo Barros Filho A. Calcium intake by adolescents: a population-based health survey. J Pediatr (Rio J). 2016;92:251-9.