Osteoporosis literally means 'porous bone" and is characterized by an increase in bone fragility and susceptibility to fracture, which typically involves the wrist, spine and hip (South African Medical Association (SAMA) Working Group, 2000). In South Africa osteoporosis and fractures are more common in whites than in blacks. African-American men experience hip fractures at a rate of only half of that of Caucasian men. The bone mass in Africans were found to be 6 - 12 % higher than in Caucasians at all ages. A higher peak bone density at skeletal maturity in African-Americans were found, so that despite comparable age related bone loss, African Americans reach the fracture threshold less frequently than whites. Age-related bone loss that begins later, is less severe, or occurs in different skeletal sites in African-Americans than whites (Luckey et al., 1996). American whites have a higher bone turnover than American blacks, but in contrast to this American data. South African blacks may have a higher bone turnover and lower bone density than whites (Daniels et a/., 1995). If it is compared with Caucasians a lower rate of hip fracture in South African blacks were found, despite lower bone density at all ages (Villa, 1994). The lower fracture rate in blacks than in whites is because of greater bone mass and higher bone turnover leading to more frequent renewal of damaged bone. Blacks excrete less urinary calcium, and show no skeletal sensitivity towards the parathyroid hormone. Few studies focus on older black South African men and osteoporosis. Objectives The aim of this study was to investigate the relationship of calcium intake, vitamin D status, anthropometry and physical activity and bone density in black South African men. Methods A case-control study design was used, in which variables associated with bone density were compared. The case group were men with fractures of the proximal femur, the proximal humerus or the distal radius and an equal number of age-matched healthy black men (with not more than a 5-year age difference) with no fracture (the proximal femur and humerus and distal radius) previously, was recruited as a control group. Bone density was measured with DEXA. Fat percentage was measured with a Tanita scale. Biochemical analyses were done. Questionnaires were used to gather demographic, activity and dietary information. To our knowledge, this is the first case-control study on osteoporotic fractures in South African black men. Results Both the groups' bone mineral densities were lower than recommended. The bone density of the case group for lumbar and hip regions was 0.86 and 0.88 and the control group's bone density for lumbar region was 0.95 and hip region 0.91. The control group was more physically active and had a better nutritional status than the case group. The control group's calcium intake was higher but the vitamin D status was lower than the case group. Both calcium and vitamin D status were not statistically significant (pc0.5), between the two groups. Body mass indices of the groups were the same. The serum albumin was higher in the control group than in the case group. The case group serum calcium was higher than the control group. Both serum albumin and serum calcium were statistical significant between the two groups. There were no statistically significant differences in any of the other biochemical variables between the two groups. Serum phosphate and serum vitamin D were statistical significant for bone density of the hip and lumbar regions. Conclusion To conclude it seems logical to suggest a healthy diet with optimal macro- and micro nutrient intake. Maintain ideal body weight and body fat percentage and recommend regular but moderate-weight-bearing exercise from a young age throughout adult life, as part of a strategy to prevent and treat osteoporosis. In the present study black South African men present with low bone mineral density, but other studies indicated a lower rate of hip fracture in South African blacks, despite lower bone density at all ages. It can be recommended that other factors may play a role in black South African men with osteoporosis. Factors such as serum phosphorus, 25-hydroxy-vitamin D, body mass index (BMI), physical activity index (PAI), animal protein, total fat intake and dietary calcium are important determinants of BMD in older South African blacks, as shown in the present study. Osteoporosis is a multi factorial problem and must be treated that way. / Thesis (M.Sc. (Dietetics))--North-West University, Potchefstroom Campus, 2004.

Osteoporosis literally means 'porous bone" and is characterized by an increase in bone fragility and susceptibility to fracture, which typically involves the wrist, spine and hip (South African Medical Association (SAMA) Working Group, 2000). In South Africa osteoporosis and fractures are more common in whites than in blacks. African-American men experience hip fractures at a rate of only half of that of Caucasian men. The bone mass in Africans were found to be 6 - 12 % higher than in Caucasians at all ages. A higher peak bone density at skeletal maturity in African-Americans were found, so that despite comparable age related bone loss, African Americans reach the fracture threshold less frequently than whites. Age-related bone loss that begins later, is less severe, or occurs in different skeletal sites in African-Americans than whites (Luckey et al., 1996). American whites have a higher bone turnover than American blacks, but in contrast to this American data. South African blacks may have a higher bone turnover and lower bone density than whites (Daniels et a/., 1995). If it is compared with Caucasians a lower rate of hip fracture in South African blacks were found, despite lower bone density at all ages (Villa, 1994). The lower fracture rate in blacks than in whites is because of greater bone mass and higher bone turnover leading to more frequent renewal of damaged bone. Blacks excrete less urinary calcium, and show no skeletal sensitivity towards the parathyroid hormone. Few studies focus on older black South African men and osteoporosis. Objectives The aim of this study was to investigate the relationship of calcium intake, vitamin D status, anthropometry and physical activity and bone density in black South African men. Methods A case-control study design was used, in which variables associated with bone density were compared. The case group were men with fractures of the proximal femur, the proximal humerus or the distal radius and an equal number of age-matched healthy black men (with not more than a 5-year age difference) with no fracture (the proximal femur and humerus and distal radius) previously, was recruited as a control group. Bone density was measured with DEXA. Fat percentage was measured with a Tanita scale. Biochemical analyses were done. Questionnaires were used to gather demographic, activity and dietary information. To our knowledge, this is the first case-control study on osteoporotic fractures in South African black men. Results Both the groups' bone mineral densities were lower than recommended. The bone density of the case group for lumbar and hip regions was 0.86 and 0.88 and the control group's bone density for lumbar region was 0.95 and hip region 0.91. The control group was more physically active and had a better nutritional status than the case group. The control group's calcium intake was higher but the vitamin D status was lower than the case group. Both calcium and vitamin D status were not statistically significant (pc0.5), between the two groups. Body mass indices of the groups were the same. The serum albumin was higher in the control group than in the case group. The case group serum calcium was higher than the control group. Both serum albumin and serum calcium were statistical significant between the two groups. There were no statistically significant differences in any of the other biochemical variables between the two groups. Serum phosphate and serum vitamin D were statistical significant for bone density of the hip and lumbar regions. Conclusion To conclude it seems logical to suggest a healthy diet with optimal macro- and micro nutrient intake. Maintain ideal body weight and body fat percentage and recommend regular but moderate-weight-bearing exercise from a young age throughout adult life, as part of a strategy to prevent and treat osteoporosis. In the present study black South African men present with low bone mineral density, but other studies indicated a lower rate of hip fracture in South African blacks, despite lower bone density at all ages. It can be recommended that other factors may play a role in black South African men with osteoporosis. Factors such as serum phosphorus, 25-hydroxy-vitamin D, body mass index (BMI), physical activity index (PAI), animal protein, total fat intake and dietary calcium are important determinants of BMD in older South African blacks, as shown in the present study. Osteoporosis is a multi factorial problem and must be treated that way. / Thesis (M.Sc. (Dietetics))--North-West University, Potchefstroom Campus, 2004.

The unprecedented increase in the number of older adults is expected to increase the burden of osteoporosis on the individual and society. Blacks have been understudied in osteoporosis prevention education research. Although the risk of osteoporosis is low in this population, its consequences are significant. This study employs a two-group experimental design (experimental and wait-list control groups) to evaluate the effect of an osteoporosis education on two osteoporosis prevention behaviors (OPBs) – calcium intake (CI) and physical activity (PA), in a group of community-dwelling Black older adults, 50 years and older resident in South Florida. A final sample of 110 (mean age 70.15 years), 90% female and 10% male completed a battery of questionnaires at two assessment periods. The experimental group participated in six weekly education program sessions immediately following baseline assessment, and the wait-list control group received the education following end of program assessment by all participants. The weekly educational sessions were conducted in social settings (church or senior center) employing constructs of the Revised Health Belief Model. The sessions focused on improving CI; osteoporosis knowledge (OKT), self-efficacy (SE), health beliefs (HB) and PA. Findings revealed significantly greater increase in reported CI (M = 556 mg, Wilks’ λ = .47, F(1,108)=122.97, p< .001, η2=.53), OKT (p< .001), and SE (p< .001) among participants in the experimental compared to the wait-list control group. There was no significant difference between the two groups for PA and most of the HB subscales. OKT and SE were the best predictors of CI, while perceived barrier was a predominant factor predicting PA. Over the study period, a change in SE was the only variable related to changes in both OPBs. Attrition rate was lower than expected, which can be attributed to the settings utilized for the study. These findings support the importance of utilizing a familiar social setting. These results suggested the effectiveness of a program offered in multiple short sessions among this underserved minority population to improve OKT and SE resulting in a change in OPBs (increase in CI). However, there is need to explore alternative strategies to improve PA in this population group.

Youth consuming inadequate amounts of calcium are at risk of developing osteoporosis later in life. To better assess dietary calcium intakes and the efficacy of dietary intervention strategies to improve bone health among youth, it is important to develop calcium intake assessment tools that are reliable, accurate, and interactively engaging for a new generation of youth who have a higher computer literacy and are more technologically knowledgeable than preceding generations. The goal of this dissertation was to develop and evaluate an electronic food frequency questionnaire ( eFFQ) that measures calcium intake among 11-to 18-year-old Asian, Hispanic, and White youth. Enhancing this tool was the inclusion of 100 original digital color food photographs portraying the foods listed in the eFFQ. A formal evaluation study, as well as formative and summative evaluations of food photos and the eFFQ, was accomplished.

No description available.

INTRODUÇÃO: Estudos evidenciam a relação da baixa ingestão de cálcio e osteoporose, câncer colo-retal e hipertensão. Mais recentemente, estudos epidemiológicos vêm apontando que pode haver uma diminuição do risco de obesidade e de suas comorbidades com um maior consumo de cálcio e/ou derivados de leite. Ensaios em humanos apresentam resultados conflitantes com relação à perda de peso e alteração dos parâmetros metabólicos. Pretendemos avaliar a interferência da restrição calórica e do consumo de cálcio sobre a evolução dos parâmetros antropométricos e de composição corporal e parâmetros bioquímicos de 42 meninas (11,1 + 1,4 anos) obesas (2,2 + 0,3 escore Z de IMC) em 5 meses de tratamento no ambulatório de obesidade do HCFMUSP. MÉTODOS: Nesse ensaio clínico não controlado, realizado entre agosto de 2005 a agosto de 2006, orientamos o seguimento de uma dieta hipocalórica balanceada, composta por 3 porções de derivados de leite e complementada com 4 c. sopa de leite em pó desnatado com carbonato de cálcio (adicional de 800mg cálcio). As crianças apresentaram diferentes níveis de adesão, tanto com relação ao consumo energético, quanto com relação ao consumo de cálcio e, a partir desta variação no consumo, investigamos o efeito da dieta sobre a evolução das variáveis. RESULTADOS: Após a intervenção observamos perda de peso, perda de gordura e melhora da maioria dos parâmetros metabólicos (glicose, insulina, HOMA, Colesterol e frações LDL e HDL). Não houve diferença significante na diminuição dos triacilgliceróis e VLDL-C, nem da leptina e da adiponectina. Por meio da regressão linear múltipla identificamos que o consumo de cálcio não explicou a variação do peso nem do perfil lipídico, mas interferiu na melhora da resistência insulínica. Estimamos que com um déficit de 390 kcal e um incremento de mais de 400mg de cálcio por dia seria possível, em 5 meses, diminuir a insulinemia em 9,2 ?U/ml e o HOMA em 2,6%. CONCLUSÃO: O incremento do consumo de cálcio parece não interferir na evolução das variáveis antropométricas e de composição corporal de crianças obesas submetidas à dieta hipocalórica balanceada. Sugerimos que o cálcio interfira na resistência insulínica, pois observamos que, sob a mesma restrição calórica, a diminuição da insulinemia e a melhora do HOMA é mais relevante quanto maior o consumo de cálcio. São necessários estudos clínicos controlados e a elucidação de um possível mecanismo de ação para entender o papel do cálcio no controle do metabolismo glicídico. / INTODUCTION: It has been shown a relationship between a low calcium intake and osteoporosis, colorectal cancer, and hypertension. Recently, epidemiological studies are pointing that there may be a decreased risk of obesity and its co-morbidities with a higher intakes of calcium and/or dairy. Clinical trials have been showing conflicting results related to weight loss and change in metabolic parameters. We intend to evaluate the interference of caloric restriction and calcium intake on anthropometric and body composition, metabolic and hormonal parameters of 42 obese (2,2 + 0,3 score Z of IMC) girls in 5 months of outpatient treatment at HCFMUSP. METHODS: In an uncontrolled clinical trial launched between August 2005 to August 2006, they`re counseled to include 3 portions of dairy and 40g of nonfat powdered milk with calcium carbonate per day (additional 800mg calcium). Children presented different levels of caloric and calcium intake and so we investigate the effect of these components of diet in several levels. RESULTS: Loss of weight, fat mass and lipid profile were improved independently of calcium intake. There was no significant difference in the decrease of triglycerides and VLDL-C, neither to leptin and adiponectin. Through multiple linear regressions, we identified that calcium intake did not explain the variation of weight or lipid profile, but seems to improve insulin resistance. We estimate that a deficit of 390 kcal and an increase of more than 400mg of calcium per day should decrease insulin levels in 9.2 ? U / ml and the HOMA at 2.6%, after 5 months. CONCLUSION: The increase calcium intake does not seem to interfere in the evolution of the anthropometric variables and body composition in obese children under a balanced hypocaloric diet. We suggest that under the same caloric restriction, calcium intake shold be relevant to improve insulin resistance. In order to understand the role of calcium in the control of glycolic metabolism. Controlled clinical trials are necessary and so the elucidation of a possible mechanism of action.

A densidade mineral óssea na vida adulta, um importante componente de resistência óssea, depende do pico de massa óssea adquirido até o final da segunda década de vida. Cerca de 40% da massa óssea é acumulado entre 11 e 14 anos nas meninas e entre 13 e 17 anos nos meninos. O objetivo principal deste trabalho foi avaliar a ingestão média diária de cálcio de adolescentes das escolas públicas (estaduais e municipais) e privadas do município de Chapecó-SC. Outros objetivos foram verificar se a ingestão de cálcio dos adolescentes estava de acordo com as diretrizes de referências de ingestão (DRIs), investigar fatores que pudessem interferir na ingestão diária de cálcio (fatores socioeconômicos, hábitos alimentares diversos, hábitos familiares, prática de atividade física), comparar a ingestão diária de cálcio entre os estudantes das escolas públicas (municipais e estaduais) e das escolas privadas. Foram avaliados 214 alunos, com média de idade de 14,3 ± 1,0 anos, dos quais 58% eram do sexo feminino. A maior parte dos alunos estudava em escola pública municipal ou estadual (95%) e no turno da manhã (76%). Do total de alunos, 49,3% declarou tomar café da manhã diariamente, 20% informou quase nunca fazê-lo e 30,7% não tinham este hábito. A mediana de consumo diário de cálcio por aluno foi de 540mg (IQ: 312 – 829 mg) e somente 25 alunos (11,7%) apresentaram consumo de cálcio dentro das recomendações das DRIs para a idade. A maioria dos pais, mães e irmãos consumiam leite regularmente (77%, 79% e 87% respectivamente). Quanto ao consumo regular de alimentos que pudessem estar associados à absorção do cálcio, excetuando-se leite e derivados, 41% relataram consumir refrigerantes, 79,4% informaram comer carne, 10,6% ingeriam ovos e 39,7% tinham hábito de beber chás ou café. Concluímos que o consumo de cálcio dos adolescentes do município de Chapecó é inferior às necessidades diárias de cálcio para sexo e faixa etária estudada, achado também evidenciado em outros municípios brasileiros. Portanto, medidas devem ser adotadas para mudar este hábito, aumentando a ingestão de alimentos fontes de cálcio, especialmente no escolar. / Bone mineral density in adulthood, an important component of bone strength depends on peak bone mass acquired by the end of the second decade of life. About 40% of bone mass is accumulated between 11 and 14 years in girls and between 13 and 17 years in boys. The main objective of this study was to evaluate the average daily intake of calcium in adolescents from public schools (state and local) and private Chapecó-SC. Other objectives were to determine whether the calcium intake of adolescents was in accordance with the guidelines of reference intakes (DRIs), investigating factors that might interfere with daily calcium intake (socioeconomic factors, different dietary habits, family habits, practice physical activity), compare the daily calcium intake among students in public schools (state and local) and private schools. We evaluated 214 students, with a mean age of 14.3 ± 1.0 years, of which 58% were female. Most students studying in public school or state (95%) and in the morning (76%). Of all students, 49.3% said eating breakfast daily, 20% reported almost never do so and 30.7% did not have this habit. The median daily calcium intake was 540mg per student (IQ: 312 - 829 mg) and only 25 students (11.7%) had calcium intake within the recommendations of the DRIs for age. Most parents and siblings regularly consumed milk (77%, 79% and 87% respectively). As for the regular consumption of foods that could be associated with the absorption of calcium, except for milk and dairy products, 41% reported consuming soft drinks, 79.4% reported eating meat, eggs consumed 10.6% and 39.7% had the habit of drinking tea or coffee. We conclude that calcium intake of adolescent Chapecó is less than the daily requirement of calcium for sex and age groups, a finding also evident in other municipalities. Therefore, measures should be taken to change this habit, increasing intake of foods rich in calcium, especially in school.

A densidade mineral óssea na vida adulta, um importante componente de resistência óssea, depende do pico de massa óssea adquirido até o final da segunda década de vida. Cerca de 40% da massa óssea é acumulado entre 11 e 14 anos nas meninas e entre 13 e 17 anos nos meninos. O objetivo principal deste trabalho foi avaliar a ingestão média diária de cálcio de adolescentes das escolas públicas (estaduais e municipais) e privadas do município de Chapecó-SC. Outros objetivos foram verificar se a ingestão de cálcio dos adolescentes estava de acordo com as diretrizes de referências de ingestão (DRIs), investigar fatores que pudessem interferir na ingestão diária de cálcio (fatores socioeconômicos, hábitos alimentares diversos, hábitos familiares, prática de atividade física), comparar a ingestão diária de cálcio entre os estudantes das escolas públicas (municipais e estaduais) e das escolas privadas. Foram avaliados 214 alunos, com média de idade de 14,3 ± 1,0 anos, dos quais 58% eram do sexo feminino. A maior parte dos alunos estudava em escola pública municipal ou estadual (95%) e no turno da manhã (76%). Do total de alunos, 49,3% declarou tomar café da manhã diariamente, 20% informou quase nunca fazê-lo e 30,7% não tinham este hábito. A mediana de consumo diário de cálcio por aluno foi de 540mg (IQ: 312 – 829 mg) e somente 25 alunos (11,7%) apresentaram consumo de cálcio dentro das recomendações das DRIs para a idade. A maioria dos pais, mães e irmãos consumiam leite regularmente (77%, 79% e 87% respectivamente). Quanto ao consumo regular de alimentos que pudessem estar associados à absorção do cálcio, excetuando-se leite e derivados, 41% relataram consumir refrigerantes, 79,4% informaram comer carne, 10,6% ingeriam ovos e 39,7% tinham hábito de beber chás ou café. Concluímos que o consumo de cálcio dos adolescentes do município de Chapecó é inferior às necessidades diárias de cálcio para sexo e faixa etária estudada, achado também evidenciado em outros municípios brasileiros. Portanto, medidas devem ser adotadas para mudar este hábito, aumentando a ingestão de alimentos fontes de cálcio, especialmente no escolar. / Bone mineral density in adulthood, an important component of bone strength depends on peak bone mass acquired by the end of the second decade of life. About 40% of bone mass is accumulated between 11 and 14 years in girls and between 13 and 17 years in boys. The main objective of this study was to evaluate the average daily intake of calcium in adolescents from public schools (state and local) and private Chapecó-SC. Other objectives were to determine whether the calcium intake of adolescents was in accordance with the guidelines of reference intakes (DRIs), investigating factors that might interfere with daily calcium intake (socioeconomic factors, different dietary habits, family habits, practice physical activity), compare the daily calcium intake among students in public schools (state and local) and private schools. We evaluated 214 students, with a mean age of 14.3 ± 1.0 years, of which 58% were female. Most students studying in public school or state (95%) and in the morning (76%). Of all students, 49.3% said eating breakfast daily, 20% reported almost never do so and 30.7% did not have this habit. The median daily calcium intake was 540mg per student (IQ: 312 - 829 mg) and only 25 students (11.7%) had calcium intake within the recommendations of the DRIs for age. Most parents and siblings regularly consumed milk (77%, 79% and 87% respectively). As for the regular consumption of foods that could be associated with the absorption of calcium, except for milk and dairy products, 41% reported consuming soft drinks, 79.4% reported eating meat, eggs consumed 10.6% and 39.7% had the habit of drinking tea or coffee. We conclude that calcium intake of adolescent Chapecó is less than the daily requirement of calcium for sex and age groups, a finding also evident in other municipalities. Therefore, measures should be taken to change this habit, increasing intake of foods rich in calcium, especially in school.

INTRODUÇÃO: Estudos evidenciam a relação da baixa ingestão de cálcio e osteoporose, câncer colo-retal e hipertensão. Mais recentemente, estudos epidemiológicos vêm apontando que pode haver uma diminuição do risco de obesidade e de suas comorbidades com um maior consumo de cálcio e/ou derivados de leite. Ensaios em humanos apresentam resultados conflitantes com relação à perda de peso e alteração dos parâmetros metabólicos. Pretendemos avaliar a interferência da restrição calórica e do consumo de cálcio sobre a evolução dos parâmetros antropométricos e de composição corporal e parâmetros bioquímicos de 42 meninas (11,1 + 1,4 anos) obesas (2,2 + 0,3 escore Z de IMC) em 5 meses de tratamento no ambulatório de obesidade do HCFMUSP. MÉTODOS: Nesse ensaio clínico não controlado, realizado entre agosto de 2005 a agosto de 2006, orientamos o seguimento de uma dieta hipocalórica balanceada, composta por 3 porções de derivados de leite e complementada com 4 c. sopa de leite em pó desnatado com carbonato de cálcio (adicional de 800mg cálcio). As crianças apresentaram diferentes níveis de adesão, tanto com relação ao consumo energético, quanto com relação ao consumo de cálcio e, a partir desta variação no consumo, investigamos o efeito da dieta sobre a evolução das variáveis. RESULTADOS: Após a intervenção observamos perda de peso, perda de gordura e melhora da maioria dos parâmetros metabólicos (glicose, insulina, HOMA, Colesterol e frações LDL e HDL). Não houve diferença significante na diminuição dos triacilgliceróis e VLDL-C, nem da leptina e da adiponectina. Por meio da regressão linear múltipla identificamos que o consumo de cálcio não explicou a variação do peso nem do perfil lipídico, mas interferiu na melhora da resistência insulínica. Estimamos que com um déficit de 390 kcal e um incremento de mais de 400mg de cálcio por dia seria possível, em 5 meses, diminuir a insulinemia em 9,2 ?U/ml e o HOMA em 2,6%. CONCLUSÃO: O incremento do consumo de cálcio parece não interferir na evolução das variáveis antropométricas e de composição corporal de crianças obesas submetidas à dieta hipocalórica balanceada. Sugerimos que o cálcio interfira na resistência insulínica, pois observamos que, sob a mesma restrição calórica, a diminuição da insulinemia e a melhora do HOMA é mais relevante quanto maior o consumo de cálcio. São necessários estudos clínicos controlados e a elucidação de um possível mecanismo de ação para entender o papel do cálcio no controle do metabolismo glicídico. / INTODUCTION: It has been shown a relationship between a low calcium intake and osteoporosis, colorectal cancer, and hypertension. Recently, epidemiological studies are pointing that there may be a decreased risk of obesity and its co-morbidities with a higher intakes of calcium and/or dairy. Clinical trials have been showing conflicting results related to weight loss and change in metabolic parameters. We intend to evaluate the interference of caloric restriction and calcium intake on anthropometric and body composition, metabolic and hormonal parameters of 42 obese (2,2 + 0,3 score Z of IMC) girls in 5 months of outpatient treatment at HCFMUSP. METHODS: In an uncontrolled clinical trial launched between August 2005 to August 2006, they`re counseled to include 3 portions of dairy and 40g of nonfat powdered milk with calcium carbonate per day (additional 800mg calcium). Children presented different levels of caloric and calcium intake and so we investigate the effect of these components of diet in several levels. RESULTS: Loss of weight, fat mass and lipid profile were improved independently of calcium intake. There was no significant difference in the decrease of triglycerides and VLDL-C, neither to leptin and adiponectin. Through multiple linear regressions, we identified that calcium intake did not explain the variation of weight or lipid profile, but seems to improve insulin resistance. We estimate that a deficit of 390 kcal and an increase of more than 400mg of calcium per day should decrease insulin levels in 9.2 ? U / ml and the HOMA at 2.6%, after 5 months. CONCLUSION: The increase calcium intake does not seem to interfere in the evolution of the anthropometric variables and body composition in obese children under a balanced hypocaloric diet. We suggest that under the same caloric restriction, calcium intake shold be relevant to improve insulin resistance. In order to understand the role of calcium in the control of glycolic metabolism. Controlled clinical trials are necessary and so the elucidation of a possible mechanism of action.

A densidade mineral óssea na vida adulta, um importante componente de resistência óssea, depende do pico de massa óssea adquirido até o final da segunda década de vida. Cerca de 40% da massa óssea é acumulado entre 11 e 14 anos nas meninas e entre 13 e 17 anos nos meninos. O objetivo principal deste trabalho foi avaliar a ingestão média diária de cálcio de adolescentes das escolas públicas (estaduais e municipais) e privadas do município de Chapecó-SC. Outros objetivos foram verificar se a ingestão de cálcio dos adolescentes estava de acordo com as diretrizes de referências de ingestão (DRIs), investigar fatores que pudessem interferir na ingestão diária de cálcio (fatores socioeconômicos, hábitos alimentares diversos, hábitos familiares, prática de atividade física), comparar a ingestão diária de cálcio entre os estudantes das escolas públicas (municipais e estaduais) e das escolas privadas. Foram avaliados 214 alunos, com média de idade de 14,3 ± 1,0 anos, dos quais 58% eram do sexo feminino. A maior parte dos alunos estudava em escola pública municipal ou estadual (95%) e no turno da manhã (76%). Do total de alunos, 49,3% declarou tomar café da manhã diariamente, 20% informou quase nunca fazê-lo e 30,7% não tinham este hábito. A mediana de consumo diário de cálcio por aluno foi de 540mg (IQ: 312 – 829 mg) e somente 25 alunos (11,7%) apresentaram consumo de cálcio dentro das recomendações das DRIs para a idade. A maioria dos pais, mães e irmãos consumiam leite regularmente (77%, 79% e 87% respectivamente). Quanto ao consumo regular de alimentos que pudessem estar associados à absorção do cálcio, excetuando-se leite e derivados, 41% relataram consumir refrigerantes, 79,4% informaram comer carne, 10,6% ingeriam ovos e 39,7% tinham hábito de beber chás ou café. Concluímos que o consumo de cálcio dos adolescentes do município de Chapecó é inferior às necessidades diárias de cálcio para sexo e faixa etária estudada, achado também evidenciado em outros municípios brasileiros. Portanto, medidas devem ser adotadas para mudar este hábito, aumentando a ingestão de alimentos fontes de cálcio, especialmente no escolar. / Bone mineral density in adulthood, an important component of bone strength depends on peak bone mass acquired by the end of the second decade of life. About 40% of bone mass is accumulated between 11 and 14 years in girls and between 13 and 17 years in boys. The main objective of this study was to evaluate the average daily intake of calcium in adolescents from public schools (state and local) and private Chapecó-SC. Other objectives were to determine whether the calcium intake of adolescents was in accordance with the guidelines of reference intakes (DRIs), investigating factors that might interfere with daily calcium intake (socioeconomic factors, different dietary habits, family habits, practice physical activity), compare the daily calcium intake among students in public schools (state and local) and private schools. We evaluated 214 students, with a mean age of 14.3 ± 1.0 years, of which 58% were female. Most students studying in public school or state (95%) and in the morning (76%). Of all students, 49.3% said eating breakfast daily, 20% reported almost never do so and 30.7% did not have this habit. The median daily calcium intake was 540mg per student (IQ: 312 - 829 mg) and only 25 students (11.7%) had calcium intake within the recommendations of the DRIs for age. Most parents and siblings regularly consumed milk (77%, 79% and 87% respectively). As for the regular consumption of foods that could be associated with the absorption of calcium, except for milk and dairy products, 41% reported consuming soft drinks, 79.4% reported eating meat, eggs consumed 10.6% and 39.7% had the habit of drinking tea or coffee. We conclude that calcium intake of adolescent Chapecó is less than the daily requirement of calcium for sex and age groups, a finding also evident in other municipalities. Therefore, measures should be taken to change this habit, increasing intake of foods rich in calcium, especially in school.