Calcium intake highest in Northern Europe but still below recommendations

Ahead of World Osteoporosis Day on October 20, the review identifies Iceland as having the best average dietary calcium intake among general population adults at 1233 milligrams per day (mg/day).

Only Northern European countries have national calcium intakes greater than 1000 mg/day, with the Netherlands (1102 mg/day), Germany (1068 mg/day) and the UK (994 mg/day) faring best.

Despite Northern Europe’s showing, the values fall below the European Food Safety Authority (EFSA) recommendation of at least 1200 mg of calcium daily.

“Outside of North America and most of Europe, particularly Northern Europe, there is lower intake than there should be for good bone health,"​ said study lead author Ethan Balk, an associate professor at the Center for Evidence Synthesis in Health in the Brown University School of Public Health

"In many parts of the world, the low average calcium intake may be putting most people at increased risk of fractures and osteoporosis."​

The healthy ageing issue​

Calcium intake is central to the challenge of healthy ageing, contributing to the development of optimum bone mass and preservation of bone mass in adults.

Bone loss later in life occurs at a rate of about 1% per year, resulting in calcium loss of approximately 15 grams (g) per year and recognizing low calcium intake is necessary in developing culturally appropriate strategies and policies to address the deficiency.

Along with Dr Balk, the review brings together colleagues from the International Osteoporosis Foundation.

Here, the team searched 13 electronic databases in total, extracting data to form an interactive global map, categorizing countries based on average calcium intake and summarising differences in intake based on sex, age, and socioeconomic status.

Across the 74 countries analysed, average national dietary calcium intake ranged from 175 to 1233 mg/day.

Many countries in Asia had average dietary calcium intake less than 500 mg/day with China (338 mg/day), South Korea (483 mg/day) and Japan (533 mg/day) being notable examples.

Countries in Africa and South America had low calcium intakes of between 400 and 700 mg/day.

Moulding future policy​

The paper's authors commented that the data could provide evidence to support initiatives promoting increased calcium consumption, particularly in the Asia-Pacific region as well as places where it has not been documented.

"This work draws attention to regions where calcium intake needs to be assessed and where measures to increase calcium intake are likely to have skeletal benefits,"​ they concluded.

“To the extent that the current very low calcium intake in Asia-Pacific region and South America adversely affects the skeleton, it becomes a public health priority to increase calcium intake to combat the disabling, growing, and costly problem of osteoporosis in these regions.”​

Source: Osteoporosis International​

Published online ahead of print: doi.org/10.1007/s00198-017-4230-x​​

“​Global dietary calcium intake among adults: a systematic review.”​

Authors: E. M. Balk et al.