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ARS Home » Plains Area » Houston, Texas » Children's Nutrition Research Center » Research » Publications at this Location » Publication #228664
Title: Adaptation of calcium absorption during treatment of nutritional rickets in Nigerian children

Author
item ORAMASIONWU, G - BAYLOR COLLEGE MED
item THACHER, TOM - JOS UNIV HOSP, JOS NIGERI
item PAM, SUNDAY - UNIV OF JOS, JOS NIGERIA
item PETTIFOR, JOHN - UNIV WITWATERSRAND, SA AF
item Abrams, Steven

Submitted to: British Journal of Nutrition
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 11/14/2007
Publication Date: 8/1/2008
Citation: Oramasionwu, G.E., Thacher, T.D., Pam, S.D., Pettifor, J.M., Abrams, S.A. 2008. Adaptation of calcium absorption during treatment of nutritional rickets in Nigerian children. British Journal of Nutrition. 100(2):387-392.

Interpretive Summary: Nutritional rickets in Nigerian children is very common. It has been effectively treated with calcium supplementation. We do not know if the ability of children with rickets to absorb calcium changes during therapy. Our objective in conducting this study was to identify the effect of calcium therapy on the absorption of calcium in children in Nigeria with rickets. Twelve children with rickets, 2 to 14 years of age, participated in the study. We measured calcium absorption using non-radioactive, stable isotopes, before and after 2 weeks of treatment with calcium. Ten children were studied. Calcium absorption before treatment was 72% and decreased to 57% after 2 weeks of supplementation. We concluded that Nigerian children with rickets adapt to calcium supplementation with a small decrease in absorption, but continue to absorb it well. Our results showed that although calcium absorption is changed by supplementation, recovery from rickets likely occurs through efficient use of both dietary and supplemental calcium.

Technical Abstract: Nutritional rickets in Nigerian children has been effectively treated with Ca supplementation. High values of Ca absorption efficiency have been observed in untreated children, but whether Ca absorption efficiency changes during treatment with Ca is unknown. Our objective in conducting this study was to identify the effect of Ca therapy on Ca absorptive efficiency in children with primary Ca-deficient nutritional rickets. Twelve children with radiographically active rickets, 2 to 14 years of age (median 39 months), participated in the study. We assessed dietary Ca intake via dietary recalls, and measured biochemical markers of Ca and vitamin D homeostasis. Fractional Ca absorption was measured using a dual tracer stable isotope method, before and after 2 weeks of treatment with 15.0 mmol elemental Ca daily. Ten children had adequate urine collection for inclusion in the analysis. Usual dietary Ca intake was 4.2 (sd 1.0) mmol/d. The median Ca absorption prior to treatment was 72% (range 52-97%) and decreased significantly to 57% (31-84%) (P = 0.004) after 2 weeks of supplementation. We conclude that Nigerian children with rickets adapt to Ca supplementation with a small decrease in Ca absorptive capacity, but retain very high absorptive levels during supplementation. Overall Ca absorption efficiency was comparable with that identified in other populations with low Ca intakes. These data demonstrate that although absorptive capacity is regulated by supplementation, recovery from rickets likely occurs through efficient use of both dietary and supplemental Ca.