Ms. Debbie Reid

SWH (Osteoporosis and RMH)

BC Women's Hospital & Health Centre

Room - 4500 Oak Street
Vancouver, BC V6H 3N1

Nutrition in Osteoporosis

Nutrition in mental health

Proposed Research:

Phosphorus Intakes and Calcium Supplementation Practices of Elderly Chinese Women Eating a Traditional Diet

The main purpose of this research is to determine the phosphorus intakes and calcium supplementation practices of older Chinese women eating a traditional Chinese diet.

Adequate calcium and phosphorus are essential for bone mineralization.  The diets of most North American adults are abundant in phosphorus, but the National Health and Nutrition Survey III (NHANES III) found that 10-15% of older non-Hispanic white women have intakes less than 70% of the 700mg recommended daily allowance for phosphorus.  While HANES III was conducted in the US, it is likely reflective of phosphorus intakes of older white Canadian women.  Another group whose diet warrants investigation is elderly Chinese women.  Specifically, the traditional Chinese diet is much lower in phosphorus than the typical North American diet because of small amounts of meat/alternates and no milk products.  Additionally, this is an ethnic group at increased risk of osteoporosis, and represents a considerable portion of BC's lower mainland population.

Beyond the concern of phosphorus intake, which may be marginal, is the common practice amongst the elderly of calcium supplementation in the carbonate or citrate form at one or more meals.  Taking these calcium supplements with meals may complex ingested phosphorus, making it unavailable for absorption.  For elderly Chinese women with severe osteoporosis who are being treated with bone anabolic agend, teriparatide, such as situation could compromise osteoporosis treatment.

Gaining an understanding of phosphorus, calcium, zinc and protein levels in the dietary pattern typical of many Chinese women would be useful to dietetic practice.  Specifically, if poor phosphorus intakes are found, especially with common usage of calcium carbonate or citrate supplements with meals, practical guidelines regarding meeting phosphorus and calcium needs in patients receiving teriparatide should be developed.  These guidelines would emphasize preferably working to increase phosphorus and calcium intakes through food by including fortified soy milk or cow's milk.  Suboptimal zinc and/or protein intakes would give further justification for encouraging these.  if protein and zinc were adequate, then: 1) calcium phosphate could be given at meals, 2) sodium phosphate could be given in addition to calcium carbonate, or 30 calcium citrate could be given between meals.  These approaches would spare dietary phosphorus.