1. ¹Calcium Metabolism and Osteoporosis Program, Department of Internal Medicine, American University of Beirut, Beirut, Lebanon
2. ²Department of Nutrition and Food Sciences, American University of Beirut, Beirut, Lebanon
3. ³Department of Pediatrics, American University of Beirut, Beirut, Lebanon
4. ⁴School of Health Sciences, American University of Beirut, Beirut, Lebanon

Correspondence: G El-Hajj Fuleihan, Calcium Metabolism and Osteoporosis Program, American University of Beirut Medical Center, Bliss Street, Beirut 113-6044, Lebanon. E-mail: gf01@aub.edu.lb

Received 23 December 2003; Revised 19 July 2004; Accepted 11 August 2004; Published online 6 October 2004.

Abstract

Background: Optimal dietary calcium and possibly vitamin D intake throughout childhood and adolescence may enhance bone mineral accrual. Little data on the intake of these nutrients in Mediterranean countries exist, and predictors of their suboptimal intake are not well defined.

Objective: To evaluate systematically the effect of gender, lifestyle factors, and socioeconomic status on mean calcium and vitamin D intake in healthy school children and adolescents from Lebanon.

Design: A total of 385 students aged 10–16 y were selected from four public and four private schools between Fall 1999 and Spring 2000. Information on calcium and vitamin D intake, through a semiquantitative food frequency questionnaire that was validated against a 7-day daily record, and on socioeconomic and lifestyle factors were obtained.

Results: Only 12% of the students met the adequate intake (AI) recommendation of 1300 mg of calcium/day, and only 16% met the AI recommendation of 200 IU of vitamin D/day. Boys had a significantly higher mean daily calcium intake than girls. Socioeconomic status as assessed by children's pocket money was a predictor of higher calcium and vitamin D intake. Eating breakfast and physical activity were other correlates of daily calcium and vitamin D intake.

Conclusions: Only a minority of students in our study met the AI for calcium and vitamin D. Gender, lifestyle factors, and socioeconomic status were significant predictors of calcium and vitamin D intake. Our findings have important implications regarding the institution of dietary public health strategies to promote skeletal health in Mediterranean countries during a critical time for bone mass accrual.