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Development and validation of an eight-item calcium screener to assess daily calcium intake of patients with osteoporosis in clinical practice

European Journal of Clinical Nutrition volume 78, pages 301–306 (2024)Cite this article

Subjects

Abstract

Objective

To validate a short food frequency questionnaire (screener) estimating daily average calcium intake from dietary sources to guide calcium supplementation of patients with osteoporosis in clinical practice.

Methods

An eight-item calcium screener was developed based on existing literature, food consumption data and expert opinion. Convergent validity was determined by comparison with 3-day food records using mean difference, Spearman’s correlation coefficients (SCC) and Bland-Altman analysis. Test-retest reliability was assessed by SCC and intraclass correlation coefficients (ICC). We calculated sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) to identify patients requiring calcium supplementation (<1200 mg dietary calcium intake/day).

Results

Fifty-two patients filled out the eight-item calcium screener and the 3-day Food record (mean age of 66.8 ± 12.9 (SD)) and 38 patients filled out the screener twice for reliability analysis (mean age of 65.8 ± 12.8 (SD)). Dietary calcium intake between the calcium screener and food records showed a strong correlation (N = 52 patients, SCC = 0.53, p ≤ 0.001) and mean difference of 21 mg (p = 0.70). Bland-Altman analysis showed agreement within 95% confidence intervals for 49/52 comparisons (94%). Test-retest reliability of the calcium screener was excellent (SCC = 0.96, p ≤ 0.001; ICC = 0.99, p ≤ 0.001).

Conclusion

The calcium screener shows good convergent validity, reliability and feasibility to estimate daily calcium intake of patients with osteoporosis in routine clinical practice.

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Data availability

The data that support the findings of this study are available from the corresponding author upon reasonable request.

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Acknowledgements

The authors would like to thank all study participants for contributing to this research. Natacha Dielen and Dorien Wouters (University College Leuven Limburg—BSc Dietetics) are acknowledged for their dedicated contribution to data collection and preliminary analysis. We thank the members of the Centre for Metabolic Bone Diseases for their assistance: Herman Borghs, Evelien Gielen, Frank P. Luyten, Marian Dejaeger and Kurt De Vlam.

Funding

This research was funded by a PhD Fellowship Strategic Basic Research Grant (1S96721N) of the Research Foundation Flanders (FWO).

Author information

Authors and Affiliations

  1. Clinical and Experimental Endocrinology, Department of Chronic Diseases and Metabolism, KU Leuven, Leuven, Belgium

    Joke Verbeke & Christophe Matthys

  2. Centre for Metabolic Bone Diseases, University Hospitals Leuven, Leuven, Belgium

    Michaël R. Laurent

  3. Department of Geriatrics, Imelda Hospital, Bonheiden, Belgium

    Michaël R. Laurent

  4. Department of Endocrinology, University Hospitals Leuven, Leuven, Belgium

    Christophe Matthys

Authors
  1. Joke Verbeke
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Contributions

MRL and CM conceptualized, designed and set up the study. MRL supervised the data acquisition. JV and MRL analyzed the data and wrote the manuscript. CM reviewed the manuscript. All authors approve the submitted version and are accountable for all aspects of the work.

Corresponding author

Correspondence to Christophe Matthys.

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Competing interests

MRL has received consultancy and/or lecture fees from Alexion, Amgen, Galapagos, Kyowa Kirin, Menarini, Orifarm, Pharmanovia, Takeda, UCB and Will-Pharma, unrelated to this work. The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Ethical approval

This study was approved by the Medical Ethics Committee of University Hospital Leuven (UZ Leuven) and received registration number S56083.

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Verbeke, J., Laurent, M.R. & Matthys, C. Development and validation of an eight-item calcium screener to assess daily calcium intake of patients with osteoporosis in clinical practice. Eur J Clin Nutr 78, 301–306 (2024). https://doi.org/10.1038/s41430-023-01390-9

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