No associations were found between baseline dietary calcium and vitamin D intakes and markers of vascular health including the gold standard marker for arterial stiffness cfPWV, peripheral blood pressure, PP and MAP, in addition to augmentation index corrected for heart rate, another marker of arterial stiffness. Dietary intakes were derived from FFQs that assessed usual intakes for the period of 3 months prior to the baseline visit.
An association at baseline would be a limitation to the pilot study as it could potentially obscure the final results of the pilot study and conceal findings on possible effects of calcium supplements on cardiovascular health, These results are however limited by the small sample size (n=12) and a greater number of participants may reveal different associations In fact studies have revealed inverse relationships between dietary calcium intakes and markers of vascular health, such as BR In deed a study by Appel et all demonstrated a reduction in blood pressure with the addition of low- fat dairy products by 21 mmHg (Appel et aL 1997).
Furthermore, many observational studies have linked dietary calcium intakes to a healthier plasma lipid profile, decreases in cardiovascular disease, decreases in insulin resistance and type II diabetes mellitus.
(Griffith et al. 1999; JaCdmain et al. 2003; Pittas et al. 2006; Zemel et al. 2000). Therefore a larger sample size is required to determine readiness of correlations In addition, no significant correlations were found between baseline anthropometric measures of WC, body fat, age, years post-menopause and ionized calcium levels with markers of vascular health, which could also conceal final results on the potential associations between supplement intakes of calcium and cardiovascular events, In contrast, body composition, including percentage body fat, BMI and WC are known to be associated with increased risk of cardiovascular disease, other chronic diseases and increased blood pressure in both men and women of all ages (Balkau et al.
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2007; Gillum 1987).
Furthermore, many studies have demonstrated associations between age and markers of vascular health such as arterial stiffness and blood pressure. In fact, the Framingham Heart Study demonstrated increases in systolic blood pressure with age in both men and women (Franklin et all 1997) In addition Rajkumar et all demonstrated increases in arterial stiffness measured through pulse wave velocity with age (Ra’kumar et al. 1997). Moreover, studies have found increased risk of cardiovascular disease in postmenopausal women compared non-menopausal women and estrogen has been implicated in the modulation of proteins implicated in cardiovascular disease (figiti Zagrosek 2003).
In fact accelerated increase of blood pressure was found in surgical menopause (Stampfer et al. 1991). The small sample size limited possible results, On the other hand, ionized calcium was not associated with markers of vascular health in the pilot study, however studies suggest serum calcium has a main role in the link between calcium intake and cardiovascular disease. In fact the mechanisms by which calcium may increase the risk of cardiovascular disease are still theoretical, ambiguous and open for speculation Nonetheless, studies suggest that the peak rather than the mean levels of serum calcium may drive adverse cardiovascular effects, due to the acute changes in serum calcium following calcium supplement ingestion (Karp et al. 2010; I. Reid et all m).
In addition increases in total serum calcium for prolonged periods of time, have shown to cause reconfigurations to the exposed endothelial wall, and calcium—sensing receptors (or CaSR) located on soft tissue and platelets Changes in endothelial wall configurations and CaSR structures have been found to be associated with increased mineralization and calcification of the blood vessel walls and increases in carotid plaque thickness. In addition, changes in CaSR configurations on platelets may lead to alterations in blood coagulation, causing increased risk of cardiovascular disease (Julian et al. 2007; M512 et al. 2007; I. Reid et al. 2011; I. R. Reid et al. 2010).
A larger sample size is thus necessary to determine correlations between ionized calcium in this study and vascular health markers. Results for the second objective revealed that the brief, calcium-focused education session was overall, able to generate statistically significant differences in the intakes of CFG’s Milk and Alternatives between the dietary group and the supplement
Acute changes in serum calcium sustained for prolonged periods of time have been shown to lead to molecular reconfigurations (view Appendix K) and increased cardiovascular risk factors. A potential mechanism includes the direct influence of total serum calcium on crystal-formation inhibitors such as pyrophosphate and fetuin A, expressed by soft»tissue and blood vessels. Serum calcium binds to these crystal formation inhibitors leading to a decrease in free molecules. The loss of these inhibitors have been shown to be associated with vascular mineralization and calcification, increasing arterial stiffness and carotid plaque thickness and consequently increasing cardiovascular events (I Reid et al. 2011; Ii R. Reid et all 2010)
In addition increases in total serum calcium for prolonged periods of time, have shown to cause reconfigurations to the exposed endothelial wall, and calcium—sensing receptors (or CaSR) located on soft tissue and platelets Changes in endothelial wall configurations and CaSR structures have been found to be associated with increased mineralization and calcification of the blood vessel walls and increases in carotid plaque thickness. In addition, changes in CaSR configurations on platelets may lead to alterations in blood coagulation, causing increased risk of cardiovascular disease (Julian et al. 2007; M512 et al. 2007; I. Reid et al. 2011; I. R. Reid et al. 2010).
A larger sample size is thus necessary to determine correlations between ionized calcium in this study and vascular health markers. Results for the second objective revealed that the brief, calcium-focused education session was overall, able to generate statistically significant differences in the intakes of CFG’s Milk and Alternatives between the dietary group and the supplement group, regardless of time, The dietary group had a significantly higher intake, consequently leading to statistically significant greater dietary calcium and vitamin D intakes in the dietary group compared to the supplemental group. Intakes of each group met the recommendations provided by the respective education sessions.
The outcomes also revealed that the participants were able to maintain similar energy and macronutrient intakes, and changes were uniquely applied to servings of Milk and Alternatives. Therefore changes in the individual‘s diet did not alter protein, fat or carbohydrate intakes that could affect cardiovascular markersr In addition, a group by time interaction was demonstrated for dietary calcium intakes between the 2 groups, signifying that between groups and across time (at different months), significant differences occurred in dietary calcium intakes, with higher intakes in the dietary group, particularly at months 1 and 3. A group by time interaction was not observed for vitamin D intakes although intakes different considerably.
This is possibly due to the small sample size and the high variability in the data, which affected results despite the applied log-transformations, Interestingly, a statistically significant group by time interaction was observed for carbohydrate and energy intakes. Nonetheless, these significant differences appear to be transient and seem to be only noted at month 1 of the study. This transient outcome may be caused by the small sample size, which may indeed cause results to be swayed by a unique individual. The ability of the participants in the dietary calcium group to adhere to recommendations can he owed to the variability of dairy foods to choose from such as yogourt, cheese, kefir, milk, soy beverages etc, and the ability of education sessions to provide examples of recipes where such foods can be consumed, In addition recommendations to the individual participants’ meals at follow-ups were continuously provided to enhance compliance.
Reinforcements were equally provided during monthly follow-ups, which aimed to increase the participant’s motivation. The participants‘ questions were answered upon request, further showing support and creating problem» solving scenarios, and were crucial in upholding compliance. The ability of the participants in the supplement calcium group to adhere to recommendations can be owed to the participants’ ability to consume 3/4 of a serving of CFG’s Milk and Alternatives, thus increasing the flexibility of their meals and reducing the feeling of being restricted in their dietary choicest Reinforcements were provided at monthly follow-ups for calcium and vitamin D supplement intakesi These results were however sort-termed, and whether they can be maintained is yet to be determined, Similarly, a study by Cox et al, demonstrated significant increases in vegetables and fruits intakes in individuals in the intervention groups, receiving nutrition education (P< 0.001).
These results were shown to be maintained in the long term (5 months after intervention period). The intervention however included the constant provision of recipes over 8 weeks, and the requirement that participants weigh their fruit and vegetable consumption (Cox et al. 1998) This further emphasizes the importance of reinforcements at follow- ups A more recent study by Gollwitzer et all demonstrated the ability of individuals to maintain increases in vegetable and fruit intakes for 2 years following the intervention, when information intervention sessions are combined with self-regulation trainingi Such training includes cognitive—behaviour components such as identifying barriers to success and overcoming them(Stadler et all 2010), Such tools can be integrated to the calcium- focused education session to ensure long-term adherence to recommendations for the study.
Basic Intake of Calcium and Vitamin D From Food. (2022, Jun 24). Retrieved from https://paperap.com/basic-intake-of-calcium-and-vitamin-d-from-food/
