Calcium intake, serum vitamin D and obesity in children: is there an
               association?

Cunha, Kelly Aparecida da; Magalhães, Elma Izze da Silva; Loureiro, Laís Monteiro Rodrigues; Sant'Ana, Luciana Ferreira da Rocha; Ribeiro, Andréia Queiroz; Novaes, Juliana Farias de

doi:10.1016/j.rpped.2015.03.001

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Review Articles • Rev. paul. pediatr. 33 (2) • Apr-Jun 2015 • https://doi.org/10.1016/j.rpped.2015.03.001 linkcopy

Calcium intake, serum vitamin D and obesity in children: is there an association?

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Abstract

OBJECTIVE: To evaluate the association between calcium intake and serum vitamin D levels and childhood obesity by an integrative review.

DATA SOURCE: The research was conducted in the databases PubMed/medLine, Science Direct and SciELO with 2001 to 2014 publications. We used the combined terms in English: ''children'' and ''calcium'' or ''children'' and ''vitamin D'' associated with the descriptors: ''obesity'', ''adiposity'' or ''body fat'' for all bases. Cross-sectional and cohort studies, as well as clinical trials, were included. Review articles or those that that have not addressed the association of interest were excluded.

DATA SYNTHESIS: Eight articles were part of this review, five of which were related to calcium and three to vitamin D. Most studies had a longitudinal design. The analyzed studies found an association between calcium intake and obesity, especially when age and sex were considered. Inverse relationship between serum vitamin D and measures of adiposity in children has been observed and this association was influenced by the sex of the patient and by the seasons of the year.

CONCLUSIONS: The studies reviewed showed an association between calcium and vitamin D with childhood obesity. Considering the possible protective effect of these micronutrients in relation to childhood obesity, preventive public health actions should be designed, with emphasis on nutritional education.

Children; Calcium; Vitamin D; Obesity; Adiposity

Authors/Year of publication		Country	Study design	Population/Sample	Main results
Calcium	Carruth & Skinner¹² (2001)	USA	Longitudinal (retrospective)	Caucasian children, followed from 2-96 months (n=53)	Higher mean intake of calcium, and more daily servings of dairy products were associated with lower BF
	Skinner et al.¹³ (2005)	USA	Longitudinal	Caucasian children, followed from 2-96 months (n=52)	Intake of calcium and polyunsaturated fat were negatively associated with BF%
	Dixon et al.¹⁴ (2005)	USA	Longitudinal	HC non-obese children and non-HC^e children aged 4 to 10 years (n=342)	Calcium intake was inversely associated with BMI^a sum of skinfolds and trunk SF in non-HC children aged 7 to 10 years. No association found for children aged 4-6 years
	Moreira et al.¹⁶ (2005)	Portugal	Cross-sectional	Elementary schoolchildren from Portugal aged 7 to 9 years (n=3044)	Inverse association between calcium intake and BMI only in girls
	DeJongh, Binkley & Specker¹⁵ (2006)	USA	Longitudinal (randomized, placebo-controlled trial)	Children aged 3 to 5 years (n=178)	Lowest tertile of dietary calcium intake, lower fat mass gain in the calcium-supplemented group compared to the placebo group
Vitamin D	Lee H. A. et al.¹⁷ (2013)	Korea	Cross-sectional	Children aged 7 to 9 years (n=205)	Levels of 25(OH)D were inversely associated with adiposity index
	Lee S.H. et al. ¹⁹ (2013)	Korea	Cross-sectional	Children aged 9 years (n=1,660)	Mean levels of 25 (OH) D were lower in children with total or abdominal obesity
	Lourenço et al. ²⁰ (2014)	Brazil	Longitudinal	Children younger than 10 years (n=796)	FTO gene was positively associated com weight gain. Vitamin D seems to modify the genetic effects o FTO

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[TFN01] BMI, Body Mass Index; BF, Body fat; BF%, Body Fat percentage; HC, Hypercholesterolemic; Non-HC, Non-hypercholesterolemic; SF, skin folds; GER, Resting energy expenditure.