Program ups calcium intake in kids with arthritis

A behavioral intervention can increase dietary calcium levels and subsequent bone mineral content in children with juvenile rheumatoid arthritis, according to a report in The Journal of Pediatrics.

Children with juvenile rheumatoid arthritis may have greater dietary calcium requirements than other children, the authors explain, but rates of long-term compliance with calcium supplement regimens are poor.

Dr. Lori J. Stark from Cincinnati Children’s Hospital Medical Center in Ohio and colleagues investigated the impact of a behavioral intervention in 49 children, between 4 and 10 years old, with juvenile rheumatoid arthritis and their parents on the maintenance of calcium intake and on bone mass 6 and 12 months after the intervention.

About half of the children in the behavioral intervention group consumed at least 1500 mg/d calcium at 6- and 12-month follow-up, the authors report, compared with 25 percent of the control group at 6 months and 35 percent at 12 months.

Children in the behavioral intervention group showed significantly greater increases in total body bone mineral content and arm-leg bone mineral content than did children in the control group, the results indicate, but they did not differ in lumbar spine bone mineral density at follow-up.

Height gain, weight gain, and changes in fat mass and percent body fat did not differ between the two groups at 12 months, the researchers note, and there were no differences between the groups in vitamin D status during the study.

These results are “clinically important,” the authors contend, because they demonstrate that changing calcium intake through usual food consumption via a behavioral intervention can be maintained long enough to have significant impact on bone build-up.

“Maintenance of calcium intake 1 year after treatment is clinically significant and has broader application to children with other chronic illnesses that place them at risk for suboptimal bone accretion and for non-ill children as a prevention strategy for osteoporosis,” the investigators add.

SOURCE: The Journal of Pediatrics, April 2006.

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