A randomized clinical trial of dietary calcium to improve bone accretion in children with juvenile rheumatoid arthritis

The Journal of Pediatrics
Lori J StarkHeidi J Kalkwarf

Abstract

To examine a behavioral intervention (BI) to increase calcium intake in children with juvenile rheumatoid arthritis (JRA) on calcium intake and bone mass 6 and 12 months after treatment. A randomized trial compared a 6-session BI to a 3-session enhanced standard of care (ESC) with 49 children ages 4 to 10 years with JRA. Calcium intake was assessed via 3-day diet diaries. Total body bone mineral content (BMC), arms and legs BMC, and lumbar spine bone mineral density were assessed by dual energy x-ray absorptiometry. BI maintained an average calcium intake of 1500 mg/d at 6- and 12-month follow-up. This was greater than their baseline level of 972 mg/d, but not greater than the intake of 1300 mg/day maintained by ESC (P=.09). The BI had a 4% and 2.9% greater gain in total body bone mineral content than ESC at 6 and 12 months, respectively (P=.005), and a 7.1% and 5.3% greater gain in arms and legs BMC at 6 and 12 months than ESC (P=.0007). BI is effective in increasing calcium intake and BMC in children with JRA over a 12-month period.

References

Jun 1, 1991·American Journal of Diseases of Children·G M Chan
May 1, 1982·Archives of Disease in Childhood·U ElsasserB M Ansell
Apr 1, 1995·The Journal of Pediatrics·G M ChanM McMurry
Jan 1, 1997·Osteoporosis International : a Journal Established As Result of Cooperation Between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA·C A NowsonJ D Wark
Mar 21, 2000·Rheumatology·M Zak, F K Pedersen
Jan 10, 2004·Current Rheumatology Reports·Jon M Burnham, Mary B Leonard

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Citations

Dec 10, 2008·Journal of Pediatric Psychology·Cynthia W Karlson, Michael A Rapoff
Oct 13, 2011·European Journal of Gastroenterology & Hepatology·Kevin A HommelLee A Denson
Apr 5, 2012·Pediatric Dermatology·Kara LuersenSteven R Feldman
Oct 20, 2009·Pediatric Rheumatology Online Journal·Yosef UzielPhilip J Hashkes
Jun 23, 2016·Journal of Pediatric Psychology·Mary Beth McCulloughLori Stark
Aug 28, 2009·Journal of Pediatric Psychology·Montserrat M GravesAmanda Boyer
May 18, 2018·Pediatric Rheumatology Online Journal·Sarah L FinchHassan Vatanparast

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