Response to the Editor

• Published in: Osteoporosis and Sarcopenia 2017, 3(1), 7, pp.60-60
• Main Authors: Ohta, Hiroaki, Uenishi, Kazuhiro, Shiraki, Masataka
• Format: Article
• Language: English
• Subjects: Letter to the Editor; 정형외과학
• ISSN: 2405-5255; 2405-5263
• DOI: 10.1016/j.afos.2017.01.004

Thank you for your letter to our publication in Osteoporosis and Sarcopenia entitled on “Recent nutritional trend of calcium and vitamin D in East Asia”. Although the increase in calcium nutrition from food in postmenopausal women is urgent issue, Dr Yoo Kyoung Park pointed out that our claim is still premature to apply to whole population. As Dr Y-K Park pointed out that the KNHANES study had been limited the age ( 50 years of age) of the participants and the findings about calcium insufficiency should not be expanded into entire population [1]. On the other hand, the National Nutrition Survey in Japan [2] was subjected community dwelling household (n ¼ 3507) including the people aged over 1 year. Therefore, the participants of this research consisted of entire generation of Japan. The report of the National Nutritional Survey in Japan indicated that the calcium intake in younger generation (420e454 mg/ day for age 20e40 years old) was less than postmenopausal women (568e546 mg/day for sixties and seventies). In addition, total caloric intake of younger generation (1706 and 1652 kcal/day for twenties and forties, respectively) and the postmenopausal women (1766 and 1639 kcal/day for sixties and seventies, respectively) were almost same level suggesting that the calcium density in foods (Calcium in mg/day/Caloric intake in k Cal) was around 30% less in the younger generation (0.25e0.27 mg/kcal) than those in the older generation (0.32e0.33 mg/kcal). As it was written in our article, the calcium intake in older generation was still far less from the calcium requirement (788 mg/day for old women or 0.48 mg/kcal) [3]. Therefore, the postmenopausal women, who had relatively high calcium intake, took calcium around 70% of requirement. Although there was no available data regarding the effect of calcium intake on the development of peak bone mass in a prospective study design in Asian population, the low calcium intake seen in a younger generation in Japan strongly suggested that the development of proper peak bone mass may not be achieved by the recent young generation in Japan. Bone health has been reported to improve in Vietnamese postmenopausal women, who were received nutritional education [4]. Therefore, re-education regarding calcium intake will be required for the younger population. On the other hand, since the older generation in Japan had been adapted to the traditional dietary custom, it may be difficult to increase in calcium intake from the foods,