Applying international guidelines for calcium supplementation to prevent pre-eclampsia: simulation of recommended dosages suggests risk of excess intake in Ethiopia

• Published in: Public health nutrition 2019-03, Vol.22 (3), p.531-541
• Main Authors: Tesfaye, Biniyam, Sinclair, Kate, Wuehler, Sara E, Moges, Tibebu, De-Regil, Luz Maria, Dickin, Katherine L
• Format: Article
• Language: English
• Subjects: Age; Agriculture; Archives & records; Births; Calcium; Children & youth; Community Nutrition; Dietary intake; Dietary minerals; Dietary supplements; Dosage; Drug dosages; Guidelines; Hypertension; Maternal & child health; Maternal mortality; Nutrition; Pre-eclampsia; Preeclampsia; Pregnancy; Prenatal care; Public health; Recipes; Research Paper; Risk; Risk management; Risk reduction; Simulation; Womens health
• ISSN: 1368-9800; 1475-2727; 1475-2727
• DOI: 10.1017/S1368980018002562

To simulate impact of Ca supplementation on estimated total Ca intakes among women in a population with low dietary Ca intakes, using WHO recommendations: 1·5-2·0 g elemental Ca/d during pregnancy to prevent pre-eclampsia. Single cross-sectional 24 h dietary recall data were adjusted using IMAPP software to simulate proportions of women who would meet or exceed the Estimated Average Requirement (EAR) and Tolerable Upper Intake Level (UL) assuming full or partial adherence to WHO guidelines. Nationally and regionally representative data, Ethiopia's 'lean' season 2011. Women 15-45 years ( 7908, of whom 492 pregnant). National mean usual Ca intake was 501 (sd 244) mg/d. Approximately 89, 91 and 96 % of all women, pregnant women and 15-18 years, respectively, had dietary Ca intakes below the EAR. Simulating 100 % adherence to 1·0, 1·5 and 2·0 g/d estimated nearly all women (>99 %) would meet the EAR, regardless of dosage. Nationally, supplementation with 1·5 and 2·0 g/d would result in intake exceeding the UL in 3·7 and 43·2 % of women, respectively, while at 1·0 g/d those exceeding the UL would be