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Articles

Calcium Intake Is Weakly but Consistently Negatively Associated with Iron Status in Girls and Women in Six European Countries¹

L.P.L. van de Vijver^*,2, A.F.M. Kardinaal^*, J. Charzewska, M. Rotily^**, P. Charles, M. Maggiolini, S. Ando, K. Väänänen, B. Wajszczyk, J. Heikkinen^#, A. Deloraine^§ and G. Schaafsma^*,3

^* Division of Human and Animal Nutrition, TNO Nutrition and Food Research Institute, 3700 AJ Zeist, The Netherlands, Department of Epidemiology, National Institute for Food and Nutrition, 02-903 Warsaw, Poland, ^** ORS PACA INSERM and CIC APHM-INSERM, 13006 Marseille, France, Osteoporosis Clinic, Aarhus Amtssygehus, 8000 Aarhus, Denmark, Centro Sanitario, University of Calabria, 87030 Arcavacata di Rende, Italy, Department of Anatomy, University of Oulu, 90220 Oulu, Finland, ^# Deaconess Institute of Oulu, 90100 Oulu, Finland, and ^§ CAREPS, 38043 Grenoble, France

²To whom correspondence should be addressed.

Several studies indicate that intake of calcium can inhibit iron absorption especially when taken simultaneously. In the CALEUR study, a cross-sectional study among girls (mean 13.5 y) and young women (mean 22.0 y) in six European countries, the association between calcium intake and iron status was studied. In 1,080 girls and 524 women, detailed information on calcium intake was collected by means of a 3-d food record, and serum ferritin, serum iron, serum transferrin and transferrin saturation were measured as indicators of iron status. The mean levels of serum iron, ferritin and transferrin were 15.8 ± 6.1 mmol/L, 34.5 ± 19.1 µg/L and 3.47 ± 0.47 g/L, respectively, in girls and 16.9 ± 7.5 mmol/L, 40.2 ± 30.5 and µg/L, 3.59 ± 0.60 g/L, respectively, in women. A consistent inverse association between calcium intake and serum ferritin was found, after adjusting the linear regression model for iron intake, age, menarche, protein, tea and vitamin C intake and country, irrespective of whether calcium was ingested simultaneously with iron. The adjusted overall regression coefficients for girls and women were -0.57 ± 0.20 and -1.36 ± 0.46 per 100 mg/d increase in calcium intake, respectively. Only in girls, transferrin saturation as a measure for short-term iron status was inversely associated with calcium intake (adjusted overall coefficient -0.18 ± 0.08). However, analysis per country separately showed no consistency. We conclude that dietary calcium intake is weakly inversely associated with blood iron status, irrespective of whether calcium was ingested simultaneously with iron.

KEY WORDS: • dietary calcium • iron status • ferritin • transferrin saturation • cross-sectional • girls • women

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