Abstract:
Objective: 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.
Design: 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.
Setting: Nationally and regionally representative data, Ethiopia’s ‘lean’
season 2011.
Subjects: Women 15–45 years (n 7908, of whom 492 pregnant).
Results: 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 <1 % (0·74 %) except in one region (4·95 %).
Conclusions: Most Ethiopian women consume insufficient Ca, increasing risk of
pre-eclampsia. Providing Ca supplements of 1·5–2·0 g/d could result in high
proportions of women exceeding the UL, while universal consumption of 1·0 g/d
would meet requirements with minimal risk of excess. Appropriately tested
screening tools could identify and reduce risk to high Ca consumers. Research on
minimum effective Ca supplementation to prevent pre-eclampsia is also needed to
determine whether lower doses could be recommended.
