Association of Dietary Calcium Intake with Dental, Skeletal and Non-Skeletal Fluorosis among Women in the Ethiopian Rift Valley

Demmelash Mulualem, Dejene Hailu, Masresha Tessema and Susan Joyce Whiting
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Demmelash Mulualem: School of Human Nutrition and Food Science, Hawassa University, Hawassa P.O. Box 5, Ethiopia
Dejene Hailu: School of Public Health, Hawassa University, Hawassa P.O. Box 5, Ethiopia
Masresha Tessema: Ethiopian Public Health Institute, Addis Ababa 1242, Ethiopia
Susan Joyce Whiting: College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK S7N 5E5, Canada

IJERPH, 2022, vol. 19, issue 4, 1-15

Abstract: Fluorosis is a major public health problem in the Rift Valley of Ethiopia. Low calcium (Ca) intake may worsen fluorosis symptoms. We assessed the occurrence of fluorosis symptoms among women living in high-fluoride (F) communities in South Ethiopia and their associations with dietary Ca intake. Women ( n = 270) from two villages provided clinical and questionnaire data. Dental fluorosis examination was done using Dean’s Index, and skeletal and non-skeletal fluorosis assessment was carried out using physical tests and clinical symptoms. Daily Ca intake was estimated by a food frequency questionnaire. Food, drinking water and beverage samples were analyzed for F level. Many subjects (56.3%) exhibited dental fluorosis. One-third of the women were unable to perform the physical exercises indicative of skeletal fluorosis; about half had ≥2 symptoms of skeletal/non-skeletal fluorosis. The average F level in drinking water sources was ~5 mg/L. The F content in staple food samples varied from 0.8–13.6 mg/kg. Average Ca intake was 406 ± 97 mg/day. Women having ≤400 mg/day Ca intake had ~3 times greater odds of developing skeletal rigidity with joint pains [AOR = 2.8, 95%CI: 1.6, 5.0] and muscular weakness [AOR = 2.9, 95%CI: 1.3, 6.3] compared to those with higher intakes. No association of calcium intake was seen with dental fluorosis. As low dietary Ca intake was associated with symptoms related to skeletal and non-skeletal fluorosis, this warrants nutritional intervention on calcium intakes in this setting.

Keywords: calcium intake; fluoride; dental fluorosis; skeletal fluorosis; non-skeletal fluorosis; Ethiopian Rift Valley (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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