User:Rpp58/sandboxannotatedbib

Calcium, dairy products, and bone health in children and young adults: a reevaluation of the evidence
This systemic review was conducted to determine whether prospective and epidemiologic studies support the current belief that individuals should consume 800 to 1500 mg of dietary calcium, specifically from dairy products to maintain bone density and prevent osteoporosis. Specifically, this analysis focused on calcium intake in children and young adults. The majority studies examined by this analysis indicated minimal to moderate benefits of calcium supplements via dairy products on bone health. This analysis indicates that neither dairy products nor calcium consumption benefits bone health in children and young adults. Therefore, it best supports the side stating calcium intake is not as important for bone health as nutrition policy statements make it seem. The main strength of this study is a variety of studies, including cross-sectional studies, retrospective studies, longitudinal prospective studies, and randomized trials were included in the analysis. However, the findings of this analysis are weakened due to the fact this is not a primary study and thus is not directly showing cause-and-effect relationships.

Dairy products, dietary calcium, and bone health: possibility of prevention of osteoporosis in women: the Polish experience
This study was about dairy and calcium intake and its effects on bone mineral density in women to determine how to use diet to prevent osteoporosis. The results indicated that development of osteoporosis and overall bone health is affected both by diet and by other, unchangeable  biological risk factors. This reason for this study was although there have been many previous studies that have shown the importance of calcium intake for healthy bones, calcium’s role in preventing osteoporosis is still unknown. The findings of the study indicate while daily dairy intake is important for maintaining bone mineral density, the relationship between calcium intake during adolescence and bone density is weaker. Additionally, calcium intake during adulthood does not seem as important, as it only seems to affect how fast bone is broken down. The main strength of this study is that it utilized a very large sample size (712 women). This helps to make the results more generalizable by reducing the risk of extremely biased groups. However, the entire sample was only made up of Polish women, which could decrease the generalizability of the results, making it a weakness. Although the findings regarding calcium’s role are somewhat unclear, this study probably best supports the opinion that dietary calcium is not as necessary for bone health as previously thought and thus calcium supplements may not be beneficial.

Dietary calcium intake and calcium supplementation in Hungarian patients in osteoporosis
This study examined the role of calcium supplementation in Hungarian patients suffering from osteoporosis, since the most common form of therapy for osteoporosis currently is increasing calcium intake. The findings of this study showed that although calcium intake in Hungarian patients than the current recommended value, there was still a significant relationship between calcium supplementation and bone mineral density, specifically in the lumbar spine. However, this relationship was not shown in the femoral bone. Interestingly, however, the opposite relationship was shown for dairy intake and bone mineral density. Therefore, this study supports the popular opinion that daily calcium intake is important for bone health; however, the actual amount needed per day may be lower than the current recommended value. The strengths of this study are the large sample size (8033 patients), the inclusion of both males and females, and the fact that this is a primary study. The weakness of this study is that only Hungarian patients were included, possibly decreasing generalizability of the results.

Calcium builds stronger bones, and more is better - correct? Well, maybe not.
This study, another systemic review, examined the popular belief that calcium supplements help improve bone health and treat osteoporosis. Its findings indicated that in patients suffering from osteoporosis and/or chronic kidney disease, calcium supplements do not have any benefits on bone health. In addition, there is even the possibility that too high doses of calcium may actually be harmful. Therefore, this study is also supporting the opinion that calcium is not necessary for bone health, as was once thought, and therefore its role in promoting bone health should be reevaluated. Similar to the analysis by Lanou, Berkow, and Barnard, the strength of this study is the large number of studies included in the review, and the weakness is that this is not a primary study.

Evidence-based policy on dietary calcium and vitamin D
This study analyzes the Institute of Medicine’s recommendation of calcium and vitamin D intake. The findings indicate that the general recommendation of > 75 mmol/L of vitamin D is not accurate and adults actually require a lesser amount of dietary vitamin D. In addition, the evidence shows that vitamin D and calcium do not have nonskeletal benefits, and in fact greater amounts of each could have adverse effects. Importantly, the study indicates that sunlight is the most important source of vitamin D. Thus, this study supports the side that argues calcium and vitamin D are not as necessary as it seems. The main strength of this study is its basis on a report from the Institute of Medicine and their recommendation’s comparisons to current dietary suggestions. The only weakness of these findings is the Institute does not provide a minimum required amount of dietary calcium and vitamin D or an upper limit, which could be helpful for individuals to fashion their diets.

What do we currently know about nutrition and bone health in relation to United Kingdom public health policy with particular reference to calcium and vitamin D?
This study summarizes vitamin D and calcium public health policy in the United Kingdom, based on reports by the Department of Health, World Health Organization, and Food Standards Agency. The findings indicate that all organizations recommend the intake of these two nutrients/vitamins but some specify upper limits for safe consumption as well as their effect in individuals with other variables, such as exposure to sunlight, weight/BMI, alcohol intake, and consumption of other vitamins and minerals. This paper doesn’t take a specific side of the argument; rather, it summarizes current recommendations by major organizations and provides a comparison for policy in the United States and the United Kingdom. The strength of this paper is that it reviews information from major, well-known organizations, and it provides more specific information than the paper by Reid and Avenell. However, the major limitation is its lack of argument.

Interaction of science, consumer practices and policy: calcium and bone health as a case study
Health policy regarding calcium and vitamin D intake revolve around the supposed benefits of calcium on bone health. This paper supports the pro side of the argument in regards to calcium intake via its findings, which state calcium improves bone mineral density, specifically that calcium intake decreases risk of fracture by 30%, and that calcium intake has benefits on skeletal health. However, calcium intake beyond a certain level no longer improves bone health, making it a threshold nutrient. The paper also suggests that women do not consume enough calcium, focusing on younger women since fewer studies have been conducted in regards to them. The main strength of this study is it includes a wide variety of age groups. However, it does not provide specifics about calcium health policy.

Optimizing bone health and calcium intake of infants, children, and adolescents
This paper studies the necessity of calcium intake in children and adolescents, since most adolescents do not meet the suggested amount of calcium per day. The authors argue that calcium intake is especially important during early childhood as well as adolescence for the proper development of bone mass, potentially also decreasing risk of bone diseases later in life. They suggest that in order to promote adequate calcium intake in adolescents, the entire household needs to meet the recommended levels as well via a well rounded diet. In addition, it can be helpful to obtain assistance from physicians in assessing appropriate calcium intake. The main strength of this study is it provides specific solutions for ensuring children obtain enough calcium. In addition, it focuses on children and adolescents, the age groups that are known to have the most benefits from calcium. However, the study does not provide policy adjustments.