Association Between Dietary Fluoride and Calcium Intake of School-Age Children With Symptoms of Dental and Skeletal Fluorosis in Halaba, Southern Ethiopia
BackgroundIn the Ethiopian Rift Valley, ways to reduce the fluoride (F) burden from drinking water have been unsuccessful. Calcium (Ca) intake may mitigate fluorosis by binding with F ions and preventing absorption. The purpose of this study was to examine the association between Ca intake and propo...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-03-01
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| Series: | Frontiers in Oral Health |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/froh.2022.853719/full |
| _version_ | 1818199676440018944 |
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| author | Nahom Tefera Demmelash Mulualem Kaleab Baye Masresha Tessema Meseret Woldeyohannes Asrat Yehualashet Susan J. Whiting |
| author_facet | Nahom Tefera Demmelash Mulualem Kaleab Baye Masresha Tessema Meseret Woldeyohannes Asrat Yehualashet Susan J. Whiting |
| author_sort | Nahom Tefera |
| collection | DOAJ |
| description | BackgroundIn the Ethiopian Rift Valley, ways to reduce the fluoride (F) burden from drinking water have been unsuccessful. Calcium (Ca) intake may mitigate fluorosis by binding with F ions and preventing absorption. The purpose of this study was to examine the association between Ca intake and proportion of fluorosis symptoms in school-age children in an area where F levels are known to be higher than WHO limit of 1.5 mg F/L water.MethodsA cross-sectional survey in the Halaba zone involved 135 eligible children aged 6–13 year who were recruited to have dental fluorosis assessed by a dentist and skeletal fluorosis assessed by a physiotherapist. Dietary Ca intake was determined by 24-h recall. Food items and samples from ground wells, taps and spring water were collected for F concentration. Associations were measured using bivariate logistic regression, adjusted for known confounders.ResultsWater F averaged 5.09 mg/L. Total F intake was high, 10.57 mg/day, and Ca intake was low, 520 mg/day. Prevalence of dental fluorosis (from very mild to severe symptoms) was 73.1% for younger children (6–8 years) and 68.3 % for older children (9–13 years). The prevalence of children having symptoms of skeletal fluorosis ranged between 55.1 and 72.4%, with no apparent age difference. Dietary F intake of children was significantly positively associated with presence of dental fluorosis. Dietary Ca intake of children was significantly negatively associated with dental fluorosis. Higher than average dietary F intake significantly increased the odds of developing skeletal fluorosis symptoms when measured as inability to stretch and fold arms to touch back of head. Higher than average Ca intake was significantly associated with decreased odds of developing skeletal fluorosis measured as inability to bend body to touch the toes or floor.ConclusionsHigh dietary F, as expected, was associated with fluorosis in children. In the presence of higher Ca intake (>520 mg/day) some fluorosis symptoms were mitigated. There is a need to improve Ca intakes as all were below recommended levels, and this nutritional strategy may also reduce burden of excess F. |
| first_indexed | 2024-12-12T02:25:33Z |
| format | Article |
| id | doaj.art-f86385c16d124418a1863a7933931f10 |
| institution | Directory Open Access Journal |
| issn | 2673-4842 |
| language | English |
| last_indexed | 2024-12-12T02:25:33Z |
| publishDate | 2022-03-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oral Health |
| spelling | doaj.art-f86385c16d124418a1863a7933931f102022-12-22T00:41:35ZengFrontiers Media S.A.Frontiers in Oral Health2673-48422022-03-01310.3389/froh.2022.853719853719Association Between Dietary Fluoride and Calcium Intake of School-Age Children With Symptoms of Dental and Skeletal Fluorosis in Halaba, Southern EthiopiaNahom Tefera0Demmelash Mulualem1Kaleab Baye2Masresha Tessema3Meseret Woldeyohannes4Asrat Yehualashet5Susan J. Whiting6Ethiopia and Food Science and Nutrition Research Directorate Ethiopian Public Health Institute, Center for Food Science and Nutrition, College of Natural and Computational Sciences Addis Ababa University, Addis Ababa, EthiopiaSchool of Human Nutrition and Food Science, Hawassa University, Awasa, EthiopiaCenter for Food Science and Nutrition, College of Natural and Computational Sciences Addis Ababa University, Addis Ababa, EthiopiaFood Science and Nutrition Research Directorate Ethiopian Public Health Institute, Addis Ababa, EthiopiaFood Science and Nutrition Research Directorate Ethiopian Public Health Institute, Addis Ababa, EthiopiaFood Science and Nutrition Research Directorate Ethiopian Public Health Institute, Addis Ababa, EthiopiaCollege of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK, CanadaBackgroundIn the Ethiopian Rift Valley, ways to reduce the fluoride (F) burden from drinking water have been unsuccessful. Calcium (Ca) intake may mitigate fluorosis by binding with F ions and preventing absorption. The purpose of this study was to examine the association between Ca intake and proportion of fluorosis symptoms in school-age children in an area where F levels are known to be higher than WHO limit of 1.5 mg F/L water.MethodsA cross-sectional survey in the Halaba zone involved 135 eligible children aged 6–13 year who were recruited to have dental fluorosis assessed by a dentist and skeletal fluorosis assessed by a physiotherapist. Dietary Ca intake was determined by 24-h recall. Food items and samples from ground wells, taps and spring water were collected for F concentration. Associations were measured using bivariate logistic regression, adjusted for known confounders.ResultsWater F averaged 5.09 mg/L. Total F intake was high, 10.57 mg/day, and Ca intake was low, 520 mg/day. Prevalence of dental fluorosis (from very mild to severe symptoms) was 73.1% for younger children (6–8 years) and 68.3 % for older children (9–13 years). The prevalence of children having symptoms of skeletal fluorosis ranged between 55.1 and 72.4%, with no apparent age difference. Dietary F intake of children was significantly positively associated with presence of dental fluorosis. Dietary Ca intake of children was significantly negatively associated with dental fluorosis. Higher than average dietary F intake significantly increased the odds of developing skeletal fluorosis symptoms when measured as inability to stretch and fold arms to touch back of head. Higher than average Ca intake was significantly associated with decreased odds of developing skeletal fluorosis measured as inability to bend body to touch the toes or floor.ConclusionsHigh dietary F, as expected, was associated with fluorosis in children. In the presence of higher Ca intake (>520 mg/day) some fluorosis symptoms were mitigated. There is a need to improve Ca intakes as all were below recommended levels, and this nutritional strategy may also reduce burden of excess F.https://www.frontiersin.org/articles/10.3389/froh.2022.853719/fullfluoridefluorosiscalciumdentalskeletalschool-age children |
| spellingShingle | Nahom Tefera Demmelash Mulualem Kaleab Baye Masresha Tessema Meseret Woldeyohannes Asrat Yehualashet Susan J. Whiting Association Between Dietary Fluoride and Calcium Intake of School-Age Children With Symptoms of Dental and Skeletal Fluorosis in Halaba, Southern Ethiopia Frontiers in Oral Health fluoride fluorosis calcium dental skeletal school-age children |
| title | Association Between Dietary Fluoride and Calcium Intake of School-Age Children With Symptoms of Dental and Skeletal Fluorosis in Halaba, Southern Ethiopia |
| title_full | Association Between Dietary Fluoride and Calcium Intake of School-Age Children With Symptoms of Dental and Skeletal Fluorosis in Halaba, Southern Ethiopia |
| title_fullStr | Association Between Dietary Fluoride and Calcium Intake of School-Age Children With Symptoms of Dental and Skeletal Fluorosis in Halaba, Southern Ethiopia |
| title_full_unstemmed | Association Between Dietary Fluoride and Calcium Intake of School-Age Children With Symptoms of Dental and Skeletal Fluorosis in Halaba, Southern Ethiopia |
| title_short | Association Between Dietary Fluoride and Calcium Intake of School-Age Children With Symptoms of Dental and Skeletal Fluorosis in Halaba, Southern Ethiopia |
| title_sort | association between dietary fluoride and calcium intake of school age children with symptoms of dental and skeletal fluorosis in halaba southern ethiopia |
| topic | fluoride fluorosis calcium dental skeletal school-age children |
| url | https://www.frontiersin.org/articles/10.3389/froh.2022.853719/full |
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