Urinary status of major macro-minerals of Lebanese school aged children -

Abstract

The optimal growth and development of children has been attributed to several combined factors. Adequate nutrition and mineral intake especially of calcium (Ca), magnesium (Mg), and phosphorus (P) play an important role in this aspect. A deficient diet as well as some metabolic diseases prohibit normal metabolism and affect the child health and nutritional status. Nutrient deficiencies are usually assessed through dietary assessment methods, such as validated food frequency questionnaires (FFQs), which can be biased and do not account for mineral bioavailability and other limiting factors. Ca, Mg, and P serum levels are tightly regulated and maintained in a narrow range. Hence, discrepancies only appear in extreme situations. The determination of the status and reference values for Ca, Mg, and P urinary excretion in 6-10 year old Lebanese children is proposed in this study. Using a multi-stage cluster sampling at district, school, and class levels, a sample size of 1403 children was selected. Personal information, anthropometric measurements, and non-fasting urine samples were collected. Before analysis, urine samples were acidified to increase solubility and reduce possible precipitation. Ca, Mg, P, and Creatinine (Crea) were analyzed. The means Ca-Crea, Mg-Crea, and P-Crea were not significantly different between genders. When compared between age groups, only P-Crea was statistically significant. Ca, Mg, and P statuses varied with school types, highlighting potential impact of socio-economic level on nutritional status. The 5th percentile barely changed with age for all mineral ratios. The 95th percentile fluctuates proportionally with age in Ca-Crea and P-Crea emphasizing similar bone retention rates. Geographical variability between countries proves the necessity of having Lebanon-specific pediatric references. Establishing these cutoffs for Lebanese children will allow health professionals to have objective screening methods for mineral status. This will help in the prevention of deficiencies and the