SUNLIGHT EXPOSURE, DIETARY CALCIUM INTAKE AND ITS ASSOCIATION WITH OSTEOPOROSIS RISK IN PERI AND POSTMENOPAUSAL WOMEN: A POPULATION-BASED STUDY
Bharti Shah1, Jagmeet Madan2, Meeta Singh3
1Post Graduate Department of Food Science and Nutrition, 2Principal & Professor, Department of Food Nutrition and Dietetics; SVT College of Home Science (Empowered Autonomous Status) S.N.D.T. Women’s University, Juhu campus, Mumbai, India3Chief Consultant (Ob Gyn), Tanvir Hospital, Hyderabad, India
ABSTRACT: Osteoporosis is a multifactorial condition and affects approximately 18.3% of the global population particularly in developing countries. The modifiable risk factors include adequate intake of calcium and vitamin D, physical activity and the non-food source of vitamin D (skin synthesis through exposure to sunlight). However, limited population-based research has been conducted regarding dietary calcium intake and natural exposure to sunlight as an intervention to prevent osteoporosis in postmenopausal women. This research aiming to study sunlight exposure per day in 620 perimenopausal and 590 post-menopausal women (40 to 61 years) in Mumbai, Hyderabad and Bidar. Validated sunlight exposure questionnaire includes information on participant’s exposure to sun (from 8 a.m. to 5 p.m.) and sun protection measures, use of sunscreens, and wearing cap. Validated semi-quantitative food frequency questionnaire (SFFQ)was used to collect information on participant’s frequency and quantity of food intake. According to the findings of the study, majority of perimenopausal women [Mumbai (84%), Hyderabad (61.2%), Bidar (96.2 %)] and post-menopausal women [Mumbai (88%), Hyderabad (64.7%), Bidar (98.6 %)] had sun exposure less than fifteen minutes per day with 15% exposure of skin area, which was inadequate as per clinical practice guidelines on Menopause (2020). The mean dietary calcium intake was inadequate for both groups, for perimenopausal meeting only (Mumbai- 68.4%, Hyderabad-65.7%, Bidar-55.3%) of EAR and (Mumbai- 54.7%, Hyderabad-52.6%, Bidar-44.2%) of RDA and postmenopausal meeting only (Mumbai-52%, Hyderabad-48.4%, Bidar-49.5%) of EAR and (Mumbai- 43.3%, Hyderabad-40.3%, Bidar-41.2%) of RDA. The OSTA score and sunlight exposure showed statistically significant difference between perimenopausal and post-menopausal women [Mumbai (t=3.788-, p=0.000) Hyderabad (t=-4.193, p=0.000) Bidar (t=-7.778, p=0.000)]. The study concludes that a significant proportion of postmenopausal women have inadequate sunlight exposure combined with low dietary calcium intake. There is need to educate women in both the groups about exposure to sun for good bone health along with nutrition to avoid osteoporosis risk.
KEYWORDS: Sun exposure, Dietary calcium intake, perimenopausal, post-menopausal