The Effect of Calcium Supplementation on Body Weight Before and During Pregnancy in Women Enrolled in the WHO Calcium and Preeclampsia Trial

Introduction: Obesity is a major and challenging public health problem. The aim of this substudy is to evaluate the effect of calcium supplementation on body weight in women recruited in the Calcium and Preeclampsia trial. Methods: Women were recruited before pregnancy and randomized to receive a calcium supplement containing 500 mg of elemental calcium or placebo until 20 weeks’ gestation; all women received 1.5 g from 20 weeks until delivery. Results: A total of 630 women conceived during the study, 322 allocated to calcium and 308 to placebo. Among these, 230 allocated to calcium and 227 allocated to placebo had information on body weight at baseline and at 8 weeks' gestation. During the study period, women allocated to calcium had a mean weight increase of 1.1 (SD ±5.5) kg, whereas those allocated to placebo had a mean increase of 1.5 (SD ±6.1) kg, a mean difference of 0.4 kg (95% −0.4 (−1.4 to 0.6); P = .408). Women classified as obese at the start of the trial had a lower body weight gain at 8 weeks’ gestation (1.0 kg; 95% CI: −3.2 to 1.2; P = .330) and at 32 weeks’ gestation (2.1 kg; 95% CI: 5.6-1.3; P = .225) if they received calcium as compared to placebo. However, none of these differences were statistically significant. Conclusion: The smaller increase in body weight found in women supplemented with 500 mg elemental calcium daily is quantitatively consistent with previous studies. However, in this study, the difference was not statistically significant.

[1]  J. Belizán,et al.  Mechanisms Involved in the Relationship between Low Calcium Intake and High Blood Pressure , 2019, Nutrients.

[2]  L. Magee,et al.  Prepregnancy and early pregnancy calcium supplementation among women at high risk of pre-eclampsia: a multicentre, double-blind, randomised, placebo-controlled trial , 2019, The Lancet.

[3]  A. Ciapponi,et al.  Global inequities in dietary calcium intake during pregnancy: a systematic review and meta‐analysis , 2018, BJOG : an international journal of obstetrics and gynaecology.

[4]  Yan Yan,et al.  Estimated global overweight and obesity burden in pregnant women based on panel data model , 2018, PloS one.

[5]  A. Betrán,et al.  Are women with history of pre-eclampsia starting a new pregnancy in good nutritional status in South Africa and Zimbabwe? , 2018, BMC Pregnancy and Childbirth.

[6]  Changwei Li,et al.  The Effects of Dietary Calcium Supplements Alone or With Vitamin D on Cholesterol Metabolism: A Meta-Analysis of Randomized Controlled Trials , 2017, The Journal of cardiovascular nursing.

[7]  Maria Inês Schmidt,et al.  Clinical management of pregnancy in the obese mother: before conception, during pregnancy, and post partum. , 2016, The lancet. Diabetes & endocrinology.

[8]  J. Granger,et al.  Increased risk for the development of preeclampsia in obese pregnancies: weighing in on the mechanisms. , 2015, American journal of physiology. Regulatory, integrative and comparative physiology.

[9]  S. Fawcus,et al.  The effect of calcium supplementation on blood pressure in non-pregnant women with previous pre-eclampsia: An exploratory, randomized placebo controlled study. , 2015, Pregnancy hypertension.

[10]  C. Begley,et al.  Risks associated with obesity in pregnancy, for the mother and baby: a systematic review of reviews , 2015, Obesity reviews : an official journal of the International Association for the Study of Obesity.

[11]  G. Gambaro,et al.  Dietary treatment of urinary risk factors for renal stone formation. A review of CLU Working Group. , 2015, Archivio italiano di urologia, andrologia : organo ufficiale [di] Societa italiana di ecografia urologica e nefrologica.

[12]  A. Ciapponi,et al.  Calcium supplementation for prevention of primary hypertension. , 2015, The Cochrane database of systematic reviews.

[13]  A. Caughey,et al.  Pregnancy risks associated with obesity. , 2015, Obstetrics and gynecology clinics of North America.

[14]  Marie E. Latulippe,et al.  Dietary reference intakes. , 2015, Nutrition reviews.

[15]  R. Prentice,et al.  The Effects of Calcium Supplementation on Verified Coronary Heart Disease Hospitalization and Death in Postmenopausal Women: A Collaborative Meta‐Analysis of Randomized Controlled Trials , 2015, Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research.

[16]  Andres Porta,et al.  Gaps between calcium recommendations to prevent pre-eclampsia and current intakes in one hospital in Argentina , 2014, BMC Research Notes.

[17]  E. Stevenson,et al.  Calcium co-ingestion augments postprandial glucose-dependent insulinotropic peptide1–42, glucagon-like peptide-1 and insulin concentrations in humans , 2014, European Journal of Nutrition.

[18]  P. Camacho,et al.  A Closer Look at Calcium Absorption and the Benefits and Risks of Dietary Versus Supplemental Calcium , 2013, Postgraduate medicine.

[19]  R. Martorell,et al.  Maternal and child undernutrition and overweight in low-income and middle-income countries , 2013, The Lancet.

[20]  A. Hofman,et al.  Risk factors and outcomes of maternal obesity and excessive weight gain during pregnancy , 2013, Obesity.

[21]  D. Goldfarb,et al.  Optimum nutrition for kidney stone disease. , 2013, Advances in chronic kidney disease.

[22]  K. Zhu,et al.  Adverse events from calcium supplementation: Relationship to errors in myocardial infarction self‐reporting in randomized controlled trials of calcium supplementation , 2012, Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research.

[23]  P. Lisboa,et al.  Calcium supplementation prevents obesity, hyperleptinaemia and hyperglycaemia in adult rats programmed by early weaning , 2011, British Journal of Nutrition.

[24]  E. Ernst,et al.  Efficacy of calcium supplementation for management of overweight and obesity: systematic review of randomized clinical trials. , 2011, Nutrition reviews.

[25]  R. Heaney Calcium and obesity: effect size and clinical relevance. , 2011, Nutrition reviews.

[26]  A. Avenell,et al.  Calcium supplements with or without vitamin D and risk of cardiovascular events: reanalysis of the Women’s Health Initiative limited access dataset and meta-analysis , 2011, BMJ : British Medical Journal.

[27]  K. Zhu,et al.  Calcium supplementation and the risks of atherosclerotic vascular disease in older women: Results of a 5‐year RCT and a 4.5‐year follow‐up , 2011, Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research.

[28]  Barbara Abrams,et al.  Recommendations for Weight Gain During Pregnancy in the Context of the Obesity Epidemic , 2010, Obstetrics and gynecology.

[29]  M. Turner,et al.  Maternal weight and body composition in the first trimester of pregnancy , 2010, Acta obstetricia et gynecologica Scandinavica.

[30]  D. Moher,et al.  CONSORT 2010 Explanation and Elaboration: updated guidelines for reporting parallel group randomised trials , 2010, BMJ : British Medical Journal.

[31]  V. Rodriguez,et al.  Molecular mechanisms triggered by low-calcium diets , 2009, Nutrition Research Reviews.

[32]  M. Zemel Proposed Role of Calcium and Dairy Food Components in Weight Management and Metabolic Health , 2009, The Physician and sportsmedicine.

[33]  R. Heaney Calcium Supplementation and Incident Kidney Stone Risk: A Systematic Review , 2008, Journal of the American College of Nutrition.

[34]  G. Major,et al.  Calcium plus vitamin D supplementation and fat mass loss in female very low-calcium consumers: potential link with a calcium-specific appetite control. , 2008, The British journal of nutrition.

[35]  G. Major,et al.  Recent developments in calcium‐related obesity research , 2008, Obesity reviews : an official journal of the International Association for the Study of Obesity.

[36]  A. Hingorani,et al.  Pre-eclampsia and risk of cardiovascular disease and cancer in later life: systematic review and meta-analysis , 2007, BMJ : British Medical Journal.

[37]  R. Heaney Calcium intake and disease prevention. , 2006, Arquivos brasileiros de endocrinologia e metabologia.

[38]  M. Zemel,et al.  Calcium and dairy products inhibit weight and fat regain during ad libitum consumption following energy restriction in Ap2-agouti transgenic mice. , 2004, The Journal of nutrition.

[39]  R Clinton Webb,et al.  Smooth muscle contraction and relaxation. , 2003, Advances in physiology education.

[40]  T. Vaskonen Dietary minerals and modification of cardiovascular risk factors. , 2003, The Journal of nutritional biochemistry.

[41]  S. Harris The effect of calcium consumption on iron absorption and iron status. , 2002, Nutrition in clinical care : an official publication of Tufts University.

[42]  J. Anderson,et al.  Obesity and disease management: effects of weight loss on comorbid conditions. , 2001, Obesity research.

[43]  M. Zemel Calcium Modulation of Hypertension and Obesity: Mechanisms and Implications , 2001, Journal of the American College of Nutrition.

[44]  K. Davies,et al.  Hormones, weight change and menopause , 2001, International Journal of Obesity.

[45]  P. Thuras,et al.  Weight loss and gender: an examination of physician attitudes. , 2001, Obesity research.

[46]  A. Astrup,et al.  Obesity : Preventing and managing the global epidemic , 2000 .

[47]  R. Nahhas,et al.  Iron status, menarche, and calcium supplementation in adolescent girls. , 1998, The American journal of clinical nutrition.

[48]  H. Kalkwarf,et al.  Effects of calcium supplementation and lactation on iron status. , 1998, The American journal of clinical nutrition.

[49]  B. Dawson-Hughes,et al.  Calcium supplementation and plasma ferritin concentrations in premenopausal women. , 1992, The American journal of clinical nutrition.

[50]  J. Repke,et al.  The relationship between calcium intake and pregnancy-induced hypertension: up-to-date evidence. , 1988, American journal of obstetrics and gynecology.

[51]  C. Calviño,et al.  Dietary calcium supplementation in adult rats reverts brown adipose tissue dysfunction programmed by postnatal early overfeeding. , 2017, The Journal of nutritional biochemistry.

[52]  M. Soares,et al.  Calcium and Vitamin D in Obesity and Related Chronic Disease. , 2016, Advances in food and nutrition research.

[53]  P. Bower,et al.  Antenatal interventions for reducing weight in obese women for improving pregnancy outcome. , 2011, The Cochrane database of systematic reviews.

[54]  W. Saris,et al.  An intervention study of the effects of calcium intake on faecal fat excretion, energy metabolism and adipose tissue mRNA expression of lipid-metabolism related proteins , 2007, International Journal of Obesity.

[55]  K. Resch,et al.  Calcium Supplementation with Calcium-Rich Mineral Waters: A Systematic Review and Meta-analysis of its Bioavailability , 2000, Osteoporosis International.