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Association of calcium intake, lactose intolerance and physical activity with bone health assessed via quantitative ultrasound among young adults of a Malaysian university

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Abstract

Summary

Lactose intolerance has been proposed to cause poor bone health. This study found the prevalence of lactose intolerance was high among Malaysian young adults, but not associated with bone health status, unlike calcium intake. This is the first study that investigated the association of lactose intolerance and bone health status in Malaysia.

Purpose

The aims of this study were to determine the prevalence of lactose intolerance, calcium intake and physical activity level and to investigate the association between these variables with bone health status among young adults.

Methods

This cross-sectional study consisted of 300 Malay, Chinese and Indian students from Universiti Kebangsaan Malaysia with mean age of 22.5 ± 3.2 years. Determination of lactose tolerance status was performed using hydrogen breath test, lactose tolerance test and visual analogue scales. Calcium intake and physical activity level were evaluated using Food Frequency Questionnaire and International Physical Activity Questionnaire, respectively. Bone health status was assessed on calcaneal bone, using quantitative ultrasound.

Results

Lactose intolerance was highly reported among the Malay subjects (72%) followed by Chinese (59%) and Indians (42%). The mean calcium intake was 542.9 ± 365.2 mg/day whilst the mean physical activity was 2757.6 ± 2007.2 MET-min/week. The bone assessment showed that 91% of the subjects had a low risk of developing osteoporosis. Only calcium intake showed a significant association with bone health status (β = 0.006; p = 0.033), whilst no association was shown for lactose intolerance and physical activity level.

Conclusions

Malaysian young adults showed a high prevalence of lactose intolerance. Calcium intake is associated with increased bone health status. In contrast, lactose intolerance and physical activity level did not directly influence bone health status. Nutrition education promoting adequate calcium intake should be implemented among young adults due to high lactose intolerance prevalence and low calcium intake among subjects.

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Data availability

Data are not available as participants have not consented to have their data shared with other than the research team.

Abbreviations

FFQ:

Food frequency questionnaire

IPAQ:

International Physical Activity Questionnaire

BUA:

broadband ultrasound attenuation

BMD:

Bone mineral density

QUS:

Quantitative ultrasound

HBT:

Hydrogen breath test

LTT:

Lactose tolerance test

VAS:

Visual analogue scale

MET:

Metabolic equivalent task

DXA:

Dual-energy X-ray absorptiometry

WHO:

World Health Organization

SD:

Standard deviation

USD:

United States dollar

UKM:

Universiti Kebangsaan Malaysia

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Acknowledgements

We would like to acknowledge Universiti Kebangsaan Malaysia (UKM) Health Centre, Bangi, Selangor, Malaysia, for providing us facilities to conduct the research. We thank all subjects who participated in this research. We also wish to express our appreciation to the Faculty of Science and Technology, UKM, for the support.

Funding

We would like to extend our gratitude to UKM for funding this research (grant number: GGPM-2013-077).

Author information

Authors and Affiliations

  1. Department of Food Sciences, Faculty of Science and Technology, Universiti Kebangsaan Malaysia, 43600, Bangi, Selangor, Malaysia

    Noor Fairuzi Suhana Yahya, Norlida Mat Daud, Ika Aida Aprilini Makbul & Qurratul Aini Salma Abdul Aziz

  2. Centre of Nutrition and Dietetic, Faculty of Health Science, Universiti Teknologi MARA, 42300, Puncak Alam, Selangor, Malaysia

    Noor Fairuzi Suhana Yahya

  3. Innovation Centre for Confectionery Technology (MANIS), Faculty of Science and Technology, Universiti Kebangsaan Malaysia, UKM, 43600, Bangi, Selangor, Malaysia

    Norlida Mat Daud

  4. Centre For Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300, Kuala Lumpur, Malaysia

    Ika Aida Aprilini Makbul

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  1. Noor Fairuzi Suhana Yahya
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Contributions

Study design: NMD and NFSY. Study conduct: NFSY and QASAA. Data collection: NFSY, IAAM and QASAA. Data analysis: NFSY. Data interpretation: NFSY and NMD. Drafting manuscript: NFSY. Revising manuscript content: NMD and NFSY. Approving final version of manuscript: NFSY, NMD, IAAM and QASAA. NFSY takes responsibility for the integrity of the data analysis.

Corresponding author

Correspondence to Norlida Mat Daud.

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Ethical approval

Ethical approval was granted by the Secretariat for Medical Research and Innovation of Universiti Kebangsaan Malaysia, 2014 (Code:1.5.3.5/244/GGPM-2013-077). All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Yahya, N.F.S., Daud, N.M., Makbul, I.A.A. et al. Association of calcium intake, lactose intolerance and physical activity with bone health assessed via quantitative ultrasound among young adults of a Malaysian university. Arch Osteoporos 16, 14 (2021). https://doi.org/10.1007/s11657-020-00874-6

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