Osteoporosis International

, Volume 25, Issue 6, pp 1765–1773

Validation of a short questionnaire for estimating dietary calcium intakes

  • H. M. Macdonald
  • A. Garland
  • J. Burr
  • A. Strachan
  • A. D. Wood
  • N. A. Jamil
  • D. McLernon
  • A. J. Black
Original Article



Concern about calcium supplements, and mainly minor side effects (e.g. constipation) impacting on compliance, means that assessing dietary calcium intake is important. There is no suitable biomarker. Compared to food diaries, a short questionnaire was an efficient way of confirming that patients had adequate calcium intakes (>700 or >1,000 mg)


Calcium is usually given alongside treatments for osteoporosis, but recent concerns about potential side effects have led to questioning whether supplements are always necessary. It is difficult to assess calcium intake in a clinical setting and be certain that the patient is getting enough calcium. The aim of this study was to determine whether a short questionnaire for estimating dietary calcium intakes in a clinical setting was fit for purpose.


We assessed dietary calcium intakes using a short questionnaire (CaQ) in patients attending an osteoporosis clinic (n = 117) and compared them with calcium intakes obtained from a 7-day food diary (n = 72) and a food frequency questionnaire (FFQ) (n = 33).


Mean (SD) daily calcium intakes from the CaQ were 836 (348) mg; from the diaries, 949 (384) mg; and from the FFQ, 1,141 (387) mg. The positive predictive value (PPV) was >80 % for calcium cut-offs > 700 mg and 70 % for cut-offs > 1,000 mg. The calcium intakes for the false positives results were not far below the cut-off. For 1,200 mg, the PPV was 67 % or less.


The CaQ is an adequate tool for assessing whether a patient has daily calcium intakes above 700 or 1,000 mg; if below these cut-offs, it is possible that the patient still has enough calcium in the diet, which could be clarified by questioning the patient further. As there were few patients with calcium intakes above 1,200 mg a day, the CaQ cannot be recommended as a tool for confirming higher dietary calcium intakes.


Dietary calcium Osteoporosis patients Questionnaire Validation 

Supplementary material

198_2014_2694_MOESM1_ESM.docx (19 kb)
ESM 1(DOCX 18 kb)


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Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2014

Authors and Affiliations

  • H. M. Macdonald
    • 1
    • 3
  • A. Garland
    • 1
  • J. Burr
    • 1
  • A. Strachan
    • 1
  • A. D. Wood
    • 1
  • N. A. Jamil
    • 1
  • D. McLernon
    • 1
  • A. J. Black
    • 2
  1. 1.School of Medicine and DentistryUniversity of AberdeenForesterhillUK
  2. 2.Grampian Osteoporosis ServiceWoolmanhill HospitalAberdeenUK
  3. 3.Musculoskeletal Research, Health Sciences BuildingUniversity of Aberdeen, ForesterhillAberdeenUK

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