Calcium Deficiency in Bangladesh

Background: Bangladesh incurs among the highest prevalence of stunting and micronutrient deficiencies in the world, despite efforts against diarrheal disease, respiratory infections, and proteinenergy malnutrition which have led to substantial and continuous reductions in child mortality over the past 35 years. Although programs have generally paid more attention to other micronutrients, the local importance of calcium to health has been less recognized. Objective: To synthesize available information on calcium deficiency in Bangladesh in order to inform the design of an effective national calcium program. Methods: We searched 3 online databases and a multitude of survey reports to conduct a narrative review of calcium epidemiology in Bangladesh, including population intake, determinants and consequences of deficiency, and tested interventions, with particular reference to young children and women of childbearing age. This was supplemented with secondary analysis of a national household survey in order to map the relative extent of calcium adequacy among different demographics. Results: Intake of calcium is low in the general population of Bangladesh, with potentially serious and persistent effects on public health. These effects are especially pertinent to young children and reproductive-age women, by virtue of increased physiologic needs, disproportionately poor access to dietary calcium sources, and a confluence of other local determinants of calcium status in these groups. Conclusion: A tablet supplementation program for pregnant women is an appealing approach for the reduction in preeclampsia and preterm birth. Further research is warranted to address the comparative benefit of different promising approaches in children for the prevention of rickets.