Prevention of osteoporosis: a randomized clinical trial to increase calcium intake in children with juvenile rheumatoid arthritis.

OBJECTIVE To test the efficacy of a behavioral intervention (BI) compared to an enhanced standard of care (ESC) dietary counseling on increasing dietary calcium (Ca) intake in children with juvenile rheumatoid arthritis (JRA). METHODS Three-day food diaries collected at baseline and posttreatment were analyzed for Ca intake in 49 children with JRA randomly assigned to either BI or an ESC treatment. RESULTS Children in the BI (N = 25) demonstrated a significantly greater increase in average dietary Ca intake (M = 839) than children in the ESC (N = 24; M = 420) (F = 14.39; p < .001). Post hoc analysis revealed that children in both groups demonstrated significant gains in dietary Ca intake baseline to posttreatment. A significantly greater percentage of children in the BI (92%) attained the goal of 1500 mg/Ca at posttreatment compared to the ESC (17%), X2= 28.09; p < .001. CONCLUSIONS Behavioral intervention can have a positive impact on increasing dietary Ca intake. Future research will need to evaluate the maintenance of gains in dietary Ca intake following treatment cessation and the impact of increased Ca intake on bone mineral density.