{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T16:25:35Z","timestamp":1791822335872,"version":"4.3.4"},"reference-count":37,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2022,2,14]],"date-time":"2022-02-14T00:00:00Z","timestamp":1644796800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004828","name":"Grand Challenges Canada","doi-asserted-by":"publisher","award":["R-ST-POC-1707-05521"],"award-info":[{"award-number":["R-ST-POC-1707-05521"]}],"id":[{"id":"10.13039\/501100004828","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Fluorosis is a major public health problem in the Rift Valley of Ethiopia. Low calcium (Ca) intake may worsen fluorosis symptoms. We assessed the occurrence of fluorosis symptoms among women living in high-fluoride (F) communities in South Ethiopia and their associations with dietary Ca intake. Women (n = 270) from two villages provided clinical and questionnaire data. Dental fluorosis examination was done using Dean\u2019s Index, and skeletal and non-skeletal fluorosis assessment was carried out using physical tests and clinical symptoms. Daily Ca intake was estimated by a food frequency questionnaire. Food, drinking water and beverage samples were analyzed for F level. Many subjects (56.3%) exhibited dental fluorosis. One-third of the women were unable to perform the physical exercises indicative of skeletal fluorosis; about half had \u22652 symptoms of skeletal\/non-skeletal fluorosis. The average F level in drinking water sources was ~5 mg\/L. The F content in staple food samples varied from 0.8\u201313.6 mg\/kg. Average Ca intake was 406 \u00b1 97 mg\/day. Women having \u2264400 mg\/day Ca intake had ~3 times greater odds of developing skeletal rigidity with joint pains [AOR = 2.8, 95%CI: 1.6, 5.0] and muscular weakness [AOR = 2.9, 95%CI: 1.3, 6.3] compared to those with higher intakes. No association of calcium intake was seen with dental fluorosis. As low dietary Ca intake was associated with symptoms related to skeletal and non-skeletal fluorosis, this warrants nutritional intervention on calcium intakes in this setting.<\/jats:p>","DOI":"10.3390\/ijerph19042119","type":"journal-article","created":{"date-parts":[[2022,2,14]],"date-time":"2022-02-14T03:46:00Z","timestamp":1644810360000},"page":"2119","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Association of Dietary Calcium Intake with Dental, Skeletal and Non-Skeletal Fluorosis among Women in the Ethiopian Rift Valley"],"prefix":"10.3390","volume":"19","author":[{"given":"Demmelash","family":"Mulualem","sequence":"first","affiliation":[{"name":"School of Human Nutrition and Food Science, Hawassa University, Hawassa P.O. Box 5, Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7870-1753","authenticated-orcid":false,"given":"Dejene","family":"Hailu","sequence":"additional","affiliation":[{"name":"School of Public Health, Hawassa University, Hawassa P.O. Box 5, Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7155-4815","authenticated-orcid":false,"given":"Masresha","family":"Tessema","sequence":"additional","affiliation":[{"name":"Ethiopian Public Health Institute, Addis Ababa 1242, Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7573-0425","authenticated-orcid":false,"given":"Susan Joyce","family":"Whiting","sequence":"additional","affiliation":[{"name":"College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK S7N 5E5, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,2,14]]},"reference":[{"key":"ref_1","unstructured":"WHO (2008). Guidelines for Drinking-Water Quality, World Health Organization. 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