{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T19:35:34Z","timestamp":1778009734403,"version":"3.51.4"},"reference-count":34,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2018,3,28]],"date-time":"2018-03-28T00:00:00Z","timestamp":1522195200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"IFAFS of the USDA Cooperative State Research, Education and Extension Service","award":["00-52102-9696"],"award-info":[{"award-number":["00-52102-9696"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Calcium intake during adolescence is important for attainment of peak bone mass. Lactose maldigestion is an autosomal recessive trait, leading to lower calcium intake. The Adequate Calcium Today study aimed to determine if a school-based targeted behavioral intervention over one year could improve calcium intake and bone mass in early adolescent girls. The school-randomized intervention was conducted at middle schools in six states over one school year. A total of 473 girls aged 10\u201313 years were recruited for outcome assessments. Bone mineral content (BMC) was determined by dual energy X-ray absorptiometry. Dietary calcium intake was assessed with a semi-quantitative food frequency questionnaire. Baseline calcium intake and BMC were not significantly different between groups. After the intervention period, there were no differences in changes in calcium intake and BMC at any site between groups. An unanticipated outcome was a greater increase in spinal BMC among lactose digesters than lactose maldigesters in the intervention schools only (12 months) (6.9 \u00b1 0.3 g vs. 6.0 \u00b1 0.4 g, p = 0.03) and considering the entire study period (18 months) (9.9 \u00b1 0.4 vs. 8.7 \u00b1 0.5 g, p &lt; 0.01). Overall, no significant differences between the intervention and control schools were observed. However, lactose digesters who received the intervention program increased bone mass to a greater extent than lactose maldigesters.<\/jats:p>","DOI":"10.3390\/nu10040421","type":"journal-article","created":{"date-parts":[[2018,3,29]],"date-time":"2018-03-29T05:26:37Z","timestamp":1522301197000},"page":"421","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Behavioral Intervention in Adolescents Improves Bone Mass, Yet Lactose Maldigestion Is a Barrier"],"prefix":"10.3390","volume":"10","author":[{"given":"Yujin","family":"Lee","sequence":"first","affiliation":[{"name":"Department of Nutrition Science, Purdue University, West Lafayette, IN 47907, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dennis A.","family":"Savaiano","sequence":"additional","affiliation":[{"name":"Department of Nutrition Science, Purdue University, West Lafayette, IN 47907, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"George P.","family":"McCabe","sequence":"additional","affiliation":[{"name":"Department of Statistics, Purdue University, West Lafayette, IN 47907, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francis M.","family":"Pottenger","sequence":"additional","affiliation":[{"name":"Curriculum Research and Development Group, University of Hawaii, Honolulu, HI 96822, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kathleen","family":"Welshimer","sequence":"additional","affiliation":[{"name":"Department of Health Education and Recreation, Southern Illinois University, Carbondale, IL 62901, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Connie M.","family":"Weaver","sequence":"additional","affiliation":[{"name":"Department of Nutrition Science, Purdue University, West Lafayette, IN 47907, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Linda D.","family":"McCabe","sequence":"additional","affiliation":[{"name":"Department of Nutrition Science, Purdue University, West Lafayette, IN 47907, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rachel","family":"Novotny","sequence":"additional","affiliation":[{"name":"Department of Human Nutrition, Food, and Animal Sciences, University of Hawaii, Honolulu, HI 96822, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marsha","family":"Read","sequence":"additional","affiliation":[{"name":"Graduate School, University of Nevada, Reno, NV 89557, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Scott","family":"Going","sequence":"additional","affiliation":[{"name":"Department of Nutritional Sciences, University of Arizona, Tucson, AZ 85721, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"April","family":"Mason","sequence":"additional","affiliation":[{"name":"Kansas State University, Manhattan, KS 66506, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marta","family":"Van Loan","sequence":"additional","affiliation":[{"name":"Western Human Nutrition Research Center, USDA, Davis, CA 95616, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7517-787X","authenticated-orcid":false,"given":"Carol J.","family":"Boushey","sequence":"additional","affiliation":[{"name":"Department of Nutrition Science, Purdue University, West Lafayette, IN 47907, USA"},{"name":"Epidemiology Program, University of Hawaii, Honolulu, HI 96813, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2018,3,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2815","DOI":"10.1001\/jama.286.22.2815","article-title":"Identification and fracture outcomes of undiagnosed low bone mineral density in postmenopausal women: Results from the national osteoporosis risk assessment","volume":"286","author":"Siris","year":"2001","journal-title":"JAMA"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"523","DOI":"10.1093\/ajcn\/68.3.523","article-title":"Nutrition and catch-up bone augmentation in young women","volume":"68","author":"Heaney","year":"1998","journal-title":"Am. 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