{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T11:33:41Z","timestamp":1791545621687,"version":"4.3.4"},"reference-count":38,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2021,3,24]],"date-time":"2021-03-24T00:00:00Z","timestamp":1616544000000},"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":["Nutrients"],"abstract":"<jats:p>Dietary calcium binds Fluoride (F), thus preventing excess F absorption. We aimed to assess the efficacy of supplementing calcium-containing Eggshell Powder (ESP) on F absorption using urine F excretion and on fluorosis symptoms. In total, 82 women (41 Intervention Group, IG; 41 Control Group, CG) were recruited; overall, 39 in each group completed the trial. Morning spot urine was collected before (baseline, BL) and after (endline, EL) the intervention that was 6-months daily supplementation with 2.4 g ESP (providing ~1000 mg of calcium). Dental, skeletal, and non-skeletal fluorosis assessments was carried out at BL and, except for dental, at EL. Relative risk (RR) and linear generalized estimating equation were used to compare outcomes between groups. At BL, urinary F excretion in the IG and CG groups was similar, ~10 mg\/L. At EL, urinary F excretion in IG women was six-fold lower (\u03b2 = \u22126.1 (95% CI: \u22127.1, \u22125.1)) compared to CG. The risk of developing skeletal and non-skeletal fluorosis were significantly (p &lt; 0.001) reduced in the intervention group. A significant reduction in urinary F excretion and reduction in many fluorosis symptoms were observed among women supplemented with calcium-containing ESP, thus providing evidence for using this dietary calcium source for mitigation of fluorosis. Clinical trials registration: NCT03355222.<\/jats:p>","DOI":"10.3390\/nu13041052","type":"journal-article","created":{"date-parts":[[2021,3,24]],"date-time":"2021-03-24T21:36:51Z","timestamp":1616621811000},"page":"1052","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Efficacy of Calcium-Containing Eggshell Powder Supplementation on Urinary Fluoride and Fluorosis Symptoms in Women in the Ethiopian Rift Valley"],"prefix":"10.3390","volume":"13","author":[{"given":"Demmelash","family":"Mulualem","sequence":"first","affiliation":[{"name":"School of Human Nutrition and Food Science, Hawassa University, P.O. Box 5 Hawassa, 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, P.O. Box 5 Hawassa, 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, P.O. Box 1242 Addis Ababa, Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7573-0425","authenticated-orcid":false,"given":"Susan J.","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":[[2021,3,24]]},"reference":[{"key":"ref_1","unstructured":"Tandon, V., Tirth, A., and Singh, V. (2015). Fluoride Toxicity, LAP Lambert Academic Publishing."},{"key":"ref_2","unstructured":"Pickford, J. Contact precipitation for defluoridation of water. 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