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Clinical Trial
. 2021 Mar 24;13(4):1052.
doi: 10.3390/nu13041052.

Efficacy of Calcium-Containing Eggshell Powder Supplementation on Urinary Fluoride and Fluorosis Symptoms in Women in the Ethiopian Rift Valley

Demmelash Mulualem  1 , Dejene Hailu  2 , Masresha Tessema  3 , Susan J Whiting  4
Affiliations
Clinical Trial

Efficacy of Calcium-Containing Eggshell Powder Supplementation on Urinary Fluoride and Fluorosis Symptoms in Women in the Ethiopian Rift Valley

Demmelash Mulualem et al. Nutrients. .

Abstract

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 (β = -6.1 (95% CI: -7.1, -5.1)) compared to CG. The risk of developing skeletal and non-skeletal fluorosis were significantly (p < 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.

Keywords: Ethiopia; Rift Valley; calcium; dental; eggshell; fluoride; fluorosis; women.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Flow diagram of the progress through the phases of the clinical trial.
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References

    1. Tandon V., Tirth A., Singh V. Fluoride Toxicity. LAP Lambert Academic Publishing; Sunnyvale, CA, USA: 2015. pp. 56–60.
    1. Dahi E. Contact precipitation for defluoridation of water. In: Pickford J., editor. Reaching the Unreached: Challenges for the 21st Century. Practical Action; Rugby, UK: pp. 262–265. 22nd WEDC Conference: Discussion Paper.
    1. Fawell J., Bailey K., Chilton J., Dahi E., Fewtrell L., Magara Y. Fluoride in Drinking-Water. IWA Publishing, Alliance House; London, UK: 2006. [(accessed on 30 December 2020)]. pp. 1–35. Available online: https://www.who.int/water_sanitation_health/publications/fluoride_drinki....
    1. Tekle-Haimanot R., Melaku Z., Kloos H., Reimann C., Fantaye W., Zerihun L., Bjorvatn K. The geographic distribution of fluoride in surface and groundwater in Ethiopia with an emphasis on the Rift Valley. Sci. Total Environ. 2006;367:182–190. doi: 10.1016/j.scitotenv.2005.11.003. - DOI - PubMed
    1. Demelash H., Beyene A., Abebe Z., Melese A. Fluoride concentration in ground water and prevalence of dental fluorosis in Ethiopian Rift Valley: Systematic review and meta-analysis. BMC Publ. Health. 2019;19:1298. doi: 10.1186/s12889-019-7646-8. - DOI - PMC - PubMed

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