VARIATIONS IN THE
CALCIUM METABOLISM OF
PRESCHOOL CHILDREN

THESIS FOR THE DEGREE OF M. S.

Veda E. HiIIcr ‘
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VARIATIONS

IN THE

C A L C I U H M E T A B O L I S M

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. P R E S C H O O L C H I L D R E N

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A Thesis Submitted
to the Faculty of
Michigen_8tate College
in Partial Fulfillment
of the Requirements for the
Degree of Master of Science

. by 1.5“]
Veda Engiller

Department of Foods and Nutrition
Division of Home Economics

1932

Acknowledgement

It is indeed a real pleasure to take this
opportunity to express, in some measure, appreciation
of the untiring interest and helpful criticism of Dr.
Jean Hawks who directed this investigation.

Grateful appreciation is due, also, to Dr. Marie
Dye, for her kind advice and suggestions during the
entire study.

101410

I.
II.

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IV.

V.

Table of Contents

Page
Introduction. . . . . . . . . . . . . . ._. . . .

Review of Literature. . . . . . . . . . . . . .'.

01 up +4

Discussion of Results . . . . . . . .'. . . . . . 16

1. Daily variations in the calcium balances.

2. Differences in calcium metabolism of the two
children on each diet.

3. Comparison of the reactions of the two children.

A. Variations in the Caz? retention ratios.

Summary......A...........c....}7

List of Tables

Table: Page

I. Summary of Studies on Calcium Metabolism of

Preschool Children. . . . . . . . . . . . . . . 5
II. A Comparison of the Height and Weight.of'the

Children with the Woodbury Tables. . . . . . . 10
III. Composition of Medium Protein Diet. . . . . . . 12
IV. Composition of High Protein Diet. . . . . . . . 13
V. 'Tests of the Accuracy of'the Method on Known

Solutions and Previously Analyzed Food Samples. 15
VI. Comparison of Calculated with Analyzed Values

for Calcium Content of Food . . . . . . . . . . 17
VII. Daily Calcium Balances on the Medium.Protein

Diet. . . . . . . . . . . . . . . . . . . . . . l9
VIII.Daily Calcium Balances on the High Protein Diet 22
11. Percentage of the Calcium Intake Excreted . . ."23
x. Daily Calcium Balances on the Medium Protein

Diet Calculated Per Kilogram of Body Weight . . 26
XI. Daily Calcium Balances on the High Protein Diet

Calculated Per Kilogram of Body Weight. . . . . 29
XII. Daily Calcium Balances on the Medium Protein

Diet Calculated Per Square Meter of Body

Surface . . . . .‘. . . . . . . . . . . . . . . 31
XIII.Daily Calcium Balances on the High Protein Diet

Calculated Per Square Meter of Body Surface . . 32

Table: Page
11?. Daily Intake and Retention Ratios of Calcium
to Phosphorus on the medium Protein Diet. . . . 33
IV. Daily Intake and Retention Ratios of Calcium
to Phosphorus on the High Protein Diet. . . . . 34
XVI. Comparison of Balances of the Two-Children. . . 36

VARIATIONS IN THE CALCIUM IMTABOLISII
OF PRESCI—IOCL CHILDREEI

du n

Little is known concerning the calcium requirement of
children. Investigators first estimated this requirement
by preportionally reducing suggested-standards for adults,
which had been obtained through dietary and balance
studies. The values thus obtained did not indicate the
increased need for calcium during the growth period and
were therefore inadequate. Later, through dietary studies
on children, investigators determined the calcium needs I
for the growing child more accurately. This type of re-
search measured the amount of oalciun.shich children con-
sumed but did not determine the amount actually needed for
optimum storage. To obtain this information, it was
necessary to conduct quantitative metabolism studies. Al-
though several of such studies have been made they do not
give a complete picture of the child's metabolic processes.

This investigation is an attempt to give additional
information on this problem through making a study of the
daily variations in the calcium metabolism of two normal
preschool children. It includes a study of their reactions
on medium and high protein diets.

-2-
W

Sherman and Hasley (8) conducted a series of calcium
metabolism studies, in order to determine the rate of cal-
cium storage in normal children of different ages; the
quantity of calcium required for optimum storage; and the
most valuable sources of the calcium. Twelve children from
three to thirteen years of age served as subjects for per-
iods consisting of one preliminary day plus two or three
collection periods of three days each.

In order to measure the rate of storage, the investi~
gators gave the children a fairly constant diet containing
750 grams of milk. The food consumed contained about one
gram of calcium per day. The retentions varied from 0.15
to 0.62 gram of calcium, the amount increasing as the age
and the size of the child increased. Table I shows that
the Children of preschool age, on the basis of body weight,
received 0.5} gram and stored 0.010 gram of calcium per
kilogram per day.

To find the quantity of calcium requir d for Optimum
storage, the calcium intake of three of the children was
varied by adding 250, 500, 750, 1000 and 1500 grams of
milk to a fixed diet. The data for the two preschool
children are shown in Table I. The amount retained varied
from 0.008 to 0.01% gram of calcium per kilogram of body

weight. The differences between the amounts stored on the

- 3 -
500, 750 or 1000 grams of milk were negligible.

To determine whether children could utilize the cal-
cium in the form of vegetables as efficiently as the cal-
cium of milk, the daily allowance of 750 grams of milk was
‘reduced to 375 grams and enough vegetables were added to
yield an equivalent amount of calcium. The retention on
this diet was 0.006 gram per kilogram, as compared with
0.011 gram per kilogram mn.the former diet. The authors
state that this difference hn the retentions indicated
that the calcium of milk is somewhat better utilized than
that of vegetables. 0n the basis of all these retention
figures they conclude that one quart of milk per day should
be given to each child.

Wang and her associates (IO) conducted calcium metab-
olism studies on ten normal children and fifty undernour-
ished children between four and thirteen years of age.

The children received a weighed diet during a three day
preliminary and a three day experimental period. On the
basis of body weight, the calcium intakes of the preschool
children (Table I) ranged from 0.061 to 0.082 gram per
kilogram and the retentions varied from 0.006 to 0.019
gram. On the whole, the intakes and retentions were higher
than those observed by Sherman and Hauley (8). The calcium
absorption and retention, however, showed wide individual
variations among both normal and undernourished children.

In 1930, Wang and her associates (11) compiled the

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data on 18 children obtained during their study of underb
nourished children, in order to show the minimum calcium
requirement. The calcium intakes varied from 0.009 to
0.103 gram of calcium per kilogram of body weight per day,
and on the same basis the retentions ranged from 0.003 to
0.018 gram. In every case a calcium intske above 0.0278
gram per kilo of body weight resulted in a positive balance
and below that figure the balance was negative. This diff-
erence may have been due to the difference in the source
of calcium, since the milk consumed varied from 130 to 1&00
grams per day. The authors concluded from their results
that the minimum and not the Optimum calcium requirements
for a growing child weighing 20 kilograms and living on a
mixed diet would be 0.46 gram of calcium per day.
, Willard and Blunt (12) made a study on the comparative
influence of evaporated and commercially pasteurized milk
on the calcium metabolism of three normal children, three,
four and eight years of age. The method of procedure was
the same as that used by Wang and her associates (10) (11).
The children received a simple, adequate diet which was
varied by the addition of 810 grams of pasteurized milk or
_an equivalent amount of irradiated milk. As shown in
Table I, the calcium intakes of the children of preschool
vage ranged from 0.06# to 0.070 gram per kilogram of body
weight and they retained from 0.0309 to 0.013 gram per

kilogram. The amounts retained varied with the calcium

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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Thhba I
._ 001311” 01‘ 010012;... 012: 001.0130 m301.1:;;s.:~,;_ 014‘ 111120013001. calm-0:13 . m w
20 hours
hildren Intake Output Retentian 9g :1 P
Total '2 mt
investigator Age ‘00. Total 123; aces brine Total Per Tit—e Tm.'i‘11'r-Q
W1: C§§s. (am) "(007 am am (am ”am am am am
gherman-Hawley 3~5 3 0.883 0.053 0.69 0.02 0.71 O.Q#2 0.17 0.010 19.3
"(béggiéiaii 0—3 2 0.386 0.020 0.23 0.02 0.25 0.013 0.14 0.000 36.3
.. u~5 2 0.677 0.03 0.02 0.02 0.00 0.023 0.20 0.013 35.5 0.211191211_. 0 00 m
__ 0.5 2 0.932 0.040 0. 6 0.03 0.69 0.036 0.20 0.013 25.0 0.8:1m0.§;;‘_ 0 m
_._ 4.5 2 1.207 0.063 0.90 0.00 0.94 0.009_0.2e 0.014 23.2 1giahghaLaL.JmuaaL1ithLJEXELJmLJmuug__.._i_
__ 0.5 2__ . 22 0.089 1.113 0.03 1.116. 0.076 0.27 0.009 1&1_MWWW
aeg1e§ 111 0.5 2 0.666 0.033 0.51 0.02 0.53 0.026 0.10 0.007 21.0 4; . .H ' v .
0.3 2 ll&gig 0 o 0.92 0.02 0.94 0.006 0.09 0.000 8.7
.~._§eries.1v 6 _1 0.95 0.050 0.73 0.02 0.75 0.221.Q.§0 0.011 21.0 0.9;1_ fi1;1_,r x 01 m k
__ 6 1 0.390 0.05 0.03 0.80 0.046 0.11 0.006 12.3
KangmL111L1930‘ 3 1 0.318 0.01 0.25 0.09 0.34 0.020 0.02,
_. a .1. 1.483 0.082 1.10 0.15 1.29 0.072.0.1§.0.009 11.3
__. u 1 0.323 0.041 0.22 0.02 0.30 0.020 0.22 0.017 02.2
.1. ‘ . u 1 0.666 0.009 0.00 0.02 0.02 0.031 0.25 0.012 37.3
2222;1101L13281 5 ,1 .1.450 0.00271.1&“0.21“1.35“0.035 0.11 0.006 7.07
__ 5 2 0.900 0.067 0.74 0.07 0.01 0.057 ofimqgfl
__. 5 1 0.970 0.06 0.72 0.06_0.70 0.049 0.18 0.012.19.0
_. . 1.5 2 0.778 0.061 0.51gldxagagzLjhgfle 0.209.019m11g0_
§9f33§o§2’ 3~6 4 1.09 0.05 0.60 0.06 0.66 0.001 0.02 0.0&§_55.0 1:1
.1. 3.5 u 1.36 0.0e0 0.69 0.04 0.73 0.005 0.6310.039 06.0 0.2.1
0 12. Egg??? 3-0 1.12 0.07 0.90 0.02 0.92 0.52. 0.21 0.013 13.5 1:1
W3: 3. 1‘0“ oiQQ—Qnfig 0:029:ng 0.55 0-14 0.009 13.0 1:;-

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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intake and were higher than those given by Sherman and
-Hauley (8).

Burton (2) conducted a study to determine the influp
ence of cereals upon the calcium retention in four normalflfl,
boys from three to five years of age. The children rear
eived a fixed diet to which was added either refined wheat
‘ or oatmeal. The procedure was the same as that used by Wang
and her coeworkers (10) (11), and only one day was allowed
between the change in diets. Since the children had been
receiving sun lamp treatments these were continued during
the experimental period. The calcium intakes varied from
.0.080 to 0.084 gram per kilogram of body weight and the
.retention ranged from 0.039 to 0.048 gram. These retentions
were considerably higher than those reported by other inves-
tigators possibly due, either to the high intakes or to the
influence of the ultraviolet light. iang and her associates
(11) found that the calcium retention varied diryctly with
"the calcium intake. A number of other investigators have
shown that vitamin D may be a controlling factor in mineral
metabolism whether administered as ultraviolet light, cod-
liver oil or irradiated food or ergosterol. In Burton's
study the intakes and retentions of calcium were less in
the oatmeal period than in the wheat period. Calculated
figures showed that the residues of the two diets were
practically neutral. According to Blunt and Ocean (1),

present day investigators believe that a neutral diet is

- 7 -
the most satisfactory for the storage of calcium and that
diets with an alkaline residue give better retention than
those with an acid residue.

Recently Stearns (9) reported a study on the signif-
icance of the retention ratio of calcium and phosphorus in
children. She stated that a ratio of two parts of calcium
to one of phosphorus would indicate a more rapid growth of
bone than of the soft tissues and that ratios above this
would signify a previous starvation of calcium. A ratio of
less than 1 to 1 would indicate that the major growth was
in the soft tissues and if long continued would result in a
deficiency in the bone growth. She confirmed the statement
made by Sherman and Harley (S) that more calcium is stored
by very young children than by children of school age.

Sherman (7): however, stated in his latest edition of
“The Chemistry of Food and Nutrition,“ that if Optimum
amounts are retained the ratios will care for themselves.
Therefore, with the normal develcpment of the child the
Optimum ratio will be constantly changing.

These studies show the tendencies in calcium absorption
and retention but are not conclusive because of the small
number of children studied. The results of different inves-
tigators are not entirely cemparable on account of the great
number of variables. Some of the children studied were not
physically normal, nor were their previous environmental

conditions comparable in all respects. The diets used also

- g -
varied to a great extent and some of them were planned to
study the comparative values of different foods. The pre-
liminary periods were not more than three days in length
and the experimental periods varied from three to nine d ys.
In some studies the time between different diets was not
more than one day. Investigators assumed that the body
reached equilibrium during the short preliminary periods
and that the experimental periods which followed were in-
dicative of the metabolic process occurring in the child
at all times. With these facts in mind, the plan of this
experiment was to continue a test period for a long period
of time and note the ordinary fluctuations which might oc-

cur in calcium metabolism.

W

The general purpose of this entire investigation was
to study the daily variations in the metabolism of two nor-
mal, preschool boys, who were fed a fixed diet for an extenp
ded period of time. The experiment consisted of three parts,
a 15 day preliminary period, a 30 day period when the child-
ren received a constant diet containing three grams of pro-
tein per kilOgram of body weight and a 15 day period when
the diet contained four grams of protein per kilogram. This
paper is only a portion of the entire investigation and re—
ports the data on the calcium metabolism of the children

during the last six days of the medium protein level and

-.9 -
the first nine days of the high protein level. There acre
several reasons for conducting this portion of the inves-
tigation; first, to determine the daily variations in the
calcium absorption and retention; second, to find the dif-
ference in the metabolism on the two levels of protein;
third, to discover whether each child re<ohed equilibrium
in the nine days following the change in diet; fourth, to
study the retention ratio of calcium to phosphorus; and
fifth, to compare the variations in the reactions of the
two children.

The children D.A. and W.W. came from an institution
for orphan children where they had received exceptionally
good care. They had followed a regular daily routine of
eating, sleep and play. Their diet consisted of practically
three-fourths quart of milk, one egg, two er three vegeta-
bles, tao fruits, meat, cereal, bread and enough of other
foods to make a total of 1600 to 1700 calories per day.
According to estimatbne, this diet contained 55 to 65
grams of protein and approximately 1 gram each of calcium
and phosphorus. Physical and medical examination of the
children in December, 1931, showed that they were, apparu
ently, in ' good physical condition. Table II shows that
D.A., aged four years and nine months, varied from the
Woodbury, Height-Weight-Age tables-2.Sl per ant according
to weight, and f2.08 per cent according to height. W.W.,
who was four years and seven months old varied ~O.6O from
the same table according to weight, and f0.56 per cent
according to height.

TABLE II
A COMPARISON OF THE HEIGHT AND

"1TH IKE WOODBQE: TREEES

  

 

 

 

 

 

 

H Weight
Woodbury's Woodbury's
Ob— ' Vari- ' Ob- ’ 'A . M
_i--_= L.1‘.L.L'32.°_J.“.i.- ii“ _ .2 s... . {11-3)}.-. -ii' 3: -'- -" -1!
o n n ’ es :s
57 has; - .o . _maa - -2 s
- “1+“. ._ . e C e .

 

 

 

 

 

During the experiment the boys lived in the apartment
in the Home Economics building where they were under con-
stant supervision. The children observed good health habits;
such as regular meals, sufficient sleep, both inside and out-
door exercise, fresh air and regulrr toilet habits. They
had their morning play period out of doors with the nursery
school children. Immediately after lunch they slept from
one to two hours and when possible played out of doors for
the remainder of the afternoon.

Both of the diets which the children received were ad-
equate in all dietary essentials as shown by Table III. The
amounts in the table are for D.A., since W.W. weighed one
and one-tenth times as much, he received one-tenth more
food than is recorded. The food each day was identical but
the preparation of it varied in order that the diet would
not seem so monotonous. The caloric values were the same on
the two diets inst for D.A. and 1643 for v.15. The vitamin
content was adequate as shown by the amount of fruits, veg-
etables, milk and cod liver oil given daily. As recommended
by Sherman and Barley (8), the calcium as well as the phos-
phorus content of the diet approximated one gram. Everyday
the children received weighed portions of distilled water
for drinking.

The subjects ate all of the weighed food. Such pre-
cautions as wiping the plate with a small piece of bread,
rinsing a cup of milk or orange Juice with distilled water

insured complete intake of the food. Weighing, cooking and

TABLE III

 

COMPOSITION OF MED-UH PRorggfiuDIE ‘

  

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Br-
0688 0688
W0” .11. _______..-___-__ ______.____._.___,-__ 1338
cc 00
smirking) 753 496.; 2“},5 0._6 - 0,5396 1 o
uncooked
m AL 61+.s 2.0 9.9033 o,g225 1.1
RIM—121.224 igo an; 0.0522 0.0285 11.1
e as 45 52,2 10 0.0059 0.106u 5.2
W 1&5 66.6 6.0 0.9221 0,0§10 5.0
stra nedT
90 1 .u 0. 0.01nu 0,0219 1g.g
e rs ned7 '
au 90 88,2 0,} 9,0055 0.0099 :5;
tu in 22 02 gm 0.0059 0
We rained) “—4—7‘4‘ "" 1"
Wed) 7;. 23.5 0.8 0.0140} 00 z._8_
ran ~
W 3Q._J§..9__lih_9im9_9_i_gi9_§4 Ll
tk 7 is 138.5 0.2 0.0021 00
000
2.9.3959 g6}._lliL_Li_QiQL’fin 0 0 2 ‘52
m; . 1.1.12.2 a
m 15%,}; 1.0 0.0160 01260 5.3
’PA a 7-? ' - _ 'i a _ .. -

’ Allowance for D.A.

 

f figures from.tables, Sherman, Chemistry of Food and

Nutrition.

(7)

I.W. received 1.1 times this amount.

-13-

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

TABLE IV
COMPOSITION OF HIGH PROTEIN DI___
Ex— Ex-
Cal Pro- Phos- case case
_--._°2_..___....1h4_.:_._..;4:___.,.._._;- 'iitu.-2_a..._..}_1:.-_;:m.:
00 cc
mammal—5.: 293:3 £2 0 00 0 95 7.1
it ‘kkim tag 151,} 1h.5 0,5355 o,uoso 1.],
ed
1222;; 15.. 654 2.0 0,003§ 0.0225 1.1
Wfifl ' M552. 0 0 2 1...? n
W 90 104.4 Q.QnZ..._Q...2].§9_,J.Q..&.—__
unco
133,3 13,9 Q,Q§9& o.1§go 9.9
ictnainod) go_
1 ed} gg_‘1;3,# 9,5 9,9155 0,0222 Lh,6
I n
_amaeeahimwa 1.1
{£32337 _JLJLfimcfliJfii 1:9
‘gfi-‘firfidf 1L_£§il__9_.§__9.&19£. 0 Lfi
Wfifimfimm 5.5
gd) 3.1..“ .440 2 WM 0
coo ‘
£23519! ELM—LLWMZES lug.
M 491M
m LikiLJiimm

’ Allovence for D.A. N.W. received 1.1 times this amount.

1‘ Figures from table, Sherman, Chemistry of Food and
Nutrition. (7)

- 1h -
serving the food in the same container prevented any loss
which would occur it food was transferred. The food was
either mixed, ground or served before it was served to be
sure that the children received a fair sample.

To simplify the procedure the food for three days plus
that necessary for analysis was prepared at one time and the
allowance for each day weighed and stored in the ice box.
Exact samples of each of these foods were combined into a
diet and two such diets were saved for analysis. These sam-
ples were dried on a steam bath and then placed in an elec-
tric even at 60 degrees oentigrade until the weights were
constant. After that they were ground and stored in glass
bottles.

The faces were collected in one day periods which were
marked of! alternately with carmine and charcoal. The feces
for each day were dried and stored in the same manner as the
food.

The urine was collected in an hour samples. The creat-
inine values varied between the two periods, but were fair-
ly constant from day to day. These results indicated that
there had been little loss in the collection of the samples.
For the mineral analysis 200 cubic centimeters of the fresh
urine were measured into beakers and dried on a steam bath.

Calcium was determined by the Kramer and Rowland meth-
od (6). A preliminary testing showed that the method was

satisfactory.(Table‘V). Results on a known solution of

 

 

 

 

 

 

 

 

 

 

 

 

TABLE V
TES T3 OF T117“ CCURACY OF 1323 ..Z‘."'1‘ 1013 CH
KNOWN SCLUT IONS ARI) sz’VICUSLY AHAL are FOCD estrus __
Humber of Ga.
Deter- Ca Recov-
__§me_s Sample minationgk gs. Recovered cred
isms} (ems) (:75)
1 an 10 0.0165 0 .0758 99.;
_..-,__.___ 2...... H23 ____________._S2
2 Food 6 O O 08 0.0502 98.8
-mW. _._ 0 0-1 8
A. 5 F999. find Q... } Q,1&Q§ 9,306 _9_9_,_§
2 o a W 1 99,2

 

 

 

- 16 -
calcium shows averages of 99.1 and 98.2 per cent recovery.
Determinations of the calcium in a food previously analyzed
checked within two per cent. When a known solution of cal-
cium was added to the food sample, the recovery of calcium
was 99.8 and 99.2 per cent.

Weighed amounts of the food and the feces were dryed
ashed in a muffle furnace at a dull red heat. The ash was
taken up with 1:9 Hcl, evaporated to dryness in order to
dehydrate any silica present, again taken up with 1:“ H01
and made up to volume.

The dried samples of urine were ashed by adding five
to ten cubic'centimeters of concentrated nitric acid,
digested on a steam bath and then ashing in a muffle furnace
at a dull red heat. Owing to the small amounts of calcium
found in the urine, N/lOO Kmn0h was used for titrating in-
stead of the H/BO Khnou used in the analysis of the food

and feces.

WW

Table VI gives the results of the calcium analysis of
the food on the two protein levels and the values as cal-
culated from Sherman's tables (7). It will be noted that
the calculated values are from 6.1 to 10.3 per cent higher
than those found by analysis, possibly due to the method
of preparation of the foods or to the variations in the

composition of foods. There was, however, only a slight

   

cospARIson or CALCULATED
. oowrsnrm or_ ro03-_

- 17 -

TABLE VI

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

' ' ' if. - ‘:-.--.;.i;.a':.._-_._ .?::'A.~--:‘_--.’_- . _ .2. '13
‘ ‘edium. * 3 days gm, Per cen
.zrnisin. '~ ....1.525 19.1...
i _g 0.990 4.0.8.5 9.5
.Lrarass: $1.987 1.255. 9.9
High
- _JL l.l§8 .l.2§3: 9.1...
___ 2 ;,299 1,2g2' 6,1
3 175 .l.2§§. 9.1...

 

 

 

 

‘ Intakes for D.A.

v.v. received 1.1 times these amounts.

-13-
variation between the values found during the different per-
iods. The calcium ingested on the high protein diet was
1.18% grams, 0.2 gram higher than that on the medium protein
level, due without doubt to the higher amount of milk in the
former diet.

The actual quantities of calcium consumed and utilized
daily by the children on the medium protein diet, as deter»
mined by analysis are given in Table VII. The variations
in the intakes throughout the experiment were due to impurb
ities of the carmine and charcoal which were used in mark-
ing Off the feces. 0n the respective days when they were
used for markingrthe children received 0.00? gram of cal—
cium from carmine and 0.289 gram from charcoal in addition
to the calcium in their food. Therefore, both children
received varied intakes.

It will also be noted that there were large daily
variations in the total calcium output. These variations
were not due to fluctuations in the calcium of the urine
since the calcium thus excreted was quite constant. The
values for D.A. varied within 0.008 gram and those for W.W.
within 0.015 gram. The total amount excreted in the feces
was greater than that in the urine and varied from 0.726 to
1.19} grams for D.A. and from 1.034 to 1.276 grams for W.d.
These variations in total output might be due to the verb
ied intake or to the unavoidable experimental errors in the

collection of the daily feces samples.

  
 

-19-

TABLE VII

pr v -._-——

'0? U” 2:0??13 01WT4.

-m-.—.

 

 

 

   
   

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Output Retention Ab t on
Percent-r Percent-
Sub- age of age of
1%“ Ba; Intafiifigas Urine Totallgmgntake Total mg
(1;) (M) (*mT T ) T13) _*
LA 1 91 E’0 spoiogafla 083132 0.00? W
__ 2 1.21 0.a 0.033 0.93 ogfiAs 0.1.24 33.3
3 0.99 0.334 0.052 0.912 0.074 1.5 0.151%
4 1.21 08 _0_._11 mama 7.4 041.12%
5 0.39 0.226‘0.0a;_g,§07 0.1.91 19.1 0.211%
.__...,__§__‘ _wuu93 0.052 maroon 0.3 0.006 6.7
Aver-
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lhdh._JL_.JaQ§3_lll§§.QlQZQ.lllfliegllflfi ~02973
2 mmamwnam 22.2 MAL
3 03 0,02§ imagine --o.
2; ;,3zj_i.276 0.027 r403 03.075 5.1; 0402 Lu
'L 1.09] ;,035 0.91:234‘077 0.020 1.8 “0.062 5.7
6 0 0,028 1.130 0.203 Fig-0 0.216 20.0
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e .1 2 t o 0 2 1.1 642.02; ":9... 0.082 he

- 20 -

These fluctuations would of course give wide variations
in the daily amount absorbed and retained. On some days the
children apparently absorbed no calcium and on other days
as much as one—third of their intake. The differences be-
tveen the high and low values for absorption were as much
as 0.5 gram of calcium. The retention values were slightly
lower than the absorption values, those for D.A. ranging
from a negative result of 0.132 to a positive result of
0.3hl or 26.8 per cent of the calcium intake. The retention
for W.W. ranged from -O.198 gram to f0.30h gram, the latter
being 22 per cent of his intake.

When average figures were considered on the basis of
grams of calcium per day, D.A. had an‘intake of 1.135 grams
and absorbed 0.177 gram of which he retained 0.095 gram, a
percentage absorption of 15.6 and a percentage retention
of 8.4. The values for D.A. were quite similiar to those
for a five year old vigorous, normal child studied by flang
and her associates (10). W.W. who received 1.23” grams of
calcium.per day absorbed only 0.089 gram of which he re-
tained 0.057 gram a percentage absorption and retention of
7.2 and n.6, respectively.

The toe children showed slight variation in the amount
of calcium utilised. was. absorbed and retained only about
half as much calcium as D.A. These differences were prob-
ably individual differences which might have due to the
differences in the acid-base condition of the intestine.

- 21 -
According to Hawk and Bergeim (4), the acidity of the
intestinal contents is important for the absorption of the
relatively insoluble salts of calcium. Nevertheless their
might have been other differences in their metabolic pro-
ceases, such as parathyroid activity, or differences in
the physical condition. Since D.A. was taller for his
weight than W.W. (Table IV), his bony structure might have
been developing, at that time, more rapidly than that of
W.W. Perhaps both children would have stored more calcium
if the experiment had been conducted in the season of the
year when there was more sunshine.

Table VIII gives the daily calcium balances of the
children on the high protein diet. The intake of D.A. avb
eraged 1.3h7 gram of calcium on this diet in comparison
. with 1.135 gram on the medium protein diet. That of W.W.
was l.h66 gram in place of 1.23“ on the first diet. The
daily intake varied again due to the earmine and charcoal
used to mark the feces.-

There was as much day by day variation on this diet in
all the calcium figures as there was on the medium protein
diet. The percentage of the intake excreted, as shown in
Table IX, was greater on the high than on the lower protein
diet. The excretion was from 96.5 to 97.3 percent of the
intake on the high protein diet, while it was from 91.6 to

95.3 per cent on the medium protein diet.
The calcium retention and absorption on the high pro—

 

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-23-

TABLE IX

 

 

 

 

 

 

  

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um...— .—.#.._.o. ”w...“-

 

- 2h -
tein diet (Table VIII) again shows irregular daily variations.
0n only one day did D.A. appear to absorb no calcium, on the
other days he absorbed from 3.7 to 31.7 per cent of his in-
take. On five days he apparently re-excreted more calcium
than be absorbed, since the retention figures were negative
on those days. Three of these days immediately followed
the change in diet. This might have been due to the fact
that on the medium protein diet the body had obtained equi~
librium and on the changed diet the body was attempting to
adjust its processes. However, the fourth day was near the
end of the period. There were four days when D.A. did re—
tain calcium, the amount varying from 7.6 to 25.0 per cent
of his intake.

The variations for 8.3. were similiar, since on three
days he apparently absorbed and retained no calcium . Two
of these three days were near the beginning of the high
protein period. The percentage absorbed varied from 7 to
#1.} per cent and the amount retained from “.6 to 39.1 per
cent of his intake. These daily fluctuations were somewhat
greater than those othhe medium protein diet.

When all of the data for the high protein diet were
considered both children were storing calcium. D.A. absorb-
ed 11 per cent of his intake and of this amount retained 3.5
per out. While W.W. absorbed only 5.1 per cent and retained
2.7 per cent. This amounts to a daily retention of 0.0%?
and 0.039 gram of calcium, respectively. As in the previous

- 2r -

diet W.W. did not store quite as such calcium as did D.A.
Both children, however, failed to store as much calcium on
the high protein as they did on the medium protein diet.
Analysis of this data statistically showed that this diff»
erence was not significant.

From the results of Wang and her co-workers (11), one
would expect better retention on the high protein diet
because the calcium intake was increased. Nevertheless, the
380 single balances of children reviewed by Craig indicated,
that the quantity of calcium did not consistently follow the
intake, results similar to those found in this experiment.

Calculated values for the acid-base residues of the two
diets (Tables III and I?) show that the medium protein diet
left a slightly more alkaline residue than did the high
protein diet. This might have influenced the retentions on
the diets as Blunt and Ocean (1) state that most investiga-
tors find better assimilation of minerals on diets leaving
an alkaline residue than on those leaving an acid residue.
The difference, however, of 6.2 cubic centimeters of N/lO
excess base on the medium protein diet was probably not
enough to influence the retentions greatly.

Table X records the data on the calcium balances of the
two children on the medium protein diet per kilogram of
body weight. As was previously noted in the data per 2%
hours (Table Vl),there were daily variations in both calcium
intake and output. The intake for D.A. per kilogram, varied

-26-

TABLE I

DAILY CALCIUM BALANCES 0! THE
MEDIUM PmTE N D ET CALCULATED PER KILOGRALI CF BODY WEIGH'

tut

' Ret en- Absorp-

”Lair-rd“;

 

 

 

 

 

 

 

-g,og§ - 00

4; 42.005, 0.013 9.021;
3 0.057 0.951 0.001; 0.099
1!: 0.0114040“ MM 0.006 0.0;0
5 chemm 0,0;0 0.05
6 0.074 0.;6_9__0_,_925 0.071; 0.000 0.005

 

 

    

 

 

0 05] 0.066 0.002 0 068 -0.0 1 -0i009

O 0 2 0.067 0.0Q_l_0,068 0.9% 0,905
mm 4 002 to reclaim.

0 0 2 0.022.002 o 060 0.9152 0.03
06 ,9 969 -OO-O 9» _- 09 9m

 

 

 

 

 

 

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- 27 -
from 0.057 to 0.074 gram and that for w.w. from 0.057 to
0.072 gram. The urinary excretion was practically constant
0.005 gram for D.A. and 0.002 gram for W.W. The grams em-
creted through the feces varied greatly. When both child-
ren vere considered, however, in 7 out of the 12 days the
erces as well as the total output followed the variation in
the intake. Since the daily output was not constant the
absorption and retention varied greatly in both children.
On the basis of kilograms of body weight the absorption val-
ues varied for D.A. from a negative value of 0.003 to a
positive figure of 0.015 gram and the retention values
ranged from -0.008 to 0.019. On the other hand W.W. had
two days in which the absorption was negative but on the
other four days he absorbed values for calcium up to 0.016
gram and retained up to 0.016 gram.per kilogram of body
weight. '

' Considering the average values on the basis of kilograms
of body weight D.A. shows absorption and retention of 0.010
and 0.005 gram, respectively. The results for D.A. are
again comparable to those of the same normal child, she, as
reported by Wang-and her cc-sorkers (10), retained 0.006
gram of calcium.per kilogram of body weight. On this basis
D.A., also had a slightly better storage and absorption of
calcium than W.W., who absorbed only 0.005 gram and retained
0.003 gram. In her survey of the calcium and phosphorus of

children, Craig (3) found that #3 per cent of all cases

- 23 -
stored from -0.001 to 0.009 gram per kilogram of body weight.
The average figures for both children were within this range.

On this same basis the data in Table XI shows the daily
balances of the children on the high protein diet. The same
daily variations were again prevalent. The intakes for both
children varied from 0.068 to 0.086 gram per kilogram of
body weight. The urinary output was again constant 1 0.006
gram for D.A. and 0.002 gram for W.W. The excretion of the
calcium in the feces did not increase and decrease with the
variation in the intake as consistently as they did on the
medium.protein diet. The total output varied for D.A. from
0.065 to 0.093 and for W.W. from 0.051 to 0.093 gram per
kilogram. The variations between the highest and lowest
absorption and retention values were 0.0h5 gram for D.A.
rand 0.057 gram for W.W.

The averages of the daily calcium balances on the high
protein diet showed that even though D.A. and W.W. absorbed,
respectively, 0.008 and 0.004 grams per kilogram, they both
retained 0.002 grams of this amount. For D.A. the differ-
ence in the retention on the two diets was 0.00} grams,
while for W.W. the difference was not significant being only
0.001 grams. On the medium protein diet the per cent of
absorbed calcium which was retained was 50 for D.A. and 60
for W.W. On the high protein diet, however, these same
percentages were reduced to 25 for D.L. and 50 for W.W. This
indicates that possibly D.A. was slightly more effective by
the change in the diet. The difference in the reactions of

   
 

HIGH PROTEIN D ET

 

- 29 -

TABLE XI
DAILY CALCIUM BALANCES ON THE

 

 

 

ALCULATEE PER KILOG¥AE;OF BODY WVTGNT

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

utpu
Sub- Reten— Absorp-
igpt Dav Weight 2k 0 Urine T0ta tion tion__
(ks Tam (am (am) (am) Ten) (gm)
Mall 12- 0.9.6.1....” 062 _.__.5..0 00 ML000 4.096..
a 0.0010 0 8 0.006 0.0011 0.000 0.006
3 0.063 0.065 0.00 0.070% -0 002 0.003
F—é—d
.u 0. 0.951 0 0.065 0.021___0.021_
5 0.010 0,035 0.005 0.093 -0.023 -o.0;_§_
J 6 0.0000066 0.006 001241.015 0.020
7 0.002096000060072 0.012 0.012.
a MQ.O§5 9.006 0.011 -o.003 0.003
.. 9 000000119400 60.011.022L0 ' .40 0
Aver-
ggg. 0.069 0.006 2.015....Qmog 0.008
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2 r 0 0.009 0.002 0.305% 0.012 0,031;
.2 3 (210600.901... 002 .08 “019.15.49.21L
A 0.005 0.077 0.002 0.079 0.006 0.00§_
..5, 0.070 0.065 0.002 0.067 0.003 0.005
_— 6 04905. 02002 0&7wa
_ 1 0.083 0.070 0.002 0.072 0.011 0.01;
_ 0 0.06; 0.062 0.062 0.054 -0.016 .0011;
.0 9 83 0.07:; 0.002 0.076 0.007 0.003
Aver-
age 0.077 0&7} 0.002 0.075 0.002 0.004

 

 

 

 

 

 

 

 

 

 

- 30 a
the two children might be due to the fact that they were
storing their optimum amount of calcium on the medium pro-
tein diet and that adjustment to the new diet occurred at
different rates.

Since calculations for caloric values are often made
on the basis of the body's surface area, the present data
calculated on that basis would show if there was any cor-
relation between utilization of calcium and surface area.
(Tables X11 and XIII). The calculations indicated the same
daily variations in all figures as were found for total
calcium and calcium per kilogram.

Tables XIV and XV give the daily calcium to phosphorus
(5) intake and retention ratios on the medium and high pro~
tein diets. There were wide variations in these ratios. .
oFor both children the intake ratios vary from_0.8:l to 1:1.
Since there were many days on which there was no retention,
and when there was a retention the ratios varied so widely,
only the average ratios could be considered. ‘The Caz? re-
tention ratios of D.A. were 111 on the medium protein and
0.7:1 on the high protein diet. 'Acccrding to Stearns (9),
the 1:1 ratio would be indicative of very good growth both
in bone and soft tissue. While the ratio of 0.7:1 would
signify that the major growth was in the soft tissues.

This might explain why D.A. did not store as much calcium
during the high protein period.

The average retention ratios for 0.0. on the medium

and high protein diets were 0.5:1 and 0.4:1. Stearns (9)

-31-

TABLE III
DAILY CALCIUM BALANCES ON THE MEDIUM

 

 

 

P TE N DIET CALCULATEQ;PER SQUARE HETER 0F BODY SURFACE

 

 

 

 

 

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- 32

TABLE XIII

DAILY CALCIUM BALAHCES ON THE HIGH
PROTEIN DIET CALCULATED PER SQUARE METER OF BODY SURFACE

 

Day

Surface
AuumL__

 

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Urine

Tot;

Reten-
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Absorp-
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12.610
1.806
2.33

0.339
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TABLE XIV
DAILY INTAKE AND RETENTION RATIOS

g? CALQEUE g2 P§g§£§ORUS Qfl TE§_!ED1UM PROTEIN DIET

 

 

 

 

 

 

 

igntage Bet tion
2 qa.-2__ 2
W’mfi) (gm "(3°37 (337 m"
m 0.29.142 9 0.30---_:0.112___2._02_2_

 

 

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1.250 0.5.1 0-070 0.127. 0-6.1

 

 

 

 

 

 

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- 3h -

TABLE XV

DAILY INTAKE A00 RETENTIOH RATIOS
QF cspcgun 30:3203220203 on TH§_gIGH racra;n DIET

 

 

 

 

Intake Retentidh

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

wr~mh2~ur
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F?

 

 

 

 

 

 

 

 

 

agrees... Ln66 4.71140..me

- 35 -
states that if long continued such ratios would result in a
deficiency of bone growth. As was previously stated Sherb
man (7) says that with the normal develOpment of the child
the Optimal ratios will be constantly changing. Since 2.2.
appeared to be developing normally, this low retention ratio
might have been Optimum for him. At this particular time
his soft tissues might have been deveIOping faster than his
bony structure. If this was the case,he needed to retain
more phosphorus than calcium.

The difference in the retention ratios of the two
children again mightwindicate that a change in diet slightly
effected the metabolic processes of D.A. more than that of
0.0.

The following table, number XVI, summarizes the average
calcium retention and absorption values for 24 hours and per
kilogram of body weight of both children on each level of
protein.

There is a difference between the amount of calcium
retained on the two levels of protein in twenty four hours
of 0.093 gram, but calculated.on the basis of body weight
the difference is only 0.002 gram.a certainly not a signif-
icant figure. The results on the absorption of calcium are
practically the same 0.022 and 0.002 gram. The experiments
indicate that the calcium utilization of these two boys did
not vary when the amount of protein in the diet was changed
'from 3 to u grams per kilogram of body weight per day.

-35...-

, _ 12.--- . ' ‘
. .— . -
‘—
. .-._. . I _
, '
':
-2 . 2.. . _
’
' .

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

The general purpose of this investigation was to study
the actual daily variations which might occur in the cal-
cium metabolism of two normal preschool children on differ—
ent diets.

1. The daily amounts of calcium absorbed and retained by
the children varied greatly, possibly due to the daily var—
iations in the intakes or to the difficulty of collecting
daily fecal samples.

2. 0n the medium protein diet D.A. and 0.3. stored daily
0.095 and 0.057 gram of calcium, respectively. On the basis
of per kilogram of body weight these same values were 0.005
gram for D.A. and 0.003 gram for W.W.

3. Both children failed to store as much calcium on the
high protein diet as they did on the medium protein diet.
Statistical treatment of this data, however, showed that
this difference was not significant. 0n the higher protein
level 0.0. and W.fi. retained 0.047 gram and 0.039 gram,
respectively. In grams per kilogram of body weight, both
children retained 0.002 gram.

n. There was a slight difference in the reactions of the
two children, since 0.5. stored more calcium than 0.0. on
'the medium protein diet. The difference in the amounts
retained on the high protein diet was practically negligible.

5. The average retention ratios of Caz? for D.A. and 0.0.

-33..

on the medium.protein diet were 1:1 and 0.5:1, respectively.
On the high protein diet these ratios were slightly lower
and were 0.781 for D.A. and 0.“:1 for W.W.

(1)

(2)

(3)

(1t)

(5)

(6)

(7)

(8)

(9)

i re h

Blunt and Cowan, “Ultraviolet Light and Vitamin D in
Hutrition“,-University of Chicago Press, (1930),
pp . 150-161}. ,

Burton, H. B., “The Influence of Cereals Upon the Re—
tention of Calcium and Phosphorus in Children and
Adults.“ 1. giol, chem., es, hos (1930).

Craig, L. P., "An Analysis of the Literature Pertaining
to Calcium and Phosphorus Metabolism in Children.“
anublighed Thesis, University of Chicago, 1931.

Hank and Bargain, “Practical Physiological chemistry:
Maple Press Company, 1927, p. 286, Ninth Edition.

Kilpetrick, A., 'Variations in Phosphorus Metabolism

of Preschool Children.“ gnpuhlighed Theses,

Michigan State Qollegg, 1932.
Kramer and Howland, I'The Quantitative Estimation of

 

Calcium, Magnesium, Phosphate and Carbonate in
the Bone.‘I 4, Biol, Chem., 68, 711 (1926).

Sherman, H. 0., IThe Chemistry of Food and Nutrition.“
Macmillan Company, (1932), pp. ash and 55h,
Fourth Edition.

Sherman H. 0., and Harley, E., 'Caloium and Phosphorus
Metabolism in Childhood,“ g, Biol. Chem., 53,
375 (1922)-

Stearns, G. “The Significance of the Retention Ratio
of 03:? in Infants and in Children.“ Am Jour.

£fl£h.§2ll§w. 92. 799 (1933).

- 2 -

(10) Wang, C. 0., Kaucher, M., Frank, 1. "Metabolism of
Underncuriehed Children." Am, Jaunpis, Chgd”
35a 856 (1923).

(11) Wang, C. 0., Kern, R., Rancher, M., “Minimum Require-
ments of Calcium and Phosphorus in Children."
Am, Jour, Dig, Child" 39. 763 (1930).

(12') Willard, A. 0., Blunt. 1., I'C'omparison of Evaporated
Milk with Pasteurized Milk as a Source of Cal-

cium, Phosphorus and Nitrogen. g, 3191, Chem.,

759 251 (192?).
(13) Woodbury, Height-Height~Age Tables, Supplement to

Issue of Mother and Child. ‘(July), 1923.
American Child Health Association.

ROOM USE ONLY

 

 

 

 

 

 

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