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WOMEN TAKING AEDS MAY NEED CALCIUM BOOST
PHILADELPHIA —Nearly three quarters of premenopausal women with epilepsy taking an antiepileptic drug (AED) have a calcium intake that is lower than the recommended daily allowance, according to a new study. Because of the association between long-term AED treatment and bone disease, women with epilepsy should be regularly monitored to ensure that they are getting enough calcium, advised Hyunmi Choi, MD, and colleagues from the Columbia-Presbyterian Medical Center in New York. Dr. Choi’s team presented their findings at the 2001 Annual Meeting of the American Epilepsy Society.
EPILEPSY, AEDs, AND BONE DISEASE
Seventy-nine women between ages 18 and 40, with epilepsy and receiving AED monotherapy, were enrolled in a bone health study, which assessed bone density and bone turnover rate for one year. All study participants completed a Food Frequency Questionnaire created by the National Cancer Institute. They reported daily dietary and supplement intake, which included calcium. One of the variables was an analysis of nutrition and vitamin supplementation. Total daily calcium intake was calculated from dietary calcium intake with or without supplementation.
The researchers found that the average total daily calcium intake per study participant was 988 mg. Fifty-eight women (73.4%) ingested less than the recommended daily allowance of 1,200 mg of calcium per day for this age-group. Furthermore, only 38 women (48.1%) took calcium supplements, and among those women taking calcium supplements, 23 (61%) still consumed less than the recommended amount of total daily calcium.
AEDs are associated with bone diseases such as osteopenia, osteoporosis, osteomalacia, and pathologic fractures. Although no definitive preventive guidelines are yet available, certain risk factors are modifiable. One preventive measure is ensuring adequate calcium intake, according to the researchers.
OTHER AT-RISK GROUPS
Other patient groups receiving AEDs who are at risk for bone disease include premenopausal women with small frames or anovulatory menstrual cycles, postmenopausal women, older men, children, and institutionalized patients. Recommended strategies for preventing bone disease include calcium supplementation; adequate vitamin D intake through either sunlight exposure or dietary supplement; avoiding smoking; avoiding alcohol intake of more than two drinks per day; regular exercise, especially resistance and high-impact activities; and assessment of bone mass in patients at risk.
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—Colby Stong
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