Association Between Calcium Status, Diet, and Lifestyle Factors Among School-Aged Children in Al Bayda, Libya

Abstract

The acquisition of peak bone mass during early and middle childhood is a fundamental determinant of long-term skeletal integrity. In Al-Bayda, Libya, unique environmental variables—including extreme seasonal thermoregulation challenges—may significantly alter behavioral and physical activity patterns, potentially compromising mineral homeostasis within the pediatric population. This study aimed to evaluate serum calcium status among children aged 5–10 years in Al-Bayda and to delineate the dietary, environmental, and lifestyle factors associated with deficiency. A cross-sectional study was conducted involving 198 children (75 males; 123 females) at the Al-Bayda Specialized Laboratory. Following the quantification of serum calcium levels, a structured 25-item validated questionnaire was administered to caregivers to assess nutritional habits, sedentary versus active behaviors, and clinical symptomatology. Statistical analysis was performed using Student’s t-tests and Odds Ratio (OR) calculations to identify significant correlates of deficiency. Quantitative analysis indicated that 86% of the cohort maintained normocalcemia (mean = 9.815 mg/dL), whereas 14% exhibited clinical deficiency (mean = 7.770 mg/dL). High-frequency fast-food consumption was identified as the primary dietary risk factor, yielding a 32.3-fold increase in the likelihood of deficiency. Conversely, daily milk consumption (OR = 12.38) and regular solar radiation exposure (OR = 53.48) served as the most robust protective factors. Clinically, calcium depletion was strongly associated with osteodynia (74.1%), dental caries (74.1%), and a universal prevalence of anorexia (100%). Notably, children with calcium deficiency were 35.6 times more likely to present with clinical markers indicative of impaired immune function. Pediatric calcium status in Al-Bayda is predominantly influenced by modifiable lifestyle behaviors rather than age-dependent physiological variables. The profound correlation between insufficient heliotherapy, poor dietary quality, and mineral depletion underscores the exigency for targeted public health interventions. Enhancing community literacy regarding safe UV exposure and implementing fortified school-based nutritional programs are imperative to mitigate the risk of impaired skeletal development in this region.