Amy R. Mobley


Foods and Nutrition


Nutrition, Diet, Milk, Milk Products, Health



Background: Calcium has been identified as a nutrient which many individuals are lacking in their diets. Furthermore, the calcium intake of low income individuals tends to be lower than their higher income counterparts. The purpose of this research study was to specifically assess the overall calcium intake level and knowledge, attitudes and behaviors regarding consumption of milk products for low-income female Indiana residents ages 19 and older.

Methods: Women ages 19 and older throughout Indiana and eligible to participate in the Family Nutrition Program (FNP) and/or Expanded Food and Nutrition Education Program (EFNEP) were recruited by FNP and EFNEP paraprofessionals on a voluntary basis. The study was a cross-sectional baseline analysis of calcium intake and knowledge, attitudes and behaviors about milk products among participants. A three-part survey, including: 1) a pre-validated one-page Short Calcium Questionnaire as well as 2) demographic and 3) behavioral questions, was administered to participants, through face-to-face interviews conducted by paraprofessionals, prior to any milk-related nutrition education lessons. Descriptive statistics as well as chi-square, linear and multivariate regression and ANCOVA were conducted using SPSS software after establishing normality of the data.

Results: The sample (n=673) population was primarily ages 19-50 years old, white, had completed high school, was neither pregnant nor breastfeeding and had 1-2 children. Across all subjects mean daily dietary calcium intake was found to be 1,063 mg (SD = 478 mg), mean daily supplemental calcium was 160 mg (SD = 247 mg), mean total daily calcium was 1,233 mg (SD = 531 mg) and mean consumption of milk and milk equivalents per day was 1.8 cups (SD = 1.1 cups). When examined by age, a significant different (P=0.001) was observed in dietary calcium intake between women ages 19-50 (1,100 mg) and women ages 51 and older (951 mg). No significant differences existed when total calcium intake was compared between age groups. There were no significant differences in calcium intake among women of different races. Significant relationships existed between some, but not all, of the knowledge, attitude and behavior questions and calcium or milk product intake. The more participants liked the taste of milk, the more calcium they consumed in their diet yet, the more concerned they were about their intake or if they had lactose intolerance, the less calcium they consumed in their diet. In addition, participants were less likely to know about the relationship of milk/calcium with blood pressure (68%) and weight management (41%), were unconcerned about their calcium intake (50%), and preferred the taste of reduced fat or whole milk (60%).

Discussion: Based on data collected, women ages 51 and older tend to have lower dietary calcium intakes than younger women, with 70% of older women not meeting the Adequate Intake (AI) compared with 44% younger women not meeting their respective AI for calcium. However, when total calcium intake (dietary and supplemental calcium) was compared among the age groups, a smaller insignificant difference existed between the two groups, indicating that older women may be compensating for a lower dietary intake of calcium by using calcium-containing supplements. Information obtained from knowledge, attitude and behavior questions identified several potential focus areas for educational programming within the representative population.