High prevalence of low dairy calcium intake and association with insomnia, anxiety, depression and musculoskeletal pain in university students from Jordan

Public Health Nutr. 2021 May;24(7):1778-1786. doi: 10.1017/S1368980020002888. Epub 2020 Aug 24.


Objective: To assess dairy Ca intake and investigate its relationship with insomnia and other common co-morbidities including anxiety, depression and musculoskeletal pain (MSP) among university students.

Design: Cross-sectional study.

Setting: University, Irbid, Jordan.

Participants: Male and female individuals (n 1000), aged 20·87 ± 2·69 years.

Results: Low dairy Ca intake (<1000 mg/d) was reported by 96·5 % of participants, and moderate to severe insomnia reported by 15·6 % of participants. Abnormal anxiety and depression scores were reported by 26·2 and 18·0 % of participants, respectively. MSP was reported by 42·9 % of participants. Participants with moderate to severe insomnia had lower dairy Ca, higher anxiety and depression scores and higher measures of MSP compared to participants with no insomnia (P-values < 0·05). Dairy Ca was weakly inversely correlated with Insomnia Severity Index (ISI) score, depression score and measures of MSP (P-values < 0·05). Regression analysis indicated that insomnia was predicted by low dairy Ca, anxiety, depression, MSP and smoking (P-values < 0·05). Both anxiety and depression were predicted by increased ISI score (P-values < 0·05), while depression alone was predicted by low dairy Ca (P-value < 0·01). MSP was predicted by increased ISI and anxiety scores (P-values < 0·05).

Conclusions: Low dairy Ca was highly prevalent and associated with insomnia and depression among university students. Individuals should be advised to increase dietary Ca intake to achieve the recommended daily amount. Further research is required to investigate a potential causal relationship between low Ca and both insomnia and its related co-morbidities.

Keywords: Anxiety; Calcium; Depression; Insomnia; Musculoskeletal pain.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anxiety / epidemiology
  • Calcium
  • Cross-Sectional Studies
  • Depression / epidemiology
  • Female
  • Humans
  • Jordan / epidemiology
  • Male
  • Musculoskeletal Pain* / epidemiology
  • Prevalence
  • Sleep Initiation and Maintenance Disorders* / epidemiology
  • Students
  • Universities


  • Calcium