Calcium daily intake and the efficacy of a training intervention on optimizing calcium supplementation therapy: A clinical audit

Nutr Metab Cardiovasc Dis. 2021 Jan 4;31(1):354-360. doi: 10.1016/j.numecd.2020.08.005. Epub 2020 Aug 18.


Background and aims: Calcium is an essential element for human health, with key roles in the prevention and therapy of multifactorial conditions. Calcium dietary intake is often insufficient in the general population. The aim of this study was to perform a clinical audit for general practitioners (GPs) to understand the efficacy of training intervention on doctors' awareness about dietary calcium and supplements.

Methods and results: General practice outpatients were enrolled (Before Clinical Audit, BCA) from the same sanitary district, and calcium dietary intake was evaluated with a validated questionnaire, also collecting information about the consumption of calcium and vitamin D supplements. Then, a training intervention with a frontal lesson and discussion with GPs involved was performed. After one month of this intervention, a second outpatient enrolment was performed (Post Clinical Audit, PCA) in the same general practices to evaluate differences in nutritional suggestions and supplement prescription by GPs. In BCA, the calcium dietary intake was low, with nobody reaching 1000 mg as suggested by the guidelines. Only 6.6% and 24.5% took calcium and vitamin D supplements, respectively; in the PCA, these percentages increased to 28% and 78% for calcium and vitamin D supplements, respectively (p < 0.01 PCA vs BCA). There were no differences in calcium dietary intake between BCA and PCA.

Conclusion: Training intervention on GPs was successful to sensitize them regarding calcium intake problems; GPs tended to increase the prescription of supplements but not to suggest changes in dietary habits.

Keywords: Calcium; Calcium dietary intake; Calcium rich food; Calcium supplements; Clinical audit; General population; Vitamin D; Vitamin D supplement.

Publication types

  • Comparative Study
  • Meta-Analysis

MeSH terms

  • Adult
  • Aged
  • Calcium / administration & dosage*
  • Calcium / deficiency
  • Calcium, Dietary / administration & dosage*
  • Diet, Healthy
  • Dietary Supplements*
  • Drug Prescriptions
  • Drug Utilization
  • Education, Medical, Continuing*
  • Feeding Behavior
  • Female
  • General Practitioners / education*
  • Health Knowledge, Attitudes, Practice*
  • Humans
  • Italy
  • Male
  • Medical Audit
  • Middle Aged
  • Practice Patterns, Physicians'*
  • Recommended Dietary Allowances


  • Calcium, Dietary
  • Calcium