Low Calcium Intake of Pre-Adolescent Girls from Customary Diets in A Semi-Rural Setting in Khyber Pakhtunkhwa, Pakistan

Calcium is a critical nutrient for adolescent bone development and overall health, yet intake often remains below recommended levels in many populations. Objectives: To assess the calcium intake of pre-adolescent girls, their calcium fortified preferences, and perceived barriers to calcium-rich foods to inform targeted nutritional interventions. To assess the calcium intake of adolescent girls, their calcium fortified preferences, and perceived barriers to calcium-rich foods. Methods: A descriptive cross-sectional study was conducted, where 78 school girls aged 9-14 years completed FFQ with a focus on foods rich in calcium. The questionnaire also contained questions inquiring about the perceived barriers which could result in low intake/no intake of calcium-dense foods. Results: A total of 174 calcium-rich foods and products were available in Charsadda city. Mean intake of calcium (275 ± 52) was well below the RDI. Notable gaps in students' awareness of calcium sources and their importance existed. The top 8 Key barriers that potentially hinder the intake of nutritious foods were identified, including cost, low availability in the school environment, low awareness, inappropriate storage facilities at school, food habits, low nutrition education, food stigma, and junk food pressure. The data highlights a clear preference among students for certain calcium-fortified food types over others. Conclusions: Mean calcium intake from foods available to pre-adolescent girls was low, with numerous barriers identified that hinder calcium intake in this age group. Further, pre-adolescent girls preferred a variety of calcium-fortified foods, biscuits and milk on top of the list.