Validation of a Six-Item Dietary Calcium Assessment Tool among HIV Patients in China.

OBJECTIVE Individuals with HIV are at increased risk for osteoporosis. A healthy diet with adequate calcium is recommended to promote bone health. However, lengthy nutritional assessments pose barriers to routine screenings in clinical practice. This study aimed to examine the validity and reproducibility of a six-item dietary calcium screening tool among Chinese individuals with HIV. DESIGN We conducted a two time-point study in an outpatient setting. Volunteers self-administered the six-item tool upon enrollment and again at one-month follow-up. At baseline, participants also completed a validated food frequency questionnaire and surveys regarding demographic and clinical risk factors. SETTING Beijing, China; Shenzhen, Guangdong, China. PARTICIPANTS Upon enrollment, 127 individuals with HIV participated in the study, of whom 83 completed the follow-up screening. RESULTS Mean age of participants was 35.2±9.3 years, average BMI was 22.8±3.8 kg/m2, and 89% were men. Among the participants, 54.7% reported calcium intake less than 800 mg/day. The six-item tool demonstrated fair-to-moderate relative validity with a correlation of 0.39 and 75.7% of subjects classified in same/adjacent quartiles as the reference, and moderate-to-good reproducibility with a correlation of 0.60 and 83.1% of subjects classified in same/adjacent quartiles. Finally, ROC analyses yielded a sensitivity of 87.0% and a specificity of 39.4% with optimized cut-off level. CONCLUSIONS The six-item tool presented adequate validity and reproducibility to identify individuals with low calcium intake among the target population, providing a convenient instrument for categorizing calcium intake in clinical practice, prompting referrals for further assessment, and raising awareness of dietary calcium in bone disease prevention.