Search

The aging process is frequently characterized by an involuntary loss of muscle (sarcopenia) and bone (osteoporosis) mass. Both chronic diseases are associated with decreased metabolic rate, increased risk of falls/fracture, and, as a result, increased morbidity and loss of independence in the elderly. The quality and quantity of protein intake affects bone and muscle mass in several ways and there is evidence that increased essential amino acid or protein availability can enhance muscle protein synthesis and anabolism, as well as improve bone homeostasis in older subjects. A thorough evaluation of renal function is important, since renal function decreases with age. Finally, protein and calcium intake should be considered in the prevention or treatment of the chronic diseases osteoporosis and sarcopenia. doi: 10.1111/j.1753-4887.2010.00321.x

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.jada.2010.05.003 Byline: Nan Lv, J. Lynne Brown Abstract: Chinese Americans have a high risk of osteoporosis and their calcium intake is substantially below the daily recommendation. However, little has been done to reduce the risk of this hard-to-reach population. This theory-based qualitative study explored how first-generation Chinese American couples with children view dairy products, how they use them in their family food system, and how these uses influence their dietary behavior or intake. Twenty couples, recruited from weekend Chinese schools at three locations in Pennsylvania, were interviewed. Taste, texture, and use of additives and growth hormones appeared to be more important influences on dairy choice than lactose intolerance. In these families, parental use of food rules and power to influence food patterns affected family flexibility about dairy use. Father's power, his views of dairy products, and his preference for Chinese-based dinners had a greater influence than those of his wife or children on the use of dairy-based dinner dishes. In contrast, choices at breakfast or lunch and for snacks were more flexible and could include dairy products. Nutrition educators can encourage introduction of dairy products into the traditional dietary pattern of Chinese Americans by offering opportunities to taste unfamiliar dairy products, demonstrating use of dairy products to prepare familiar foods, including both parents in any intervention or at least in tasting recipes, and providing information on importance of calcium to bone health and amount of calcium needed from reputable sources. Article History: Accepted 3 November 2009

Racial differences in bone become apparent during puberty. Studies of areal bone mineral density (aBMD) generally show the greatest aBMD in African Americans followed by American white, Hispanic, and Native Americans, with the least aBMD in Asian Americans. Racial differences in fracture risk, however, do not exactly follow racial variation in aBMD. These group differences in bone mass are largely explained by differences in bone size, although calcium intake and physical activity are also significant predictors of aBMD and bone mineral content. Racial differences in calcium metabolism, as influenced by calcium and sodium intake, explain much of the black vs. white differences in skeletal calcium accretion during puberty. The relative importance of calcium and sodium in calcium metabolism has not yet been elucidated among Asians. Predictors of aBMD have been reported for African American and American white adults and predictors of aBMD in Chinese American women have recently been studied. Much remains to be studied regarding interactions between race and diet.

Background: It is estimated that over 200 million people worldwide have osteoporosis. The prevalence of osteoporosis is continuing to escalate with the increasingly aging population. The major complication of osteoporosis is an increase in fragility fractures leading to morbidity, mortality, and decreased quality of life. This investigation profiled the incidence and risk of osteoporosis in adult women firm a rural setting using ultrasonic boyle storming technology. Methods: Between 2001 and 2005, adult female subjects (n = 323) ill the age range of 40-87 were drawn front all independent, community dwelling, convenience sample. Bone mineral density T-scores were evaluated using heel ultrasonometry. Demographic and risk factor data. Merck Osteoporosis Evaluation SCORE questionnaire data, and the Osteoporosis Risk Assessment questionnaire data were analyzed. Results: Results of these scans indicate that 25% of the total population had a T-score [less than or equal to] a 1.5-implying a 1.5-to 2.0-fold increase it risk ratio of hip or spinal fracture for each standard deviational decrease. Age at menopause and weight had a positive correlation with T-scores. While the overall scores on the Merck SCORE questionnaire were inversely correlated to T-scores, no significant correlation was found between the Osteoporosis Risk Assessment questionnaire and T-score data. Additionally, women who had taken estrogen had significantly higher T-scores (p = 0.038) than those who had not. Conclusion: That approximately 25% of this sample has low bone mass or osteoporosis underscores the importance of early screening ill order to develop preventative awareness and provide education on bone health management. This finding has particularly important ramifications, since the sample was rural women, who typically have limited access to diagnostic bone density procedures. KEYWORDS. Osteoporosis. bone mineral density, ultrasound, calcaneus. T-score, rural women

This article highlights a silent disease that threatens the health and vitality of older men. Among elderly men and women, osteoporosis is among one of the leading causes of morbidity and mortality in the United States. Once perceived as only a female dominated disease, osteoporosis is now known to be gender blind. The following discussion will review the epidemiology and pathology of osteoporosis, and identify the concerns raised for men, including neglect. Special management considerations for older men and recommendations for future research into this overlooked major health problem will be explored. Better understanding of how osteoporosis affects older men may help to encourage prevention strategies earlier in life, appropriate screening and monitoring, as well as more effective treatment later in life. doi: 10.1300/J084v19n01_05 KEYWORDS. Osteoporosis, bone density, fragility fractures, male gender, risk indicators, screening prevention

Byline: N. Dursun (1,3), S. AkA+-n (2), E. Dursun (1), I. Sade (1), F. Korkusuz (2) Keywords: Breast-feeding; Osteoporosis; Risk factors Abstract: Introduction Despite numerous studies on risk factors for osteoporosis the effect of breast-feeding on bone mineral density (BMD) is unclear. In this study our aim was to determine the influence of total duration of breast-feeding on BMD, and subsequent risk of osteoporosis. Methods A total of 1,486 postmenopausal women over the age of 40 were included in the study. Women with diseases or who were under drug treatments known to affect bone metabolism were excluded. The BMD of the lumbar spine and femoral neck were measured by dual-energy X-ray absorptiometry technique, using either the Norland XA-26 or Lunar DPX-IQ densitometers and were transferred to standard values. Patients were placed in groups of five with respect to the duration of their breast-feeding as never, 1--12 months, 12--24 months, 24--60 months, &gt 60 months. Results One-way ANOVA test showed a significant difference between the lumbar spine and femoral neck BMD of these groups of women (p&lt 0.001, p&lt 0.001). Post hoc Bonferroni correction revealed that both the lumbar spine and femoral neck BMD results of women with longer duration of total breast-feeding were significantly lower than those of women with less duration of total breast-feeding. In subsequent analysis other potential risk factors were also considered in a multiple linear stepwise regression model. Years since menopause (p&lt 0.001), weight (p&lt 0.001), total duration of breast-feeding (p&lt 0.001), and body mass index (p=0.001) were found to be the most important predictors for lumbar spine BMD and age (p&lt 0.001), weight (p&lt 0.001), years since menopause (p&lt 0.001), and total duration of breast-feeding (p&lt 0.001) for femoral neck BMD. Conclusions This study showed significant associations between total duration of breast-feeding and BMD. In conclusion, total duration of breast-feeding might be an important risk factor besides age, weight, and years since menopause in postmenopausal osteoporosis. Author Affiliation: (1) Department of Physical Medicine and Rehabilitation, Kocaeli University Faculty of Medicine, Kocaeli, Turkey (2) Medical Center, Middle East Technical University, Ankara, Turkey (3) dummy, 55 Ada, Manolya 1/6, Daire:2, 81120, AtaAehir, Istanbul, Turkey Article History: Registration Date: 13/10/2005 Received Date: 17/11/2004 Accepted Date: 12/10/2005 Online Date: 01/03/2006

A study conducted to find out the relation between circulating homocysteine and the risk of incident osteoporotic fracture is presented. According to the results, increased homocysteine level appears to be a strong and independent risk factor for osteoporotic fractures in older men and women.

Byline: W. S. S. Chee (1), A. R. Suriah (2), S. P. Chan (3), Y. Zaitun (4), Y. M. Chan (4) Keywords: Bone mineral density; Calcium; Milk supplementation; Parathyroid hormone; Postmenopausal Malaysian women; Serum 25-hydroxy vitamin D Abstract: Dietary studies often report low calcium intake amongst post-menopausal Malaysian women and calcium deficiency has been implicated as part of the etiology of age-related bone loss leading to osteoporosis. Therefore, the objective of this study was to examine the effectiveness of high calcium skimmed milk (Anlene Gold[TM], New Zealand Milk, Wellington, New Zealand) to reduce bone loss in Chinese postmenopausal women. Two hundred subjects aged 55--65 years and who were more than 5 years postmenopausal were randomized to a milk group and control group. The milk group consumed 50 g of high calcium skimmed milk powder daily, which contained 1200 mg calcium (taken as two glasses of milk a day). The control group continued with their usual diet. Using repeated measures ANCOVA, the milk supplement was found to significantly reduce the percentage of bone loss at the total body compared to the control group at 24 months (control -1.04%, milk -0.13% P&lt 0.001). At the lumbar spine, the percentage of bone loss in the control group was significantly higher (-0.90%) when compared to the milk (-0.13%) supplemented group at 24 months (P&lt 0.05). Similarly, milk supplementation reduced the percentage of bone loss at the femoral neck (control -1.21%, milk 0.51%) (P&lt 0.01) and total hip (control -2.17%, milk -0.50%) (P&lt 0.01). The supplemented group did not experience any significant weight gain over the 24 months. The serum 25-hydroxy vitamin D level improved significantly (P&lt 0.01) from 69.1+-16.1 nmol/l at baseline to 86.4+-22.0 nmol/l at 24 months in the milk group. In conclusion, ingestion of high calcium skimmed milk was effective in reducing the rate of bone loss at clinically important lumbar spine and hip sites in postmenopausal Chinese women in Malaysia. Supplementing with milk had additional benefits of improving the serum 25-hydroxy vitamin D status of the subjects. Author Affiliation: (1) Department of Nutrition &amp Dietetics, Faculty of Allied Health Sciences, National University of Malaysia, Jalan Raja Muda Abdul Aziz, 50300, Kuala Lumpur, Malaysia (2) Program of Food Science, School of Chemical Science and Food Technology, Faculty of Science and Technology, National University of Malaysia, 40300, Bangi, Malaysia (3) Department of Medicine, Faculty of Medicine, University of Malaysia, Kuala Lumpur, Malaysia (4) Department of Nutrition and Health Science, Faculty of Medicine and Health Sciences, Putra University Malaysia, Serdang, Malaysia Article History: Received Date: 06/01/2003 Accepted Date: 05/06/2003 Online Date: 12/08/2003

Byline: H. Libouban (1), M. F. Moreau (1), E. Legrand (2), M. Audran (2), M. F. BasleA' (1), D. Chappard (1) Keywords: Key words:Bone histomorphometry -- DXA -- Fractal geometry -- Male osteoporosis -- Orchidectomy Abstract: We have compared different methods for measuring bone loss in the orchidectomized (ORX) rat model of male osteoporosis: densitometry (DXA), ash weight, anatomic bone indices, histomorphometry and two-dimensional trabecular architecture analysis. Forty-eight male Wistar rats were studied at 2, 4, 8 and 16 weeks (four groups). In each group, 6 rats were ORX and 6 sham-operated were used as control. DXA was performed on the whole body, tibia and femur. Histomorphometry was performed on the secondary spongiosa of the tibia: trabecular bone volume (BV/TV) and trabecular characteristics (number, separation and thickness) were measured. Architecture analysis comprised strut identification, star volume of the marrow spaces and trabeculae, Euler-PoincareA' number (E) and Kolmogorov fractal dimension (D.sub.k). Bone mineral densities of the whole body, tibia and femur were reduced at 16 weeks in the ORX group. BV/TV was significantly decreased in the ORX group from the fourth week. Differences in the sensitivity of the architectural methods were found. There were no differences in trabecular thickness nor in trabecular star volume between ORX and controls even after 16 weeks. E became different at 8 weeks. Trabecular number, node count, star volume of the marrow spaces and trabecular separation became significantly different at 4 weeks D.sub.k was modified after 2 weeks (p&lt 0.05 at 2 weeks, p&lt 0.001 from 4 weeks). In the ORX model, D.sub.k appeared the most potent descriptor of trabecular bone disorganization by revealing the earliest changes at the network level. Author Affiliation: (1) LHEA-GEROM, Laboratoire d'Histologie-Embryologie, CHU &amp FaculteA' de MeA'decine, Angers, France, FR (2) Service de Rhumatologie-GEROM, CHU d'Angers, Angers, France, FR Article note: Received: 13 July 2001 / Accepted: 27 November 2001

Byline: O. Lofman (1), K. Berglund (2), L. Larsson (3), G. Toss (4) Keywords: Key words:Epidemiology -- Hip fractures -- Incidence -- Osteoporosis -- Sex -- Time trend Abstract: After several reports of increasing hip fracture incidence some studies have suggested a trend-break. In a previous study of hip fractures we forecast a 70% increase in the total number of fractures from 1985 up to year 2000. We therefore studied the incidence trend for the last 15 years and supply a new prognosis up to year 2010. We recorded all incident hip fractures treated in the county of Ostergotland, Sweden ([approximately equal to] 400000 inhabitants) 1982--96. A total of 11 517 hip fractures in men and women aged 50 years and above were included in the study after cross-validation between a computerized register of radiologic investigations and the hospital records. The projected number of fractures up to year 2010 was estimated by a Poisson regression model, considering both age and year of fracture in every single year 1982--96 for the respective fracture type and gender, and applied to the projected population. The annual number of hip fractures increased by 39% in men and 25% in women during the study period. Amongst men, the age-adjusted incidence of cervical fractures increased from 188 to 220/100000 and of trochanteric fractures from 138 to 170/100000. In women the incidence of cervical fractures decreased from 462/100000 to 418/100000 and of trochanteric fractures from 407/100000 to 361/100000. Cervical/trochanteric fracture incidence rate ratio leveled off, and also the female/male fracture rate ratio declined. A prognosis assuming that the incidence development will continue as during 1982--96, and a population in agreement with the forecast, predicts that the total age- and sex-adjusted number of hip fractures will decrease by 11% up to year 2010 compared with 1996. In women and men, however, a decrease of 19% and an increase of 7% respectively were projected. If the age- and sex-specific incidence remains at the same level as at the end of the study period, no significant change in the total numbers will occur. A trend-break was thus found in hip fracture incidence for women but not for men. Whether this is due to therapeutic and/or preventive measures in women is unknown. According to the most probable scenario a substantial increase in male trochanteric fractures (36%) is expected up to 2010, while all other hip fractures in both genders will decrease by 4--32% resulting in a total reduction of 11%. Author Affiliation: (1) Center for Public Health Sciences, Linkoping, Department of Health and Environment, SE (2) Department of Community Medicine, County Council of Uppsala, Uppsala, SE (3) Department of Biomedicine and Surgery, Division of Clinical Chemistry, Linkoping , SE (4) Osteoporosis Unit, Department of Medicine and Care, Division of Internal Medicine, University Hospital of Linkoping, Sweden, SE Article note: Received: 17 November 2000 / Accepted: 2 July 2001

Background. Osteoporosis risk in middle-aged women is twofold greater than that in men, and the difference increases with age. Gender differences in bone mineral density, estimated rates of bone loss, and usefulness of markers of bone metabolism for predicting bone density have not been well described in healthy elders aged 65 and above. The purpose of this cross-sectional analysis was to describe associations of bone mineral density at the hip, spine, and whole body with age, serum osteocalcin, and urinary N-telopeptide crosslinks of Type I collagen in healthy elderly men and women. Methods. A total of 1,087 healthy adults (273 men and 814 women) aged 65 to 87 years were enrolled in a collaborative study at 3 sites: Tufts University (Boston, MA), University of Connecticut Health Center (Farmington, CT), and Creighton University (Omaha, NE). Bone mineral density (BMD) at three regions of the hip, the lumbar spine, and whole body was determined by dual-energy x-ray absorptiometry. Serum osteocalcin was measured by immunoassay, and measurement of N-telopeptide crosslinks (Ntx) in urine was made using an enzyme-linked radioimmunoassay (ELISA). Results. Among women, the age-related decline in BMD at all non-spine skeletal sites was significantly different from zero, with the largest decline seen at the femoral neck (-.0038 g/[cm.sup.2]/y, p < .001) and the smallest at the trochanter of the hip (-.0023 g/[cm.sup.2]/y, p = .03). Among men, the changes at all non-spine sites were not significant. In both sexes, spine BMD tended to increase with age (men, + .0045 g/[cm.sup.2]/y, women, + .0003 g/[cm.sup.2]/y). Serum osteocalcin and urinary Ntx were inversely related to BMD at all skeletal sites, but the weakest associations were observed at the spine. Individuals whose values of both osteocalcin and Ntx were in the lowest quartiles of the respective sex-specific distributions had mean femoral neck BMD that were 11% higher than individuals with marker values in the highest quartiles. Conclusions. These findings suggest that age-related decreases in BMD may vary by gender and skeletal site. Determinations of osteocalcin and N-telopeptide crosslinks at a single point in time may potentially be used as indicators of current bone status, particularly at non-spine skeletal sites.

Osteoporosis, which is the loss of mineral density in the bone, contributes greatly to the risk of bone fractures in later life. Postmenopausal women are at high risk for osteoporosis. However, there are significant racial differences in this risk. Black people of either sex generally have greater bone mass than white people, and black women, therefore, are at a correspondingly lower risk for osteoporosis. There are other racial differences as well; Polynesians generally have higher bone mass than whites, while Asians generally have lower bone mass. Although there have been some published reports suggesting that black children have higher bone mineral density than white children, there is little data indicating whether there are racial differences in the maturation process. To learn more about the development of the skeleton and bone mineral density in girls, bone density was measured in 75 black girls and 75 white girls. Both groups ranged in age from 2 to 20 years, and were matched for age and stage of sexual development. In the present study, no differences in bone density were found between black and white girls prior to puberty. In both groups, the bone mineral density increased during puberty, but the increase was greater for black girls. During adolescence, the bone mineral density increased 34 percent among the black girls and 11 percent among the white girls; this difference in adolescent growth suggests that the metabolic and maturational changes which occur during puberty contribute greatly to the racial differences in bone mineral density that are observed later in life. (Consumer Summary produced by Reliance Medical Information, Inc.)

Black and white women in the United States differ with respect to bone mass and the risk of developing osteoporosis. It has been suggested that greater body size among U.S. blacks may contribute to greater bone density in this group. It is not known whether the fat or lean component contributes more to this relationship. Bone density was measured at seven sites in 161 normal black and white women using single and dual photon absorptiometry. The first principal component accounted for 73% of the variance in the sample and constitutes an index of skeletal mass. The second principal component added another 10% and contrasts the axial and appendicular sites. Both the regional bone densities and the first principal component showed significantly greater bone densities for blacks; adjustment for body size reduced bone mass differences by approximately 50%. Body composition analysis done on a subset of these women indicated that the fat component of body mass may be the more important factor in its effect on bone mass.

Comparison of age- and sex-specific incidence rates of fractures of the proximal femura nd the distal forearm showed significantly lower rates in Ibadan than in two urban centres in England, with risk ratio of up to 20. In the Ibadan data no evidence of higher rates in women or of a prominent age-associated increase in rates was observed.

The excavation of a Medieval cemetery gave us the opportunity to investigate 49 Danish skeletons comprising 29 males aged 29-80 years (mean 49.6 years) and 20 females aged 26-72 years (mean 41.0 years) dating from AD 1000 to 1250 in comparison with contemporary Danes and assess the millennial trend in bone mineral density (BMD) in populations considered genetically closely related. BMD of the femoral neck was measured by Dual-Energy X-ray Absorptiometry (DEXA) and compared with data from contemporary healthy Danish women (n=184) and men (n=114) aged 19-79 years. BMD was transformed into z-scores on the basis of BMD of the contemporary controls. BMD (z-score) was significantly reduced in Medieval women (-0.54 [+ or -] 0.25; p=0.04) while BMD (z-score) in Medieval men was significantly elevated (0.55 [+ or -] 0.22; p=0.02). In Medieval women, BMD (z-score) tended to increase with age (r=0.42; p=0.07) while no change was seen in men (r=0.19; n.s.). In conclusion, our data brings focus on different aspects of the development of osteoporosis. We observe that Medieval women had lower BMD in comparison with contemporary women but that this relationship was reversed in women who survived to older ages. In contrast, Medieval men had significantly higher BMD as compared to contemporary men at all ages, and the age-related bone loss was almost identical. A higher degree of physical activity in the Medieval time period is supposed to account for the higher BMD observed among the men. The observed lower BMD in Medieval women as compared to contemporary women can be explained by the well-known selective mortality among the younger women. A high birth rate and prolonged periods of lactation are the main reasons for the observed increased mortality and therefore very likely also for the associated low BMD.