Fructan-Enriched Diet Increases Bone Quality in Female Growing Rats at Calcium Deficiency

This study was designed to determine the effect of feeding female rats with low-calcium diet containing one of three fructan sources (Jerusalem artichoke, yacon, Beneo Orafti Synergy1), on selected bone parameters. Growing Wistar rats were fed modified AIN-93 G diet enriched in fructan sources (8%), added alone or as a strawberry sorbet ingredient. Two of eight groups were a validation model, where the positive control group was fed with recommended calcium dose in the diet (RCD), and negative one - with low calcium diet (LCD). After 12 weeks, femoral Ca content, bone densitometry, architecture and hardness were examined. The positive effects on femoral Ca content and cortical thickness, area and content in distal part of bone was observed after feeding animals diet enriched in Jerusalem artichoke sorbet. Beneficial action on other bone tomographic parameters (particularly trabecular volumetric bone mineral density) in this part of femur were associated mainly with the consumption of the diet with sorbet containing yacon. Our results showed an important role of diet containing frozen strawberry desserts enriched in fructan sources in the maintenance of healthy bones of growing organism. It may suggest possible synergisms between fructans and bioactive substances of strawberry.

Dairy product intake and bone properties in 70-year-old men and women

In the present population-based study including 70-year-old men and women, total dairy product intake was associated with a weak positive association with tibia trabecular and cortical cross-sectional areas.

PURPOSE

Milk consumption has recently been suggested to increase fracture risk. Therefore, we aimed to investigate associations between dairy product consumption and peripheral bone properties. Furthermore, we explored whether consumption of milk and fermented dairy products affected bone properties differently.

METHODS

The Healthy Aging Initiative is a population-based, cross-sectional study investigating the health of 70-year-old men and women. Out of the 2904 individuals who met the inclusion criteria, data on self-reported daily dairy product consumption (dl/day), peripheral quantitative computed tomography (pQCT) examinations at the 4 and 66% scan sites of the tibia and radius, and dual-energy X-ray absorptiometry (DXA) scans were collected from 2040 participants. Associations between dairy product consumption and bone properties were examined using multiple linear regression models adjusted for sex, muscle area, meal size, dietary protein proportion, current smoking status, and objectively measured physical activity.

RESULTS

Total dairy product intake was associated with larger trabecular (2.296 (95% CI, 0.552-4.039) mm², per dl/day increase, p = 0.01) and cortical cross-sectional areas (CSAs) in the tibia (1.757 (95% CI, 0.683-2.830 mm², p = 0.001) as measured by pQCT and higher areal bone mineral density (aBMD) of the radius (3.231 (95% CI, 0.764-5.698) mg/cm², p = 0.01) as measured by DXA. No other measurement in the tibia, radius, femoral neck, or lower spine was associated significantly with dairy product intake. Bone properties did not differ according to the type of dairy product consumed.

CONCLUSION

No evidence of a negative association between dairy product consumption and bone health was found. Furthermore, total dairy product consumption was associated with increased CSAs in the tibia, regardless of dairy product type. Collectively, our findings indicate the existence of a weak but significant positive association between dairy product consumption bone properties in older adults.

Dairy Intake Is Protective against Bone Loss in Older Vitamin D Supplement Users: The Framingham Study

Background: Previous studies showed beneficial effects of specific dairy foods on bone health in middle-aged adults.Objective: We examined the association of milk, yogurt, cheese, cream, fluid dairy (milk + yogurt), and milk + yogurt + cheese intakes with bone mineral density (BMD) and 4-y percentage of change in BMD [▵%BMD; femoral neck, trochanter, and lumbar spine (LS)]. We further assessed whether these associations were modified by vitamin D supplement use in this cohort of older adults.Methods: Food-frequency questionnaire responses, baseline BMD (hip and spine, n = 862 in 1988-1989), and follow-up BMD (n = 628 in 1992-1993) were measured in the Framingham study, a prospective cohort study of older Caucasian men and women aged 67-93 y. Outcomes included baseline BMD and ▵%BMD. Dairy-food intakes (servings per week) were converted to energy-adjusted residuals, and linear regression was used, adjusting for covariates. These associations were further examined by vitamin D supplement use.Results: The mean age of the participants was 75 y. In the full sample, dairy-food items were not associated with BMD (P = 0.11-0.99) or with ▵%BMD (P = 0.29-0.96). Among vitamin D supplement users, but not among nonusers, higher milk, fluid dairy, and milk + yogurt + cheese intakes were associated with higher LS BMD (P = 0.011-0.009). Among vitamin D supplement users, but not among nonusers, higher milk + yogurt + cheese intakes were protective against trochanter BMD loss (P = 0.009).Conclusions: In this population of older adults, higher intakes of milk, fluid dairy, and milk + yogurt + cheese were associated with higher LS BMD, and a higher intake of milk + yogurt + cheese was protective against trochanter BMD loss among vitamin D supplement users but not among nonusers. These findings underscore that the benefits of dairy intake on the skeleton may be dependent on vitamin D intake.

Japanese female Kendo practitioners are associated with high radial bone mineral density

Osteopenia is a condition in which bone mineral density (BMD) is lower than normal. Exercise increases BMD in both the young and adults. This study aimed to compare the radial apparent BMD (aBMD) in Japanese females who are Kendo practitioners (KPs) and those with no regular exercise habits (no-REH). The analysis participants consisted of 45 KPs (mean age: 49.4 years old) and 110 no-REH (mean age: 48.8 years old). Radial aBMD was measured using an ultrasonic bone densitometry system. Radial aBMD in KPs was 196.1 ± 33.9 mg/cm³, and was 182.9 ± 45.3 mg/cm³ in no-REH participants. KPs had significantly higher BMD than no-REH participants. In KPs, left radial aBMD was 196.1 ± 33.9 mg/cm³, and right radial aBMD was 184.5 ± 37.7 mg/cm³. The left radius was also significantly higher than the right radius with respect to aBMD in KPs. After adjusting for age, body mass index, menstrual status, parous women and frequency of milk and dairy intake, the odds ratio (OR) of osteopenia associated with no-REH was 6.58 (95% confidence interval (CI): 1.72-25.1) and the prevalence ratio (PR) of osteopenia associated with no-REH was 4.12 (95% CI: 1.23-13.7). Therefore, the Kendo practice may have a protective efficacy for osteopenia in women.

Mitigating Nutrition and Health Deficiencies in Older Adults: A Role for Food Innovation?

The aim of this review is to describe the factors contributing to diminished food intake, resulting in nutritional deficiencies and associated health conditions in older adults and proposes food innovation strategies to mitigate these. Research has provided convincing evidence of a link between healthy eating patterns and healthy aging. There is a need to target new food product development (NPD) with functional health benefits specifically designed to address the particular food-related needs of older consumers. When developing foods for older adults, consideration should be given to the increased requirements for specific macro- and micronutrients, especially protein, calcium, vitamin D, and vitamin B. Changes in chemosensory acuity, chewing difficulties, and reduced or poor swallowing ability should also be considered. To compensate for the diminished appetite and reduced intake, foods should be energy dense, nutritionally adequate, and, most importantly, palatable, when targeting this cohort. This paper describes the potential of new food product development to facilitate dietary modification and address health deficiencies in older adults.

Effects of vitamin D deficiency and daily calcium intake on bone mineral density and osteoporosis in Korean postmenopausal woman

OBJECTIVE

We evaluated the combined effects of vitamin D and daily calcium intake on bone mineral density (BMD) and osteoporosis in Korean postmenopausal women.

METHODS

This study is a cross-sectional study consisting of 1,921 Korean postmenopausal women aged 45 to 70 years without thyroid dysfunction, from the 2008-2011 Korean National Health and Nutrition Examination Survey. Participants were classified into six groups according to serum 25-hydroxyvitamin D (25(OH)D) levels and daily calcium intake. BMD was measured using dual-energy X-ray absorptiometry at femur and at lumbar spine, and the serum vitamin D levels were measured by radioimmunoassay.

RESULTS

The BMD divided according to serum 25(OH)D and daily calcium intakes were not statistically different among the groups. However, when both daily calcium intake and serum 25(OH)D were not sufficient, risk of osteopenia and osteoporosis showed significant increase in both femur neck and lumbar spine (odds ratio [OR] 2.242, P=0.006; OR 3.044, P=0.001; respectively). Although daily calcium intake was sufficient, risks of osteopenia and osteoporosis significantly increased in lumbar spine group if serum 25(OH)D is <20 ng/mL (OR 2.993, P=0.006).

CONCLUSION

The combined effects of insufficient daily calcium intake and vitamin D deficiency may cause low BMD and increase in prevalence of osteopenia and osteoporosis in Korean postmenopausal women aged 45 to 70 years.

Association between dietary patterns and low bone mineral density among adults aged 50 years and above: findings from the North West Adelaide Health Study (NWAHS)

Studies on the association between dietary patterns and bone mineral density (BMD) have reported inconsistent findings. Data from the North West Adelaide Health Study, a population-based cohort study undertaken in Australia, were used to assess this association among adults aged 50 years and above. In this specific study, 1182 adults (545 males, 45·9 %) had dietary data collected using a FFQ and also had BMD measurements taken using dual-energy X-ray absorptiometry. Factor analysis with principal component method was applied to ascertain dietary patterns. Two distinct dietary patterns were identified. Pattern 1 ('prudent pattern') was characterised by high intake of fruits, vegetables, sugar, nut-based milk, fish, legumes and high-fibre bread. In contrast, pattern 2 ('Western pattern') was characterised by high levels of processed and red meat, snacks, takeaway foods, jam, beer, soft drinks, white bread, poultry, potato with fat, high-fat dairy products and eggs. Compared with the study participants in the first tertile (T1, lowest consumption) of the prudent pattern, participants in the third tertile (T3) had a lower prevalence of low BMD (prevalence ratio (PR)=0·52; 95 % CI 0·33, 0·83) after adjusting for socio-demographic, lifestyle and behavioural characteristics, chronic conditions and energy intake. Participants in T3 of the Western pattern had a higher prevalence of low BMD (PR=1·68; 95 % CI 1·02, 2·77) compared with those in T1. In contrast to the Western diet, a dietary pattern characterised by high intake of fruits, vegetables and dairy products is positively associated with BMD.

Eggshell fractions containing different particle sized affect mineral absorption but not bone mineral retention in growing rats

The purpose of this study was to compare the calcium (Ca) bioavailability from eggshell fractions containing different particle size to purified CaCO₃ in male growing rats. Mineral absorption, bone mineral concentration, and biomechanical properties were evaluated. Mean Ca absorption of rats fed with eggshell diets amounted to 56.2% of the ingested Ca, which is considered high. However, we observed lower Ca absorption in large-sized particle eggshell fraction (ES L) and small-sized particle eggshell fraction groups but similar Ca absorption in intermediate-sized particle eggshell fraction (ES M) compared with the CaCO₃ group. Rats that received ES M and ES L had higher P and Mg absorption than the CaCO₃ group. No changes were observed in the bone mineral deposition, weight or mechanical resistance. We conclude that eggshell Ca is well absorbed by the intestine and retained in bones of growing rats, being a low cost alternative to achieve adequate Ca ingestion.

Is bone equally responsive to calcium and vitamin D intake from food vs. supplements? Use of (41)calcium tracer kinetic model

Background

Few interventions directly compare equivalent calcium and vitamin D from dairy vs. supplements on the same bone outcomes. The radioisotope calcium-41 (⁴¹Ca) holds promise as a tracer method to directly measure changes in bone resorption with differing dietary interventions.

Objective

Using ⁴¹Ca tracer methodology, determine if 4 servings/day of dairy foods results in greater ⁴¹Ca retention than an equivalent amount of calcium and vitamin D from supplements. Secondary objective was to evaluate the time course for the change in ⁴¹Ca retention.

Methods

In this crossover trial, postmenopausal women (n = 12) were dosed orally with 100 nCi of ⁴¹Ca and after a 180 day equilibration period received dairy (4 servings/day of milk or yogurt; ~ 1300 mg calcium, 400 IU cholecalciferol (vitamin D₃/day)) or supplement treatments (1200 mg calcium carbonate/day and 400 IU vitamin D₃/day) in random order. Treatments lasted 6 weeks separated by a 6 week washout (WO). Calcium was extracted from weekly 24 h urine collections; accelerator mass spectrometry (AMS) was used to determine the ^41/40Ca ratio. Primary outcome was change in ^41/40Ca excretion. Secondary outcome was the time course for change in ⁴¹Ca excretion during intervention and WO periods.

Results

The ^41/40Ca ratio decreased significantly over time during both treatments; there was no difference between treatments. Both treatments demonstrated a significant retention of ⁴¹Ca within 1–2 weeks (p = 0.0007 and p < 0.001 for dairy and supplements, respectively). WO demonstrated a significant decrease (p = 0.0024) in ⁴¹Ca retention within 1–2 weeks, back to pre-intervention levels.

Conclusion

These data demonstrate that urinary ⁴¹Ca retention is increased with an increase in calcium and vitamin D intake regardless of the source of calcium, and the increased retention occurs within 1–2 weeks.

•

Investigated, using ⁴¹Ca tracer, whether bone response to calcium and vitamin D differed based on the source of nutrients, foods vs. supplements.

•

There was no difference in the bone response by treatment group.

•

Both dairy foods and supplements resulted in reduce ⁴¹Ca excretion in urine.

•

Reduction in ⁴¹Ca excretion occurred with 2 weeks of initiating the interventions.

•

Removal of interventions resulted in 41Ca excretion returning to pre-intervention levels

Factors associated with (risk of) undernutrition in community-dwelling older adults receiving home care: a cross-sectional study in the Netherlands

Objective

It is generally thought that causes of undernutrition are multifactorial, but there are limited quantitative studies performed. We therefore examined a wide range of potential factors associated with undernutrition in community-dwelling older adults.

Design

Cross-sectional study.

Setting

Community-dwelling older adults (≥65 years) receiving home care in the Netherlands.

Subjects

Data on potential factors associated with (risk of) undernutrition were collected among 300 older adults. Nutritional status was assessed by the SNAQ65+ instrument. Undernutrition was defined as mid-upper arm circumference <25 cm or unintentional weight loss of ≥4 kg in 6 months. Being at risk of undernutrition was defined as having poor appetite and inability to walk up and down stairs of fifteen steps, without resting.

Results

Of all participants, ninety-two (31·7 %) were undernourished and twenty-four (8·0 %) were at risk of undernutrition. Based on multivariate logistic regression analyses, the statistically significant factors associated with (risk of) undernutrition (P<0·05) were: unable to go outside (OR=5·39), intestinal problems (OR=2·88), smoking (OR=2·56), osteoporosis (OR=2·46), eating fewer than three snacks daily (OR=2·61), dependency in activities of daily living (OR=1·21), physical inactivity (OR=2·01), nausea (OR=2·50) and cancer (OR=2·84); a borderline significant factor was depression symptoms (OR=1·83, P=0·053).

Conclusions

The study suggests that (risk of) undernutrition is a multifactorial problem and that associated factors can be found in several domains. These findings may support the development of intervention trials for the prevention and treatment of undernutrition in community-dwelling older adults.

Hake fish bone as a calcium source for efficient bone mineralization

Calcium is recognized as an essential nutritional factor for bone health. An adequate intake is important to achieve or maintain optimal bone mass in particular during growth and old age. The aim of the present study was to evaluate the efficiency of hake fish bone (HBF) as a calcium source for bone mineralization: in vitro on osteosarcoma SaOS-2 cells, cultured in Ca-free osteogenic medium (OM) and in vivo on young growing rats fed a low-calcium diet. Lithotame (L), a Ca supplement derived from Lithothamnium calcareum, was used as control. In vitro experiments showed that HBF supplementation provided bone mineralization similar to standard OM, whereas L supplementation showed lower activity. In vivo low-Ca HBF-added and L-added diet similarly affected bone deposition. Physico-chemical parameters concerning bone mineralization, such as femur breaking force, tibia density and calcium/phosphorus mineral content, had beneficial effects from both Ca supplementations, in the absence of any evident adverse effect. We conclude HBF derived from by-product from the fish industry is a good calcium supplier with comparable efficacy to L.

Peer-led nutrition education programs for school-aged youth: a systematic review of the literature

To date, the impacts of school-based, peer-led nutrition education initiatives have not been summarized or assessed collectively. This review presents the current evidence, identifies knowledge gaps, and provides recommendations for future research. PubMed, Scopus, ERIC and Google Scholar were searched for refereed Canadian and American primary studies published between January 2000 and November 2013, following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Seventeen articles (11 programs) from Canada (24%) and the United States (76%) were identified. The results were summarized in terms of the study population, program design and main outcomes. Common outcome measures included healthy eating knowledge (n = 5), self-efficacy or attitudes towards healthy eating (n = 13), dietary measures (n = 9) and body mass index (n = 4), all of which tended to improve as a result of the programs. More research is needed to ascertain the effect of improvements in knowledge, self-efficacy and attitudes towards healthy eating on food behaviors. When evaluated, programs were generally well received, while the long-term maintenance of positive impacts was a challenge. Studies of sustainability and feasibility to promote long-term impact are a logical next step.

Short communication: Selecting the most informative mid-infrared spectra wavenumbers to improve the accuracy of prediction models for detailed milk protein content

The objective of this study was to investigate the ability of mid-infrared spectroscopy (MIRS) to predict protein fraction contents of bovine milk samples by applying uninformative variable elimination (UVE) procedure to select the most informative wavenumber variables before partial least squares (PLS) analysis. Reference values (n=114) of protein fractions were measured using reversed-phase HPLC and spectra were acquired through MilkoScan FT6000 (Foss Electric A/S, Hillerød, Denmark). Prediction models were built using the full data set and tested with a leave-one-out cross-validation. Compared with MIRS models developed using standard PLS, the UVE procedure reduced the number of wavenumber variables to be analyzed through PLS regression and improved the accuracy of prediction by 6.0 to 66.7%. Good predictions were obtained for total protein, total casein (CN), and α-CN, which included αS1- and αS2-CN; moderately accurate predictions were observed for κ-CN and total whey protein; and unsatisfactory results were obtained for β-CN, α-lactalbumin, and β-lactoglobulin. Results indicated that UVE combined with PLS is a valid approach to enhance the accuracy of MIRS prediction models for milk protein fractions.

Effects of Dairy Products Consumption on Health: Benefits and Beliefs--A Commentary from the Belgian Bone Club and the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases

Dairy products provide a package of essential nutrients that is difficult to obtain in low-dairy or dairy-free diets, and for many people it is not possible to achieve recommended daily calcium intakes with a dairy-free diet. Despite the established benefits for bone health, some people avoid dairy in their diet due to beliefs that dairy may be detrimental to health, especially in those with weight management issues, lactose intolerance, osteoarthritis, rheumatoid arthritis, or trying to avoid cardiovascular disease. This review provides information for health professionals to enable them to help their patients make informed decisions about consuming dairy products as part of a balanced diet. There may be a weak association between dairy consumption and a possible small weight reduction, with decreases in fat mass and waist circumference and increases in lean body mass. Lactose intolerant individuals may not need to completely eliminate dairy products from their diet, as both yogurt and hard cheese are well tolerated. Among people with arthritis, there is no evidence for a benefit to avoid dairy consumption. Dairy products do not increase the risk of cardiovascular disease, particularly if low fat. Intake of up to three servings of dairy products per day appears to be safe and may confer a favourable benefit with regard to bone health.

Dietary cation-anion difference and day length have an effect on milk calcium content and bone accretion of dairy cows

Milk and dairy products are an important source of Ca for humans. Recent studies have shown fluctuations in cow milk Ca content during the year in France, with high values in winter and with corn silage diets, and a decrease during May and June and with grass diets. The aim of this study was to identify the reasons for this seasonal decrease in milk Ca content by testing the effect of 2 levels of dietary cation-anion differences (DCAD; 0 mEq/kg of dry matter for DCAD 0 and 400 mEq/kg for DCAD 400) and 2 day lengths (8 h of light/d for short days: SD; and 16 h/d for long days: LD) on the Ca balances of dairy cows. The DCAD treatments were designed to mimic diets based either on corn silage or on herbage. The cows were only illuminated by solarium lights providing UVA and UVB. The trial was conducted according to 2 simultaneous replicates of a 4×4 Latin square design using 8 dairy cows averaging 103±44 d in milk with 4 periods of 14 d. Data were analyzed by ANOVA with a model including treatment, cow, and period effects. No significant interaction was found between day length and DCAD treatments. With DCAD 400 compared with DCAD 0, blood pH increased and plasma ionized Ca content decreased, whereas the plasma total Ca content did not differ between treatments. Milk Ca content, however, increased with DCAD 400 compared with DCAD 0, in relation to a decrease in the amount of Ca excreted in urine. The DCAD had no significant effect on protein and casein contents and DCAD 400 tended to decrease milk yield. This illustrates that the udder did not decrease Ca uptake from the blood at high DCAD even though DCAD 400 decreased the mammary availability of Ca by decreasing the proportion of blood ionized Ca. Milk Ca and casein contents were significantly lower with LD compared with SD, whereas day length had no effect on milk yield after 14 d of treatment. Bone accretion of cows increased when the Ca content of milk increased (i.e., with DCAD 400 compared with DCAD 0 and with SD compared with LD). This work suggests that long and sunny days could explain part of the seasonal decrease in milk Ca content in summer and refutes the hypothesis that low milk Ca contents at grazing could be due to the high DCAD of herbage.

Nutrition and bone health in women after the menopause

Osteoporosis affects one out of three postmenopausal women. Their remaining lifetime risk of fragility fractures exceeds that of breast cancer. The risk of osteoporosis and/or fragility fractures can be reduced through healthy lifestyle changes. These include adequate dietary intakes of calcium, vitamin D and protein, regular weight-bearing exercise, reduction in alcohol intake and smoking cessation. European guidance for the diagnosis and management of osteoporosis in postmenopausal women recommends a daily intake of at least 1000 mg/day for calcium, 800 IU/day for vitamin D and 1 g/kg body weight of protein for all women aged over 50 years. The development of programs that encourage lifestyle changes (in particular balanced nutrient intakes) are therefore essential for the reduction of osteoporosis risk.

Dairy Products and Health: Recent Insights

Milk, cheese, yogurt, and other dairy products have long been known to provide good nutrition. Major healthful contributors to the diets of many people include the protein, minerals, vitamins, and fatty acids present in milk. Recent studies have shown that consumption of dairy products appears to be beneficial in muscle building, lowering blood pressure and low-density lipoprotein cholesterol, and preventing tooth decay, diabetes, cancer, and obesity. Additional benefits might be provided by organic milk and by probiotic microorganisms using milk products as a vehicle. New research on dairy products and nutrition will improve our understanding of the connections between these products, the bioactive compounds in them, and their effects on the human body.

The influence of dairy consumption, sedentary behaviour and physical activity on bone mass in Flemish children: a cross-sectional study

Background

This cross-sectional study aimed to look for an association in young children between whole body bone mineral content (BMC) and areal bone mineral density (aBMD) and dairy consumption as well as sedentary behaviour (SB) and physical activity (PA). Moreover, we investigated whether there was an interaction effect between dairy consumption and SB or PA on BMC and aBMD.

Methods

Healthy children (6-12 years) were recruited from primary schools. Body composition and whole body bone mass were measured with dual-energy X-ray absorptiometry (DXA), dairy consumption was assessed with a food frequency questionnaire (FFQ) and PA and SB with an accelerometer. In total, 272 children underwent a DXA scan. Complete FFQ data were available for 264 children and 210 children had matching data from accelerometry recordings. Regression analyses were used to study the associations between (1) BMC and aBMD and (2) dairy consumption, SB and PA, adjusting for age, gender, pubertal stage, height and body composition.

Results

Dairy consumption was positively associated with whole body BMC and aBMD (absolute value as well as z-score), after correction for relevant confounders. SB was negatively associated with aBMD z-score and light PA was positively associated with both BMC and aBMD z-score. No gender differences were found. Moreover, an interaction effect between vigorous PA (VPA) and dairy consumption on aBMD (z-score) and BMC z-score was found, indicating that children with both high VPA and high dairy consumption had higher values for BMC and aBMD of the whole body minus the head.

Conclusion

Already at young age, PA and dairy consumption positively influence whole body bone mass assessed by DXA. Moreover, this study indicates clearly that SB is negatively associated with whole body bone density. Promoting regular PA and sufficient dairy consumption in young children and limiting SB can be expected to positively influence their bone mass accumulation, which can help in the prevention of osteoporosis later in life.

Metabolomics to Explore Impact of Dairy Intake

Dairy products are an important component in the Western diet and represent a valuable source of nutrients for humans. However, a reliable dairy intake assessment in nutrition research is crucial to correctly elucidate the link between dairy intake and human health. Metabolomics is considered a potential tool for assessment of dietary intake instead of traditional methods, such as food frequency questionnaires, food records, and 24-h recalls. Metabolomics has been successfully applied to discriminate between consumption of different dairy products under different experimental conditions. Moreover, potential metabolites related to dairy intake were identified, although these metabolites need to be further validated in other intervention studies before they can be used as valid biomarkers of dairy consumption. Therefore, this review provides an overview of metabolomics for assessment of dairy intake in order to better clarify the role of dairy products in human nutrition and health.

Adolescence physical activity is associated with higher tibial pQCT bone values in adulthood after 28-years of follow-up--the Cardiovascular Risk in Young Finns Study

High peak bone mass and strong bone phenotype are known to be partly explained by physical activity during growth but there are few prospective studies on this topic. In this 28-year follow-up of Cardiovascular Risk in Young Finns Study cohort, we assessed whether habitual childhood and adolescence physical activity or inactivity at the age of 3-18 years were associated with adult phenotype of weight-bearing tibia and the risk of low-energy fractures. Baseline physical activity and data on clinical, nutritional and lifestyle factors were assessed separately for females and males aged 3-6-years (N=395-421) and 9-18-years (N=923-965). At the age of 31-46-years, the prevalence of low-energy fractures was assessed with a questionnaire and several tibial traits were measured with pQCT (bone mineral content (BMC; mg), total and cortical cross-sectional areas (mm(2)), trabecular (for the distal site only) and cortical (for the shaft only) bone densities (mg/cm(3)), stress-strain index (SSI; mm(3), for the shaft only), bone strength index (BSI; mg(2)/cm(4), for the distal site only) and the cortical strength index (CSI, for the shaft only)). For the statistical analysis, each bone trait was categorized as below the cohort median or the median and above and the adjusted odds ratios (OR) were determined. In females, frequent physical activity at the age of 9-18-years was associated with higher adulthood values of BSI, total and cortical areas, BMC, CSI and SSI at the tibia independently of many health and lifestyle factors (ORs 0.33-0.53, P≤0.05; P-values for trend 0.002-0.05). Cortical density at the tibial shaft showed the opposite trend (P-value for trend 0.03). Similarly in males, frequent physical activity was associated with higher values of adult total and cortical areas and CSI at the tibia (ORs 0.48-0.53, P≤0.05; P-values for trend 0.01-0.02). However, there was no evidence that childhood or adolescence physical activity was associated with lower risk of low energy fractures during the follow-up. In conclusion, frequent habitual physical activity in adolescence seems to confer benefits on tibial bone size and geometry in adulthood.

Impact of the removal of chocolate milk from school milk programs for children in Saskatoon, Canada

Studies in the United States report inclusion of flavoured milk in the diets of children and youth improves nutrient intakes. No research has investigated the contribution of flavoured milk to overall milk intake or the milk preferences of Canadian children. The objective of the study was to measure milk consumption (plain milk and flavoured milk) by children in an elementary school environment and investigate factors contributing to milk choice. A mixed-method research design was applied across 6 schools for 12 weeks. Milk waste was measured in grades 1–8 for 12 weeks. Weeks 1–4 (phase 1) and 9–12 (phase 3) provided both plain milk and flavoured milk as chocolate milk while weeks 5–8 (phase 2) provided plain milk only. Beverage Frequency Questionnaires were used in each phase (in grades 5–8 only) to assess usual beverage consumption. Statistical nutrient modelling was conducted to determine the effects of removing chocolate milk during phase 2 as a milk choice. Later, focus groups were conducted with students in grades 5–8 to determine what influences them to choose/not choose to drink milk. Total milk intake decreased by 12.3% when chocolate milk was removed from the schools (26.6% ± 5.2% to 14.31% ± 1.6%, p < 0.001). Milk choice was influenced by environmental factors as well as taste, cost, convenience, and variety. Total milk intake was associated with location (p = 0.035) and cost (p < 0.001), with rural students and/or those students receiving free milk drinking the greatest amount of milk. Nutrient modelling revealed chocolate milk is more cost-efficient and convenient at providing nutrients than alternative food/drink combinations.

The influence of dairy consumption and physical activity on ultrasound bone measurements in Flemish children

The study's aim was to analyse whether children's bone status, assessed by calcaneal ultrasound measurements, is influenced by dairy consumption and objectively measured physical activity (PA). Moreover, the interaction between dairy consumption and PA on bone mass was studied. Participants of this cross-sectional study were 306 Flemish children (6-12 years). Body composition was measured with air displacement plethysmography (BodPod), dairy consumption with a Food Frequency Questionnaire, PA with an accelerometer (only in 234 of the 306 children) and bone mass with quantitative ultrasound, quantifying speed of sound (SOS), broadband ultrasound attenuation (BUA) and Stiffness Index (SI). Regression analyses were used to study the associations between dairy consumption, PA, SOS, BUA and SI. Total dairy consumption and non-cheese dairy consumption were positively associated with SOS and SI, but no significant association could be demonstrated with BUA. In contrast, milk consumption, disregarding other dairy products, had no significant effect on calcaneal bone measurements. PA [vigorous PA, moderate to vigorous physical activity (MVPA) and counts per minute] was positively associated and sedentary time was negatively associated with BUA and SI, but no significant influence on SOS could be detected. Dairy consumption and PA (sedentary time and MVPA) did not show any interaction influencing bone measurements. In conclusion, even at young age, PA and dairy consumption positively influence bone mass. Promoting PA and dairy consumption in young children may, therefore, maximize peak bone mass, an important protective factor against osteoporosis later in life.

Nutritional aspects of bone health

Bone mass, geometry and microstructure, and bony tissue material level properties determine bone strength, hence the resistance to fracture. At a given age, all these variables are the consequence of the amount accumulated and of the structure developed during growth, up to the so-called peak bone mass, and of the bone loss and microstructure degradation occurring later in life. Genetic factors primarily contribute to the variance of the determinants of bone strength. Nutritional intakes are environmental factors that influence both processes, either directly by modifying modelling and remodelling, or indirectly through changes in calcitropic hormone secretion and action. Some effects of nutrition on the offspring bone could take place during foetal life. There are interplays between genetic factors, nutritional intakes and physical exercise. Among the nutrients, sufficient dietary intakes of calcium and protein are necessary for bone health in childhood and adolescence as well as later in life.

Parkinson's disease: no milk today?

Several prospective epidemiological studies on large cohorts have consistently reported an association between milk intake and a higher incidence of Parkinson’s disease (PD). Pesticide contamination of milk and milk’s urate-lowering effects have been put forward as risk factors to explain epidemiological data. This has led to considerable uncertainty among physicians and avoidance of dairy products by PD patients. However, neither factor stands up to the rational and detailed examination of the literature carried out in this mini-review. We suggest that changes in eating behavior related to pre-motor PD are an alternative potential explanation of correlations observed between milk intake and PD occurrence. Despite clear-cut associations between milk intake and PD incidence, there is no rational explanation for milk being a risk factor for PD. Based on current knowledge, limiting the consumption of dairy products does not seem to be a reasonable strategy in the prevention of the development and progression of PD.

The role of healthy diet in the prevention of osteoporosis in perimenopausal period

OBJECTIVE

The aim of the study was to assess the diet for its effect on normal bone mineralization and qualitative analysis of dietary supplements used in the prevention of osteoporosis.

METHODS

Research data were acquired based on a questionnaire developed by the author. A 24-hour diet recall method was used with the involvement of Dieta 5.0 software developed by the National Food and Nutrition Institute in Warsaw in Poland. The second part of the study involved an analysis of the most popular dietary supplements available over the counter. Complexometric titration was used to separate and identify calcium.

RESULTS

The results of a 24-hour diet recall indicate that 47% of the respondents consumed 550-750 mg of calcium daily, and only 21% of the subjects consumed more than 1200 mg of calcium every day. The results give cause for concern: none of the analyzed diets supplied the recommended daily amounts of vitamin D, and only 29% of the respondents admitted taking vitamin D supplements. The results of the survey indicate that consumers have insufficient knowledge about lifestyle diseases, including osteoporosis.

CONCLUSION

Diet of large part of society is not properly balanced which can cause abnormalities in achieving proper bone mineralization. Long-term deficiencies in calcium and vitamin D in daily diet are the cause for taking dietary supplements. Unfortunately, some preparations on the market do not have adequate storage. It happens that these preparations are poorly absorbed and the amount of active compound is too low. Changes in the nutritional regimen are required already during childhood because nutritional mistakes are the main cause of diet-related diseases in adulthood.

The role of dietary protein and vitamin D in maintaining musculoskeletal health in postmenopausal women: a consensus statement from the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO)

From 50 years of age, postmenopausal women are at an increased risk of developing sarcopenia and osteoporosis as a result of deterioration of musculoskeletal health. Both disorders increase the risk of falls and fractures. The risk of developing sarcopenia and osteoporosis may be attenuated through healthy lifestyle changes, which include adequate dietary protein, calcium and vitamin D intakes, and regular physical activity/exercise, besides hormone replacement therapy when appropriate. Protein intake and physical activity are the main anabolic stimuli for muscle protein synthesis. Exercise training leads to increased muscle mass and strength, and the combination of optimal protein intake and exercise produces a greater degree of muscle protein accretion than either intervention alone. Similarly, adequate dietary protein intake and resistance exercise are important contributors to the maintenance of bone strength. Vitamin D helps to maintain muscle mass and strength as well as bone health. These findings suggest that healthy lifestyle measures in women aged >50 years are essential to allow healthy ageing. The European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO) recommends optimal dietary protein intake of 1.0-1.2g/kgbodyweight/d with at least 20-25g of high-quality protein at each main meal, with adequate vitamin D intake at 800IU/d to maintain serum 25-hydroxyvitamin D levels >50nmol/L as well as calcium intake of 1000mg/d, alongside regular physical activity/exercise 3-5 times/week combined with protein intake in close proximity to exercise, in postmenopausal women for prevention of age-related deterioration of musculoskeletal health.

Dairy products, yogurts, and bone health

Fracture risk is determined by bone mass, geometry, and microstructure, which result from peak bone mass (the amount attained at the end of pubertal growth) and from the amount of bone lost subsequently. Nutritional intakes are an important environmental factor that influence both bone mass accumulation during childhood and adolescence and bone loss that occurs in later life. Bone growth is influenced by dietary intake, particularly of calcium and protein. Adequate dietary calcium and protein are essential to achieve optimal peak bone mass during skeletal growth and to prevent bone loss in the elderly. Dairy products are rich in nutrients that are essential for good bone health, including calcium, protein, vitamin D, potassium, phosphorus, and other micronutrients and macronutrients. Studies supporting the beneficial effects of milk or dairy products on bone health show a significant inverse association between dairy food intake and bone turnover markers and a positive association with bone mineral content. Fortified dairy products induce more favorable changes in biochemical indexes of bone metabolism than does calcium supplementation alone. The associations between the consumption of dairy products and the risk of hip fracture are less well established, although yogurt intake shows a weakly positive protective trend for hip fracture. By consuming 3 servings of dairy products per day, the recommended daily intakes of nutrients essential for good bone health may be readily achieved. Dairy products could therefore improve bone health and reduce the risk of fractures in later life.

Milk consumption throughout life and bone mineral content and density in elderly men and women

Association between bone mineral density and bone mineral content in old age and milk consumption in adolescence, midlife, and old age was assessed. The association was strongest for milk consumption in midlife: those drinking milk daily or more often had higher bone mineral density and content in old age than those drinking milk seldom or never.

INTRODUCTION

The role of lifelong milk consumption for bone mineral density (BMD) and bone mineral content (BMC) in old age is not clear. Here we assess the association between hip BMD and BMC in old age and milk consumption in adolescence, midlife, and current old age.

METHODS

Participants of the Age, Gene/Environment Susceptibility-Reykjavik Study, aged 66-96 years (N = 4,797), reported retrospective milk intake during adolescence and midlife as well as in current old age, using a validated food frequency questionnaire. BMC of femoral neck and trochanteric area was measured by volumetric quantitative computed tomography and BMD obtained. Association was assessed using linear regression models. Differences in BMC, bone volume, and BMD in relation to milk intake were portrayed as gender-specific Z-scores.

RESULTS

Men consuming milk ≥ once/day during midlife had 0.21 higher Z-scores for BMD and 0.18 for BMC in femoral neck (95 % confidence interval 0.05-0.39 and 0.01-0.35, respectively) compared with < once/week. Results were comparable for trochanter. For women the results were similar, with slightly lower differences according to midlife milk consumption. For current and adolescent milk consumption, differences in Z-scores were smaller and only reached statistical significance in the case of BMD for current consumption in men, while this association was less pronounced for BMC.

CONCLUSIONS

Our data suggest that regular milk consumption throughout life, from adolescence to old age, is associated with higher BMC and BMD in old age, with no differences seen in bone volume. The strongest associations are seen for midlife milk consumption in both genders.

Nutrition and bone health: turning knowledge and beliefs into healthy behaviour

Primary osteoporosis prevention requires healthy behaviours, such as regular physical exercise and adequate dietary intakes of calcium, vitamin D and protein. Calcium and vitamin D can decrease postmenopausal bone loss and prevent fracture risk. However, there is still a high prevalence of calcium and vitamin D insufficiency in women aged 50+ years. Dietary sources of these nutrients are the preferred choice, and dairy products represent a valuable dietary source of calcium due to the high content, high absorptive rate and relatively low cost. Furthermore, dairy products also contain other key nutrients including vitamin D, phosphorus and protein that contribute to bone health. Studies of women's beliefs and behaviours with respect to osteoporosis highlight poor knowledge of the importance of dietary nutrient intakes and low concern regarding bone health. Osteoporosis educational programmes exist to help women change behaviours relevant to bone health. Such programmes can have positive influences on women's knowledge, attitudes, perceived norms, motivation and behaviours. Increased awareness of the consequences of low calcium and vitamin D intakes may promote women's attitudes towards dietary sources, in particular dairy products, and lead to better adherence to health recommendations. Increasing dietary nutrient intakes through educational initiatives should be further developed to aid the prevention of osteoporosis and the efficacy of osteoporosis management.

Milk nutritional composition and its role in human health

Dairy and milk consumption are frequently included as important elements in a healthy and balanced diet. It is the first food for mammals and provides all the necessary energy and nutrients to ensure proper growth and development, being crucial in respect to bone mass formation. However, several controversies arise from consumption of dairy and milk products during adulthood, especially because it refers to milk from other species. Despite these controversies, epidemiologic studies confirm the nutritional importance of milk in the human diet and reinforce the possible role of its consumption in preventing several chronic conditions like cardiovascular diseases (CVDs), some forms of cancer, obesity, and diabetes. Lactose malabsorption symptoms and cow milk protein allergy are generally considered to be the adverse reactions to milk consumption. The present article reviews the main aspects of milk nutritional composition and establishes several associations between its nutritious role, health promotion, and disease prevention.

Variation of vitamin D in cow's milk and interaction with β-lactoglobulin

Vitamin D is the collective name for a group of closely related lipids, whose main biological function is to maintain serum calcium and phosphorus concentrations within the normal range by enhancing the efficiency of the small intestine to absorb these minerals from the diet. We used a commercially available ELISA method for the determination of vitamin D in bovine milk. Individual milk samples from two different Italian Friesian herds were analysed. The enzyme immunoassay method used was confirmed as a useful tool to measure the vitamin D in the milk as it greatly reduces the time required to perform the conventional HPLC analysis. An interesting variation was found among individual animals that may be associated with management factors and specific genetic effects. A relationship was highlighted between vitamin D and the genetic polymorphism of β-lactoglobulin, the main bovine whey protein which is involved in the transport of small hydrophobic molecules such as retinol and vitamin D. The relatively high content of vitamin D in most milk samples suggests an opportunity to improve the natural content of vitamin D in milk either by acting on the herd management or selecting individuals genetically predisposed to produce milk with a higher vitamin D content.

Validation of a food-frequency questionnaire for the assessment of calcium intake in schoolchildren aged 9-10 years

Bone mass increases steadily until age 20-30 years, when peak bone mass (PBM) is acquired. Nutrition plays a critical role in achievement of the optimal genetically programmed PBM, with reduction in the risk of osteoporosis later in life. Intake of nutrients can be estimated through the use of various tools; typically, food-frequency questionnaires (FFQs) are used in epidemiologic studies. The aim of this study was to validate a 21-item, semiquantitative FFQ to assess important nutrient intakes for bone health in Italian schoolchildren 9-10 years of age. Relative validation was accomplished through comparison of the 7-days weighed food record (7D records) with an FFQ developed ad hoc, completed by a group of 75 Italian schoolchildren (36 females, 39 males). Agreement between the two methods was evaluated by Spearman's correlation test and Bland-Altman analysis applied on the data on intake of energy, macronutrients, and micronutrients. Particular attention was devoted to nutrients relevant for bone health. Good correlations between the two methods (FFQ and 7D records) were observed for all nutrients. In particular, mean dietary calcium intakes were 725.6 mg/day (95 % CI 683.2-768.1) from 7D records and 892.4 mg/day (95 % CI 844.6-940.2) from the FFQ. These results indicate that our FFQ for schoolchildren aged 9-10 years is highly acceptable as it is an accurate method that can be used in large-scale or epidemiological studies for the evaluation of nutrient intakes important for the prevention of osteoporosis in a similar population.

Osteoporosis - a current view of pharmacological prevention and treatment

Postmenopausal osteoporosis is the most common bone disease, associated with low bone mineral density (BMD) and pathological fractures which lead to significant morbidity. It is defined clinically by a BMD of 2.5 standard deviations or more below the young female adult mean (T-score =−2.5). Osteoporosis was a huge global problem both socially and economically – in the UK alone, in 2011 £6 million per day was spent on treatment and social care of the 230,000 osteoporotic fracture patients – and therefore viable preventative and therapeutic approaches are key to managing this problem within the aging population of today. One of the main issues surrounding the potential of osteoporosis management is diagnosing patients at risk before they develop a fracture. We discuss the current and future possibilities for identifying susceptible patients, from fracture risk assessment to shape modeling and in relation to the high heritability of osteoporosis now that a plethora of genes have been associated with low BMD and osteoporotic fracture. This review highlights the current therapeutics in clinical use (including bisphosphonates, anti-RANKL [receptor activator of NF-κB ligand], intermittent low dose parathyroid hormone, and strontium ranelate) and some of those in development (anti-sclerostin antibodies and cathepsin K inhibitors). By highlighting the intimate relationship between the activities of bone forming (osteoblasts) and bone-resorbing (osteoclasts) cells, we include an overview and comparison of the molecular mechanisms exploited in each therapy.

Dairy in adulthood: from foods to nutrient interactions on bone and skeletal muscle health

The risk of fragility fractures exponentially increases with aging. Reduced mass and strength of both bone in osteoporosis and skeletal muscle in sarcopenia play a key role in the age-related incidence of fragility fractures. Undernutrition is often observed in the elderly, particularly in those subjects experiencing osteoporotic fractures, more likely as a cause than a consequence. Calcium (Ca), inorganic phosphate (Pi), vitamin D, and protein are nutrients that impact bone and skeletal muscle integrity. Deficiency in the supply of these nutrients increases with aging. Dairy foods are rich in Ca, Pi, and proteins and in many countries are fortified with vitamin D. Dairy foods are important souces of these nutrients and go a long way to meeting the recommendations, which increase with aging. This review emphaszes the interactions between these 4 nutrients, which, along with physical activity, act through cellular and physiological pathways favoring the maintenance of both bone and skeletal muscle structure and function.

Fluid intake patterns: an epidemiological study among children and adolescents in Brazil

BACKGROUND

Energy from liquids is one of the most important factors that could impact on the high prevalence of children and adolescents obesity around the world. There are few data on the liquid consumption in Brazil. The aim of this study is to evaluate the volume and quality of liquids consumed by Brazilian children and adolescents and to determine the proportion of their daily energy intake composed of liquids.

METHODS

A multicenter study was conducted in five Brazilian cities; the study included 831 participants between 3 and 17 years of age. A four-day dietary record specific to fluids was completed for each individual, and the volume of and Kcal from liquid intake were evaluated. The average number of Kcal in each beverage was determined based on label information, and the daily energy intake data from liquids were compared with the recommendations of the National Health Surveillance Agency (Agência Nacional de Vigilância Sanitária- ANVISA), the Brazilian food regulation authority, according to each subject's age.

RESULTS

As the children aged, the volume of carbonated beverages that they consumed increased significantly, and their milk intake decreased significantly. For children between the ages of 3 and 10, milk and dairy products contributed the greatest daily number of Kcal from liquids. Sugar sweetened beverages which included carbonated beverages, nectars and artificial beverages, accounted for 37% and 45% of the total Kcal from liquid intake in the 3- to 6-year-old and 7- to 10- year-old groups, respectively. Among adolescents (participants 11- to 17- years old), most of the energy intake from liquids came from carbonated beverages, which accounted for an average of 207 kcal/day in this group (42% of their total energy intake from liquids). Health professionals should be attentive to the excessive consumption of sugar sweetened beverages in children and adolescents. The movement toward healthier dietary patterns at the individual and population levels may help to improve programs for preventing overweight and obesity in children and adolescents.

CONCLUSION

From childhood to adolescence the daily volume of liquid ingested increased reaching a total of 2.0 liters on average. Of this volume, the daily volume of milk ingested decreased while the carbonated drinks, sweetened, nectars and artificial beverages increased significantly. The proportion of water remained constant in about 1/3 of the total volume. From 3 to 17 years of age the energy intake from carbonated beverages increased by about 20%. The carbonated drinks on average corresponded to a tenth of the daily requirements of energy of adolescents.

[Hungarian Diet and Nutritional Status Survey - the OTAP2009 study. IV. Macroelement intake of the Hungarian population]

The adequate intake of minerals is basically important for healthy nutrition.

AIM AND METHOD

The Hungarian Diet and Nutritional Status Survey - joining to the European Health Interview Survey - studied the dietary habits of the Hungarian population. The present publication describes the macroelement intake.

RESULTS

The salt intake is unusually high (17.2 g in men and 12.0 g in women), the potassium intake remains well below the recommendation. These factors substantially increase the risk of cardiovascular diseases including high blood-pressure. The calcium intake stays below the recommendation except in the youngest males, the oldest men and women are at risk from this point of view. While magnesium intake suited the recommendation, the intake of phosphorus exceeded it twice.

CONCLUSIONS

Focusing on marcroelements, high sodium/salt intake represents the highest public health risk. The implementation of STOP SALT! National Salt Reducing Programme, i.e. decrease the salt content of processed food and provide proper information to the population about excessive salt consumption, should result in a beneficial change of salt intake and ameliorate the public health conditions.