1
|
Wan M, Wu H, Wang X, Gu Y, Meng G, Zhang Q, Liu L, Zhang J, Sun S, Jia Q, Song K, Gao W, Yao Z, Niu K, Guo C. There is a significantly inverse relationship between dietary riboflavin intake and prevalence of osteoporosis in women but not in men: Results from the TCLSIH cohort study. Front Nutr 2023; 10:1112028. [PMID: 36824170 PMCID: PMC9941537 DOI: 10.3389/fnut.2023.1112028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 01/23/2023] [Indexed: 02/10/2023] Open
Abstract
Background Epidemiological evidence for the relationship between riboflavin intake and bone health is inconsistent, and this relationship has not been examined in Chinese population. This study aimed to investigate the relationship between dietary intake of riboflavin and prevalence of osteoporosis in a Chinese adult population. Methods A total of 5,607 participants (mean age, 61.2 years; males, 34.4%) were included in this cross-sectional study. We calculated the riboflavin intake by using the food frequency questionnaire (FFQ) in combination with Chinese food composition database. Bone mineral density (BMD) was detected by an ultrasound bone densitometer. Multivariable logistic regression models were used to evaluate the relationship between dietary riboflavin intake and prevalence of osteoporosis. Results In this population, the dietary intake of riboflavin ranged from 0.13 to 1.99 mg/d, and the proportion of abnormal BMD was 36.6%. The prevalence of osteoporosis decreased gradually with increasing quartiles of riboflavin intake, before and after adjustment for a range of confounding factors. In the final model, the multivariate-adjusted ORs (95% CI) across the quartiles of riboflavin intake were 1.00 (reference), 0.84 (0.54, 1.31), 0.59 (0.34, 1.04), and 0.47 (0.22, 0.96), respectively (P for trend < 0.05). In sex-disaggregated analysis, similar results to the total population were observed in women, while no significant results were found in men. Conclusion The dietary riboflavin intake was negatively associated with the prevalence of osteoporosis. However, the association was significant in women but not in men. Our findings indicated that women are more sensitive to riboflavin intake in maintaining a normal BMD.
Collapse
Affiliation(s)
- Min Wan
- Tianjin Institute of Environmental and Operational Medicine, Tianjin, China
| | - Hongmei Wu
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China
| | - Xuena Wang
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China
| | - Yeqing Gu
- Nutrition and Radiation Epidemiology Research Center, Institute of Radiation Medicine, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China
| | - Ge Meng
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China
| | - Qing Zhang
- Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China
| | - Li Liu
- Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China
| | - Juanjuan Zhang
- Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China
| | - Shaomei Sun
- Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China
| | - Qiyu Jia
- Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China
| | - Kun Song
- Health Management Centre, Tianjin Medical University General Hospital, Tianjin, China
| | - Weina Gao
- Tianjin Institute of Environmental and Operational Medicine, Tianjin, China
| | - Zhanxin Yao
- Tianjin Institute of Environmental and Operational Medicine, Tianjin, China,*Correspondence: Zhanxin Yao,
| | - Kaijun Niu
- Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China,Nutrition and Radiation Epidemiology Research Center, Institute of Radiation Medicine, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China,Kaijun Niu,
| | - Changjiang Guo
- Tianjin Institute of Environmental and Operational Medicine, Tianjin, China,Changjiang Guo,
| |
Collapse
|
2
|
Ilesanmi-Oyelere BL, Kruger MC. B-vitamins and homocysteine as determinants of bone health: a literature review of human studies. J Hum Nutr Diet 2022; 36:1031-1044. [PMID: 36056551 DOI: 10.1111/jhn.13080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Accepted: 08/15/2022] [Indexed: 11/27/2022]
Abstract
Although there are several factors related to bone diseases such as physical activity, gender (oestrogen), race/ethnicity, smoking and alcohol habits, nutrition is a modifiable risk factor that could be employed to prevent or manage the onset of bone health diseases such as osteoporosis in humans. Aside from calcium and vitamin D, B-vitamins are a group of water-soluble vitamins that play a vital role in cell metabolism. In this review, current evidence on B-vitamins and bone health was assessed. Clinical trials (interventions) indicated that treatment with B-vitamins impact the concentrations of total plasma/serum homocysteine concentrations (tHcy), however, most studies reported a lack of an effect of low homocysteine concentrations on bone turnover markers, bone mineral density (BMD) or fracture risks. Current studies have been inconsistent in their reports on the role of B-vitamins and homocysteine in bone health. More data are therefore required to show the mechanism and effect of tHcy and B-vitamins on BMD, bone metabolism and fracture risk. This article is protected by copyright. All rights reserved.
Collapse
Affiliation(s)
- Bolaji L Ilesanmi-Oyelere
- School of Health Sciences, College of Health, Massey University, Private Bag 11 222, Palmerston North, 4442, New Zealand
| | - Marlena C Kruger
- School of Health Sciences, College of Health, Massey University, Private Bag 11 222, Palmerston North, 4442, New Zealand
| |
Collapse
|
3
|
Rondanelli M, Faliva MA, Barrile GC, Cavioni A, Mansueto F, Mazzola G, Oberto L, Patelli Z, Pirola M, Tartara A, Riva A, Petrangolini G, Peroni G. Nutrition, Physical Activity, and Dietary Supplementation to Prevent Bone Mineral Density Loss: A Food Pyramid. Nutrients 2021; 14:74. [PMID: 35010952 PMCID: PMC8746518 DOI: 10.3390/nu14010074] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 12/21/2021] [Accepted: 12/21/2021] [Indexed: 12/15/2022] Open
Abstract
Bone is a nutritionally modulated tissue. Given this background, aim of this review is to evaluate the latest data regarding ideal dietary approach in order to reduce bone mineral density loss and to construct a food pyramid that allows osteopenia/osteoporosis patients to easily figure out what to eat. The pyramid shows that carbohydrates should be consumed every day (3 portions of whole grains), together with fruits and vegetables (5 portions; orange-colored fruits and vegetables and green leafy vegetables are to be preferred), light yogurt (125 mL), skim milk (200 mL,) extra virgin olive oil (almost 20 mg/day), and calcium water (almost 1 l/day); weekly portions should include fish (4 portions), white meat (3 portions), legumes (2 portions), eggs (2 portions), cheeses (2 portions), and red or processed meats (once/week). At the top of the pyramid, there are two pennants: one green means that osteopenia/osteoporosis subjects need some personalized supplementation (if daily requirements cannot be satisfied through diet, calcium, vitamin D, boron, omega 3, and isoflavones supplementation could be an effective strategy with a great benefit/cost ratio), and one red means that there are some foods that are banned (salt, sugar, inorganic phosphate additives). Finally, three to four times per week of 30-40 min of aerobic and resistance exercises must be performed.
Collapse
Affiliation(s)
- Mariangela Rondanelli
- IRCCS Mondino Foundation, 27100 Pavia, Italy;
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy
| | - Milena Anna Faliva
- Endocrinology and Nutrition Unit, Azienda di Servizi alla Persona “Istituto Santa Margherita”, University of Pavia, 27100 Pavia, Italy; (M.A.F.); (G.C.B.); (A.C.); (F.M.); (G.M.); (L.O.); (Z.P.); (M.P.); (A.T.)
| | - Gaetan Claude Barrile
- Endocrinology and Nutrition Unit, Azienda di Servizi alla Persona “Istituto Santa Margherita”, University of Pavia, 27100 Pavia, Italy; (M.A.F.); (G.C.B.); (A.C.); (F.M.); (G.M.); (L.O.); (Z.P.); (M.P.); (A.T.)
| | - Alessandro Cavioni
- Endocrinology and Nutrition Unit, Azienda di Servizi alla Persona “Istituto Santa Margherita”, University of Pavia, 27100 Pavia, Italy; (M.A.F.); (G.C.B.); (A.C.); (F.M.); (G.M.); (L.O.); (Z.P.); (M.P.); (A.T.)
| | - Francesca Mansueto
- Endocrinology and Nutrition Unit, Azienda di Servizi alla Persona “Istituto Santa Margherita”, University of Pavia, 27100 Pavia, Italy; (M.A.F.); (G.C.B.); (A.C.); (F.M.); (G.M.); (L.O.); (Z.P.); (M.P.); (A.T.)
| | - Giuseppe Mazzola
- Endocrinology and Nutrition Unit, Azienda di Servizi alla Persona “Istituto Santa Margherita”, University of Pavia, 27100 Pavia, Italy; (M.A.F.); (G.C.B.); (A.C.); (F.M.); (G.M.); (L.O.); (Z.P.); (M.P.); (A.T.)
| | - Letizia Oberto
- Endocrinology and Nutrition Unit, Azienda di Servizi alla Persona “Istituto Santa Margherita”, University of Pavia, 27100 Pavia, Italy; (M.A.F.); (G.C.B.); (A.C.); (F.M.); (G.M.); (L.O.); (Z.P.); (M.P.); (A.T.)
| | - Zaira Patelli
- Endocrinology and Nutrition Unit, Azienda di Servizi alla Persona “Istituto Santa Margherita”, University of Pavia, 27100 Pavia, Italy; (M.A.F.); (G.C.B.); (A.C.); (F.M.); (G.M.); (L.O.); (Z.P.); (M.P.); (A.T.)
| | - Martina Pirola
- Endocrinology and Nutrition Unit, Azienda di Servizi alla Persona “Istituto Santa Margherita”, University of Pavia, 27100 Pavia, Italy; (M.A.F.); (G.C.B.); (A.C.); (F.M.); (G.M.); (L.O.); (Z.P.); (M.P.); (A.T.)
| | - Alice Tartara
- Endocrinology and Nutrition Unit, Azienda di Servizi alla Persona “Istituto Santa Margherita”, University of Pavia, 27100 Pavia, Italy; (M.A.F.); (G.C.B.); (A.C.); (F.M.); (G.M.); (L.O.); (Z.P.); (M.P.); (A.T.)
| | - Antonella Riva
- Research and Development Department, Indena SpA, 20139 Milan, Italy; (A.R.); (G.P.)
| | | | - Gabriella Peroni
- Endocrinology and Nutrition Unit, Azienda di Servizi alla Persona “Istituto Santa Margherita”, University of Pavia, 27100 Pavia, Italy; (M.A.F.); (G.C.B.); (A.C.); (F.M.); (G.M.); (L.O.); (Z.P.); (M.P.); (A.T.)
| |
Collapse
|
4
|
Rondanelli M, Tartara A, Fossari F, Vecchio V, Faliva MA, Naso M, Perna S, Nichetti M, Peroni G. Adequate intake and supplementation of B vitamins, in particular folic acid, can play a protective role in bone health. Curr Aging Sci 2021; 15:110-120. [PMID: 34610784 DOI: 10.2174/1874609814666211005101730] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 07/12/2021] [Accepted: 08/12/2021] [Indexed: 11/22/2022]
Abstract
In vitro and animal model studies have shown that B vitamins (VB) deficiency have negative consequences on bone, as a result of direct or mediated activity of hyperhomocysteinemia. However, there are still no precise indications regarding a possible VB role in order to maintain bone health. So, the aim of this narrative review was to consider the state of the art on correlation between VB dietary intake, blood levels and supplementation and bone health (bone mineral density (BMD), bone turnover markers and fractures risk) in humans. This review included 29 eligible studies. Considering VB blood levels, the 14 studies considered have shown that low serum folate can be a factor risk for reduced BMD and fractures in elderly, particularly women; no independent association was found for other VB. Studies that evaluate relationship between VB dietary intake and BMD are only 2; one, conducted on 1869 women, demonstrated a positive effect of folate intake on BMD, another demonstrated a dose-dependent inverse relationship between vitamin B6 dietary intake and risk of hip fracture, but only for 35298 female participants. Regarding the relationship between BV supplementation and bone health (9 studies with only VB and 4 with other nutrients), all studies that considered patients with hyperhomocysteinemia or with low folate blood levels, are in agreement in demonstrating that folate supplementation (500mcg-5mg) is useful in improving BMD. In conclusion, a request for folate and homocysteine blood levels in elderly patients with osteopenia/osteoporosis is mandatory. For patients with hyperhomocysteinemia or with low folate blood levels, folate supplementation (500mcg-5mg) is crucial.
Collapse
Affiliation(s)
| | - Alice Tartara
- Endocrinology and Nutrition Unit, Azienda di Servizi alla Persona ''Istituto Santa Margherita'', University of Pavia, Pavia, 27100, Italy
| | - Federica Fossari
- Endocrinology and Nutrition Unit, Azienda di Servizi alla Persona ''Istituto Santa Margherita'', University of Pavia, Pavia, 27100, Italy
| | - Viviana Vecchio
- Endocrinology and Nutrition Unit, Azienda di Servizi alla Persona ''Istituto Santa Margherita'', University of Pavia, Pavia, 27100, Italy
| | - Milena Anna Faliva
- Endocrinology and Nutrition Unit, Azienda di Servizi alla Persona ''Istituto Santa Margherita'', University of Pavia, Pavia, 27100, Italy
| | - Maurizio Naso
- Endocrinology and Nutrition Unit, Azienda di Servizi alla Persona ''Istituto Santa Margherita'', University of Pavia, Pavia, 27100, Italy
| | - Simone Perna
- Department of Biology, University of Bahrain, College of Science, Sakhir Campus P. O. Box 32038. Bahrain
| | - Mara Nichetti
- Endocrinology and Nutrition Unit, Azienda di Servizi alla Persona ''Istituto Santa Margherita'', University of Pavia, Pavia, 27100, Italy
| | - Gabriella Peroni
- Endocrinology and Nutrition Unit, Azienda di Servizi alla Persona ''Istituto Santa Margherita'', University of Pavia, Pavia, 27100, Italy
| |
Collapse
|
5
|
Wen K, Tao L, Tao Z, Meng Y, Zhou S, Chen J, Yang K, Da W, Zhu Y. Fecal and Serum Metabolomic Signatures and Microbial Community Profiling of Postmenopausal Osteoporosis Mice Model. Front Cell Infect Microbiol 2020; 10:535310. [PMID: 33330117 PMCID: PMC7728697 DOI: 10.3389/fcimb.2020.535310] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 10/26/2020] [Indexed: 12/14/2022] Open
Abstract
Background Multiple studies have shown that an imbalance in the intestinal microbiota is related to bone metabolism, but the role of the intestinal microbiota in postmenopausal osteoporosis remains to be elucidated. We explored the effect of the intestinal microbiota on osteoporosis. Methods We constructed a postmenopausal osteoporosis mouse model, and Micro CT was used to observe changes in bone structure. Then, we identified the abundance of intestinal microbiota by 16S RNA sequencing and found that the ratio of Firmicutes and Bacteroidetes increased significantly. UHPLC-MS analysis was further used to analyze changes in metabolites in feces and serum. Results We identified 53 upregulated and 61 downregulated metabolites in feces and 2 upregulated and 22 downregulated metabolites in serum under OP conditions, and interestedly, one group of bile acids showed significant differences in the OP and control groups. Network analysis also found that these bile acids had a strong relationship with the same family, Eggerthellaceae. Random forest analysis confirmed the effectiveness of the serum and fecal models in distinguishing the OP group from the control group. Conclusions These results indicated that changes in the gut microbiota and metabolites in feces and serum were responsible for the occurrence and development of postmenopausal osteoporosis. The gut microbiota is a vital inducer of osteoporosis and could regulate the pathogenesis process through the “microbiota-gut-metabolite-bone” axis, and some components of this axis are potential biomarkers, providing a new entry point for the future study on the pathogenesis of postmenopausal osteoporosis.
Collapse
Affiliation(s)
- Kaicheng Wen
- Department of Orthopaedics, First Affiliated Hospital of China Medical University, Shenyang, China
| | - Lin Tao
- Department of Orthopaedics, First Affiliated Hospital of China Medical University, Shenyang, China
| | - Zhengbo Tao
- Department of Orthopaedics, First Affiliated Hospital of China Medical University, Shenyang, China
| | - Yan Meng
- Department of Orthopaedics, First Affiliated Hospital of China Medical University, Shenyang, China
| | - Siming Zhou
- Department of Orthopaedics, First Affiliated Hospital of China Medical University, Shenyang, China
| | - Jianhua Chen
- Department of Orthopaedics, Shengjing Hospital of China Medical University, Shenyang, China
| | - Keda Yang
- Department of Orthopaedics, First Affiliated Hospital of China Medical University, Shenyang, China
| | - Wacili Da
- Department of Orthopaedics, First Affiliated Hospital of China Medical University, Shenyang, China
| | - Yue Zhu
- Department of Orthopaedics, First Affiliated Hospital of China Medical University, Shenyang, China
| |
Collapse
|
6
|
Macêdo LLGD, Carvalho CMRGD, Cavalcanti JC, Freitas BDJESDA. Vitamin B12, bone mineral density and fracture risk in adults: A systematic review. REVISTA DA ASSOCIACAO MEDICA BRASILEIRA (1992) 2017; 63:801-809. [PMID: 29239465 DOI: 10.1590/1806-9282.63.09.801] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/15/2017] [Accepted: 12/03/2017] [Indexed: 01/30/2023]
Abstract
OBJECTIVE To consolidate information available on the effect of vitamin B12 on bone mineral density and fracture risk, with emphasis on clinical trials, observational and longitudinal data conducted in humans. METHOD A systematic review of the literature of the past decade on the role of vitamin B12 in bone mineral density and fracture risk in subjects of all ages and both sexes was performed by means of a PubMed, Science Direct, Medline and SciELO database search. Articles included in this review were identified using the search terms: B12 Vitamin and Bone Mineral Density and Vitamin B12 and Risk of Fractures. Evidence quality of the included articles was evaluated by GRADE system. RESULTS A total of 25 original studies were identified. After reviewing the titles and abstracts of articles, only 17 articles met the inclusion criteria. The present review provides evidence that the role of vitamin B12 on bone mineral density or fracture risk should be further elucidated. Controversies are explained by heterogeneity of methodologies used for the diagnosis of vitamin B12 and also by differences among populations investigated on the studies. CONCLUSION A real effect of vitamin B12 deficiency in bone health and the mechanisms associated with bone metabolism is not well established yet. It is extremely important to carry out more clarifying studies about this theme, especially with vulnerable groups such as postmenopausal and elderly women, as is well-known that they are greatly affected by deficiency of this vitamin.
Collapse
Affiliation(s)
| | | | - Janaína Costa Cavalcanti
- Internal Medicine Residency Training Program at Hospital Regional da Asa Norte, Hospital Universitário, Universidade Federal do Piauí, Brazil
| | | |
Collapse
|
7
|
Turck D, Bresson JL, Burlingame B, Dean T, Fairweather-Tait S, Heinonen M, Hirsch-Ernst KI, Mangelsdorf I, McArdle HJ, Naska A, Nowicka G, Pentieva K, Sanz Y, Siani A, Sjödin A, Stern M, Tomé D, Van Loveren H, Vinceti M, Willatts P, Lamberg-Allardt C, Przyrembel H, Tetens I, Dumas C, Fabiani L, Forss AC, Ioannidou S, Neuhäuser-Berthold M. Dietary Reference Values for riboflavin. EFSA J 2017; 15:e04919. [PMID: 32625611 PMCID: PMC7010026 DOI: 10.2903/j.efsa.2017.4919] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Following a request from the European Commission, the EFSA Panel on Dietetic Products, Nutrition and Allergies (NDA) derives dietary reference values (DRVs) for riboflavin. The Panel considers that the inflection point in the urinary riboflavin excretion curve in relation to riboflavin intake reflects body saturation and can be used as a biomarker of adequate riboflavin status. The Panel also considers that erythrocyte glutathione reductase activation coefficient is a useful biomarker, but has limitations. For adults, the Panel considers that average requirements (ARs) and population reference intakes (PRIs) can be determined from the weighted mean of riboflavin intake associated with the inflection point in the urinary riboflavin excretion curve reported in four intervention studies. PRIs are derived for adults and children assuming a coefficient of variation of 10%, in the absence of information on the variability in the requirement and to account for the potential effect of physical activity and the methylenetetrahydrofolate reductase 677TT genotype. For adults, the AR and PRI are set at 1.3 and 1.6 mg/day. For infants aged 7-11 months, an adequate intake of 0.4 mg/day is set by upward extrapolation from the riboflavin intake of exclusively breastfed infants aged 0-6 months. For children, ARs are derived by downward extrapolation from the adult AR, applying allometric scaling and growth factors and considering differences in reference body weight. For children of both sexes aged 1-17 years, ARs range between 0.5 and 1.4 mg/day, and PRIs between 0.6 and 1.6 mg/day. For pregnant or lactating women, additional requirements are considered, to account for fetal uptake and riboflavin accretion in the placenta during pregnancy or the losses through breast milk, and PRIs of 1.9 and 2.0 mg/day, respectively, are derived.
Collapse
|
8
|
B-vitamins and bone health--a review of the current evidence. Nutrients 2015; 7:3322-46. [PMID: 25961321 PMCID: PMC4446754 DOI: 10.3390/nu7053322] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2015] [Revised: 04/24/2015] [Accepted: 04/27/2015] [Indexed: 12/23/2022] Open
Abstract
Because of ongoing global ageing, there is a rapid worldwide increase in incidence of osteoporotic fractures and the resultant morbidity and mortality associated with these fractures are expected to create a substantial economic burden. Dietary modification is one effective approach for prevention of osteoporosis in the general population. Recently, B vitamins have been investigated for their possible roles in bone health in human studies. In this review, we provide different lines of evidence and potential mechanisms of individual B vitamin in influencing bone structure, bone quality, bone mass and fracture risk from published peer-reviewed articles. These data support a possible protective role of B vitamins, particularly, B2, B6, folate and B12, in bone health. However, results from the clinical trials have not been promising in supporting the efficacy of B vitamin supplementation in fracture reduction. Future research should continue to investigate the underlying mechanistic pathways and consider interventional studies using dietary regimens with vitamin B enriched foods to avoid potential adverse effects of high-dose vitamin B supplementation. In addition, observational and interventional studies conducted in Asia are limited and thus require more attention due to a steep rise of osteoporosis and hip fracture incidence projected in this part of the world.
Collapse
|
9
|
Karamati M, Yousefian-Sanni M, Shariati-Bafghi SE, Rashidkhani B. Major nutrient patterns and bone mineral density among postmenopausal Iranian women. Calcif Tissue Int 2014; 94:648-58. [PMID: 24687522 DOI: 10.1007/s00223-014-9848-5] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2013] [Accepted: 03/07/2014] [Indexed: 11/27/2022]
Abstract
Our understanding of the influence of overall nutrient intake on bone mineral density (BMD) is limited because most studies to date have focused on the intakes of calcium, vitamin D, or a few isolated nutrients. Therefore, we examined the association of major nutrient patterns with BMD in a sample of postmenopausal Iranian women. In this cross-sectional study, 160 women aged 50-85 years were studied and their lumbar spine and femoral neck BMDs were measured using dual-energy X-ray absorptiometry. Dietary intakes were assessed using a validated 168-item food frequency questionnaire, and daily intakes of 30 nutrients were calculated. All nutrient intakes were energy adjusted by the residual method and were submitted to principal component factor analysis to identify major nutrient patterns. Overall, three major nutrient patterns were identified, among which only the first pattern, which was high in folate, total fiber, vitamin B6, potassium, vitamin A (as retinol activity equivalent), vitamin C, β-carotene, vitamin K, magnesium, copper, and manganese, had a significant association with BMD. After controlling for potential confounders, multivariate adjusted mean of the lumbar spine BMD of women in the highest tertile of the first pattern scores was significantly higher than those in the lowest tertile (mean difference 0.08; 95% confidence interval 0.02-0.15; P = 0.01). A nutrient pattern similar to pattern 1, which is associated with high intakes of fruits and vegetables, may be beneficial for bone health in postmenopausal Iranian women.
Collapse
Affiliation(s)
- Mohsen Karamati
- National Nutrition and Food Technology Research Institute (WHO Collaborating Center), Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | | | | |
Collapse
|
10
|
Abstract
Vitamin B12 and folic acid deficiency are associated with a higher serum concentration of homocysteine. A high serum homocysteine is a risk factor for fractures. Both vitamins play a role in the remethylation of homocysteine to methionine. The pathophysiology from a high serum homocysteine to fractures is not completely clear, but might involve bone mineral density, bone turnover, bone blood flow, DNA methylation, and/or physical function and fall risk. Genetic variation, especially polymorphisms of the gene encoding for methylenetetrahydrofolate reductase may play a role in homocysteine metabolism and fracture risk. It is uncertain whether supplementation with vitamin B12 and folate can decrease fracture incidence. One double blind clinical trial in post-stroke patients showed that these B vitamins could decrease hip fracture incidence, but the results of further clinical trials should be awaited before a definite conclusion can be drawn.
Collapse
Affiliation(s)
- Karin M A Swart
- Department of Epidemiology and Biostatistics and the EMGO Institute of Health and Care Research, VU University Medical Center, Van de Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands
| | | | | |
Collapse
|
11
|
Nieves JW. Skeletal effects of nutrients and nutraceuticals, beyond calcium and vitamin D. Osteoporos Int 2013; 24:771-86. [PMID: 23152094 DOI: 10.1007/s00198-012-2214-4] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2012] [Accepted: 10/01/2012] [Indexed: 12/23/2022]
Abstract
There is a need to understand the role of nutrition, beyond calcium and vitamin D, in the treatment and prevention of osteoporosis in adults. Results regarding soy compounds on bone density and bone turnover are inconclusive perhaps due to differences in dose and composition or in study population characteristics. The skeletal benefit of black cohosh and red clover are unknown. Dehydroepiandrosterone (DHEA) use may benefit elderly individuals with low serum dehydroepiandrosterone-sulfate levels, but even in this group, there are inconsistent benefits to bone density (BMD). Higher fruit and vegetable intakes may relate to higher BMD. The skeletal benefit of flavonoids, carotenoids, omega-3-fatty acids, and vitamins A, C, E and K are limited to observational data or a few clinical trials, in some cases investigating pharmacologic doses. Given limited data, it would be better to get these nutrients from fruits and vegetables. Potassium bicarbonate may improve calcium homeostasis but with little impact on bone loss. High homocysteine may relate to fracture risk, but the skeletal benefit of each B vitamin is unclear. Magnesium supplementation is likely only required in persons with low magnesium levels. Data are very limited for the role of nutritional levels of boron, strontium, silicon and phosphorus in bone health. A nutrient rich diet with adequate fruits and vegetables will generally meet skeletal needs in healthy individuals. For most healthy adults, supplementation with nutrients other than calcium and vitamin D may not be required, except in those with chronic disease and the frail elderly.
Collapse
Affiliation(s)
- J W Nieves
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168th Street, New York, NY 10032, USA.
| |
Collapse
|
12
|
High Folic Acid Intake during Pregnancy Lowers Body Weight and Reduces Femoral Area and Strength in Female Rat Offspring. J Osteoporos 2013; 2013:154109. [PMID: 23781391 PMCID: PMC3678445 DOI: 10.1155/2013/154109] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2013] [Accepted: 04/29/2013] [Indexed: 01/28/2023] Open
Abstract
Rats fed gestational diets high in multivitamin or folate produce offspring of altered phenotypes. We hypothesized that female rat offspring born to dams fed a gestational diet high in folic acid (HFol) have compromised bone health and that feeding the offspring the same HFol diet attenuates these effects. Pregnant rats were fed diets with either recommended folic acid (RFol) or 10-fold higher folic acid (HFol) amounts. Female offspring were weaned to either the RFol or HFol diet for 17 weeks. HFol maternal diet resulted in lower offspring body weights (6%, P = 0.03) and, after adjusting for body weight and femoral length, smaller femoral area (2%, P = 0.03), compared to control diet. After adjustments, HFol pup diet resulted in lower mineral content (7%, P = 0.01) and density (4%, P = 0.002) of lumbar vertebra 4 without differences in strength. An interaction between folate content of the dam and pup diets revealed that a mismatch resulted in lower femoral peak load strength (P = 0.01) and stiffness (P = 0.002). However, the match in folate content failed to prevent lower weight gain. In conclusion, HFol diets fed to rat dams and their offspring affect area and strength of femurs and mineral quantity but not strength of lumbar vertebrae in the offspring.
Collapse
|
13
|
Kesiktas N, Karan A, Erkan H, Gungor F, Eskiyurt N, Yalcin O. Is There a Relationship between Vitamin B12 and Stress Urinary Incontinence? Low Urin Tract Symptoms 2012; 4:55-8. [PMID: 26676525 DOI: 10.1111/j.1757-5672.2011.00116.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Pelvic floor, which includes collagen, elastin, and smooth muscle, is very important in preventing urinary incontinence (UI). Studies suggest that vitamin B12 is involved in collagen synthesis. In the present study we aimed to determine the association of vitamin B12 deficiency with stress UI in a sample of Turkish women. METHODS Forty-two women with stress UI or mixed UI who met the inclusion criteria from a group of 541 women with stress UI or mixed UI, were included in the study. The study group was compared with a control group of 20 healthy women without UI who matched to the study group's demographic data and met the inclusion criteria. Demographic data as well as duration of symptoms and vitamin B12 levels were analyzed and compared. RESULTS The mean ages of the study and the control groups were 50.04 ± 4.6 and 49.02 ± 5.1 years, respectively. Vitamin B12 level was 300.95 ± 142.9 pg/mL in the study group, whereas in the control group it was 598.98 ± 120.3 pg/mL (P < 0.001). In the study group, 66.6% of the patients with stress UI had vitamin B12 levels less than 300 pg/mL. When the duration of symptoms and vitamin B12 levels were compared, women with vitamin B12 levels less than 200 pg/mL had symptoms for a longer duration (P < 0.01). CONCLUSION One of the main etiologic factors for stress UI is a defect in pelvic floor support. Vitamin B12 is lower in women with stress UI. Analysis of vitamin B12 levels should also be considered in the evaluation of women with stress UI.
Collapse
Affiliation(s)
- Nur Kesiktas
- Departments of Physical Medicine and RehabilitationDepartments of Obstetrics and Gynecology, Istanbul University, Istanbul, Turkey
| | - Ayse Karan
- Departments of Physical Medicine and RehabilitationDepartments of Obstetrics and Gynecology, Istanbul University, Istanbul, Turkey
| | - Habibe Erkan
- Departments of Physical Medicine and RehabilitationDepartments of Obstetrics and Gynecology, Istanbul University, Istanbul, Turkey
| | - Funda Gungor
- Departments of Physical Medicine and RehabilitationDepartments of Obstetrics and Gynecology, Istanbul University, Istanbul, Turkey
| | - Nurten Eskiyurt
- Departments of Physical Medicine and RehabilitationDepartments of Obstetrics and Gynecology, Istanbul University, Istanbul, Turkey
| | - Onay Yalcin
- Departments of Physical Medicine and RehabilitationDepartments of Obstetrics and Gynecology, Istanbul University, Istanbul, Turkey
| |
Collapse
|
14
|
Tylavsky FA, Smith K, Surprise H, Garland S, Yan X, McCammon E, Hudson MM, Pui CH, Kaste SC. Nutritional intake of long-term survivors of childhood acute lymphoblastic leukemia: evidence for bone health interventional opportunities. Pediatr Blood Cancer 2010; 55:1362-9. [PMID: 20981691 PMCID: PMC3586793 DOI: 10.1002/pbc.22737] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Survivors of childhood acute lymphoblastic leukemia (ALL) are vulnerable to exaggeration of the aging process including decreased bone mineral density (BMD). As little is known about their dietary or nutrient intake that may affect their long-term bone health, we examined nutrient intake in long-term survivors of childhood ALL. PROCEDURE Survivors (n = 164) of childhood ALL who had completed treatment for at least 5 years and were in continuous remission, completed a 110-item food questionnaire that reflected dietary intake over the previous year. The analyzed cohort comprised 34 females and 38 males younger than 19 years and 45 females and 47 males at least 19 years. Reported nutrient intake and food selection were compared with age-specific Recommended Dietary Allowance and USDA Pyramid Food Guide. Body mass index was compared to the general US population, adjusted for age, gender, Tanner stage and race. RESULTS Less than 30% of participants met recommended dietary intakes for vitamin D, calcium, potassium, or magnesium regardless of age. Mean daily caloric intake was 2,204 kcal (51% from carbohydrates) for younger and 2,160 kcal (49% from carbohydrates) for older participants. Energy intake from sweets was 70% higher than recommended. Participants < 19 years were less likely to have a healthy weight (odds ratio 0.48, 95% CI 0.30-0.79); > 19 years more likely to be overweight (odds ratio 1.95, 95% CI 1.11-3.32, P < 0.002). CONCLUSIONS Survivors of childhood ALL need careful dietary intervention to optimize long-term health.
Collapse
Affiliation(s)
- Frances A. Tylavsky
- Department of Preventive Medicine, University of Tennessee, Health Science Center, Memphis, TN, USA
| | - Karen Smith
- Department of Nutritional Services, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Harriet Surprise
- Department of Nutritional Services, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Sarah Garland
- Department of Biostatistics, University of Memphis, Memphis, TN, USA
| | - Xiaowei Yan
- Department of Biostatistics, University of Memphis, Memphis, TN, USA
| | - Elizabeth McCammon
- Department of Radiological Sciences, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Melissa M. Hudson
- Department of Oncology, St. Jude Children's Research Hospital, Memphis, TN, USA
- Departments of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN, USA
- Department of Pediatrics, College of Medicine, University of Tennessee, Health Science Center, Memphis, TN, USA
| | - Ching-Hon Pui
- Department of Oncology, St. Jude Children's Research Hospital, Memphis, TN, USA
- Department of Pediatrics, College of Medicine, University of Tennessee, Health Science Center, Memphis, TN, USA
| | - Sue C. Kaste
- Department of Oncology, St. Jude Children's Research Hospital, Memphis, TN, USA
- Department of Radiological Sciences, St. Jude Children's Research Hospital, Memphis, TN, USA
- Department of Radiology, University of Tennessee, Health Science Center, Memphis, TN, USA
| |
Collapse
|
15
|
|
16
|
Nissen N, Madsen JS, Bladbjerg EM, Beck Jensen JE, Jørgensen NR, Langdahl B, Abrahamsen B, Brixen K. No association between hip geometry and four common polymorphisms associated with fracture: the Danish osteoporosis prevention study. Calcif Tissue Int 2009; 84:276-85. [PMID: 19225709 DOI: 10.1007/s00223-009-9219-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2008] [Accepted: 01/16/2009] [Indexed: 10/21/2022]
Abstract
Both osteoporosis and hip geometry are independently associated with fracture risk. There is a significant genetic contribution to the risk of osteoporosis, and evidence provided by twin studies has suggested that hip geometry may also in part be genetically programmed. Polymorphisms in a number of genes, including those coding for methylene-tetrahydrofolate reductase (MTHFR c.677C > T), the purinergic P2X(7) receptor (Glu496Ala and Ile568Asn), and the low-density lipoprotein receptor-related protein 5 (LRP5 exon 9 [c.266A > G]), have been associated with an increased fracture incidence and/or reduced bone mineral density (BMD). The aim of the present study was to test whether these polymorphisms influence hip structural geometry in perimenopausal women. The four polymorphisms were genotyped in 800 healthy recently perimenopausal women never using hormone replacement therapy. BMD of the femoral neck was measured using a Hologic QDR-2000 densitometer and femoral neck axis length, neck width, neck shaft angle, and femoral head diameter were measured from the screen images. Genotype frequencies were compatible with Hardy-Weinberg equilibrium. No significant differences between homozygotes for the minor allele and carriers of the common allele regarding parameters of hip geometry were demonstrated. According to the anthropometric characteristics of the subjects, only body height in the MTHFR TT genotype group was significantly different from the combined CT/CC genotype group (P < 0.05). The geometric dimensions of the proximal femur in perimenopausal women are not associated with the MTHFR c.677C > T, P2X(7) (Glu496Ala), P2X(7) (Ile568Asn), and LRP5 exon 9 (c.266A > G) polymorphisms.
Collapse
Affiliation(s)
- N Nissen
- Department of Endocrinology, Odense University Hospital, University of Southern Denmark, Odense, 5000, Odense C, Denmark.
| | | | | | | | | | | | | | | |
Collapse
|