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Malczewska-Lenczowska J, Surała O, Granda D, Szczepańska B, Czaplicki A, Kubacki R. The Relationship between Bone Health Parameters, Vitamin D and Iron Status, and Dietary Calcium Intake in Young Males. Nutrients 2024; 16:215. [PMID: 38257108 PMCID: PMC10818825 DOI: 10.3390/nu16020215] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 12/29/2023] [Accepted: 01/02/2024] [Indexed: 01/24/2024] Open
Abstract
Vitamin D, calcium, and iron are micronutrients crucial for bone health. However, their effect has been studied primarily in the cortical bone, with vitamin D status being assessed mainly from the total 25(OH)D serum fraction. The study aimed to investigate the impact of vitamin D (total and free fraction) and iron status (i.e., serum ferritin or soluble transferrin receptor) and calcium intake (ADOS-Ca questionnaire) on lumbar cortical and trabecular bone. In a cohort of 113 male subjects (76 athletes, 37 non-athletes) aged 15-19, the lumbar spine status (Z-score, bone mineral apparent density (BMAD), and trabecular bone score (TBS)) was determined using dual-energy X-ray absorptiometry (DXA). Relationships between the examined micronutrients and bone health parameters were observed only in athletes. Free 25(OH)D was significantly (p < 0.001) correlated with Z-score and BMAD, while total 25(OH)D (p < 0.001) and iron status (ferritin, Fe stores; p < 0.01) correlated solely with BMAD. Free 25(OH)D and ferritin concentrations were the best determinants of bone status (R2 = 0.330; p < 0.001) and explained 25% and 7% of the BMAD variance, respectively. No relationships were found between the micronutrients and TBS. The results confirmed the positive influence of vitamin D and iron on cortical, but not trabecular, bone status solely in physically active subjects. In athletes, free 25(OH)D seems to be a superior indicator of bone health to a total 25(OH)D fraction.
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Affiliation(s)
- Jadwiga Malczewska-Lenczowska
- Department of Nutrition Physiology, Institute of Sport, National Research Institute, 01-982 Warsaw, Poland; (J.M.-L.); (D.G.); (B.S.)
| | - Olga Surała
- Department of Nutrition Physiology, Institute of Sport, National Research Institute, 01-982 Warsaw, Poland; (J.M.-L.); (D.G.); (B.S.)
| | - Dominika Granda
- Department of Nutrition Physiology, Institute of Sport, National Research Institute, 01-982 Warsaw, Poland; (J.M.-L.); (D.G.); (B.S.)
| | - Beata Szczepańska
- Department of Nutrition Physiology, Institute of Sport, National Research Institute, 01-982 Warsaw, Poland; (J.M.-L.); (D.G.); (B.S.)
| | - Adam Czaplicki
- Faculty of Physical Education and Health in Biała Podlaska, Józef Piłsudski University of Physical Education, 00-968 Warsaw, Poland;
| | - Rafał Kubacki
- Faculty of Physical Education & Sport, University School of Physical Education, 51-612 Wroclaw, Poland;
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Wilson-Barnes SL, Lanham-New SA, Lambert H. Modifiable risk factors for bone health & fragility fractures. Best Pract Res Clin Rheumatol 2022; 36:101758. [PMID: 35750569 DOI: 10.1016/j.berh.2022.101758] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Osteoporosis is an ageing disorder characterised by poor microstructural architecture of the bone and an increase in the risk of fragility fractures, which often leads to hospitalisation and eventually a loss of mobility and independence. By 2050, it is estimated that more than 30 million people in Europe will be affected by bone diseases, and European hospitalisation alone can approximately cost up to 3.5 billion euros each year [1]. Although inherited variation in bone mineral density (BMD) is pre-determined by up to 85% [2], there is a window of opportunity to optimise BMD and reduce fracture risk through key modifiable lifestyle factors during the life course. An optimal diet rich in micronutrients, such as calcium, vitamin D, and potassium, has long been considered an important modifiable component of bone health, which is attributed to their direct roles within bone metabolism. Recently, there has been emerging evidence to suggest that protein and even an adequate intake of fruit and vegetables may also play an important role in improving BMD [3,4]. Maintaining a physically active lifestyle is not only protective from non-communicable diseases such as cardiovascular disease but it also has been shown to lessen the risk of fractures later in life, thereby making it an imperative modifiable factor for bone health, particularly as it also supports peak bone mass attainment during childhood/adolescence and can facilitate the maintenance of bone mass throughout adulthood [5]. Other key lifestyle factors that could be potentially modified to reduce the risk of osteoporosis or osteoporotic fractures later in life include smoking status, alcohol intake, and body composition [6]. Therefore, the principle aim of this review is to highlight the recent evidence pertaining to modifiable lifestyle factors that contribute to optimal bone health and the prevention of fragility fractures in later life.
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Affiliation(s)
- Saskia L Wilson-Barnes
- Department of Nutritional Sciences, School of Biosciences & Medicine, Faculty of Health & Medical Sciences, University of Surrey, Guildford, UK.
| | - Susan A Lanham-New
- Department of Nutritional Sciences, School of Biosciences & Medicine, Faculty of Health & Medical Sciences, University of Surrey, Guildford, UK
| | - Helen Lambert
- Department of Nutritional Sciences, School of Biosciences & Medicine, Faculty of Health & Medical Sciences, University of Surrey, Guildford, UK
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3
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Batty B, Kutzler M, Campbell S, Turner R, Bionaz M. Effect of milk vs. sugar-sweetened beverage supplementation on bone development in pre-pubertal pigs as model for children. ITALIAN JOURNAL OF ANIMAL SCIENCE 2020. [DOI: 10.1080/1828051x.2020.1816508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Brandon Batty
- Department of Animal and Rangeland Sciences, Oregon State University, Corvallis, OR, USA
| | - Michelle Kutzler
- Department of Animal and Rangeland Sciences, Oregon State University, Corvallis, OR, USA
| | - Scott Campbell
- Department of Mechanical, Industrial, and Manufacturing Engineering, Oregon State University, Corvallis, OR, USA
| | - Russell Turner
- College of Public Health and Human Science, Oregon State University, Corvallis, OR, USA
| | - Massimo Bionaz
- Department of Animal and Rangeland Sciences, Oregon State University, Corvallis, OR, USA
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4
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Yu F, Xu Y, Hou Y, Lin Y, Jiajue R, Jiang Y, Wang O, Li M, Xing X, Zhang L, Qin L, Hsieh E, Xia W. Age-, Site-, and Sex-Specific Normative Centile Curves for HR-pQCT-Derived Microarchitectural and Bone Strength Parameters in a Chinese Mainland Population. J Bone Miner Res 2020; 35:2159-2170. [PMID: 32564403 PMCID: PMC9719438 DOI: 10.1002/jbmr.4116] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Revised: 06/03/2020] [Accepted: 06/13/2020] [Indexed: 12/18/2022]
Abstract
High-resolution peripheral quantitative computed tomography (HR-pQCT) is an advanced 3D imaging technology that has the potential to contribute to fracture risk assessment and early diagnosis of osteoporosis. However, to date no studies have sought to establish normative reference ranges for HR-pQCT measures among individuals from the Chinese mainland, significantly restricting its use. In this study, we collected HR-pQCT scans from 863 healthy Chinese men and women aged 20 to 80 years using the latest-generation scanner (Scanco XtremeCT II, Scanco Medical AG, Brüttisellen, Switzerland). Parameters including volumetric bone mineral density, bone geometry, bone microarchitecture, and bone strength were evaluated. Age-, site-, and sex-specific centile curves were established using generalized additive models for location, scale, and shape with age as the only explanatory variable. Based on established models, age-related variations for different parameters were also quantified. For clinical purposes, the expected values of HR-pQCT parameters for a defined age and a defined percentile or Z-score were provided. We found that the majority of trabecular and bone strength parameters reached their peak at 20 years of age, regardless of sex and site, then declined steadily thereafter. However, most of the cortical bone loss was observed after the age of 50 years. Among the measures, cortical porosity changed most dramatically, and overall, changes were more notable at the radius than the tibia and among women compared with men. Establishing such normative HR-pQCT reference data will provide an important basis for clinical and research applications in mainland China aimed at elucidating microstructural bone damage driven by different disease states or nutritional status. © 2020 American Society for Bone and Mineral Research.
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Affiliation(s)
- Fan Yu
- Department of Endocrinology, Key Laboratory of Endocrinology, Ministry of Health, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Beijing, China
| | - Yuping Xu
- Department of Endocrinology, Key Laboratory of Endocrinology, Ministry of Health, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Beijing, China
| | - Yanfang Hou
- Department of Endocrinology, Key Laboratory of Endocrinology, Ministry of Health, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Beijing, China
| | - Yuanyuan Lin
- Department of Endocrinology, Key Laboratory of Endocrinology, Ministry of Health, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Beijing, China
| | - Ruizhi Jiajue
- Department of Endocrinology, Key Laboratory of Endocrinology, Ministry of Health, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Beijing, China
| | - Yan Jiang
- Department of Endocrinology, Key Laboratory of Endocrinology, Ministry of Health, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Beijing, China
| | - Ou Wang
- Department of Endocrinology, Key Laboratory of Endocrinology, Ministry of Health, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Beijing, China
| | - Mei Li
- Department of Endocrinology, Key Laboratory of Endocrinology, Ministry of Health, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Beijing, China
| | - Xiaoping Xing
- Department of Endocrinology, Key Laboratory of Endocrinology, Ministry of Health, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Beijing, China
| | - Li Zhang
- Department of Endocrinology, Key Laboratory of Endocrinology, Ministry of Health, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Beijing, China
| | - Ling Qin
- Bone Quality and Health Center, Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong, China
| | - Evelyn Hsieh
- Section of Rheumatology, Allergy, and Immunology, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Weibo Xia
- Department of Endocrinology, Key Laboratory of Endocrinology, Ministry of Health, Peking Union Medical College Hospital, Chinese Academy of Medical Science, Beijing, China
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Gou GH, Tseng FJ, Wang SH, Chen PJ, Shyu JF, Pan RY. Nutritional factors associated with femoral neck bone mineral density in children and adolescents. BMC Musculoskelet Disord 2019; 20:520. [PMID: 31699056 PMCID: PMC6839089 DOI: 10.1186/s12891-019-2901-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Accepted: 10/17/2019] [Indexed: 12/16/2022] Open
Abstract
Background Nutritional factors including vitamin D, magnesium, and fat are known to affect bone mineral accrual. This study aimed to evaluate associations between dietary nutrient intakes (both macronutrients and micronutrients) and bone mineral density (BMD) in children and adolescents. Methods Data for this cross-sectional, population-based study were derived from the National Health and Nutrition Examination Survey (NHANES). Participants aged from 8 to 19 years were included. The primary outcome was femoral neck BMD. Results Multivariate analyses revealed that for participants aged 8 to 11, daily sodium intake was significantly and positively associated with femoral neck BMD (B = 0.9 × 10− 5, p = 0.031); in particular, subgroup analyses by sex found that in male participants aged 8–11, daily total cholesterol intake (B = 5.3 × 10− 5, p = 0.030) and calcium intake (B = − 2.0 × 10− 5, p < 0.05) were significantly associated with femoral neck BMD in a positive and negative manner, respectively, but neither were observed in female participants of this age group. In contrast, daily intakes of vitamin D and magnesium were significantly and positively associated with femoral neck BMD in female participants aged 8–11 (B = 246.8 × 10− 5 and 16.3 × 10− 5, p = 0.017 and 0.033, respectively). For participants aged 16 to 19, daily total fat intake was significantly and negatively associated with femoral neck BMD (B = − 58 × 10− 5, p = 0.048); further stratification by sex found that magnesium and sodium intakes were significantly and positively associated with femoral neck BMD only in females of this age group (B = 26.9 × 10− 5 and 2.1 × 10− 5, respectively; both p < 0.05). However, no significant associations between daily nutrient intakes and femoral neck BMD were identified in participants aged 12–15 before or after subgroup stratification. Conclusion The study found that associations of specific nutrition-related variables with BMD of the femoral neck is dependent upon age and gender.
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Affiliation(s)
- Guo-Hau Gou
- Graduate Institute of Medical Sciences, National Defense Medical Center, No. 161, Sec.6 Minquan E. Rd., Neihu Dist., Taipei, 11490, Taiwan, Republic of China.,Department of Nursing, Hsin Sheng Junior College of Medical Care and Management, Taoyuan, 32544, Taiwan, Republic of China
| | - Feng-Jen Tseng
- Department of Orthopedics, Hualien Armed Force Hospital, Hualien, 971, Taiwan, Republic of China.,Department of Life Science and the Institute of Biotechnology, National Dong Hwa University, Hualien, 974, Taiwan, Republic of China
| | - Sheng-Hao Wang
- Graduate Institute of Medical Sciences, National Defense Medical Center, No. 161, Sec.6 Minquan E. Rd., Neihu Dist., Taipei, 11490, Taiwan, Republic of China.,Department of Orthopaedics, Tri-Service General Hospital, National Defense Medical Center, Taipei, 11490, Taiwan, Republic of China
| | - Pao-Ju Chen
- Department of Nursing, Hsin Sheng Junior College of Medical Care and Management, Taoyuan, 32544, Taiwan, Republic of China
| | - Jia-Fwu Shyu
- Department of Biology and Anatomy, National Defense Medical Center, Taipei, 11490, Taiwan, Republic of China
| | - Ru-Yu Pan
- Graduate Institute of Medical Sciences, National Defense Medical Center, No. 161, Sec.6 Minquan E. Rd., Neihu Dist., Taipei, 11490, Taiwan, Republic of China. .,Department of Orthopaedics, Tri-Service General Hospital, National Defense Medical Center, Taipei, 11490, Taiwan, Republic of China.
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6
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Calcium Intake in Bone Health: A Focus on Calcium-Rich Mineral Waters. Nutrients 2018; 10:nu10121930. [PMID: 30563174 PMCID: PMC6316542 DOI: 10.3390/nu10121930] [Citation(s) in RCA: 86] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Revised: 11/26/2018] [Accepted: 11/30/2018] [Indexed: 02/06/2023] Open
Abstract
Calcium is an essential element that plays numerous biological functions in the human body, of which one of the most important is skeleton mineralization. Bone is a mineralized connective tissue in which calcium represents the major component, conferring bone strength and structure. Proper dietary calcium intake is important for bone development and metabolism, and its requirement can vary throughout life. The mineral composition of drinking water is becoming relevant in the modulation of calcium homeostasis. In fact, calcium present in mineral drinking waters is an important quantitative source of calcium intake. This, together with its excellent bioavailability, contributes to the maintenance of the bone health. This article aims to examine studies that assessed the bioavailability of the calcium contained in calcium-rich mineral waters and their impact on bone health, including original data collected in a recent study in humans.
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7
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Xi HR, Ma HP, Yang FF, Gao YH, Zhou J, Wang YY, Li WY, Xian CJ, Chen KM. Total flavonoid extract of Epimedium herb increases the peak bone mass of young rats involving enhanced activation of the AC10/cAMP/PKA/CREB pathway. JOURNAL OF ETHNOPHARMACOLOGY 2018; 223:76-87. [PMID: 29783019 DOI: 10.1016/j.jep.2018.05.023] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2018] [Revised: 05/09/2018] [Accepted: 05/17/2018] [Indexed: 06/08/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Epimedium sagittatum brevicornum Maxim. is an important traditional Chinese herb that has long been used to promote bone fracture healing and treat osteoporosis. AIM OF THE STUDY Achieving peak bone mass by adolescence has now been accepted to be fundamental for preventing osteoporosis in adulthood life. This study investigated the possibility of increasing peak bone mass in young rats using the total flavonoid extract of Epimedium herb (TFE). MATERIALS AND METHODS TFE was intragastrically administered to one-month-old Wistar rats at a low (100 mg/kg), middle (200 mg/kg) or high dose (400 mg/kg). Whole body bone mineral density (BMD) was measured by dual-energy X-ray absorptiometry every two weeks. When BMD of any one of TFE groups was found to be significantly higher than that of the control, all rats were sacrificed, serum samples were collected for bone turnover biochemical assays, and femurs, tibiae and vertebrae were isolated and used in BMD, mechanical, micro-structural, histomorphometric and mechanistic studies. RESULTS Administration of TFE at middle and high doses for two months significantly increased the whole body, femoral and vertebral BMDs, and improved the bone mechanical and micro-architectural properties. The serum turnover biochemical results and the enhanced expression levels of bone-formation regulatory genes (Runx-2, OSX, and BMP-2) demonstrated that TFE administration increased bone formation but had no effect on bone resorption. The increased phosphorylation levels in femurs of PKA and CREB and expression of AC10 (the only soluble form of adenylyl cyclase) and the increased serum cAMP level after 4 h of TFE administration indicated that TFE promoted bone formation by activating the AC10/cAMP/PKA/CREB pathway in vivo. CONCLUSIONS Oral administration of TFE at 200 mg/kg for two months can increase the peak bone mass of growing rats, suggesting the possibility of using total flavonoid extract of Epimedium herb to increase the peak bone mass in adolescence which is important for preventing osteoporosis in adult life.
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Affiliation(s)
- Hui-Rong Xi
- School of Pharmacy, Ningxia Medical University, Yinchuan 750004, PR China; Institute of Orthopaedics, Lanzhou General Hospital of CPLA, Lanzhou 730050, PR China
| | - Hui-Ping Ma
- School of Pharmacy, Ningxia Medical University, Yinchuan 750004, PR China; Department of Pharmacy, Lanzhou General Hospital of CPLA, Lanzhou 730050, PR China.
| | - Fang-Fang Yang
- Institute of Orthopaedics, Lanzhou General Hospital of CPLA, Lanzhou 730050, PR China
| | - Yu-Hai Gao
- Institute of Orthopaedics, Lanzhou General Hospital of CPLA, Lanzhou 730050, PR China
| | - Jian Zhou
- Institute of Orthopaedics, Lanzhou General Hospital of CPLA, Lanzhou 730050, PR China
| | - Yuan-Yuan Wang
- Institute of Orthopaedics, Lanzhou General Hospital of CPLA, Lanzhou 730050, PR China
| | - Wen-Yuan Li
- Institute of Orthopaedics, Lanzhou General Hospital of CPLA, Lanzhou 730050, PR China
| | - Cory J Xian
- Sansom Institute for Health Research, School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, SA 5001, Australia
| | - Ke-Ming Chen
- Institute of Orthopaedics, Lanzhou General Hospital of CPLA, Lanzhou 730050, PR China.
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Zhu BY, Yang ZD, Chen XR, Zhou J, Gao YH, Xian CJ, Chen KM. Exposure Duration Is a Determinant of the Effect of Sinusoidal Electromagnetic Fields on Peak Bone Mass of Young Rats. Calcif Tissue Int 2018; 103:95-106. [PMID: 29362823 DOI: 10.1007/s00223-018-0396-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Accepted: 01/17/2018] [Indexed: 11/26/2022]
Abstract
We proposed a three-step strategy to obtain the optimal therapeutic parameters, which is composed of large-scale screening at cellular level, verification in animal experiments, and confirmation by a clinical trial. The objective of the current study was to test the feasibility of our strategy. Newborn rat calvarial osteoblasts were treated by 50 Hz 1.8 mT sinusoidal electromagnetic fields (SEMFs) with 0.5, 1.0, 1.5, 2.0, 2.5, and 3.0 h/days, respectively. The osteogenic differentiation and maturation of the osteoblast were assayed and compared to obtain the optimal duration. One-month-old growing rats were then treated by the same SEMFs with 0.5, 1.5, and 2.5 h/days, respectively, and the peak bone mass was analyzed after 2 months. It was found that the optimal exposure duration to promote the osteogenic differentiation and maturation of osteoblasts was 1.5 h/days, judging by the increasing degrees of ALP activity, calcified nodules formed, the gene and protein expression levels of Runx-2, BMP-2, and Col-I, as well as the expression levels of signaling proteins of the BMP-2/Smad1/5/8 pathway. The highest increase of peak bone mass after 2 months was also obtained by 1.5 h/days, judging by the results of X-ray dual-energy absorptiometry, mechanical property analysis, micro-CT scanning, and serum bone turnover marker examinations. The above results indicated that exposure duration is a determinant for the therapeutic effect of EMFs, and the optimal therapeutic effects only can be obtained by the optimal exposure duration.
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Affiliation(s)
- B Y Zhu
- School of Life Science and Engineering, Lanzhou University of Technology, Lanzhou, 730050, People's Republic of China
- Institute of Orthopaedics, Lanzhou General Hospital of CPLA, Lanzhou, 730050, People's Republic of China
| | - Z D Yang
- School of Life Science and Engineering, Lanzhou University of Technology, Lanzhou, 730050, People's Republic of China.
| | - X R Chen
- College of Life Sciences, Northwest A & F University, Yanglin, 712100, People's Republic of China
| | - J Zhou
- Institute of Orthopaedics, Lanzhou General Hospital of CPLA, Lanzhou, 730050, People's Republic of China
| | - Y H Gao
- Institute of Orthopaedics, Lanzhou General Hospital of CPLA, Lanzhou, 730050, People's Republic of China
| | - C J Xian
- Sansom Institute for Health Research, School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, SA, 5001, Australia
| | - K M Chen
- Institute of Orthopaedics, Lanzhou General Hospital of CPLA, Lanzhou, 730050, People's Republic of China.
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Chaput C, Beaulieu-Gagnon S, Bélanger V, Drouin S, Bertout L, Lafrance L, Olivier C, Robitaille M, Laverdière C, Sinnett D, Marquis M, Marcil V. Research- and Practice-Based Nutrition Education and Cooking Workshops in Pediatric Oncology: Protocol for Implementation and Development of Curriculum. JMIR Res Protoc 2018; 7:e2. [PMID: 29317383 PMCID: PMC5980485 DOI: 10.2196/resprot.8302] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Revised: 10/04/2017] [Accepted: 10/29/2017] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Progresses in childhood cancer treatment, diagnosis, and management have resulted in childhood cancer survival rates of over 80%. However, this therapeutic success comes with a heavy price: two-thirds of childhood cancer survivors will be affected by further complications, including cardiovascular and metabolic diseases. Adequate nutrition during cancer treatment is essential to ensure the child's optimal development, improve tolerance to treatments, and can contribute to lower the risk of developing cardiometabolic diseases. Side effects of cancer treatments can negatively impact children's nutritional intake and eating behaviors. Involving the families of childhood cancer patients in educational workshops could be a promising avenue to promote healthy eating during and after cancer treatment. OBJECTIVE The objectives of this study were to develop, validate, and implement a family-based nutrition education and cooking workshop curriculum in a pediatric oncology setting that addresses the nutritional issues encountered during treatments while promoting the adoption of healthy eating habits for the prevention of long-term cardiometabolic effects. METHODS The workshops were developed and validated following an 8-step iterative process, including a review of the literature and consultations with a steering committee. An evaluation tool was also developed. A nonrandomized study protocol was elaborated to implement the workshops and measure their impact. The themes of the 6 research- and practice-based lessons are as follows: meal fortification during cancer treatment, changes in taste during cancer therapy and their impact on children, adapting diet to eating-related side effects of treatments, nutritional support during cancer treatment, Mediterranean diet and health, and planning quick and economic meals. The validation process included consultations with the institution's clinical nutrition professionals. Self-administered post questionnaires were developed according to the content of each workshop to measure short-term outcomes, namely, participants' perception of knowledge acquisition, behavioral intention, and satisfaction. Medium-term outcomes that will be evaluated are participants' anthropometric profile, quality of the diet, and circulating biomarkers of metabolic health. RESULTS The project was funded in 2016 and enrollment will be completed in 2021. Data analysis is currently under way and the first results are expected to be submitted for publication in 2019. CONCLUSIONS This research- and practice-based nutrition education and cooking demonstration curriculum could be a valuable complement to a multidisciplinary lifestyle intervention for the prevention of long-term cardiometabolic complications in childhood cancer.
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Affiliation(s)
- Cynthia Chaput
- Department of Nutrition, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada.,Research Center of Sainte-Justine University Health Center, Montreal, QC, Canada.,Institute of Nutrition and Functional Foods, Laval University, Quebec City, QC, Canada
| | - Sabrina Beaulieu-Gagnon
- Department of Nutrition, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada.,Research Center of Sainte-Justine University Health Center, Montreal, QC, Canada.,Institute of Nutrition and Functional Foods, Laval University, Quebec City, QC, Canada
| | - Véronique Bélanger
- Department of Nutrition, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada.,Research Center of Sainte-Justine University Health Center, Montreal, QC, Canada.,Institute of Nutrition and Functional Foods, Laval University, Quebec City, QC, Canada
| | - Simon Drouin
- Research Center of Sainte-Justine University Health Center, Montreal, QC, Canada
| | - Laurence Bertout
- Research Center of Sainte-Justine University Health Center, Montreal, QC, Canada
| | - Lucie Lafrance
- Division of Hematology-Oncology, Sainte-Justine University Health Center, Montreal, QC, Canada
| | - Cinthia Olivier
- Division of Hematology-Oncology, Sainte-Justine University Health Center, Montreal, QC, Canada
| | - Marthe Robitaille
- Division of Hematology-Oncology, Sainte-Justine University Health Center, Montreal, QC, Canada
| | - Caroline Laverdière
- Division of Hematology-Oncology, Sainte-Justine University Health Center, Montreal, QC, Canada.,Department of Pediatrics, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada
| | - Daniel Sinnett
- Research Center of Sainte-Justine University Health Center, Montreal, QC, Canada.,Division of Hematology-Oncology, Sainte-Justine University Health Center, Montreal, QC, Canada.,Department of Pediatrics, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada
| | - Marie Marquis
- Department of Nutrition, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada
| | - Valérie Marcil
- Department of Nutrition, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada.,Research Center of Sainte-Justine University Health Center, Montreal, QC, Canada.,Institute of Nutrition and Functional Foods, Laval University, Quebec City, QC, Canada
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