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Heilberg IP, Carvalho AB, Denburg MR. Between a Rock and a Short Place-The Impact of Nephrolithiasis on Skeletal Growth and Development Across the Lifespan. Curr Osteoporos Rep 2024:10.1007/s11914-024-00888-w. [PMID: 39356465 DOI: 10.1007/s11914-024-00888-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/10/2024] [Indexed: 10/03/2024]
Abstract
PURPOSE OF REVIEW The impact of nephrolithiasis on skeletal growth and bone health across the life span of kidney stone formers is reviewed. MAIN FINDINGS Bone disease is an early event among kidney stone formers (SF), with distinct phenotypes according to each age, sex, menopausal status, dietary, hormonal and genetic factors. Nephrolithiasis-associated bone disorder is characterized by reduced bone mineral density (BMD) and histologically discloses low bone formation, high bone resorption and abnormal mineralization. Although hypercalciuria has been presumed to be pathogenic for bone loss in SF, the association of BMD with urinary calcium is not uniform in all studies. Hypocitraturia, metabolic disturbances, cytokines and receptors, growth factors and acid-base status may all influence skeletal outcomes. The potential link of bone disease with vascular calcification and cardiovascular disease among SF is discussed. The unique vulnerability of the younger skeleton to the effects of nephrolithiasis on attainment of peak bone mass and strength is highlighted and the association of bone loss with kidney stone formation early in life indicate the opportunity for intervention to reduce the risk of future bone fractures.
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Affiliation(s)
- Ita Pfeferman Heilberg
- Nephrology Division, Department of Medicine, Universidade Federal de São Paulo, Rua Botucatu 740 - Vila Clementino, São Paulo, 04023-900, Brazil.
| | - Aluizio Barbosa Carvalho
- Nephrology Division, Department of Medicine, Universidade Federal de São Paulo, Rua Botucatu 740 - Vila Clementino, São Paulo, 04023-900, Brazil
| | - Michelle R Denburg
- Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, USA
- Division of Pediatric Nephrology, Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
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Dimai HP, Muschitz C, Amrein K, Bauer R, Cejka D, Gasser RW, Gruber R, Haschka J, Hasenöhrl T, Kainberger F, Kerschan-Schindl K, Kocijan R, König J, Kroißenbrunner N, Kuchler U, Oberforcher C, Ott J, Pfeiler G, Pietschmann P, Puchwein P, Schmidt-Ilsinger A, Zwick RH, Fahrleitner-Pammer A. [Osteoporosis-Definition, risk assessment, diagnosis, prevention and treatment (update 2024) : Guidelines of the Austrian Society for Bone and Mineral Research]. Wien Klin Wochenschr 2024; 136:599-668. [PMID: 39356323 PMCID: PMC11447007 DOI: 10.1007/s00508-024-02441-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/23/2024] [Indexed: 10/03/2024]
Abstract
BACKGROUND Austria is among the countries with the highest incidence and prevalence of osteoporotic fractures worldwide. Guidelines for the prevention and management of osteoporosis were first published in 2010 under the auspices of the then Federation of Austrian Social Security Institutions and updated in 2017. The present comprehensively updated guidelines of the Austrian Society for Bone and Mineral Research are aimed at physicians of all specialties as well as decision makers and institutions in the Austrian healthcare system. The aim of these guidelines is to strengthen and improve the quality of medical care of patients with osteoporosis and osteoporotic fractures in Austria. METHODS These evidence-based recommendations were compiled taking randomized controlled trials, systematic reviews and meta-analyses as well as European and international reference guidelines published before 1 June 2023 into consideration. The grading of recommendations used ("conditional" and "strong") are based on the strength of the evidence. The evidence levels used mutual conversions of SIGN (1++ to 3) to NOGG criteria (Ia to IV). RESULTS The guidelines include all aspects associated with osteoporosis and osteoporotic fractures, such as secondary causes, prevention, diagnosis, estimation of the 10-year fracture risk using FRAX®, determination of Austria-specific FRAX®-based intervention thresholds, drug-based and non-drug-based treatment options and treatment monitoring. Recommendations for the office-based setting and decision makers and institutions in the Austrian healthcare system consider structured care models and options for osteoporosis-specific screening. CONCLUSION The guidelines present comprehensive, evidence-based information and instructions for the treatment of osteoporosis. It is expected that the quality of medical care for patients with this clinical picture will be substantially improved at all levels of the Austrian healthcare system.
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Affiliation(s)
- Hans Peter Dimai
- Klinische Abteilung für Endokrinologie und Diabetologie, Universitätsklinik für Innere Medizin, Medizinische Universität Graz, Graz, Österreich
| | - Christian Muschitz
- healthPi Medical Center, Medizinische Universität Wien, Wollzeile 1-3, 1010, Wien, Österreich.
- Medizinische Universität Wien, Währinger Gürtel 18-20, 1090, Wien, Österreich.
| | - Karin Amrein
- Klinische Abteilung für Endokrinologie und Diabetologie, Universitätsklinik für Innere Medizin, Medizinische Universität Graz, Graz, Österreich
| | | | - Daniel Cejka
- Interne 3 - Nieren- und Hochdruckerkrankungen, Transplantationsmedizin, Rheumatologie, Ordensklinikum Linz Elisabethinen, Linz, Österreich
| | - Rudolf Wolfgang Gasser
- Universitätsklinik für Innere Medizin, Medizinische Universität Innsbruck, Innsbruck, Österreich
| | - Reinhard Gruber
- Universitätszahnklinik, Medizinische Universität Wien, Wien, Österreich
| | - Judith Haschka
- Hanusch Krankenhaus Wien, 1. Medizinische Abteilung, Ludwig Boltzmann Institut für Osteologie, Wien, Österreich
- Rheuma-Zentrum Wien-Oberlaa, Wien, Österreich
| | - Timothy Hasenöhrl
- Universitätsklinik für Physikalische Medizin, Rehabilitation und Arbeitsmedizin, Medizinische Universität Wien, Wien, Österreich
| | - Franz Kainberger
- Klinische Abteilung für Biomedizinische Bildgebung und Bildgeführte Therapie, Universitätsklinik für Radiologie und Nuklearmedizin, Medizinische Universität Wien, Wien, Österreich
| | - Katharina Kerschan-Schindl
- Universitätsklinik für Physikalische Medizin, Rehabilitation und Arbeitsmedizin, Medizinische Universität Wien, Wien, Österreich
| | - Roland Kocijan
- Hanusch Krankenhaus Wien, 1. Medizinische Abteilung, Ludwig Boltzmann Institut für Osteologie, Wien, Österreich
| | - Jürgen König
- Department für Ernährungswissenschaften, Universität Wien, Wien, Österreich
| | | | - Ulrike Kuchler
- Universitätszahnklinik, Medizinische Universität Wien, Wien, Österreich
| | | | - Johannes Ott
- Klinische Abteilung für gynäkologische Endokrinologie und Reproduktionsmedizin, Universitätsklinik für Frauenheilkunde, Medizinische Universität Wien, Wien, Österreich
| | - Georg Pfeiler
- Klinische Abteilung für Gynäkologie und Gynäkologische Onkologie, Universitätsklinik für Frauenheilkunde, Medizinische Universität Wien, Wien, Österreich
| | - Peter Pietschmann
- Institut für Pathophysiologie und Allergieforschung, Zentrum für Pathophysiologie, Infektiologie und Immunologie (CEPII), Medizinische Universität Wien, Wien, Österreich
| | - Paul Puchwein
- Universitätsklinik für Orthopädie und Traumatologie, Medizinische Universität Graz, Graz, Österreich
| | | | - Ralf Harun Zwick
- Ludwig Boltzmann Institut für Rehabilitation Research, Therme Wien Med, Wien, Österreich
| | - Astrid Fahrleitner-Pammer
- Privatordination Prof. Dr. Astrid Fahrleitner-Pammer
- Klinische Abteilung für Endokrinologie und Diabetes, Universitätsklinik für Innere Medizin, Medizinische Universität Graz, Graz, Österreich
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Sánchez C, Larenas F, Arroyave JS, Connors C, Giménez B, Palese MA, Fulla J. Artificial Intelligence in Urology: Application of a Machine Learning Model to Predict the Risk of Urolithiasis in a General Population. J Endourol 2024; 38:712-718. [PMID: 38874940 DOI: 10.1089/end.2023.0702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2024] Open
Abstract
This research presents our application of artificial intelligence (AI) in predicting urolithiasis risk. Previous applications, including AI for stone disease, have focused on stone composition and aiding diagnostic imaging. AI applications centered around patient-specific characteristics, lifestyle considerations, and diet have been limited. Our study comprised a robust sample size of 976 Chilean participants, with meticulously analyzed demographic, lifestyle, and health data through a comprehensive questionnaire. We developed a predictive model using various classifiers, including logistic regression, decision trees, random forests, and extra trees, reaching high accuracy (88%) in identifying individuals at risk of kidney stone formation. Key protective factors highlighted by the algorithm include the pivotal role of hydration, physical activity, and dietary patterns that played a crucial role, emphasizing the protective nature of higher fruit and vegetable intake, balanced dairy consumption, and the nuanced impact of specific protein sources on kidney stone risk. In contrast, identified risk factors encompassed gender disparities with males found to be 2.31 times more likely to develop kidney stones than females. Thirst and self-perceived dark urine color emerged as strong predictors, with a significant increase in the likelihood of stone formation. The development of predictive tools with AI, in urolithiasis management signifies a paradigm shift toward more precise and personalized health care. The algorithm's ability to process extensive datasets, including dietary habits, heralds a new era of data-driven medical practice. This research underscores the transformative impact of AI in medical diagnostics and prevention, paving the way for a future where health care interventions are not only more effective but also tailored to individual patient needs. In this case, AI is an important tool that can help patients stay healthy, prevent diseases, and make informed decisions about their overall well-being.
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Affiliation(s)
- Catherine Sánchez
- Clínica MEDS, Santiago, Chile
- Faculty of Medicine, University of Chile, Santiago, Chile
| | - Francisca Larenas
- Faculty of Medicine, University of Chile, Santiago, Chile
- Department of Urology, Hospital Clínico San Borja Arriarán, Santiago, Chile
| | | | - Christopher Connors
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Belén Giménez
- Faculty of Medicine, University of Chile, Santiago, Chile
- Department of Urology, Hospital Clínico San Borja Arriarán, Santiago, Chile
| | - Michael A Palese
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Juan Fulla
- Clínica MEDS, Santiago, Chile
- Faculty of Medicine, University of Chile, Santiago, Chile
- Department of Urology, Hospital Clínico San Borja Arriarán, Santiago, Chile
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Schneider H, Brüdgam D, Nowotny HF, Schmidmaier R, Reincke M, Adolf C. Moderate salt restriction in primary aldosteronism improves bone metabolism through attenuation of urinary calcium and phosphate losses. Eur J Endocrinol 2024; 190:K47-K52. [PMID: 38557596 DOI: 10.1093/ejendo/lvae020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 01/09/2024] [Accepted: 02/05/2024] [Indexed: 04/04/2024]
Abstract
Accumulating evidence links osteoporosis and dietary salt consumption. Primary aldosteronism (PA) is a model disease with increased dietary salt intake and constitutes an independent risk factor for osteoporosis. We, thus, assessed whether a short-term moderate reduction in salt intake in PA results in detectable osteoanabolic effects. Forty-one patients with PA on stable mineralocorticoid receptor antagonist therapy were subjected to a 12-week salt restriction. Serum and urinary electrolytes, markers of bone turnover, and a 15 steroids plasma profile were registered. After 12 weeks, urinary calcium and phosphate decreased, while plasma testosterone, serum phosphate, and bone alkaline phosphatase (BAP) all increased significantly. Longitudinal changes in BAP were independently correlated with changes in serum phosphate, parathyroid hormone, and urinary calcium in multivariate analysis. Salt restriction in PA limits urinary calcium and phosphate losses and may confer favorable osteoanabolic effects. Our findings suggest that salt restriction should be considered in patients with PA to improve bone health.
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Affiliation(s)
- Holger Schneider
- Department of Medicine IV, LMU University Hospital, LMU Munich, Munich, Germany
| | - Denise Brüdgam
- Department of Medicine IV, LMU University Hospital, LMU Munich, Munich, Germany
| | - Hanna F Nowotny
- Department of Medicine IV, LMU University Hospital, LMU Munich, Munich, Germany
| | - Ralf Schmidmaier
- Department of Medicine IV, LMU University Hospital, LMU Munich, Munich, Germany
| | - Martin Reincke
- Department of Medicine IV, LMU University Hospital, LMU Munich, Munich, Germany
| | - Christian Adolf
- Department of Medicine IV, LMU University Hospital, LMU Munich, Munich, Germany
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Fravel MA, Meaney CJ, Noureddine L. Management of Hyperkalemia in Patients with Chronic Kidney Disease Using Renin Angiotensin Aldosterone System Inhibitors. Curr Hypertens Rep 2023; 25:395-404. [PMID: 37747576 DOI: 10.1007/s11906-023-01265-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/28/2023] [Indexed: 09/26/2023]
Abstract
PURPOSE OF REVIEW Use of renin-angiotensin-aldosterone system (RAAS) inhibiting medications is critical in the prevention of cardiovascular disease and kidney function decline in patients with chronic kidney disease (CKD); however, these agents can lead to hyperkalemia, an electrolyte disorder associated with risk of arrythmia, conduction disorders, and increased overall mortality. Discontinuation, or reduction of dose, of RAAS inhibitor therapy in hyperkalemic patients with CKD can lead to loss of kidney and cardiovascular protection afforded by these medications. Given the high prevalence of hyperkalemia among patients with CKD utilizing RAAS inhibitors, clear management principles are critical to minimize risk and maximize benefit when facing this clinical dilemma. RECENT FINDINGS Strategies to mitigate hyperkalemia that do not interfere with optimal RAAS inhibitor therapy should be prioritized when managing potassium elevation in patients with CKD. These strategies include discontinuing non-RAAS inhibitor medications known to cause hyperkalemia, correction of metabolic acidosis, and maximization of medication therapies that lower serum potassium, including diuretics and sodium-glucose cotransporter-2 (SGLT-2) inhibitors. Initiation of potassium exchange resins should also be considered to allow for sustained RAAS inhibitor utilization. An approach which employs multiple strategies concurrently is important to mitigate hyperkalemia and maintain long-term use of RAAS-inhibitors. Persistence of RAAS inhibitor use in patients with CKD is important to slow kidney function decline, delay onset of dialysis or the need for kidney transplant, and prevent adverse cardiovascular outcomes. When hyperkalemia develops among patients with CKD utilizing a RAAS inhibitor, a deliberate effort to reduce serum potassium levels using an approach that allows for continuation of maximally dosed RAAS inhibitor therapy is important. Patient education and engagement in the potassium management process is important for sustained success.
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Affiliation(s)
- Michelle A Fravel
- University of Iowa College of Pharmacy, 167 CPB, 180 S. Grand Ave, Iowa City, IA, 52242, USA.
| | | | - Lama Noureddine
- Department of Internal Medicine, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, Iowa City, IA, 52242, USA
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Andreo-López MC, Contreras-Bolívar V, García-Fontana B, García-Fontana C, Muñoz-Torres M. The Influence of the Mediterranean Dietary Pattern on Osteoporosis and Sarcopenia. Nutrients 2023; 15:3224. [PMID: 37513646 PMCID: PMC10385532 DOI: 10.3390/nu15143224] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 07/13/2023] [Accepted: 07/19/2023] [Indexed: 07/30/2023] Open
Abstract
Diet is a modifiable factor in bone and muscle health. The Mediterranean diet (MedDiet) is rich in nutrients and contains key bioactive components with probable protective effects on muscle and bone deterioration. Osteoporosis (OP) and sarcopenia are diseases that increase frailty and susceptibility to fracture, morbidity and mortality. Therefore, it is necessary to combat them in the population. In this regard, MedDiet adherence has proven to be beneficial to bone mineral density (BMD), muscle mass, physical function, OP and sarcopenia. Hence, this diet is proposed as a therapeutic tool that could slow the onset of osteoporosis and sarcopenia. However, there is doubt about the interaction between the MedDiet, strength and fracture risk. Perhaps the amount of EVOO (extra virgin olive oil), fruits, vegetables and fish rich in anti-inflammatory and antioxidant nutrients ingested has an influence, though the results remain controversial.
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Affiliation(s)
| | - Victoria Contreras-Bolívar
- Endocrinology and Nutrition Unit, University Hospital Clínico San Cecilio, 18016 Granada, Spain
- Instituto de Investigación Biosanitaria de Granada (Ibs. Granada), 18014 Granada, Spain
- CIBER on Frailty and Healthy Aging (CIBERFES), Instituto de Salud Carlos III, 18012 Granada, Spain
| | - Beatriz García-Fontana
- Instituto de Investigación Biosanitaria de Granada (Ibs. Granada), 18014 Granada, Spain
- CIBER on Frailty and Healthy Aging (CIBERFES), Instituto de Salud Carlos III, 18012 Granada, Spain
- Department of Cell Biology, University of Granada, 18016 Granada, Spain
| | - Cristina García-Fontana
- Endocrinology and Nutrition Unit, University Hospital Clínico San Cecilio, 18016 Granada, Spain
- Instituto de Investigación Biosanitaria de Granada (Ibs. Granada), 18014 Granada, Spain
- CIBER on Frailty and Healthy Aging (CIBERFES), Instituto de Salud Carlos III, 18012 Granada, Spain
| | - Manuel Muñoz-Torres
- Endocrinology and Nutrition Unit, University Hospital Clínico San Cecilio, 18016 Granada, Spain
- Instituto de Investigación Biosanitaria de Granada (Ibs. Granada), 18014 Granada, Spain
- CIBER on Frailty and Healthy Aging (CIBERFES), Instituto de Salud Carlos III, 18012 Granada, Spain
- Department of Medicine, University of Granada, 18016 Granada, Spain
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Ceglia L, Shea K, Rasmussen H, Gilhooly CH, Dawson-Hughes B. A Randomized Study on the Effect of Dried Fruit on Acid-Base Balance, Diet Quality, and Markers of Musculoskeletal Health in Community Dwelling Adults. JOURNAL OF THE AMERICAN NUTRITION ASSOCIATION 2023; 42:476-483. [PMID: 35815972 DOI: 10.1080/27697061.2022.2082599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
OBJECTIVES We tested whether 100 g/day of dried fruit (vs. no supplemental fruit control) for 6 months alters 24-hr urinary net acid excretion (NAE), bone resorption, weight, body composition, muscle performance, and diet quality. We explored consistency of self-selected dietary composition and potential renal acid load (PRAL). METHODS This randomized, single-blind, 2-armed study included 83 normal- and over-weight men and postmenopausal women (age ≥50 years) on self-reported low fruit diets. Endpoints included group differences in NAE (primary), 24-hr urinary N-telopeptide (NTX), weight, body composition, muscle performance, and diet quality. RESULTS At baseline, mean (±SD) age was 69 ± 8 years; 86% were Caucasian; body mass index was 24.5 ± 2.8 kg/m2; 46% female, and NAE was 32.4 ± 23.1 mmol with no significant baseline group differences. No significant group differences were noted in NAE (primary), NTX, weight, body composition, muscle performance or diet quality at 6 months. In the cohort as a whole, 6-month change in NAE was positively associated with change in NTX, but no significant associations were noted in other outcomes. PRAL on the day of the urine collection was positively associated with NAE. Comparison of two consecutive baseline 24-hr diet recalls revealed wide intra-individual variability in PRAL in self-selected diets in our participants. CONCLUSION In this field study of older adults consuming self-selected diets, making one change to the diet by adding 100 g/day of dried fruit (equivalent to 4 servings per day) had no significant impact on NAE when compared to a no supplemental fruit control. This null finding may be attributable to the high day-to-day variability in consumption of foods affecting NAE. Added fruit also had no significant effect on weight, fat, muscle, or bone outcomes over a 6-month period.
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Affiliation(s)
- L Ceglia
- Division of Endocrinology, Tufts Medical Center, Boston, MA, USA
- Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA, USA
| | - K Shea
- Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA, USA
| | - H Rasmussen
- Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA, USA
| | - C H Gilhooly
- Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA, USA
| | - B Dawson-Hughes
- Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA, USA
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Gholami F, Bahrampour N, Samadi M, Rasaei N, Yarizadeh H, Naghshi S, Mirzaei K. The association of dietary acid load (DAL) with estimated skeletal muscle mass and bone mineral content: a cross-sectional study. BMC Nutr 2023; 9:31. [PMID: 36788599 PMCID: PMC9926757 DOI: 10.1186/s40795-022-00658-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 12/21/2022] [Indexed: 02/16/2023] Open
Abstract
BACKGROUND & AIMS Dietary patterns that promote mild metabolic acidosis may have a negative effect on bone and muscle, and a high dietary acid load (DAL) may be detrimental to skeletal muscle mass and bone mineral content. However, the association between skeletal muscle mass and bone mineral content with dietary acid load has not been consistently reported in previous studies. The objective of the study was to evaluate the association of potential renal net acid load (PRAL) and net endogenous acid production (NEAP) with bone mineral content and skeletal muscle mass in pre-menopause women with overweight or obesity in Iran. METHOD Three hundred and ninety women with a body mass index (BMI) of 25 were included in this cross-sectional study. We used a validated 147-item semi-quantitative food frequency questionnaire (FFQ) for evaluating the dietary intake. Based on the dietary data, potential renal net acid load (PRAL) and net endogenous acid production (NEAP) were calculated. Muscle mass and bone mineral content were estimated by a bioelectrical impedance analyzer (BIA). RESULTS After controlling for potential confounders, we discovered a significant linear relationship between PRAL (β = -0.027, 95%CI = -0.049 to -0.004, P = 0.02) and NEAP (β = -0.05, 95%CI = -0.097 to -0.003, P = 0.03) and skeletal muscle mass index. However, there was no significant difference between SMM and BMC across PRAL and NEAP tertiles. CONCLUSION PRAL and NEAP were found to be inversely related to skeletal muscle mass index among overweight/obese women. Further research is required to establish whether this relationship is important for musculoskeletal health in these populations.
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Affiliation(s)
- Fatemeh Gholami
- grid.411705.60000 0001 0166 0922Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), P.O Box 6446, Tehran, 14155 Iran
| | - Niki Bahrampour
- grid.411463.50000 0001 0706 2472Department of Nutrition, Science and Research Branch, Islamic Azad University (SRBIAU), Tehran, Iran
| | - Mahsa Samadi
- grid.411705.60000 0001 0166 0922Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), P.O Box 6446, Tehran, 14155 Iran
| | - Niloufar Rasaei
- grid.411705.60000 0001 0166 0922Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), P.O Box 6446, Tehran, 14155 Iran
| | - Habib Yarizadeh
- grid.411705.60000 0001 0166 0922Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), P.O Box 6446, Tehran, 14155 Iran
| | - Sina Naghshi
- grid.411705.60000 0001 0166 0922Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), P.O Box 6446, Tehran, 14155 Iran
| | - Khadijeh Mirzaei
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), P.O Box 6446, Tehran, 14155, Iran.
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9
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Nouri M, Mahmoodi M, Shateri Z, Ghadiri M, Rajabzadeh-Dehkordi M, Vali M, Gargari BP. How do carbohydrate quality indices influence on bone mass density in postmenopausal women? A case-control study. BMC Womens Health 2023; 23:42. [PMID: 36721166 PMCID: PMC9887922 DOI: 10.1186/s12905-023-02188-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 01/23/2023] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Carbohydrates are the primary energy source in Asian countries, including Iran. An emerging method can be used to measure the quality of carbohydrates, including the carbohydrate quality index (CQI), which includes a variety of components. Low-carbohydrate diet score (LCDS) has been proposed as a new method of scoring micronutrient intake that could provide a reasonable explanation for the link between diet and the risk of chronic diseases. OBJECTIVE This study aimed to investigate the relationship between CQI, LCDS, glycemic index (GI), glycemic load (GL), insulin load (IL), and insulin index (II) with bone mass density (BMD) in postmenopausal women. METHOD In this case-control study, 131 postmenopausal women with osteoporosis/osteopenia and 131 healthy postmenopausal women aged 45-65 participated. The dual-energy X-ray absorptiometry (DEXA) method measured the BMD of the lumbar vertebrae and femoral neck. A validated semi-quantitative food frequency questionnaire was used to assess dietary intake. Logistic regression were used to evaluate the relation between GI, GL, II, IL, CQI, and LCDS with BMD. RESULTS Diets with higher GI increased the risk of osteopenia and osteoporosis, but LCDS and CQI decreased the risk of osteopenia and osteoporosis. CONCLUSION These findings suggest that a higher intake of fruits and vegetables and receiving various dietary vitamins, minerals, and antioxidant compounds may be a useful way to prevent osteopenia in Iranian women.
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Affiliation(s)
- Mehran Nouri
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
- Department of Community Nutrition, School of Nutrition and Food Science, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Marzieh Mahmoodi
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
- Nutrition Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Zainab Shateri
- Student Research Committee, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Marzieh Ghadiri
- Student Research Committee, Department of Biochemistry and Diet Therapy, Faculty of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Milad Rajabzadeh-Dehkordi
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
- Department of Community Nutrition, School of Nutrition and Food Science, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohebat Vali
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Bahram Pourghassem Gargari
- Nutrition Research Center, Department of Biochemistry and Diet Therapy, Faculty of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
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10
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Choi SS, Kim YA, Kim HJ, Cho YJ, Lee GH. The Relationship between Dietary Na/K Ratio and Bone Mineral Density in Korean Middle-Aged Women. Korean J Fam Med 2023; 44:21-27. [PMID: 36709957 PMCID: PMC9887444 DOI: 10.4082/kjfm.21.0208] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 12/20/2021] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Dietary Na+ or Na+/K+ ratio has been reported to be associated with bone mineral density (BMD). However, this remains unclear, and only a few studies have been reported on the Korean population. Therefore, this study aimed to determine the association between dietary Na+, K+, and Na+/K+ ratios and BMD in middle-aged Korean women. METHODS This study used data from the Korea National Health and Nutrition Examination Survey 2008-2011. A total of 3,690 women aged >50 years were included. Study participants were classified into quartiles (lowest quartile Q1-highest quartile Q4) according to dietary Na+, K+, and Na+/K+ ratio, and we examined the association of these parameters with BMD. Total femur and lumbar spine BMD were measured using dual-energy X-ray absorptiometry. Multiple linear regression analyses were performed using IBM SPSS ver. 19.0. RESULTS The mean age was 62 years, and a significant negative trend in the β-coefficient regarding dietary Na+ was only observed in the total femur BMD. However, the total femur and lumbar spine BMD decreased from Q1 to Q4 regarding the dietary Na+/K+ ratio (P-value for trend: 0.044 for total femur BMD and 0.002 for lumbar spine BMD). CONCLUSION A significant negative trend in the β-coefficient for both total femur and lumbar spine BMD was observed regarding the Na+/K+ ratio. Therefore, based on the results of this study, a higher dietary Na+/K+ ratio may be associated with a lower BMD.
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Affiliation(s)
- Seong Su Choi
- Department of Family Medicine, Daegu Catholic University School of Medicine, Daegu, Korea
| | - Yun-A Kim
- Department of Family Medicine, Daegu Catholic University School of Medicine, Daegu, Korea
| | - Hyun Ji Kim
- Department of Family Medicine, Daegu Catholic University School of Medicine, Daegu, Korea
| | - Yoon Jeong Cho
- Department of Family Medicine, Daegu Catholic University School of Medicine, Daegu, Korea
| | - Geon Ho Lee
- Department of Family Medicine, Daegu Catholic University School of Medicine, Daegu, Korea,Corresponding Author: Geon Ho Lee https://orcid.org/0000-0003-0696-3804 Tel: +82-53-650-4696, Fax: +82-53-650-4122, E-mail:
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Unravelling the Complex Relationship between Diet and Nephrolithiasis: The Role of Nutrigenomics and Nutrigenetics. Nutrients 2022; 14:nu14234961. [PMID: 36500991 PMCID: PMC9739708 DOI: 10.3390/nu14234961] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Revised: 11/14/2022] [Accepted: 11/14/2022] [Indexed: 11/24/2022] Open
Abstract
Nephrolithiasis is an increasingly prevalent condition, especially in high income countries, and is associated with high morbidity. Extraordinary progress in genetics made the identification of genetic forms of nephrolithiasis possible. These genetic diseases are usually rare and do not account for the most common forms of nephrolithiasis that are the result of several factors such as environment, dietary habits, and predisposing genes. This knowledge has shaped what we classify as nephrolithiasis, a condition that is now recognized as systemic. How and to what extent all these factors interact with one another and end in kidney stone formation, growth, and recurrence is not completely understood. Two new research fields have recently been trying to give some answers: nutrigenomics and nutrigenetics. These fields have the aim of understanding the intricate diet/genome interface that influences gene expression regulation mainly through epigenetic mechanisms and results in specific medical conditions such as cancer, metabolic syndrome, and cardiovascular diseases. Epigenetics seems to play a crucial role and could represent the link between environmental factors, that we are constantly exposed to, and risk factors for nephrolithiasis. In this systematic review, we summarize all the available evidence of proven or hypothesized epigenetic mechanisms related to nephrolithiasis.
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12
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Tang J, Tang O. Introductory Chapter: Potassium in Human Health. Physiology (Bethesda) 2022. [DOI: 10.5772/intechopen.101409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
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13
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Gregson CL, Armstrong DJ, Bowden J, Cooper C, Edwards J, Gittoes NJL, Harvey N, Kanis J, Leyland S, Low R, McCloskey E, Moss K, Parker J, Paskins Z, Poole K, Reid DM, Stone M, Thomson J, Vine N, Compston J. UK clinical guideline for the prevention and treatment of osteoporosis. Arch Osteoporos 2022; 17:58. [PMID: 35378630 PMCID: PMC8979902 DOI: 10.1007/s11657-022-01061-5] [Citation(s) in RCA: 163] [Impact Index Per Article: 81.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 01/03/2022] [Indexed: 02/03/2023]
Abstract
The National Osteoporosis Guideline Group (NOGG) has revised the UK guideline for the assessment and management of osteoporosis and the prevention of fragility fractures in postmenopausal women, and men age 50 years and older. Accredited by NICE, this guideline is relevant for all healthcare professionals involved in osteoporosis management. INTRODUCTION The UK National Osteoporosis Guideline Group (NOGG) first produced a guideline on the prevention and treatment of osteoporosis in 2008, with updates in 2013 and 2017. This paper presents a major update of the guideline, the scope of which is to review the assessment and management of osteoporosis and the prevention of fragility fractures in postmenopausal women, and men age 50 years and older. METHODS Where available, systematic reviews, meta-analyses and randomised controlled trials were used to provide the evidence base. Conclusions and recommendations were systematically graded according to the strength of the available evidence. RESULTS Review of the evidence and recommendations are provided for the diagnosis of osteoporosis, fracture-risk assessment and intervention thresholds, management of vertebral fractures, non-pharmacological and pharmacological treatments, including duration and monitoring of anti-resorptive therapy, glucocorticoid-induced osteoporosis, and models of care for fracture prevention. Recommendations are made for training; service leads and commissioners of healthcare; and for review criteria for audit and quality improvement. CONCLUSION The guideline, which has received accreditation from the National Institute of Health and Care Excellence (NICE), provides a comprehensive overview of the assessment and management of osteoporosis for all healthcare professionals involved in its management. This position paper has been endorsed by the International Osteoporosis Foundation and by the European Society for the Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases.
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Affiliation(s)
- Celia L Gregson
- Musculoskeletal Research Unit, Bristol Medical School, Learning and Research Building, University of Bristol, Southmead Hospital, Bristol, BS10 5NB, UK.
- Royal United Hospital NHS Foundation Trust, Bath, UK.
| | - David J Armstrong
- Western Health and Social Care Trust (NI), Nutrition Innovation Centre for Food and Health, Ulster University, and Visiting Professor, Belfast, Northern Ireland
| | - Jean Bowden
- Musculoskeletal Research Unit, Bristol Medical School, Learning and Research Building, University of Bristol, Southmead Hospital, Bristol, BS10 5NB, UK
| | - Cyrus Cooper
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
- NIHR Oxford Biomedical Research Centre, University of Oxford, Oxford, UK
| | - John Edwards
- Primary Care Centre Versus Arthritis, School of Medicine, Keele University, Staffordshire, and Wolstanton Medical Centre, Newcastle under Lyme, UK
| | - Neil J L Gittoes
- Centre for Endocrinology, Diabetes and Metabolism, Queen Elizabeth Hospital, University Hospitals Birmingham & University of Birmingham, Birmingham, UK
| | - Nicholas Harvey
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - John Kanis
- Mary McKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia and Centre for Metabolic Bone Diseases, University of Sheffield, Sheffield, UK
| | | | - Rebecca Low
- Abingdon and Specialty Doctor in Metabolic Bone Disease, Marcham Road Health Centre, Nuffield Orthopaedic Centre, Oxford, UK
| | - Eugene McCloskey
- Department of Oncology & Metabolism, MRC Versus Arthritis Centre for Integrated Research in Musculoskeletal Ageing (CIMA), Mellanby Centre for Musculoskeletal Research, University of Sheffield, Sheffield, UK
| | - Katie Moss
- St George's University Hospital, London, UK
| | - Jane Parker
- Musculoskeletal Research Unit, Bristol Medical School, Learning and Research Building, University of Bristol, Southmead Hospital, Bristol, BS10 5NB, UK
| | - Zoe Paskins
- School of Medicine, Keele University, Keele, Haywood Academic Rheumatology Centre, Haywood Hospital, Midlands Partnership NHS Foundation Trust, Stoke-on-Trent, UK
| | - Kenneth Poole
- Department of Medicine, University of Cambridge, Cambridge, UK
- NIHR Cambridge Biomedical Research Centre, Cambridge, UK
| | | | - Mike Stone
- University Hospital Llandough, Cardiff and Vale University Health Board, Llandough, UK
| | | | - Nic Vine
- Musculoskeletal Research Unit, Bristol Medical School, Learning and Research Building, University of Bristol, Southmead Hospital, Bristol, BS10 5NB, UK
| | - Juliet Compston
- University of Cambridge, School of Clinical Medicine, Cambridge, UK
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14
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Stock JM, Chelimsky G, Edwards DG, Farquhar WB. Dietary sodium and health: How much is too much for those with orthostatic disorders? Auton Neurosci 2022; 238:102947. [PMID: 35131651 PMCID: PMC9296699 DOI: 10.1016/j.autneu.2022.102947] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 11/09/2021] [Accepted: 01/16/2022] [Indexed: 10/19/2022]
Abstract
High dietary salt (NaCl) increases blood pressure (BP) and can adversely impact multiple target organs including the vasculature, heart, kidneys, brain, autonomic nervous system, skin, eyes, and bone. However, patients with orthostatic disorders are told to increase their NaCl intake to help alleviate symptoms. While there is evidence to support the short-term benefits of increasing NaCl intake in these patients, there are few studies assessing the benefits and side effects of long-term high dietary NaCl. The evidence reviewed suggests that high NaCl can adversely impact multiple target organs, often independent of BP. However, few of these studies have been performed in patients with orthostatic disorders. We conclude that the recommendation to increase dietary NaCl in patients with orthostatic disorders should be done with care, keeping in mind the adverse impact on dietary NaCl in people without orthostatic disorders. Modest, rather than robust, increases in NaCl intake may be sufficient to alleviate symptoms but also minimize any long-term negative effects.
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Affiliation(s)
- Joseph M Stock
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, DE, United States of America
| | - Gisela Chelimsky
- Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI, United States of America
| | - David G Edwards
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, DE, United States of America
| | - William B Farquhar
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, DE, United States of America.
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15
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Short-Term Supplemental Dietary Potassium from Potato and Potassium Gluconate: Effect on Calcium Retention and Urinary pH in Pre-Hypertensive-to-Hypertensive Adults. Nutrients 2021; 13:nu13124399. [PMID: 34959951 PMCID: PMC8707887 DOI: 10.3390/nu13124399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Revised: 11/24/2021] [Accepted: 12/06/2021] [Indexed: 11/17/2022] Open
Abstract
Potassium supplementation has been associated with reduced urinary calcium (Ca) excretion and increased Ca balance. Dietary interventions assessing the impact of potassium on bone are lacking. In this secondary analysis of a study designed primarily to determine blood pressure effects, we assessed the effects of potassium intake from potato sources and a potassium supplement on urinary Ca, urine pH, and Ca balance. Thirty men (n = 15) and women (n = 15) with a mean ± SD age and BMI of 48.2 ± 15 years and 31.4 ± 6.1 kg/m2, respectively, were enrolled in a cross-over, randomized control feeding trial. Participants were assigned to a random order of four 16-day dietary potassium interventions including a basal diet (control) of 2300 mg/day (~60 mmol/day) of potassium, and three phases of an additional 1000 mg/day (3300 mg/day(~85 mmol/day) total) of potassium in the form of potatoes (baked, boiled, or pan-heated), French fries (FF), or a potassium (K)-gluconate supplement. Calcium intake for all diets was approximately 700–800 mg/day. Using a mixed model ANOVA there was a significantly lower urinary Ca excretion in the K-gluconate phase (96 ± 10 mg/day) compared to the control (115 ± 10 mg/day; p = 0.027) and potato (114 ± 10 mg/day; p = 0.033). In addition, there was a significant difference in urinary pH between the supplement and control phases (6.54 ± 0.16 vs. 6.08 ± 0.18; p = 0.0036). There were no significant differences in Ca retention. An increased potassium intake via K-gluconate supplementation may favorably influence urinary Ca excretion and urine pH. This trial was registered at ClinicalTrials.gov as NCT02697708.
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16
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Cao JJ, Roemmich JN, Sheng X, Jahns L. Increasing Vegetable Intake Decreases Urinary Acidity and Bone Resorption Marker in Overweight and Obese Adults: An 8-Week Randomized Controlled Trial. J Nutr 2021; 151:3413-3420. [PMID: 34386816 DOI: 10.1093/jn/nxab255] [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: 05/02/2021] [Revised: 05/18/2021] [Accepted: 07/08/2021] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Controlled intervention trials are needed to confirm a positive association from epidemiological studies between vegetable consumption and bone health. OBJECTIVE We investigated whether providing vegetables at the Dietary Guidelines for Americans (DGA) recommended amount affects excretion of acid and calcium in urine and bone turnover markers in serum in adults with low vegetable intake. METHODS In total, 102 adults (19 males and 83 females, age 18-65 y, BMI ≥25 kg/m2) consuming ≤1 serving of vegetables (128 g raw leafy or 64 g cooked vegetables) per d were recruited in a 2-arm, parallel, randomized, controlled, and community-based 8-wk feeding intervention trial. The 2 arms included a vegetable intervention (VI) during which participants received extra vegetables (∼270 g/d) and an attention control (CON) group that conducted only the testing visits. Measurements included nutrient intake, plasma carotenoids, and bone-related markers in serum and urine. Differences between CON and VI at week 8 were tested using the ANCOVA with baseline values as a covariate. RESULTS Compared with CON, carotenoid intake (mean ± SD) was higher (6.4 ± 3.4 compared with 2.0 ± 1.2 mg/d) (P < 0.01) and dietary potential renal acid load was lower (20 ± 13 compared with 3.4 ± 14 mEq/d) (P < 0.01) in VI. Compared with CON at week 8, urine titratable acid and Mg were 24 and 26% lower, respectively, while urine pH was 3% greater (P < 0.05) and serum C-terminal telopeptide of type I collagen (CTX) was 19% lower in VI. There were no group differences in serum concentrations of propeptide of type 1 procollagen and tartrate-resistant acid phosphatase or urinary excretion of deoxypyridinoline and CTX. CONCLUSIONS Consumption of vegetables at the DGA-recommended amount by adults with low vegetable intake potentially benefits bone health. This trial was registered at clinicaltrials.gov as NCT02585102.
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Affiliation(s)
- Jay J Cao
- USDA, Agricultural Research Service, Grand Forks Human Nutrition Research Center, Grand Forks, ND, USA
| | - James N Roemmich
- USDA, Agricultural Research Service, Grand Forks Human Nutrition Research Center, Grand Forks, ND, USA
| | - Xiaoming Sheng
- Applied Statistics, University of Utah College of Nursing, Salt Lake City, UT, USA
| | - Lisa Jahns
- USDA, Agricultural Research Service, Grand Forks Human Nutrition Research Center, Grand Forks, ND, USA
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Chuang SY, Chang HY, Fang HL, Lee SC, Hsu YY, Yeh WT, Liu WL, Pan WH. The Healthy Taiwanese Eating Approach is inversely associated with all-cause and cause-specific mortality: A prospective study on the Nutrition and Health Survey in Taiwan, 1993-1996. PLoS One 2021; 16:e0251189. [PMID: 33956833 PMCID: PMC8101962 DOI: 10.1371/journal.pone.0251189] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Accepted: 04/21/2021] [Indexed: 11/18/2022] Open
Abstract
Background Few longitudinal studies have investigated the association between foods/dietary pattern and mortality risk in the Asian population. We investigated the prospective association between foods/dietary pattern and risk of death among ethnic Chinese adults in Taiwan. Methods The study population included 2475 young and middle-aged adults (aged 18–65 years at baseline) who completed the questionnaires and physical examinations in the Nutrition and Health Survey in Taiwan from 1993 to 1996. A food frequency questionnaire was administered to assess food consumption habits in a face-to-face interview. With survey data linked to the Taiwanese Death Registry, Cox proportional hazard model was used to identify the foods associated with all-cause mortality(followed until 2012), which were then tallied to calculate a dietary pattern score called Taiwanese Eating Approach(TEA) score. The TEA scores were then associated with various kinds of mortality outcomes. In addition, data from 431 elders (aged≥65 yrs) with 288 death endpoints were used to conduct a sensitivity analysis. Results A total of 385(15.6%) participants died (111 cardiovascular related deaths and 122 cancer related deaths) during the 17.8-year follow-up period(41274 person-years). Twelve foods (9 inverse [vegetables/fish/milk/tea](+1) and 3 positive[fatty meats/fermented vegetables/sweet drinks](-1)) were significantly associated with all-cause mortality risk. All adults were grouped by their cumulative food score into three diet groups: poor diet(29.3% of all subjects), average diet(44.0%), and healthy diet(26.70%). The better the diet, the lower the total, cardiovascular, and other cause mortality outcomes (trend-p < .001). The hazard ratio for the healthy diet was 0.64 (95% confidence interval:0.47–0.87) for total mortality, and 0.52(0.28–0.95) for cardiovascular death, compared with the poor diet in the multivariable models. This phenomenon was also seen in older adults for all-cause, cancer, and other cause mortalities. Conclusion Consuming a healthy Taiwanese Eating Approach (TEA) diet is negatively associated with all-cause, cardiovascular, and other-cause mortalities in Taiwan.
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Affiliation(s)
- Shao-Yuan Chuang
- Institute of Population Health Science, National Health Research Institutes, Miaoli, Taiwan, R.O.C
- * E-mail: (SYC); (WHP)
| | - Hsing-Yi Chang
- Institute of Population Health Science, National Health Research Institutes, Miaoli, Taiwan, R.O.C
- Institute of Public Health, National Yang Ming University, Taipei, Taiwan, R.O.C
| | - Hsin-Ling Fang
- Institute of Population Health Science, National Health Research Institutes, Miaoli, Taiwan, R.O.C
| | - Shu-Chen Lee
- Institute of Biomedical Sciences, Academic Sinica, Taipei, Taiwan, R.O.C
| | - Yueh-Ying Hsu
- Institute of Population Health Science, National Health Research Institutes, Miaoli, Taiwan, R.O.C
| | - Wen-Ting Yeh
- Institute of Biomedical Sciences, Academic Sinica, Taipei, Taiwan, R.O.C
| | - Wen-Ling Liu
- Institute of Population Health Science, National Health Research Institutes, Miaoli, Taiwan, R.O.C
| | - Wen-Harn Pan
- Institute of Population Health Science, National Health Research Institutes, Miaoli, Taiwan, R.O.C
- Institute of Biomedical Sciences, Academic Sinica, Taipei, Taiwan, R.O.C
- * E-mail: (SYC); (WHP)
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18
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Özkaya İ. Nutritional status of the free-living elderly. Cent Eur J Public Health 2021; 29:68-75. [PMID: 33831289 DOI: 10.21101/cejph.a5925] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Accepted: 01/06/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Measuring malnutrition is difficult in all settings and confused with the signs of aging. Mini nutritional assessment is an effective tool designed to identify older adults who have a risk of developing malnutrition. METHODS Three hundred and one free-living elderly who lived with their family or alone were included in the study. Nutritional screening was performed with mini nutritional assessment and mini nutritional assessment short form. Dietary intake was assessed by a 3-days weighted food record. RESULTS According to mini nutritional assessment in the 65-74 years young-old group, malnutrition, risk of malnutrition, and normal nutrition was 2.4%, 39.5%, 58.2%, respectively, and in the 75-84 years old-old group it was 10.2%, 48.7%, 41.0%, respectively, and in the older than 85 years oldest-old group 92.3%, 7.7%, 0%, respectively. The lowest nutritional intake by recommended dietary allowance was zinc and the highest intake was sodium. Neither young-old group nor old-old group nor oldest-old group met the B12 and zinc requirements. CONCLUSIONS The free-living elderly at an age of 85 years and above are, accompanied by the existence of factors which may mask their weight losses, under a severe risk of malnutrition unless they receive adequate medical care and attention.
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Affiliation(s)
- İsmail Özkaya
- Department of Nutrition and Dietetics, School of Health, Kirklareli University, Kirklareli, Turkey
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19
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Abstract
PURPOSE OF REVIEW Much of what we know about dietary patterns (DPs) and bone is derived from cross-sectional studies in adults. Given, establishing healthy bones during childhood serves as a blueprint for adult bone, it is important to better understand the role of DPs on pediatric bone. The purpose of this review is to determine if DPs influence bone strength in children. RECENT FINDINGS The majority of studies investigating the role of DPs on pediatric bone are cross-sectional in design and examine data-derived "a posterori" DPs. Overall, the DPs characterized by high intakes of fruits and vegetables demonstrated positive effects on pediatric bone. Results from both "a posteriori" and "a priori" DPs approaches in children suggests that DPs dominated by the intake of fruits and vegetables might be beneficial for pediatric bone. Future studies may consider "a priori" DPs interventions to better understand relationship between DPs and pediatric bone.
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Affiliation(s)
- Lauren M Coheley
- Department of Foods and Nutrition, The University of Georgia, 279 Dawson Hall, 305 Sanford Drive, Athens, GA, USA.
| | - Richard D Lewis
- Department of Foods and Nutrition, The University of Georgia, 279 Dawson Hall, 305 Sanford Drive, Athens, GA, USA
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Shahriarpour Z, Nasrabadi B, Shariati-Bafghi SE, Karamati M, Rashidkhani B. Adherence to the dietary approaches to stop hypertension (DASH) dietary pattern and osteoporosis risk in postmenopausal Iranian women. Osteoporos Int 2020; 31:2179-2188. [PMID: 32556519 DOI: 10.1007/s00198-020-05450-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Accepted: 05/04/2020] [Indexed: 12/14/2022]
Abstract
UNLABELLED This is the first study to examine the association of adherence to the dietary approaches to stop hypertension (DASH) dietary pattern and osteoporosis risk in postmenopausal Iranian women. Findings suggest the inverse association of adherence to the DASH dietary pattern and osteoporosis risk in postmenopausal Iranian women. INTRODUCTION This study was aimed to examine the association of adherence to the dietary approaches to stop hypertension (DASH) dietary pattern and osteoporosis risk in postmenopausal Iranian women, hypothesizing that higher adherence to this pattern is associated with lower risk of postmenopausal osteoporosis. METHODS One hundred fifty-one postmenopausal Iranian women aged 50-85 years participated in this cross-sectional study. Lumbar spine and femoral neck bone mineral densities (BMDs) were measured via dual-energy X-ray absorptiometry. Postmenopausal osteoporosis was then defined using the WHO criteria as a BMD T-score of ≤ - 2.5 standard deviations. The usual past-year dietary intakes were assessed by a valid and reliable 168-item food frequency questionnaire. The DASH score was then calculated based on energy-adjusted intakes of eight major dietary components usually emphasized (i.e., fruits, vegetables, nuts and legumes, low-fat dairy products, and whole grains) or minimized (i.e., sodium, sweets, and red or processed meats) in the DASH diet. The higher the DASH score of a participant, the higher the adherence to the DASH dietary pattern. RESULTS After adjusting for several potential covariates in the multivariable-adjusted binary logistic regression analysis, participants in the highest tertile of DASH score had lower risk of osteoporosis at lumbar spine than those in the lowest tertile (odds ratio = 0.28; 95% confidence interval, 0.09-0.88; p = 0.029). However, no significant association was observed between adherence to the DASH dietary pattern and risk of osteoporosis at femoral neck. CONCLUSION Findings suggest the inverse association of adherence to the DASH dietary pattern and osteoporosis risk in postmenopausal Iranian women.
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Affiliation(s)
- Z Shahriarpour
- Department of Nutrition Sciences, Varastegan Institute for Medical Sciences, Mashhad, Iran
| | - B Nasrabadi
- Department of Exercise Physiology, Faculty of Physical Education and Sport Sciences, Islamic Azad University, Karaj Branch, Karaj, Iran
| | - S-E Shariati-Bafghi
- Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - M Karamati
- Department of Community Nutrition, School of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute (WHO Collaborating Center), Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - B Rashidkhani
- Department of Community Nutrition, School of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute (WHO Collaborating Center), Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Suri S, Kumar V, Kumar S, Goyal A, Tanwar B, Kaur J, Kaur J. DASH Dietary Pattern: A Treatment for Non-communicable Diseases. Curr Hypertens Rev 2020; 16:108-114. [PMID: 31589127 PMCID: PMC7499347 DOI: 10.2174/1573402115666191007144608] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Revised: 08/23/2019] [Accepted: 08/26/2019] [Indexed: 02/07/2023]
Abstract
Non-communicable diseases are the major inducer of mortality and morbidity in the Western world. In terms of nutrition, a diet high in fat (particularly saturated fat), salt and sugars have shown to be associated with innumerable incidence of diet- associated health diseases. Dietary modification is a central part of any treatment strategy. The Dietary Approach to Stop Hypertension (DASH) diet is one among such healthy dietary patterns, which emphasizes on the consumption of fruits, vegetables and low-fat dairy foods, including whole grains, poultry, fish, and small quantities of red meat, sweets and drinks containing sugar. This study provides certain practical evidence that prolonged adoption of DASH diet which can be a useful treatment for numerous non-communicable diseases with a sustained effect on the health that involves both accessibility and proximity to healthy eating choices. Long-term studies are required to assess whether these effects are maintained over time.
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Affiliation(s)
- Sheenam Suri
- Food Technology and Nutrition, School of Agriculture, Lovely Professional University, Phagwara, Punjab-144411, India
| | - Vikas Kumar
- Food Technology and Nutrition, School of Agriculture, Lovely Professional University, Phagwara, Punjab-144411, India
| | - Satish Kumar
- Food Technology and Nutrition, School of Agriculture, Lovely Professional University, Phagwara, Punjab-144411, India
| | - Ankit Goyal
- Department of Dairy Chemistry, Mansinhbhai Institute of Dairy and Food Technology, Mehsana, Gujarat- 384002, India
| | - Beenu Tanwar
- Department of Dairy Technology, Mansinhbhai Institute of Dairy and Food Technology, Mehsana, Gujarat-384002, India
| | - Jasleen Kaur
- Food Technology and Nutrition, School of Agriculture, Lovely Professional University, Phagwara, Punjab-144411, India
| | - Jaspreet Kaur
- Food Technology and Nutrition, School of Agriculture, Lovely Professional University, Phagwara, Punjab-144411, India
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Zhu L, Hua F, Ding W, Ding K, Zhang Y, Xu C. The correlation between the Th17/Treg cell balance and bone health. IMMUNITY & AGEING 2020; 17:30. [PMID: 33072163 PMCID: PMC7557094 DOI: 10.1186/s12979-020-00202-z] [Citation(s) in RCA: 54] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Accepted: 10/06/2020] [Indexed: 02/08/2023]
Abstract
With the ageing of the world population, osteoporosis has become a problem affecting quality of life. According to the traditional view, the causes of osteoporosis mainly include endocrine disorders, metabolic disorders and mechanical factors. However, in recent years, the immune system and immune factors have been shown to play important roles in the occurrence and development of osteoporosis. Among these components, regulatory T (Treg) cells and T helper 17 (Th17) cells are crucial for maintaining bone homeostasis, especially osteoclast differentiation. Treg cells and Th17 cells originate from the same precursor cells, and their differentiation requires involvement of the TGF-β regulated signalling pathway. Treg cells and Th17 cells have opposite functions. Treg cells inhibit the differentiation of osteoclasts in vivo and in vitro, while Th17 cells promote the differentiation of osteoclasts. Therefore, understanding the balance between Treg cells and Th17 cells is anticipated to provide a new idea for the development of novel treatments for osteoporosis.
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Affiliation(s)
- Lei Zhu
- The Third Affiliated Hospital of Soochow University, The First People's Hospital of Changzhou, Jiangsu, 213003 China
| | - Fei Hua
- The Third Affiliated Hospital of Soochow University, The First People's Hospital of Changzhou, Jiangsu, 213003 China
| | - Wenge Ding
- The Third Affiliated Hospital of Soochow University, The First People's Hospital of Changzhou, Jiangsu, 213003 China
| | - Kai Ding
- The Third Affiliated Hospital of Soochow University, The First People's Hospital of Changzhou, Jiangsu, 213003 China
| | - Yige Zhang
- The Third Affiliated Hospital of Soochow University, The First People's Hospital of Changzhou, Jiangsu, 213003 China
| | - Chenyang Xu
- The Third Affiliated Hospital of Soochow University, The First People's Hospital of Changzhou, Jiangsu, 213003 China
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23
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Humalda JK, Yeung SMH, Geleijnse JM, Gijsbers L, Riphagen IJ, Hoorn EJ, Rotmans JI, Vogt L, Navis G, Bakker SJL, de Borst MH. Effects of Potassium or Sodium Supplementation on Mineral Homeostasis: A Controlled Dietary Intervention Study. J Clin Endocrinol Metab 2020; 105:5854371. [PMID: 32506135 PMCID: PMC7365698 DOI: 10.1210/clinem/dgaa359] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 06/03/2020] [Indexed: 11/19/2022]
Abstract
CONTEXT Although dietary potassium and sodium intake may influence calcium-phosphate metabolism and bone health, the effects on bone mineral parameters, including fibroblast growth factor 23 (FGF23), are unclear. OBJECTIVE Here, we investigated the effects of potassium or sodium supplementation on bone mineral parameters. DESIGN, SETTING, PARTICIPANTS We performed a post hoc analysis of a dietary controlled randomized, blinded, placebo-controlled crossover trial. Prehypertensive individuals not using antihypertensive medication (n = 36) received capsules containing potassium chloride (3 g/d), sodium chloride (3 g/d), or placebo. Linear mixed-effect models were used to estimate treatment effects. RESULTS Potassium supplementation increased plasma phosphate (from 1.10 ± 0.19 to 1.15 ± 0.19 mmol/L, P = 0.004), in line with an increase in tubular maximum of phosphate reabsorption (from 0.93 ± 0.21 to 1.01 ± 0.20 mmol/L, P < 0.001). FGF23 decreased (114.3 [96.8-135.0] to 108.5 [93.5-125.9] RU/mL, P = 0.01), without change in parathyroid hormone and 25-hydroxy vitamin D3. Fractional calcium excretion decreased (from 1.25 ± 0.50 to 1.11 ± 0.46 %, P = 0.03) without change in plasma calcium. Sodium supplementation decreased both plasma phosphate (from 1.10 ± 0.19 to 1.06 ± 0.21 mmol/L, P = 0.03) and FGF23 (from 114.3 [96.8-135.0] to 108.7 [92.3-128.1] RU/mL, P = 0.02). Urinary and fractional calcium excretion increased (from 4.28 ± 1.91 to 5.45 ± 2.51 mmol/24 hours, P < 0.001, and from 1.25 ± 0.50 to 1.44 ± 0.54 %, P = 0.004, respectively). CONCLUSIONS Potassium supplementation led to a decrease in FGF23, which was accompanied by increase in plasma phosphate and decreased calcium excretion. Sodium supplementation reduced FGF23, but this was accompanied by decrease in phosphate and increase in fractional calcium excretion. Our results indicate distinct effects of potassium and sodium intake on bone mineral parameters, including FGF23. CLINICAL TRIAL REGISTRATION NUMBER NCT01575041.
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Affiliation(s)
- Jelmer K Humalda
- Department of Internal Medicine, Division of Nephrology, University of Groningen, University Medical Center Groningen, RB Groningen, the Netherlands
| | - Stanley M H Yeung
- Department of Internal Medicine, Division of Nephrology, University of Groningen, University Medical Center Groningen, RB Groningen, the Netherlands
| | - Johanna M Geleijnse
- Division of Human Nutrition and Health, Wageningen University, HB Wageningen, the Netherlands
| | - Lieke Gijsbers
- Division of Human Nutrition and Health, Wageningen University, HB Wageningen, the Netherlands
| | - Ineke J Riphagen
- Department of Laboratory Medicine, University of Groningen, University Medical Center Groningen, RB Groningen, the Netherlands
| | - Ewout J Hoorn
- Department of Internal Medicine, Division of Nephrology & Transplantation, Erasmus Medical Center, University Medical Center Rotterdam, CA Rotterdam, The Netherlands
| | - Joris I Rotmans
- Department of Internal Medicine, Leiden University Medical Center, RC Leiden, the Netherlands
| | - Liffert Vogt
- Department of Internal Medicine, Section of Nephrology, Amsterdam Cardiovascular Sciences, Amsterdam University Medical Centers, University of Amsterdam, DD Amsterdam Zuidoost, the Netherlands
| | - Gerjan Navis
- Department of Internal Medicine, Division of Nephrology, University of Groningen, University Medical Center Groningen, RB Groningen, the Netherlands
| | - Stephan J L Bakker
- Department of Internal Medicine, Division of Nephrology, University of Groningen, University Medical Center Groningen, RB Groningen, the Netherlands
| | - Martin H de Borst
- Department of Internal Medicine, Division of Nephrology, University of Groningen, University Medical Center Groningen, RB Groningen, the Netherlands
- Correspondence and Reprint Requests: Martin H. de Borst, MD, PhD, Department of Internal Medicine, Division of Nephrology, University of Groningen, University Medical Center Groningen, P.O. Box 30.001, 9700 RB Groningen, the Netherlands. E-mail:
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24
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Clegg DJ, Headley SA, Germain MJ. Impact of Dietary Potassium Restrictions in CKD on Clinical Outcomes: Benefits of a Plant-Based Diet. Kidney Med 2020; 2:476-487. [PMID: 32775988 PMCID: PMC7406842 DOI: 10.1016/j.xkme.2020.04.007] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
In patients with advanced-stage chronic kidney disease (CKD), progressive kidney function decline leads to increased risk for hyperkalemia (serum potassium > 5.0 or >5.5 mEq/L). Medications such as renin-angiotensin-aldosterone system inhibitors pose an additional hyperkalemia risk, especially in patients with CKD. When hyperkalemia develops, clinicians often recommend a diet that is lower in potassium content. This review discusses the barriers to adherence to a low-potassium diet and the impact of dietary restrictions on adverse clinical outcomes. Accumulating evidence indicates that a diet that incorporates potassium-rich foods has multiple health benefits, which may also be attributable to the other vitamin, mineral, and fiber content of potassium-rich foods. These benefits include blood pressure reductions and reduced risks for cardiovascular disease and stroke. High-potassium foods may also prevent CKD progression and reduce mortality risk in patients with CKD. Adjunctive treatment with the newer potassium-binding agents, patiromer and sodium zirconium cyclosilicate, may allow for optimal renin-angiotensin-aldosterone system inhibitor therapy in patients with CKD and hyperkalemia, potentially making it possible for patients with CKD and hyperkalemia to liberalize their diet. This may allow them the health benefits of a high-potassium diet without the increased risk for hyperkalemia, although further studies are needed.
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Affiliation(s)
- Deborah J. Clegg
- Drexel College of Nursing and Health Professions, Philadelphia, PA
| | - Samuel A. Headley
- Department of Exercise Science and Athletic Training, Springfield College, Springfield, MA
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25
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Noel SE, Mangano KM, Mattei J, Griffith JL, Dawson-Hughes B, Bigornia S, Tucker KL. Dietary Approaches to Stop Hypertension, Mediterranean, and Alternative Healthy Eating indices are associated with bone health among Puerto Rican adults from the Boston Puerto Rican Osteoporosis Study. Am J Clin Nutr 2020; 111:1267-1277. [PMID: 32386194 PMCID: PMC7266690 DOI: 10.1093/ajcn/nqaa090] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Accepted: 04/07/2020] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Conflicting results on associations between dietary quality and bone have been noted across populations, and this has been understudied in Puerto Ricans, a population at higher risk of osteoporosis than previously appreciated. OBJECTIVE To compare cross-sectional associations between 3 dietary quality indices [Dietary Approaches to Stop Hypertension (DASH), Alternative Health Eating Index (AHEI-2010), and Mediterranean Diet Score (MeDS)] with bone outcomes. METHOD Participants (n = 865-896) from the Boston Puerto Rican Osteoporosis Study (BPROS) with complete bone and dietary data were included. Indices were calculated from validated food frequency data. Bone mineral density (BMD) was measured using DXA. Associations between dietary indices (z-scores) and their individual components with BMD and osteoporosis were tested with ANCOVA and logistic regression, respectively, at the lumbar spine and femoral neck, stratified by male, premenopausal women, and postmenopausal women. RESULTS Participants were 59.9 y ± 7.6 y and mostly female (71%). Among postmenopausal women not taking estrogen, DASH (score: 11-38) was associated with higher trochanter (0.026 ± 0.006 g/cm2, P <0.001), femoral neck (0.022 ± 0.006 g/cm2, P <0.001), total hip (0.029 ± 0.006 g/cm2, P <0.001), and lumbar spine BMD (0.025 ± 0.007 g/cm2, P = 0.001). AHEI (score: 25-86) was also associated with spine and all hip sites (P <0.02), whereas MeDS (0-9) was associated only with total hip (P = 0.01) and trochanter BMD (P = 0.007) in postmenopausal women. All indices were associated with a lower likelihood of osteoporosis (OR from 0.54 to 0.75). None of the results were significant for men or premenopausal women. CONCLUSIONS Although all appeared protective, DASH was more positively associated with BMD than AHEI or MeDS in postmenopausal women not taking estrogen. Methodological differences across scores suggest that a bone-specific index that builds on existing indices and that can be used to address dietary differences across cultural and ethnic minority populations should be considered.
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Affiliation(s)
- Sabrina E Noel
- Department of Biomedical and Nutritional Sciences, University of Massachusetts Lowell, Lowell, MA, USA,Address correspondence to SEN (e-mail: )
| | - Kelsey M Mangano
- Department of Biomedical and Nutritional Sciences, University of Massachusetts Lowell, Lowell, MA, USA
| | - Josiemer Mattei
- Department of Nutrition, Harvard TH Chan School of Public Health, Harvard University, Boston, MA, USA
| | - John L Griffith
- Department of Health Sciences, Bouvé College of Health Sciences, Northeastern University, Boston, MA, USA
| | - Bess Dawson-Hughes
- Jean Mayer US Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA
| | - Sherman Bigornia
- Department of Agriculture, Nutrition, and Food Systems, University of New Hampshire Durham, Durham, MA, USA
| | - Katherine L Tucker
- Department of Biomedical and Nutritional Sciences, University of Massachusetts Lowell, Lowell, MA, USA
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26
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Peng M, Tabashsum Z, Anderson M, Truong A, Houser AK, Padilla J, Akmel A, Bhatti J, Rahaman SO, Biswas D. Effectiveness of probiotics, prebiotics, and prebiotic-like components in common functional foods. Compr Rev Food Sci Food Saf 2020; 19:1908-1933. [PMID: 33337097 DOI: 10.1111/1541-4337.12565] [Citation(s) in RCA: 85] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Revised: 03/18/2020] [Accepted: 03/30/2020] [Indexed: 12/18/2022]
Abstract
The bioactive ingredients in commonly consumed foods include, but are not limited to, prebiotics, prebiotic-like components, probiotics, and postbiotics. The bioactive ingredients in functional foods have also been associated with beneficial effects on human health. For example, they aid in shaping of gut microflora and promotion of immunity. These functional components also contribute in preventing serious diseases such as cardiovascular malfunction and tumorigenesis. However, the specific mechanisms of these positive influences on human health are still under investigation. In this review, we aim to emphasize the major contents of probiotics, prebiotics, and prebiotic-like components commonly found in consumable functional foods, and we present an overview of direct and indirect benefits they provide on human health. The major contributors are certain families of metabolites, specifically short-chain fatty acids and polyunsaturated fatty acids produced by probiotics, and prebiotics, or prebiotic-like components such as flavonoids, polyphenols, and vitamins that are found in functional foods. These functional ingredients in foods influence the gut microbiota by stimulating the growth of beneficial microbes and the production of beneficial metabolites that, in turn, have direct benefits to the host, while also providing protection from pathogens and maintaining a balanced gut ecosystem. The complex interactions that arise among functional food ingredients, human physiology, the gut microbiota, and their respective metabolic pathways have been found to minimize several factors that contribute to the incidence of chronic disease, such as inflammation oxidative stress.
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Affiliation(s)
- Mengfei Peng
- Department of Animal and Avian Sciences, University of Maryland, College Park, Maryland
| | - Zajeba Tabashsum
- Biological Sciences Program - Molecular and Cellular Biology, University of Maryland, College Park, Maryland
| | - Mary Anderson
- Department of Animal and Avian Sciences, University of Maryland, College Park, Maryland
| | - Andy Truong
- Department of Animal and Avian Sciences, University of Maryland, College Park, Maryland
| | - Ashley K Houser
- Department of Animal and Avian Sciences, University of Maryland, College Park, Maryland
| | - Joselyn Padilla
- Biological Sciences Program - Molecular and Cellular Biology, University of Maryland, College Park, Maryland
| | - Ahlam Akmel
- Biological Sciences Program - Molecular and Cellular Biology, University of Maryland, College Park, Maryland
| | - Jacob Bhatti
- Department of Animal and Avian Sciences, University of Maryland, College Park, Maryland
| | - Shaik O Rahaman
- Department of Nutrition and Food Sciences, University of Maryland, College Park, Maryland
| | - Debabrata Biswas
- Department of Animal and Avian Sciences, University of Maryland, College Park, Maryland.,Biological Sciences Program - Molecular and Cellular Biology, University of Maryland, College Park, Maryland.,Center for Food Safety and Security Systems, University of Maryland, College Park, Maryland
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27
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Ferraro PM, Bargagli M, Trinchieri A, Gambaro G. Risk of Kidney Stones: Influence of Dietary Factors, Dietary Patterns, and Vegetarian-Vegan Diets. Nutrients 2020; 12:E779. [PMID: 32183500 PMCID: PMC7146511 DOI: 10.3390/nu12030779] [Citation(s) in RCA: 96] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2020] [Revised: 03/10/2020] [Accepted: 03/12/2020] [Indexed: 12/21/2022] Open
Abstract
Nephrolithiasis is a common medical condition influenced by multiple environmental factors, including diet. Since nutritional habits play a relevant role in the genesis and recurrence of kidney stones disease, dietary manipulation has become a fundamental tool for the medical management of nephrolithiasis. Dietary advice aims to reduce the majority of lithogenic risk factors, reducing the supersaturation of urine, mainly for calcium oxalate, calcium phosphate, and uric acid. For this purpose, current guidelines recommend increasing fluid intake, maintaining a balanced calcium intake, reducing dietary intake of sodium and animal proteins, and increasing intake of fruits and fibers. In this review, we analyzed the effects of each dietary factor on nephrolithiasis incidence and recurrence rate. Available scientific evidence agrees on the harmful effects of high meat/animal protein intake and low calcium diets, whereas high content of fruits and vegetables associated with a balanced intake of low-fat dairy products carries the lowest risk for incident kidney stones. Furthermore, a balanced vegetarian diet with dairy products seems to be the most protective diet for kidney stone patients. Since no study prospectively examined the effects of vegan diets on nephrolithiasis risk factors, more scientific work should be made to define the best diet for different kidney stone phenotypes.
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Affiliation(s)
- Pietro Manuel Ferraro
- Università Cattolica del Sacro Cuore, 00168 Roma, Italy; (P.M.F.); (M.B.)
- U.O.C. Nefrologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Roma, Italy
| | - Matteo Bargagli
- Università Cattolica del Sacro Cuore, 00168 Roma, Italy; (P.M.F.); (M.B.)
| | | | - Giovanni Gambaro
- Division of Nephrology and Dialysis, Department of Medicine, University of Verona, P.le A. Stefani 1, 37126 Verona, Italy
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28
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Turck D, Castenmiller J, de Henauw S, Hirsch-Ernst KI, Kearney J, Knutsen HK, Maciuk A, Mangelsdorf I, McArdle HJ, Pelaez C, Pentieva K, Siani A, Thies F, Tsabouri S, Vinceti M, Aggett P, Fairweather-Tait S, Martin A, Przyrembel H, Ciccolallo L, de Sesmaisons-Lecarré A, Valtueña Martinez S, Martino L, Naska A. Dietary reference values for sodium. EFSA J 2019; 17:e05778. [PMID: 32626425 PMCID: PMC7009309 DOI: 10.2903/j.efsa.2019.5778] [Citation(s) in RCA: 67] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Following a request from the European Commission, the EFSA Panel on Nutrition, Novel Foods and Food Allergens (NDA) derived dietary reference values (DRVs) for sodium. Evidence from balance studies on sodium and on the relationship between sodium intake and health outcomes, in particular cardiovascular disease (CVD)-related endpoints and bone health, was reviewed. The data were not sufficient to enable an average requirement (AR) or population reference intake (PRI) to be derived. However, by integrating the available evidence and associated uncertainties, the Panel considers that a sodium intake of 2.0 g/day represents a level of sodium for which there is sufficient confidence in a reduced risk of CVD in the general adult population. In addition, a sodium intake of 2.0 g/day is likely to allow most of the general adult population to maintain sodium balance. Therefore, the Panel considers that 2.0 g sodium/day is a safe and adequate intake for the general EU population of adults. The same value applies to pregnant and lactating women. Sodium intakes that are considered safe and adequate for children are extrapolated from the value for adults, adjusting for their respective energy requirement and including a growth factor, and are as follows: 1.1 g/day for children aged 1-3 years, 1.3 g/day for children aged 4-6 years, 1.7 g/day for children aged 7-10 years and 2.0 g/day for children aged 11-17 years, respectively. For infants aged 7-11 months, an Adequate Intake (AI) of 0.2 g/day is proposed based on upwards extrapolation of the estimated sodium intake in exclusively breast-fed infants aged 0-6 months.
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29
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Mendes J, Padrão P, Moreira P, Santos A, Borges N, Afonso C, Negrão R, Amaral TF. Handgrip Strength and Its Association With Hydration Status and Urinary Sodium-to-Potassium Ratio in Older Adults. J Am Coll Nutr 2019; 39:192-199. [PMID: 31381481 DOI: 10.1080/07315724.2019.1633439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Objective: Older adults present higher risk of functional disability detected by handgrip strength and an increased risk of poor health conditions, such as dehydration and low values of the sodium-to-potassium (Na/K) ratio. This study aimed to quantify the association of hydration status and Na/K ratio with handgrip strength, based on the urinary excretion of older adults.Methods: A cross-sectional study was conducted in 735 older adults ≥ 65 years old. Handgrip strength was measured with a Jamar Dynamometer and low values were defined according to body mass index and to sex-specific cutoff points. The hydration status was evaluated based on free water reserve. Sodium and potassium intake were evaluated after converting 24-hour urinary sodium and potassium excretion, respectively. A logistic regression model was used to estimate the probability of presenting low handgrip strength, according to risk of hypohydration and to quartiles of Na/K, stratified by sex and adjusted for potential confounders.Results: The adjusted odds ratio (OR) for presenting low handgrip strength was higher in women at risk of hypohydration, but this association was not found in men. Both women and men with the highest values of Na/K ratio presented higher adjusted OR for low handgrip strength (OR in women was 2.03; 95% confidence interval [CI]: 1.12-3.68, and in men was 2.19; 95% CI: 1.11-4.29).Conclusions: The risk of hypohydration was directly associated with low handgrip strength in older women. In older adults, higher values of urinary Na/K ratio were also directly associated with low handgrip strength.
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Affiliation(s)
- Joana Mendes
- Department of Biomedicine, Biochemistry Unit, Faculty of Medicine, University of Porto, Porto, Portugal.,I3S-Institute for Research and Innovation in Health, University of Porto, Porto, Portugal
| | - Patrícia Padrão
- Faculty of Nutrition and Food Science, University of Porto, Porto, Portugal.,EPI Unit, Institute of Public Health, University of Porto, Porto, Portugal
| | - Pedro Moreira
- Faculty of Nutrition and Food Science, University of Porto, Porto, Portugal.,EPI Unit, Institute of Public Health, University of Porto, Porto, Portugal.,The Research Centre in Physical Activity, Health and Leisure, University of Porto, Porto, Portugal
| | - Alejandro Santos
- I3S-Institute for Research and Innovation in Health, University of Porto, Porto, Portugal.,Faculty of Nutrition and Food Science, University of Porto, Porto, Portugal
| | - Nuno Borges
- Faculty of Nutrition and Food Science, University of Porto, Porto, Portugal.,CINTESIS-Centre for Health Technology and Services Research, Porto, Portugal
| | - Cláudia Afonso
- Faculty of Nutrition and Food Science, University of Porto, Porto, Portugal
| | - Rita Negrão
- Department of Biomedicine, Biochemistry Unit, Faculty of Medicine, University of Porto, Porto, Portugal.,I3S-Institute for Research and Innovation in Health, University of Porto, Porto, Portugal
| | - Teresa F Amaral
- Faculty of Nutrition and Food Science, University of Porto, Porto, Portugal.,UISPA-IDMEC, Faculty of Engineering, University of Porto, Porto, Portugal
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30
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Cashman KD, Kenny S, Kerry JP, Leenhardt F, Arendt EK. 'Low-Salt' Bread as an Important Component of a Pragmatic Reduced-Salt Diet for Lowering Blood Pressure in Adults with Elevated Blood Pressure. Nutrients 2019; 11:nu11081725. [PMID: 31357402 PMCID: PMC6722563 DOI: 10.3390/nu11081725] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Revised: 07/21/2019] [Accepted: 07/23/2019] [Indexed: 02/07/2023] Open
Abstract
Reformulation of bread in terms of salt content remains an important measure to help achieve a reduction in salt intake in the population and for the prevention of hypertension and elevated blood pressure (BP). Our fundamental studies on the reduction of salt on dough and bread characteristics showed that wheat breads produced with 0.3 g salt/100 g (“low-salt”) were found to be comparable quality to that produced with the typical level of salt (1.2%). This food-based intervention trial examined, using a 5 week cross-over design, the potential for inclusion of “low-salt” bread as part of a pragmatic reduced-salt diet on BP, markers of bone metabolism, and plasma lipids in 97 adults with slightly to moderately elevated BP. Assuming all sodium from dietary intake was excreted through the urine, the intake of salt decreased by 1.7 g/day, on average, during the reduced-salt dietary period. Systolic BP was significantly lower (by 3.3 mmHg on average; p < 0.0001) during the reduced-salt dietary period compared to the usual-salt dietary period, but there was no significant difference (p = 0.81) in diastolic BP. There were no significant differences (p > 0.12, in all cases) in any of the urinary- or serum-based biochemical indices of calcium or bone metabolism or in plasma lipids between the two periods. In conclusion, a modest reduction in dietary salt intake, in which the use of “low-salt” (i.e., 0.3 g/100g) bread played a key role along with dietary advice, and led to a significant, and clinically meaningful, decrease in systolic, but not diastolic, BP in adults with mildly to moderately elevated BP.
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Affiliation(s)
- Kevin D Cashman
- Cork Centre for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences, University College Cork, T12 Y337 Cork, Ireland.
| | - Sorcha Kenny
- Cork Centre for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences, University College Cork, T12 Y337 Cork, Ireland
| | - Joseph P Kerry
- Muscle Foods Research Group, School of Food and Nutritional Sciences, University College Cork, T12 Y337 Cork, Ireland
| | - Fanny Leenhardt
- Cork Centre for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences, University College Cork, T12 Y337 Cork, Ireland
| | - Elke K Arendt
- Cereals Research Group, School of Food and Nutritional Sciences, University College Cork, T12 Y337 Cork, Ireland
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31
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Mai Z, Li X, Cui Z, Wu W, Liu Y, Ou L, Liang Y, Zhao Z, Liu Y, Mai X, Zhu W, Zhang T, Cai C, Yang H, Zeng G. Reference intervals for stone risk factors in 24-h urine among healthy adults of the Han population in China. Clin Chem Lab Med 2018; 56:642-648. [PMID: 29095693 DOI: 10.1515/cclm-2017-0401] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Accepted: 09/27/2017] [Indexed: 11/15/2022]
Abstract
BACKGROUND The aim of the study was to establish reference intervals for 24-h urinary stone risk factors in the healthy Chinese Han population. METHODS From May 2013 to July 2014, we collected and analyzed 24-h urine samples from healthy adult Han population during a cross-sectional study across China. The protocol for analysis of 24-h urine included volume, pH, oxalate, citrate, sodium, potassium, chloride, calcium, phosphorous, creatinine, urate, magnesium, the ion activity products of calcium oxalate (AP(CaOx) indexs) and calcium phosphate (AP(CaP) indexs). We calculated the reference intervals according to the Clinical and Laboratory Standards Institute (CLSI) 2008 guidelines and compared them with those recorded in other studies. RESULTS A total of 132 male and 123 female healthy subjects with a mean (SD, range) age of 52.4 (15.2, 19-89) years were eligible in the final analysis. Men had higher 24-h excretion of creatinine, calcium, urate and phosphorus and lower levels of citrate, magnesium, chloride, sodium and potassium than women. AP(CaOx) indexs and AP(CaP) indexs were significantly higher among men than women. When urinary findings were compared with the reference intervals, most of our data showed a high abnormality rate, especially for creatinine, calcium, citrate, magnesium, chloride, sodium and potassium. CONCLUSIONS The present study revealed the normal metabolic status for stone risk factors of the Chinese Han population. It is therefore necessary for each country or region to define their own reference intervals for comparison of stone risk factors between patients and healthy subjects.
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Affiliation(s)
- Zanlin Mai
- Department of Urology, Minimally Invasive Surgery Center, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, P.R. China
- Guangdong Key Laboratory of Urology, Guangzhou, Guangdong, P.R. China
| | - Xiaoxia Li
- Department of Urology, Minimally Invasive Surgery Center, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, P.R. China
- Guangdong Key Laboratory of Urology, Guangzhou, Guangdong, P.R. China
| | - Zelin Cui
- Department of Urology, Minimally Invasive Surgery Center, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, P.R. China
- Department of Urology, The Central Hospital of Yongzhou, Yongzhou, Hunan, P.R. China
| | - Wenqi Wu
- Department of Urology, Minimally Invasive Surgery Center, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, P.R. China
- Guangdong Key Laboratory of Urology, Guangzhou, Guangdong, P.R. China
| | - Yongda Liu
- Department of Urology, Minimally Invasive Surgery Center, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, P.R. China
- Guangdong Key Laboratory of Urology, Guangzhou, Guangdong, P.R. China
| | - Lili Ou
- Department of Urology, Minimally Invasive Surgery Center, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, P.R. China
- Guangdong Key Laboratory of Urology, Guangzhou, Guangdong, P.R. China
| | - Yueping Liang
- Department of Urology, Minimally Invasive Surgery Center, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, P.R. China
- Guangdong Key Laboratory of Urology, Guangzhou, Guangdong, P.R. China
| | - Zhijian Zhao
- Department of Urology, Minimally Invasive Surgery Center, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, P.R. China
- Guangdong Key Laboratory of Urology, Guangzhou, Guangdong, P.R. China
| | - Yang Liu
- Department of Urology, Minimally Invasive Surgery Center, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, P.R. China
- Guangdong Key Laboratory of Urology, Guangzhou, Guangdong, P.R. China
| | - Xing Mai
- Department of Urology, Minimally Invasive Surgery Center, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, P.R. China
- Guangdong Key Laboratory of Urology, Guangzhou, Guangdong, P.R. China
| | - Wei Zhu
- Department of Urology, Minimally Invasive Surgery Center, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, P.R. China
- Guangdong Key Laboratory of Urology, Guangzhou, Guangdong, P.R. China
| | - Tao Zhang
- Department of Urology, Minimally Invasive Surgery Center, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, P.R. China
- Guangdong Key Laboratory of Urology, Guangzhou, Guangdong, P.R. China
| | - Chao Cai
- Department of Urology, Minimally Invasive Surgery Center, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, P.R. China
- Guangdong Key Laboratory of Urology, Guangzhou, Guangdong, P.R. China
| | - Houmeng Yang
- Department of Urology, Minimally Invasive Surgery Center, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, P.R. China
- Guangdong Key Laboratory of Urology, Guangzhou, Guangdong, P.R. China
- Department of Urology, Ningbo Urologic and Nephrotic Hospital, Ningbo, Zhejiang, P.R. China
| | - Guohua Zeng
- Department of Urology, Minimally Invasive Surgery Center, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, P.R. China
- Guangdong Key Laboratory of Urology, Guangzhou, Guangdong, P.R. China
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Weaver CM, Stone MS, Lobene AJ, Cladis DP, Hodges JK. What Is the Evidence Base for a Potassium Requirement? NUTRITION TODAY 2018; 53:184-195. [PMID: 30369637 PMCID: PMC6181280 DOI: 10.1097/nt.0000000000000298] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Increased intake of potassium should be promoted to reduce the risk of cardiovascular disease and stroke and to protect against bone loss, but confidence in recommended intakes depends on the strength of the evidence. All public health recommendations are considerably higher than current average intakes. Evidence on which current potassium intake recommendations for the United States, Europe, and globally have limitations. More recent evidence reviewed by the Agency for Healthcare Research and Quality affirms that more evidence is needed to define specific values for optimal potassium intakes. Potassium requirements undoubtedly vary with a number of factors including energy needs, race, and intake of sodium.
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Affiliation(s)
- Connie M Weaver
- is a distinguished professor in the Department of Nutrition Science, Purdue University, West Lafayette, Indiana
- is a doctoral student conducting research on potassium effect of health in the Department of Nutrition Science, Purdue University, West Lafayette, Indiana
- is a doctoral student conducting research on sodium effect in the Department of Nutrition Science, Purdue University, West Lafayette, Indiana
- is a doctoral student conducting research on nutrient requirements and safety in the Department of Nutrition Science, Purdue University, West Lafayette, Indiana
- is a post-doctoral associate conducting research on calcium effect on health in the Department of Nutrition Science, Purdue University, West Lafayette, Indiana
| | - Michael S Stone
- is a distinguished professor in the Department of Nutrition Science, Purdue University, West Lafayette, Indiana
- is a doctoral student conducting research on potassium effect of health in the Department of Nutrition Science, Purdue University, West Lafayette, Indiana
- is a doctoral student conducting research on sodium effect in the Department of Nutrition Science, Purdue University, West Lafayette, Indiana
- is a doctoral student conducting research on nutrient requirements and safety in the Department of Nutrition Science, Purdue University, West Lafayette, Indiana
- is a post-doctoral associate conducting research on calcium effect on health in the Department of Nutrition Science, Purdue University, West Lafayette, Indiana
| | - Andrea J Lobene
- is a distinguished professor in the Department of Nutrition Science, Purdue University, West Lafayette, Indiana
- is a doctoral student conducting research on potassium effect of health in the Department of Nutrition Science, Purdue University, West Lafayette, Indiana
- is a doctoral student conducting research on sodium effect in the Department of Nutrition Science, Purdue University, West Lafayette, Indiana
- is a doctoral student conducting research on nutrient requirements and safety in the Department of Nutrition Science, Purdue University, West Lafayette, Indiana
- is a post-doctoral associate conducting research on calcium effect on health in the Department of Nutrition Science, Purdue University, West Lafayette, Indiana
| | - Dennis P Cladis
- is a distinguished professor in the Department of Nutrition Science, Purdue University, West Lafayette, Indiana
- is a doctoral student conducting research on potassium effect of health in the Department of Nutrition Science, Purdue University, West Lafayette, Indiana
- is a doctoral student conducting research on sodium effect in the Department of Nutrition Science, Purdue University, West Lafayette, Indiana
- is a doctoral student conducting research on nutrient requirements and safety in the Department of Nutrition Science, Purdue University, West Lafayette, Indiana
- is a post-doctoral associate conducting research on calcium effect on health in the Department of Nutrition Science, Purdue University, West Lafayette, Indiana
| | - Joanna K Hodges
- is a distinguished professor in the Department of Nutrition Science, Purdue University, West Lafayette, Indiana
- is a doctoral student conducting research on potassium effect of health in the Department of Nutrition Science, Purdue University, West Lafayette, Indiana
- is a doctoral student conducting research on sodium effect in the Department of Nutrition Science, Purdue University, West Lafayette, Indiana
- is a doctoral student conducting research on nutrient requirements and safety in the Department of Nutrition Science, Purdue University, West Lafayette, Indiana
- is a post-doctoral associate conducting research on calcium effect on health in the Department of Nutrition Science, Purdue University, West Lafayette, Indiana
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Jennings A, Cashman KD, Gillings R, Cassidy A, Tang J, Fraser W, Dowling KG, Hull GLJ, Berendsen AAM, de Groot LCPGM, Pietruszka B, Wierzbicka E, Ostan R, Bazzocchi A, Battista G, Caumon E, Meunier N, Malpuech-Brugère C, Franceschi C, Santoro A, Fairweather-Tait SJ. A Mediterranean-like dietary pattern with vitamin D3 (10 µg/d) supplements reduced the rate of bone loss in older Europeans with osteoporosis at baseline: results of a 1-y randomized controlled trial. Am J Clin Nutr 2018; 108:633-640. [PMID: 30007343 PMCID: PMC6134287 DOI: 10.1093/ajcn/nqy122] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Accepted: 05/15/2018] [Indexed: 01/14/2023] Open
Abstract
Background The Mediterranean diet (MD) is widely recommended for the prevention of chronic disease, but evidence for a beneficial effect on bone health is lacking. Objective The aim of this study was to examine the effect of a Mediterranean-like dietary pattern [NU-AGE (New Dietary Strategies Addressing the Specific Needs of the Elderly Population for Healthy Aging in Europe)] on indexes of inflammation with a number of secondary endpoints, including bone mineral density (BMD) and biomarkers of bone and collagen degradation in a 1-y multicenter randomized controlled trial (RCT; NU-AGE) in elderly Europeans. Design An RCT was undertaken across 5 European centers. Subjects in the intervention group consumed the NU-AGE diet for 1 y by receiving individually tailored dietary advice, coupled with supplies of foods including whole-grain pasta, olive oil, and a vitamin D3 supplement (10 µg/d). Participants in the control group were provided with leaflets on healthy eating available in their country. Results A total of 1294 participants (mean ± SD age: 70.9 ±4.0 y; 44% male) were recruited to the study and 1142 completed the 1-y trial. The Mediterranean-like dietary pattern had no effect on BMD (site-specific or whole-body); the inclusion of compliance to the intervention in the statistical model did not change the findings. There was also no effect of the intervention on the urinary biomarkers free pyridinoline or free deoxypyridinoline. Serum 25-hydroxyvitamin D significantly increased and parathyroid hormone decreased (P < 0.001) in the MD compared with the control group. Subgroup analysis of individuals with osteoporosis at baseline (site-specific BMD T-score ≤ -2.5 SDs) showed that the MD attenuated the expected decline in femoral neck BMD (n = 24 and 30 in MD and control groups, respectively; P = 0.04) but had no effect on lumbar spine or whole-body BMD. Conclusions A 1-y intervention of the Mediterranean-like diet together with vitamin D3 supplements (10 µg/d) had no effect on BMD in the normal age-related range, but it significantly reduced the rate of loss of bone at the femoral neck in individuals with osteoporosis. The NU-AGE trial is registered at clinicaltrials.gov as NCT01754012.
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Affiliation(s)
- Amy Jennings
- Department of Nutrition and Preventive Medicine, Norwich Medical School, University of East Anglia, Norwich, United Kingdom
| | - Kevin D Cashman
- Cork Center for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences,Department of Medicine, University College Cork, Cork, Ireland
| | - Rachel Gillings
- Department of Nutrition and Preventive Medicine, Norwich Medical School, University of East Anglia, Norwich, United Kingdom
| | - Aedin Cassidy
- Department of Nutrition and Preventive Medicine, Norwich Medical School, University of East Anglia, Norwich, United Kingdom
| | - Jonathan Tang
- Department of Nutrition and Preventive Medicine, Norwich Medical School, University of East Anglia, Norwich, United Kingdom
| | - William Fraser
- Department of Nutrition and Preventive Medicine, Norwich Medical School, University of East Anglia, Norwich, United Kingdom
| | - Kirsten G Dowling
- Cork Center for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences
| | - George L J Hull
- Cork Center for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences
| | | | | | - Barbara Pietruszka
- Department of Human Nutrition, Warsaw University of Life Sciences (WULS-SGGW), Warsaw, Poland
| | - Elzbieta Wierzbicka
- Department of Human Nutrition, Warsaw University of Life Sciences (WULS-SGGW), Warsaw, Poland
| | | | - Alberto Bazzocchi
- Diagnostic and Interventional Radiology, “Rizzoli” Orthopedic Institute, Bologna, Italy
| | - Giuseppe Battista
- Department of Experimental, Diagnostic, and Speciality Medicine, Alma Mater Studorium, University of Bologna, Bologna, Italy
| | | | | | - Corinne Malpuech-Brugère
- Université Clermont Auvergne, Institut National de la Recherche Agronomique (INRA), Unité de Nutrition Humaine, Centre de Recherches en Nutrition Humaine (CRNH) d'Auvergne, Clermont-Ferrand, France
| | | | - Aurelia Santoro
- Interdepartmental Center “L Galvani”,Department of Experimental, Diagnostic, and Speciality Medicine, Alma Mater Studorium, University of Bologna, Bologna, Italy
| | - Susan J Fairweather-Tait
- Department of Nutrition and Preventive Medicine, Norwich Medical School, University of East Anglia, Norwich, United Kingdom,Address correspondence to SJF-T (e-mail: )
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Rajput R, Wairkar S, Gaud R. Nutraceuticals for better management of osteoporosis: An overview. J Funct Foods 2018. [DOI: 10.1016/j.jff.2018.06.013] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
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Depletion and repletion of fruit and vegetable intake alters serum bone turnover markers: a 28-week single-arm experimental feeding intervention. Br J Nutr 2018; 120:500-507. [PMID: 30022739 DOI: 10.1017/s0007114518001642] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
This study was designed to evaluate the effects of elevated fruit and vegetable intake on bone turnover markers. In all, twenty-nine subjects (nine male and twenty female, with a mean age of 32·1 (sem 2·5) years) participated in a 28-week single-arm experimental feeding intervention trial and consumed a prescribed low-fruit and vegetable diet for 6 weeks (depletion-1), a provided high-fruit and vegetable diet for 8 weeks (fruit: 360-560 g; vegetables: 450-705 g), another prescribed low-fruit and vegetable diet for 6 weeks (depletion-2) and then their usual diets for 8 weeks (repletion). Serum bone-related biomarkers were analysed with commercial ELISA kits. Plasma carotenoid levels decreased as a result of the depletion phase and increased with the high-fruit and vegetable diet. Compared with the baseline, depletion-1 resulted in higher serum bone resorption marker C-terminal telopeptide of type 1 collagen (CTX) and lower bone formation marker alkaline phosphatase (BAP) (CTX, 0·68 (sem 0·05) v. 0·97 (sem 0·08) ng/ml and BAP, 10·7 (sem 0·7) v. 9·5 (sem 0·8) µg/l for the baseline and the depletion-1, respectively, P<0·05). High intake of fruit and vegetables decreased serum CTX (P<0·05) to 0·60 (sem 0·04) ng/ml and increased serum BAP to 11·3 (sem 0·7) µg/l (P<0·05), compared with the depletion-1 phase. Serum concentrations of CTX were inversely correlated and those of BAP were positively correlated with blood lycopene. These data show that increased fruit and vegetable consumption at or above federal dietary guidance may be beneficial to bone health.
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Fatahi S, Namazi N, Larijani B, Azadbakht L. The Association of Dietary and Urinary Sodium With Bone Mineral Density and Risk of Osteoporosis: A Systematic Review and Meta-Analysis. J Am Coll Nutr 2018; 37:522-532. [DOI: 10.1080/07315724.2018.1431161] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Affiliation(s)
- Somaye Fatahi
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Nazli Namazi
- Obesity and Eating Habits Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Bagher Larijani
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Leila Azadbakht
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
- Diabetes Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran
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Effects of Different Dietary Interventions on Calcitriol, Parathyroid Hormone, Calcium, and Phosphorus: Results from the DASH Trial. Nutrients 2018; 10:nu10030367. [PMID: 29562597 PMCID: PMC5872785 DOI: 10.3390/nu10030367] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Revised: 03/07/2018] [Accepted: 03/13/2018] [Indexed: 02/07/2023] Open
Abstract
The "Dietary Approaches to Stop Hypertension" (DASH) diet, rich in fiber and low-fat dairy, effectively lowers blood pressure. DASH's effect on calcitriol and other markers of bone-mineral metabolism is unknown. This secondary analysis of the DASH trial aimed to determine the effect of dietary patterns on blood concentrations of calcitriol, parathyroid hormone (PTH), ionized calcium, and urinary excretion of calcium and phosphorus. Outcomes were available in 334 participants in the trial. After a 3-week run-in on the control diet, participants were randomized to control, fruits and vegetables (F&V), or DASH diets. Outcomes were assessed at the end of run-in, and during the last week of the intervention period. Mean age of participants was 45.7 ± 10.7 years, 46% female, and 57% African-American. Mean ± Standard Deviation(SD) baseline serum concentrations of calcitriol, PTH, and ionized calcium were 37.8 ± 9.2 pg/mL, 46.1 ± 18.5 pg/mL and 5.2 ± 0.23 mg/dL, respectively. Mean (±SD) urinary calcium and phosphorus excretions were 150.1 ± 77.8 and 708.0 ± 251.8 mg/24 h, respectively. Compared with control, DASH reduced calcitriol -3.32 pg/mL (p = 0.004). Otherwise, there was no significant effect on other biomarkers. DASH lowered serum calcitriol perhaps more among African-Americans. These results raise important questions about the interpretation and clinical significance of low calcitriol concentrations in the setting of recommended diets.
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High dietary salt intake correlates with modulated Th17-Treg cell balance resulting in enhanced bone loss and impaired bone-microarchitecture in male mice. Sci Rep 2018; 8:2503. [PMID: 29410520 PMCID: PMC5802842 DOI: 10.1038/s41598-018-20896-y] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Accepted: 01/24/2018] [Indexed: 02/07/2023] Open
Abstract
Osteoporosis is associated with reduced density and quality of bone leading to weakened skeleton thereby increasing the risk of fractures responsible for increased morbidity and mortality. Due to preference for western food style the consumption of salt intake in our diets has increased many folds. High dietary salt intake has recently been linked with induction of Th17 cells along with impairment of Treg cells. Also, Th17 cells have been one of major players in the pathophysiology of various bone pathologies including osteoporosis. We thus hypothesized that high salt diet (HSD) intake would lead to enhanced bone loss by modulating Th17-Treg cell balance. In the present study, we report for the first time that HSD intake in male mice impairs both trabecular and cortical bone microarchitecture along with decreasing the mineral density and heterogeneity of bones. The HSD modulates host immune system and skews Treg-Th17 balance by promoting osteoclastogenic Th17 cells and inhibiting development of anti-osteoclastogenic Treg cells in mice. HSD also enhanced expression of proinflammatory cytokines (IL-6, TNF-α, RANKL and IL-17) and decreased the expression of anti-inflammatory cytokines (IL-10, IFN-γ). Taken together the present study for the first time establishes a strong correlation between high dietary salt intake and bone health via interplay between Th17-Treg cells.
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Lessens DM, Rakel D. The DASH Diet. Integr Med (Encinitas) 2018. [DOI: 10.1016/b978-0-323-35868-2.00089-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Chauveau P, Lasseur C, Nodimar C, Prezelin-Reydit M, Trolonge S, Combe C, Aparicio M. [Dietary acid load: A novel target for the nephrologist?]. Nephrol Ther 2018; 14:240-246. [PMID: 29289517 DOI: 10.1016/j.nephro.2017.10.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Accepted: 10/02/2017] [Indexed: 10/18/2022]
Abstract
The acid production of endogenous origin depends mainly on the metabolism of the food and varies with the nature of these. Of the order of 1mEq/kg/day for contemporary food in industrialized countries, it is reduced by more than one third among vegetarians and close to neutrality among vegans. The dietary acid load is eliminated by the normal kidneys, thus maintaining the acid-base equilibrium. In the setting of CKD, it will overflow the capacities of the nephrons, generating a retention of H+ ions, promoting subclinical acidosis. This tissue retention of H+ ions was confirmed by direct techniques in animal models and indirect techniques in humans. The systemic retention of H+ ions and the accompanying compensatory mechanisms have negative consequences on bone tissue, skeletal muscle, cardiovascular risk and renal function. In the animal, the substitution of casein (acid) by soy (alkaline) prevents metabolic acidosis and slows the progression of renal insufficiency. In man, various prospective studies have confirmed that the risk of renal insufficiency was positively correlated with the dietary acid load. Conversely, bicarbonate supplementation and/or a diet enriched with fruits and vegetables, have a favorable effect on renal insufficiency, including in subjects with normal bicarbonate. These results lead to reconsider the K/DOQI recommendations to correct acidosis when the bicarbonate level falls below 22mEq/L, since tissue retention of H+ ions and its negative consequences appear at higher or even normal levels of bicarbonates.
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Affiliation(s)
- Philippe Chauveau
- Service de néphrologie transplantation dialyse, hôpital Pellegrin, CHU de Bordeaux, place Amélie-Raba-Léon, 33076 Bordeaux, France; Aurad-Aquitaine, 2, allée des Demoiselles, 33170 Gradignan, France.
| | - Catherine Lasseur
- Service de néphrologie transplantation dialyse, hôpital Pellegrin, CHU de Bordeaux, place Amélie-Raba-Léon, 33076 Bordeaux, France; Aurad-Aquitaine, 2, allée des Demoiselles, 33170 Gradignan, France
| | - Céline Nodimar
- Service de néphrologie transplantation dialyse, hôpital Pellegrin, CHU de Bordeaux, place Amélie-Raba-Léon, 33076 Bordeaux, France; Aurad-Aquitaine, 2, allée des Demoiselles, 33170 Gradignan, France
| | - Mathilde Prezelin-Reydit
- Service de néphrologie transplantation dialyse, hôpital Pellegrin, CHU de Bordeaux, place Amélie-Raba-Léon, 33076 Bordeaux, France; Aurad-Aquitaine, 2, allée des Demoiselles, 33170 Gradignan, France
| | | | - Christian Combe
- Service de néphrologie transplantation dialyse, hôpital Pellegrin, CHU de Bordeaux, place Amélie-Raba-Léon, 33076 Bordeaux, France; Unité Inserm 1026, université Bordeaux, 33076 Bordeaux, France
| | - Michel Aparicio
- Service de néphrologie transplantation dialyse, hôpital Pellegrin, CHU de Bordeaux, place Amélie-Raba-Léon, 33076 Bordeaux, France
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Wu L, Luthringer BJC, Feyerabend F, Zhang Z, Machens HG, Maeda M, Taipaleenmäki H, Hesse E, Willumeit-Römer R, Schilling AF. Increased levels of sodium chloride directly increase osteoclastic differentiation and resorption in mice and men. Osteoporos Int 2017; 28:3215-3228. [PMID: 28849275 PMCID: PMC5635092 DOI: 10.1007/s00198-017-4163-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Accepted: 07/13/2017] [Indexed: 01/30/2023]
Abstract
UNLABELLED To better understand the association between high salt intake and osteoporosis, we investigated the effect of sodium chloride (NaCl) on mice and human osteoclastogenesis. The results suggest a direct, activating role of NaCl supplementation on bone resorption. INTRODUCTION High NaCl intake is associated with increased urinary calcium elimination and parathyroid hormone (PTH) secretion which in turn stimulates the release of calcium from the bone, resulting in increased bone resorption. However, while calciuria after NaCl loading could be shown repeatedly, several studies failed to reveal a significant increase in PTH in response to a high-sodium diet. Another possible explanation that we investigated here could be a direct effect of high-sodium concentration on bone resorption. METHODS Mouse bone marrow macrophage and human peripheral blood mononuclear cells (PBMC) driven towards an osteoclastogenesis pathway were cultivated under culture conditions mimicking hypernatremia environments. RESULTS In this study, a direct effect of increased NaCl concentrations on mouse osteoclast differentiation and function was observed. Surprisingly, in a human osteoclast culture system, significant increases in the number of tartrate-resistant acid phosphatase (TRAP)-positive osteoclasts, calcitonin receptor (CTR)-positive osteoclasts, nuclear factor-activated T cells c1 (NFATc1) gene expression, and areal and volumetric resorptions were observed for increasing concentrations of NaCl. This suggests a direct, activating, cell-mediated effect of increased concentrations of NaCl on osteoclasts. CONCLUSIONS The reported that enhanced bone resorption after high-sodium diets may not only be secondary to the urinary calcium loss but may also be a direct, cell-mediated effect on osteoclastic resorption. These findings allow us to suggest an explanation for the clinical findings independent of a PTH-mediated regulation.
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Affiliation(s)
- L Wu
- Department of Biological Characterisation, Institute for Materials Research, Helmholtz-Zentrum Geesthacht, Geesthacht, Germany
- Department of Plastic Surgery and Hand Surgery, Klinikum Rechts der Isar, Technical University Munich, Munich, Germany
| | - B J C Luthringer
- Department of Biological Characterisation, Institute for Materials Research, Helmholtz-Zentrum Geesthacht, Geesthacht, Germany
| | - F Feyerabend
- Department of Biological Characterisation, Institute for Materials Research, Helmholtz-Zentrum Geesthacht, Geesthacht, Germany
| | - Z Zhang
- Department of Plastic Surgery and Hand Surgery, Klinikum Rechts der Isar, Technical University Munich, Munich, Germany
- Department of Orthopedics, Hand Surgery Division, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China
| | - H G Machens
- Department of Plastic Surgery and Hand Surgery, Klinikum Rechts der Isar, Technical University Munich, Munich, Germany
| | - M Maeda
- Heisenberg Group for Molecular Skeletal Biology, Department of Trauma, Hand, and Reconstructive Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - H Taipaleenmäki
- Heisenberg Group for Molecular Skeletal Biology, Department of Trauma, Hand, and Reconstructive Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - E Hesse
- Heisenberg Group for Molecular Skeletal Biology, Department of Trauma, Hand, and Reconstructive Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - R Willumeit-Römer
- Department of Biological Characterisation, Institute for Materials Research, Helmholtz-Zentrum Geesthacht, Geesthacht, Germany
| | - A F Schilling
- Department of Plastic Surgery and Hand Surgery, Klinikum Rechts der Isar, Technical University Munich, Munich, Germany.
- Clinic for Trauma Surgery, Orthopedic Surgery, and Plastic Surgery, University Medical Center Göttingen, Göttingen, Germany.
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Dietary nitrite supplementation attenuates cardiac remodeling in l -NAME-induced hypertensive rats. Nitric Oxide 2017; 67:1-9. [DOI: 10.1016/j.niox.2017.04.009] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Revised: 04/17/2017] [Accepted: 04/20/2017] [Indexed: 12/17/2022]
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Dawson-Hughes B. Challenges in defining the role of dietary protein in bone health. Am J Clin Nutr 2017; 105:1257-1258. [PMID: 28515071 DOI: 10.3945/ajcn.117.158162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Bess Dawson-Hughes
- Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA
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Kwon SJ, Ha YC, Park Y. High dietary sodium intake is associated with low bone mass in postmenopausal women: Korea National Health and Nutrition Examination Survey, 2008-2011. Osteoporos Int 2017; 28:1445-1452. [PMID: 28074252 DOI: 10.1007/s00198-017-3904-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2016] [Accepted: 01/02/2017] [Indexed: 01/05/2023]
Abstract
UNLABELLED The present cross-sectional study performed using data from the Korea National Health and Nutrition Examination Survey in 9526 women older than 18 years of age demonstrates that high sodium intake is associated with lower bone mineral density and sodium intake ≥2000 mg/day is a risk factor for osteoporosis in postmenopausal women. INTRODUCTION Several studies have reported that large amount of dietary sodium intake is highly associated with elevated urinary calcium. However, the direct effect of excessive dietary sodium intake on bone mass, as a risk factor for osteoporosis, is still a controversial issue. The aim of the present study was to assess the relationship between high intake of sodium and lower bone mass and risk of osteoporosis in adult women. METHODS This cross-sectional study was performed using data from the Korea National Health and Nutrition Examination Survey (KNHANES), 2008-2011. Participants (n = 9526 women older than 18 years) were divided into a premenopausal (n = 4793) and postmenopausal (n = 4733) group. Both groups were subdivided into five groups according to quintiles of energy-adjusted sodium intake. Multiple regression analysis was performed to assess relationships between sodium intake and lower bone mass. RESULTS Multivariate linear regression analysis showed that high sodium intake was negatively associated with bone mineral content (BMC) and bone mineral density (BMD) in postmenopausal women. After adjusting confounding factors, high sodium intake was negatively associated with BMC and BMD of the lumbar spine in postmenopausal women. Postmenopausal women, whose sodium intake was ≥2000 mg/day (odds ratio 1.284, 95% CI 1.029-1.603, P = 0.027), were at risk of developing osteoporosis after adjustment of confounding variables. CONCLUSIONS The present study suggested that high sodium intake could be a potential risk factor for low bone mass after adjusting for confounding factors in postmenopausal women.
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Affiliation(s)
- S-J Kwon
- Department of Food and Nutrition, College of Human Ecology, Hanyang University, Wangsimni-ro 222, Seongdong-gu, Seoul, 133-791, Republic of Korea
| | - Y-C Ha
- Department of Orthopedic Surgery, Chung-Ang University College of Medicine, 102 Heukseok-ro, Dongjak-gu, Seoul, 156-755, Republic of Korea.
| | - Y Park
- Department of Food and Nutrition, College of Human Ecology, Hanyang University, Wangsimni-ro 222, Seongdong-gu, Seoul, 133-791, Republic of Korea.
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Chen GD, Ding D, Tian HY, Zhu YY, Cao WT, Wang C, Chen YM. Adherence to the 2006 American Heart Association's Diet and Lifestyle Recommendations for cardiovascular disease risk reduction is associated with bone mineral density in older Chinese. Osteoporos Int 2017; 28:1295-1303. [PMID: 27924380 DOI: 10.1007/s00198-016-3857-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2016] [Accepted: 11/22/2016] [Indexed: 12/01/2022]
Abstract
UNLABELLED This cross-sectional study investigated the association between the modified 2006 American Heart Association Diet and Lifestyle Recommendations (AHA-DLR) and bone mineral density in Chinese adults. We found that better adherence to the AHA-DLR associated with higher bone mineral density (BMD) at multiple sites. INTRODUCTION Accumulating evidence shows that cardiovascular disease (CVD) and osteoporosis are associated with each other, yet little research has focused on whether strategies to reduce CVD risk could also benefit bone health. We aimed to assess the association between adherence to the modified 2006 American Heart Association Diet and Lifestyle Recommendations (AHA-DLR) and BMD in Chinese adults. METHODS We included 2092 women and 1051 men aged 40-75 years in this community-based cross-sectional study. Dietary information was assessed using a 79-item food frequency survey through face-to-face interviews at baseline (2008-2010) and 3 years later (2011-2013). Adherence to the AHA-DLR was assessed using modified diet and lifestyle scores (American Heart Association Diet and Lifestyle Score (AHA-DLS)) adjusted for bone health. BMD for the whole body, lumbar spine, total hip, femur neck, and trochanter sites was measured using dual-energy X-ray absorptiometry in 2011-2013. RESULTS After adjusting for potential covariates, greater adherence to the modified AHA-DLS was positively and dose-dependently associated with BMD. The mean BMD was 1.93-3.11% higher in quartile 4 (vs. 1) (all p values <0.01) at multiple sites. Five-unit increases in the modified AHA-DLS score were associated with 4.20-6.07, 4.44-8.51, and 3.36-4.67 mg/cm2 increases in BMD at multiple sites for the total subjects, males, and females, respectively (all p values <0.01). CONCLUSIONS Better adherence to the AHA-DLR shows protective associations with BMD at multiple sites in the middle-aged and elderly Chinese population.
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Affiliation(s)
- G D Chen
- Department of Medical Statistics and Epidemiology, Guangdong Provincial Key Laboratory of Food, Nutrition, and Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, People's Republic of China
| | - D Ding
- Department of Medical Statistics and Epidemiology, Guangdong Provincial Key Laboratory of Food, Nutrition, and Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, People's Republic of China
| | - H Y Tian
- Department of Medical Statistics and Epidemiology, Guangdong Provincial Key Laboratory of Food, Nutrition, and Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, People's Republic of China
| | - Y Y Zhu
- Department of Medical Statistics and Epidemiology, Guangdong Provincial Key Laboratory of Food, Nutrition, and Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, People's Republic of China
| | - W T Cao
- Department of Medical Statistics and Epidemiology, Guangdong Provincial Key Laboratory of Food, Nutrition, and Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, People's Republic of China
| | - C Wang
- Department of Medical Statistics and Epidemiology, Guangdong Provincial Key Laboratory of Food, Nutrition, and Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, People's Republic of China
| | - Y M Chen
- Department of Medical Statistics and Epidemiology, Guangdong Provincial Key Laboratory of Food, Nutrition, and Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, People's Republic of China.
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Jahns L, Roemmich JN. Study design for a randomized controlled trial to increase the relative reinforcing value of vegetable consumption using incentive sensitization among obese and overweight people. Contemp Clin Trials 2016; 50:186-92. [PMID: 27565831 DOI: 10.1016/j.cct.2016.08.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2016] [Revised: 08/15/2016] [Accepted: 08/22/2016] [Indexed: 11/15/2022]
Abstract
In this manuscript, we present the protocol for a study that applies incentive sensitization theory to improve vegetable intake in overweight and obese adults. This 8-week, randomized, controlled, community-based feeding study with an 8-week follow-up seeks to use repeated exposure to amounts of vegetables recommended by federal guidance to increase the primary outcome of the relative reinforcing value of vegetables compared to a snack food. A community-based design is used to give participants autonomy in choosing their method of exposure. Secondary outcomes include: 1) Determine potential moderators of incentive sensitization of vegetables, including genetic polymorphisms associated with food reinforcement and obesity, 6-n-propylthiouracil tasting status, and delay discounting. 2) Determine whether adding vegetables to the diet results in participants substituting low-energy-dense vegetables for energy-dense foods or whether energy-dense food consumption is independent of vegetable consumption. 3) Determine whether reductions in adiposity are associated with substitution of vegetables in the diet. 4) Determine if markers of bone turnover change. 5) Assess changes in self-reported secondary outcomes measured by questionnaire such as self-efficacy to eat vegetables. The results of this study will provide information about the drivers of individual choice to consume recommended amounts of vegetables. The understanding gained will help increase the effectiveness and sustainability of behavior-based interventions focused on improving vegetable intake. This information may also be used to assist in setting dietary guidance targets for the amounts and types of vegetables Americans can, and should, consume.
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Affiliation(s)
- Lisa Jahns
- United States Department of Agriculture, Agricultural Research Service, Grand Forks Human Nutrition Research Center, 2420 2nd Ave N, Grand Forks, ND 58203, USA.
| | - James N Roemmich
- United States Department of Agriculture, Agricultural Research Service, Grand Forks Human Nutrition Research Center, 2420 2nd Ave N, Grand Forks, ND 58203, USA.
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Tyson CC, Lin PH, Corsino L, Batch BC, Allen J, Sapp S, Barnhart H, Nwankwo C, Burroughs J, Svetkey LP. Short-term effects of the DASH diet in adults with moderate chronic kidney disease: a pilot feeding study. Clin Kidney J 2016; 9:592-8. [PMID: 27478603 PMCID: PMC4957723 DOI: 10.1093/ckj/sfw046] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2016] [Accepted: 05/02/2016] [Indexed: 11/21/2022] Open
Abstract
Background Although the Dietary Approaches to Stop Hypertension (DASH) diet lowers blood pressure (BP) for adults with normal kidney function, evidence is lacking regarding its safety and efficacy in chronic kidney disease (CKD). We aimed to test the effects of the DASH diet on serum electrolytes and BP in adults with moderate CKD. Methods In a prospective before–after feeding study, 11 adults with an estimated glomerular filtration rate of 30–59 mL/min/1.73 m2 and medication-treated hypertension were provided a reduced-sodium, run-in diet for 1 week followed by a reduced-sodium, DASH diet for 2 weeks. Changes in serum electrolytes and BP were compared pre–post DASH. Results Eleven participants underwent feeding; 1 completed 1 week and 10 completed 2 weeks of DASH. Compared with baseline, DASH modestly increased serum potassium at 1 week (mean ± standard deviation, +0.28 ± 0.4 mg/dL; P = 0.043) but had no significant effect on potassium at 2 weeks (+0.15 ± 0.28 mg/dL; P = 0.13). Serum bicarbonate was reduced (−2.5 ± 3.0 mg/dL; P = 0.03) at 2 weeks. Neither incident hyperkalemia nor new onset metabolic acidosis was observed. Clinic BP and mean 24-h ambulatory BP was unchanged. DASH significantly reduced mean nighttime BP (−5.3 ± 5.8 mmHg; P = 0.018), and enhanced percent declines in both nocturnal systolic BP (−2.1% to −5.1%; P = 0.004) and diastolic BP (−3.7% to −10.0%; P = 0.008). Conclusions These pilot data suggest that a reduced-sodium DASH dietary pattern does not cause acute metabolic events in adults with moderate CKD and may improve nocturnal BP. Definitive studies are needed to determine long-term effects of DASH in CKD.
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Affiliation(s)
| | - Pao-Hwa Lin
- Department of Medicine, Duke University, Durham, NC, USA; Sarah W. Stedman Nutrition & Metabolism Center, Duke University Medical Center, Durham, NC, USA
| | - Leonor Corsino
- Department of Medicine , Duke University , Durham, NC , USA
| | - Bryan C Batch
- Department of Medicine , Duke University , Durham, NC , USA
| | - Jenifer Allen
- Sarah W. Stedman Nutrition & Metabolism Center , Duke University Medical Center , Durham, NC , USA
| | - Shelly Sapp
- Duke Clinical Research Institute , Durham, NC , USA
| | | | - Chinazo Nwankwo
- Sarah W. Stedman Nutrition & Metabolism Center , Duke University Medical Center , Durham, NC , USA
| | - Jasmine Burroughs
- Sarah W. Stedman Nutrition & Metabolism Center , Duke University Medical Center , Durham, NC , USA
| | - Laura P Svetkey
- Department of Medicine, Duke University, Durham, NC, USA; Sarah W. Stedman Nutrition & Metabolism Center, Duke University Medical Center, Durham, NC, USA
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Liu N, Zeng F, Zhang K, Tang Z. A community-based cross-sectional study for relationship of frequency of vegetables intake and osteoporosis in a Chinese postmenopausal women sample. BMC WOMENS HEALTH 2016; 16:28. [PMID: 27259804 PMCID: PMC4891848 DOI: 10.1186/s12905-016-0307-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/08/2015] [Accepted: 05/21/2016] [Indexed: 11/30/2022]
Abstract
Background The main purpose of this study was to explore the associations between frequency of vegetables intake and osteoporosis (OP) in Chinese postmenopausal women. Methods We conducted a large-scale, community-based, cross-sectional study to investigate the associations by using self-report questionnaire to access frequency of vegetables intake. The total of 1903 participants was available to data analysis in this study. Multiple regression models to include frequency of vegetables variable were performed to investigate the relationships for OP, after controlling for confounding factors. Results Multiple regression analysis indicated that the frequency of vegetables intake was independently and significantly associated with OP (P < 0.1 for model 1 and model 2). The postmenopausal women with high frequency of vegetables intake had a higher prevalence of OP. Conclusion The findings indicated that frequency of vegetables intake was independently and significantly associated with OP. The prevalence of OP was more frequent in Chinese postmenopausal women preferring vegetables food habits. Trial registration (ClinicalTrials.gov Identifier: NCT02451397; date of registration: 2015-05-28).
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Affiliation(s)
- Najia Liu
- Department of Endocrinology and Metabolism, Shanghai Tongji Hospital, Tongji University School of Medicine, Shanghai, 200065, China.,Department of Endocrinology and Metabolism, Fudan University Huashan Hospital, Shanghai, China
| | - Fangfang Zeng
- Department of Endocrinology and Metabolism, Fudan University Huashan Hospital, Shanghai, China
| | - Keqin Zhang
- Department of Endocrinology and Metabolism, Shanghai Tongji Hospital, Tongji University School of Medicine, Shanghai, 200065, China
| | - Zihui Tang
- Department of Endocrinology and Metabolism, Shanghai Tongji Hospital, Tongji University School of Medicine, Shanghai, 200065, China.
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Lin CH, Chen KH, Chen CM, Chang CH, Huang TJ, Hsu HC, Huang SY. Low vegetable intake increases the risk of fall-related fragility fracture in postmenopausal Taiwanese women, a prospective pilot study in the community. Biomed J 2016; 39:214-22. [PMID: 27621124 PMCID: PMC6140300 DOI: 10.1016/j.bj.2015.11.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2015] [Accepted: 11/16/2015] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND The aim of this prospective study was to investigate the relationship between lifestyle factors including nutrition intake and the incidence of fall-related fragility fractures in postmenopausal women. METHODS A total of 1169 female volunteers were recruited from participants at the morning health examinations held at each local public health center in the West Chiayi County of Taiwan at the beginning of the study. Laboratory examinations, anthropometric measurements, and questionnaire interviews inquiring about lifestyle factors, including weekly nutrition intake, were performed. Subsequently, four follow-up telephone interviews at intervals of about 6-12 months were performed to inquire about instances of falls and fractures. RESULTS Nine hundred and fifty-three subjects responded at least once to the four telephone interviews, and there were 183 postmenopausal women, with a mean age of 68.8 ± 8.3 (49-87) years, reporting falls. Of the 183 women, 25 had incurred new fractures from low-energy impacts. Statistical analysis revealed that older age and hypertension were associated with increased risks of falling. Intake of other deep-colored (nondark-green) vegetables and light-colored vegetables as well as total vegetable intake were associated with reduced risk of fall-related fragility fracture. CONCLUSION Among postmenopausal women, older age and the presence of hypertension were associated with increased risks of falls. Increased vegetable intake might be helpful to reduce the incidence of fall-related fragility fractures.
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Affiliation(s)
- Chu-Hsu Lin
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital at Chiayi, Chiayi, Taiwan
| | - Kai-Hua Chen
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital at Chiayi, Chiayi, Taiwan; School of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Chien-Min Chen
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital at Chiayi, Chiayi, Taiwan; School of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Chia-Hao Chang
- College of Nursing and the Chronic Diseases and Health Promotion Research Center, Chang Gung University of Science and Technology, Chiayi, Taiwan
| | - Tung-Jung Huang
- Division of Thoracic Medicine, Chang Gung Memorial Hospital at Yunlin, Yunlin, Taiwan; Department of Respiratory Care, Chang Gung University of Science and Technology, Chiayi, Taiwan.
| | - Hung-Chih Hsu
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital at Chiayi, Chiayi, Taiwan; Department of Nursing, Chang Gung University of Science and Technology, Chiayi, Taiwan; Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Shih-Yang Huang
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital at Chiayi, Chiayi, Taiwan
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