Osteoporosis-related life habits and knowledge about osteoporosis among women in El Salvador: a cross-sectional study

Association between dietary insulin index and postmenopausal osteoporosis in Iranian women: a case-control study

BACKGROUND

The relationship between the dietary insulin index (DII) and the disease's risk is unknown, despite the fact that hyperinsulinemia is presumed to contribute to osteoporosis. The insulin response of various diets determines the DII. This study aimed to investigate the connection between postmenopausal Iranian women's adherence to a diet with a higher insulinemic potential and osteoporosis.

METHODS

A total of 380 postmenopausal women were included in the current case-control study. A 168-item food frequency questionnaire (FFQ) with established validity and reliability was used to evaluate individuals' daily calorie intake. The standard formula was employed to determine the dietary insulin load of each product. Subsequently, the calculation of DII was performed by dividing the dietary insulin load by the total energy consumed for each individual. In order to investigate the relationship between osteoporosis and DII, logistic regression was implemented.

RESULTS

The results of the current study demonstrated a substantial inverse relationship between osteoporosis and the DII, even after accounting for confounding variables (OR = 0.927; 95% CI = 0.888-0.967). The mean scores of DII (P < 0.001) was significantly higher in control group (36.82 ± 8.98) compared to the case group (33.53 ± 6.28).

CONCLUSIONS

Our findings suggest that keeping a diet high in insulin index and low in foods that are insulinogenic may improve bone mass density. Consequently, it may be essential for postmenopausal women to consume nutrients that stimulate insulin production in order to prevent osteoporosis.

Assessing Osteoporosis Knowledge and Beliefs Among Adults Living in Saudi Arabia: A Cross-Sectional Study

BACKGROUND

Knowledge and beliefs about osteoporosis have been considered one of the vital parts of early prevention against it.

OBJECTIVES

This study aimed to evaluate knowledge and beliefs toward osteoporosis using the Osteoporosis Knowledge Assessment Tool (OKAT) and Osteoporosis Health Belief Scale (OHBS) questionnaires among the public in Jeddah, Saudi Arabia.

METHODS

This cross-sectional study was conducted from March 2019 to April 2019 among adults aged 15 years and above. A validated questionnaire was allocated electronically to the participants through social platforms (such as Twitterand WhatsApp) using a convenience sampling technique.

RESULTS

A total of 754 participants completed the questionnaire. The majority were females 481 (63.8%). A total of 34 (4.1%) have not heard about osteoporosis before. Respondents scored a total mean of 7.92±3.0for the OKAT questionnaire and a mean score of 126.74±22.38for the OHBS questionnaire. These two scores were significantly associated with age groups and gender (P < 0.05).

CONCLUSION

Although there is a relative increase in the knowledge of our sample, the belief towardosteoporosis is evidently lower. Therefore, implementing educational programs that tackle belief perception and other preventive measures such as healthy eating habits, physical activities, and educational materials are needed in the future.

Socioeconomic status influences on bone mineral density in American men: findings from NHANES 2011-2020

The association between socioeconomic status (SES) and bone mineral density (BMD) in men remains controversial. We showed that SES was positively associated with BMD in American men. Confounding factors like race/ethnicity and age could affect the association.

INTRODUCTION

Based on the data from the National Health and Nutrition Examination Survey (NHANES), 2011-2020, this article aims to investigate the association of SES (poverty income ratio (PIR) and education level) with the BMD in American men.

METHODS

We evaluated the association of SES with BMD in 4446 men aged ≥ 20 years (mean age, 41.0 ± 13.4 years) from the NHANES 2011-2020. BMD was measured by dual-energy X-ray absorptiometry (DXA) at the lumbar spine. We used multivariate linear regression models to examine the relationship between SES and total spine BMD, adjusted for a large range of confounding factors.

RESULTS

Compared with other PIR quarters, individuals in the highest quarter of PIR were more likely to be older and white and had fewer smoking or drinking behaviors. After adjusting for race/ethnicity, age, drinking and smoking behavior, body mass index (BMI), total protein, serum calcium, serum uric acid, cholesterol, serum phosphorus, and blood urea nitrogen, PIR was positively correlated with total spine BMD (β = 0.004 95% CI: 0.001-0.007, P = 0.006). Individuals with the highest degree (college degree or above) had a 0.057 g/cm² greater BMD than that of the lowest degree (less than 9th grade) (β = 0.057 95% CI: 0.037-0.077, P < 0.001).

CONCLUSIONS

Our study indicates that SES was positively associated with the lumbar BMD among American men. Clinicians, healthcare providers, and policymakers should consider the unequal SES of men when implementing osteoporosis prevention and treatment strategies.

Design, development, and evaluation of a self-care program for women with osteoporosis: The protocol of a mixed-method study

BACKGROUND

Osteoporosis, the fourth most common disease in the world, affects the elderly and postmenopausal women and imposes a great financial and social burden on individuals and society. Furthermore, it has a significant impact on the quality of patients' life. This study tries to take an effective step toward improving the quality of patients' life by developing and evaluating the self-care program of women with osteoporosis.

MATERIALS AND METHODS

In this research, a hybrid sequential design of quantitative and qualitative type consisting of three phases is used. This mixed-method study aimed to develop and evaluate a self-care program for women with osteoporosis.

CONCLUSION

Familiarity with the needs of these patients and the use of self-care programs and considering social, cultural, and psychological factors could be effective steps to improve the health of women with osteoporosis. These steps can improve the quality of life and reduce the costs of treatment for this group of women.

Osteoporosis knowledge, attitudes, and practices among female Princess Nourah University students in Riyadh, Saudi Arabia

BACKGROUND AND OBJECTIVE

Osteoporosis is characterized by decreased normal bone density. More than 8.9 million fractures worldwide annually are caused by osteoporosis; these fractures are a significant cause of morbidity and mortality. Evidence suggests that the modification of several lifestyle habits could assist in lowering the incidence of osteoporosis. However, limited studies have been conducted in Saudi Arabia to assess the knowledge, attitudes, and lifestyles associated with osteoporosis among college-age females. This study aimed to provide evidence to assist in the development of effective strategies against osteoporosis.

MATERIALS AND METHODS

This cross-sectional study was conducted at Princess Nourah Bint Abdul Rahman University (PNU), in February 2018; a self-administered questionnaire was used. The different components of the questionnaire assessed knowledge, attitudes, and lifestyles with regard to osteoporosis. The participants were divided into groups on the basis of their age as follows: juniors, 17-20 years of age; seniors, 21-25 years of age.

RESULTS

Of the 250 included participants, 122 (49%) and 128 (51%) were seniors and juniors respectively. Only 16% of all participants achieved a good score on the knowledge questionnaire; in particular, knowledge regarding osteoporosis risk factors was inadequate. Media was the only source of information of the included participants. Only 49% of participants believed that osteoporosis is a serious disease. Overall, only 32% and 27% of juniors and seniors are consumed sufficient dairy products, and 13% and 11% of juniors and seniors engaged in physical exercise, respectively.

CONCLUSION

Osteoporosis misconceptions were extremely prevalent among PNU students, as was poor knowledge and lifestyle habits regarding osteoporosis. Information regarding osteoporosis presented through the media needs to be revised and simplified. Concerned institutions should combine their efforts eventually practice. Information about osteoporosis presented through media need to be revised, simplified, and implement a national program to improve osteoporosis awareness and prevention.

Osteoporosis Knowledge and Health Beliefs Among Female Community Leaders in Peru

Background: Osteoporosis presents an increasing problem globally, primarily affecting older adults and postmenopausal women. Among important modifiable risk factors for osteoporosis, physical activity and calcium intake help reduce bone mineral loss and decrease the prevalence of osteoporosis. Although osteoporosis knowledge and health beliefs are associated with adopting preventive behavior and screening rates, few studies have evaluated them in Latin American populations. Materials and Methods: We conducted a cross-sectional study among female community leaders in a Peruvian periurban setting. A total of 60 women participated in the study, with a mean age of 43.7 ± 8.3 years, mean body mass index of 30.4 ± 5.3 kg/m², 88% being overweight or obese, and 58.3% having completed high school education or beyond. Participants completed translated and culturally adapted Osteoporosis Knowledge Test and Osteoporosis Health Belief Scale via semistructured interviews. Results: Most participants reported high knowledge regarding osteoporosis, perceived benefits to exercise and calcium intake, and health motivation. The level of osteoporosis knowledge was highly associated with the level of education, and we found a trend for the association between level of knowledge and perceived benefits of exercise and barriers to calcium intake among participants. Conclusions: Female community leaders with high health motivation and community engagement can contribute enormously to osteoporosis prevention programs in local communities in the future.

Discovery of potential biomarkers for osteoporosis using LC-MS/MS metabolomic methods

Our study focused on the associations of metabolites with BMD and osteoporosis, finding that several metabolites are associated with BMD, and metabolites combined with bone turnover markers tend to be more sensitive in distinguishing osteoporosis in both males and postmenopausal females, which might be meaningful for the early diagnosis of osteoporosis.

INTRODUCTION

Our study aimed to evaluate the association of metabolites with bone, trying to find new metabolic markers that are distinguishing for low bone mineral density (BMD).

METHODS

Our study recruited 320 participants, including 138 males and 182 postmenopausal females from the Shanghai area. Bone turnover markers (BTMs), including osteocalcin, PINP and β-CTX, and other biochemical traits were tested. BMD values of the lumber spine (L1-4), femoral neck and total hip were determined using dual-energy X-ray absorptiometry and the serum metabolome profiles including 221 metabolites from five groups (acylcarnitines, amino acids, biogenic amines, glycerophospholipids, sphingolipids and hexose) were assessed by mass spectrometry.

RESULTS

No visual separation in the metabolic profiles between different BMD groups was observed in principal component analysis (PCA) or partial least squares discriminant analysis (PLS-DA) models. We compared metabolites in three groups with different BMD levels in males and postmenopausal females separately and further filtering these metabolites via random forest-based feature selection, a commonly applied machine learning algorithm which could select the features with the greatest impact on osteoporosis, then metabolites with the highest importance (≥ 5%) (5 in males and 9 in postmenopausal females) were selected to construct better models for osteoporosis classification. After adding these selected metabolites to the model, the area under the curve (AUC) of receiver operating characteristic (ROC) curves increased significantly (BTMs: AUC 0.729, 95% CI 0.647-0.802, p < 0.0001, model 1: AUC = 0.828, 95% CI 0.754-0.888, p < 0.0001; model 1 versus model of BTMs: p = 0.0158) compared to the AUC of the BTM-only model in males. Similar results were also observed in postmenopausal females (BTMs: AUC = 0.638, 95% CI 0.562-0.708, p = 0.0025; model 2: AUC = 0.741, 95% CI 0.669-0.803, p < 0.0001; model 1 versus model of BTMs: p = 0.0182).

CONCLUSION

Metabolites combined with traditional BTMs tend to better markers for distinguishing osteoporosis in both males and postmenopausal females than BTMs alone.

Perception of peri-menopausal and postmenopausal Lebanese women on osteoporosis: A cross-sectional study

INTRODUCTION

Osteoporosis is a generalized skeletal disorder characterized by decreased bone mineral density and microarchitectural deterioration, resulting in increased susceptibility to fractures. The prevalence of osteoporosis in Lebanon, defined as T-score <-2.5 at the total hip using NHANES gender-specific database was estimated to be 31% among postmenopausal women.

PURPOSE

To assess the general perception of osteoporosis among women in Lebanon as well as their general knowledge of its lifestyle, risk factors, diagnostic, preventive and therapeutic measures.

METHODS

A cross-sectional study was conducted in Lebanon between January and December 2017. Women above the age of 50 were invited to participate. A standardized questionnaire regarding the perception of personal risk of osteoporosis and fractures was used. Risk factors for osteoporosis, previous fractures or falls, family history of fracture, smoking, alcohol consumption, and secondary causes of osteoporosis were evaluated. Data were recorded on excel and analyzed on SPSS using variety of descriptive analysis, ANOVA tests, and others. P value <0.05 was considered to be statistically significant.

RESULTS

From 396 interviewed women, 85% were in menopause and were more likely to be diagnosed with osteoporosis. 45% knew the true definition of osteoporosis and their most frequent source of information was doctors. Around 60% had heard of BMD screening but only 54.5% of those women actually did it.

CONCLUSION

This study reveals that osteoporosis knowledge and perception is low among the Lebanese woman aged 50 years and older.

Knowledge of risk factors and prevention of osteoporosis: the Israeli women's health at midlife study

Wide disparities in knowledge of risk factors and prevention of osteoporosis were demonstrated among midlife Israeli minority women (Arabs and immigrants from the former USSR) compared to Jewish long-time residents. Women who believed osteoporosis to be a serious disease and those who felt susceptible to it reported better knowledge.

PURPOSE

The main goals of this study were to assess knowledge of risk factors and preventive measures for osteoporosis in middle-aged women and to evaluate the relationship of knowledge to personal risk factors and personal perceptions about osteoporosis.

METHODS

Face-to-face interviews with women aged 45-64 years were conducted during 2004-2006 within three population groups: long-term Jewish residents (LTJRs), immigrants from the former Soviet Union, and Arab women. The survey instrument included five knowledge statements related to the risk after menopause, the risk of smoking, family history of fractures, decreased risk by physical activity, and by use of medications.

RESULTS

The findings indicated wide disparities in knowledge about risk factors and preventive behavior of osteoporosis between the two minority groups (immigrants from the former Soviet Union and Arab women) and the majority group of midlife Israeli women. Knowledge of osteoporosis was related to perceived severity of the disease and partly to perceived susceptibility to osteoporosis. Past diagnosis of osteoporosis, current or past smoking status, and BMI were unrelated to knowledge in multivariate analyses.

CONCLUSIONS

There is a need to improve knowledge of osteoporosis especially among less educated and minority women. Subjective perception of risk was more strongly related to knowledge than actual risk factors and should be targeted in public campaigns. The efforts should be aimed at strengthening women's perception of their own susceptibility to osteoporosis and of the severity of this disease.

Association of adiposity indices with bone density and bone turnover in the Chinese population

Associations of adiposity indices with bone mineral density (BMD) and bone turnover markers were evaluated in Chinese participants. Body mass index, fat mass, and lean mass are positively related to BMD in both genders. Subcutaneous fat area was proved to be negatively associated with BMD and positively correlated with osteocalcin in postmenopausal females.

INTRODUCTION

Obesity is highly associated with osteoporosis, but the effect of adipose tissue on bone is contradictory. Our study aimed to assess the associations of adiposity indices with bone mineral density (BMD) and bone turnover markers (BTMs) in the Chinese population.

METHODS

Our study recruited 5215 participants from the Shanghai area, evaluated related anthropometric and biochemical traits in all participants, tested serum BTMs, calculated fat distribution using magnetic resonance imaging (MRI) images and image analysis software, and tested BMD with dual-energy X-ray absorptiometry.

RESULTS

When controlled for age, all adiposity indices were positively correlated with BMD of all sites for both genders. As for the stepwise regression analysis, body mass index (BMI), fat mass, and lean mass were protective for BMD in both genders. However, subcutaneous fat area (SFA) was detrimental for BMD of the L1-4 and femoral neck (β ± SE -0.0742 ± 0.0174; p = 2.11E-05; β ± SE -0.0612 ± 0.0147; p = 3.07E-05). Adiposity indices showed a negative correlation with BTMs adjusting for age, especially with osteocalcin. In the stepwise regression analysis, fat mass was negatively correlated with osteocalcin (β ± SE -8.8712 ± 1.4902; p = 4.17E-09) and lean mass showed a negative correlation with N-terminal procollagen of type I collagen (PINP) for males (β ± SE -0.3169 ± 0.0917; p = 0.0006). In females, BMI and visceral fat area (VFA) were all negatively associated with osteocalcin (β ± SE -0.4423 ± 0.0663; p = 2.85E-11; β ± SE -7.1982 ± 1.1094; p = 9.95E-11), while SFA showed a positive correlation with osteocalcin (β ± SE: 5.5993 ± 1.1753; p = 1.98E-06).

CONCLUSION

BMI, fat mass, and lean mass are proved to be beneficial for BMD in both males and postmenopausal females. SFA is negatively associated with BMD and positively correlated with osteocalcin in postmenopausal females.

Gender Differences and Socioeconomic Factors Related to Osteoporosis: A Cross-Sectional Analysis of Nationally Representative Data

BACKGROUND

Osteoporosis has been considered a disease that primarily affects women, but recently male osteoporosis is also attracting attention. This study aims to comparatively analyze socioeconomic and other factors that are related to the prevalence of osteoporosis in both men and women.

MATERIALS AND METHODS

This study used data from the Korean Community Health Survey conducted in 2013. To determine factors related to osteoporosis prevalence, researchers applied a binary logistic regression model, first for all research participants, then separately for male and female participants.

RESULTS

Women were more likely than men to have osteoporosis (odds ratio 12.33, 95% confidence interval 11.55-13.17). Factors related to osteoporosis prevalence included age, education level, region, economic activity, alcohol consumption, salt intake, depression, and body mass index in both genders. Low education and income levels were more highly associated with osteoporosis prevalence in women than in men.

CONCLUSIONS

Most of the factors were not gender specific, but some socioeconomic determinants varied by gender. Future studies that will focus on the effects of socioeconomic factors on osteoporosis, as well as gender-related differences in prevention and control of osteoporosis, are needed.

A model of health education and management for osteoporosis prevention

Osteoporosis, a chronic disease with no therapeutic cure, affects a growing number of people as the aging population in China rapidly increases. Therefore, developing an evidence-based model of health education and management for osteoporosis prevention is required. In the present study, an osteoporosis club was established, which is a novel model of health education and management for osteoporosis prevention. A unified management of membership was used based on a digitized database. A total of 436 patients with osteoporosis were randomly assigned to the osteoporosis club group or the self-management control group. For the osteoporosis club group, multiple activities of health education were performed, including monthly systematic health education lectures, exercise programs and communication parties once a year. For the control group, the participants took charge of their own musculoskeletal health. All data of the participants were collected and evaluated prior to and following intervention. In the pre-intervention assessment, no significant difference was identified in the health education between the two groups. Through the four-year intervention, the osteoporosis knowledge, health beliefs, living behavior, medication compliance, quality of life and bone mineral density of the osteoporosis club group were improved significantly compared with the control group (P<0.001), while the pain degree of the osteoporosis club group was relieved significantly more compared with the control group (P<0.001). The results in the present study suggest that setting up an osteoporosis club is an evidence-based model of health education and management for osteoporosis prevention in China.

Osteoporosis. Conocimiento sobre prevención, tratamiento y complicaciones de estudiantes universitarios

La osteoporosis es una enfermedad prevenible con complicaciones graves, con muchos factores de riesgo modificables. La OMS y la IOF han advertido que 1 de cada 3 mujeres, y 1 de cada 8 hombres, sufrirá osteoporosis a lo largo de su vida. En Guatemala no se reconoce como un problema de salud. Objetivo: Evaluar el conocimiento sobre osteoporosis en jóvenes estudiantes de diferentes facultades la Universidad Francisco Marroquín. Comparar el conocimiento entre los estudiantes de medicina y los estudiantes de otras carreras en la UFM. Como ha sido descrito en múltiples estudios, existe una necesidad de informar a la población desde edades tempranas sobre la osteoporosis, para prevenir las complicaciones devastadoras de la enfermedad. Método: Estudio de tipo transversal, se utilizó el cuestionario OKAT (Osteoporosis Knowledge and Assessment Tool) para entrevistar a 260 estudiantes de la UFM. Se utilizó comparación de medias, para comparar el grado de conocimientos de osteoporosis entre estudiantes de medicina y el grado de conocimiento de estudiantes de las demás facultades. Resultados: El promedio de puntuación en el OKAT fue de 9.71 puntos de todos los estudiantes. La media de puntuación en estudiantes de medicina fue de 12.2 puntos. El promedio de puntuación en facultades excluyendo medicina fue de 8 puntos. Conclusión: Los estudiantes de medicina, según el OKAT, tienen un conocimiento apropiado sobre osteoporosis (por arriba de 11 puntos). La media de puntuación de todos los estudiantes de otras facultades indica que no tienen conocimiento apropiado sobre osteoporosis. La media de puntuación de los estudiantes de medicina es estadísticamente significativa mayor a la de los estudiantes de otras facultades (p< 0.0001).

[Perceptions of Tunisian women based on the health beliefs model and their practices related to osteoporosis]

Introduction

L'étude a pour objectif de décrire les croyances des femmes et leurs pratiques liées à la santé et à l'ostéoporose, afin d'élaborer des interventions efficaces et ciblées pour la prévention de cette maladie dans le contexte tunisien.

Méthodes

Une étude descriptive transversale a été effectuée auprès de 100 femmes tunisiennes, âgées de 45 ans et plus, qui consultent au centre de santé de base d'une zone périurbaine de la région de Sousse (Tunisie). La collecte de l'information a été réalisée à l'aide de « l'échelle des croyances relatives à la santé sur l'ostéoporose» développée par Kim et ses collègues traduit en arabe et validé en Tunisie et le questionnaire de «Calcul des apports calciques quotidiens» développé par Fardellone Patrice. L'interprétation des résultants s'est basée sur le «Health Belief Model ».

Résultats

La perception des participantes pourrait être considérée comme au dessus de la moyenne pour la vulnérabilité de l'ostéoporose (58%), la gravité de la maladie, les avantages de la pratique de l'activité physique, les avantages de l'apport en calcium et la motivation à la santé; par contre, elle pourrait être considérée comme modérée concernant les obstacles à la prévention. Cependant, les pratiques exposant au risque de la maladie sont relativement fréquentes et ceci essentiellement en rapport avec des facteurs socio-économiques et culturels.

Conclusion

Les programmes de promotion doivent viser la création d'un environnement physique et social favorable à l'adoption des comportements à moindre risque et viser l'éducation ciblée de la population.

An assessment of patients' knowledge of osteoporosis in Qatar: A pilot study

Osteoporosis is a disease that affects the bones. It leads to increased risk of fractures as a result of decreased bone mineral density. The goal of this study was to assess the general perception of osteoporosis as well as knowledge of lifestyle, risk factors, and preventive measures among patients in Qatar. The study was conducted between September 2013 and September 2014. The study subjects (n = 93) were patients diagnosed with osteoporosis who attended the Outpatient Rheumatology Clinic at Hamad General Hospital in Doha, Qatar. The results showed that those with a university or graduate degree had a significantly higher level of knowledge about osteoporosis (p = 0.009) than those with less education. Among those in our study, knowledge related to osteoporosis was principally obtained through media sources such as television and radio (39%). In conclusion, osteoporosis patients in Qatar need a better understanding of the disease. Identifying thought patterns related to the perception of osteoporosis and treatment might assist in building a foundation for management modalities and effective preventive strategies for the disease in Qatar.

Knowledge, attitude, and practice of osteoporosis among Saudis: a community-based study

BACKGROUND

Osteoporosis is a global public health problem currently affecting millions of people worldwide, and Saudi Arabia is not an exception. Awareness and perceptions of susceptibility and belief in the seriousness of a disease can help in its prevention and control. We aimed to assess knowledge, attitude, and practices for osteoporosis among Saudi general population and to identify its determining factors.

METHODS

A cross-sectional survey of people aged 18 years or older representing every region in the Kingdom of Saudi Arabia was carried out. A total of 2174 self-administered questionnaires were distributed to identify the levels of knowledge, attitude, and practice.

RESULTS

Responses were obtained from 1830 individuals (42% female and 58% male). The majority of the study sample had heard about osteoporosis (78%). There were significant associations between the level of awareness and the following sociodemographics of the participants: age, sex, education, occupation, income, and residence (P<0.01). Regular practice of the main preventive behaviors was correlated with an increase in the level of awareness.

CONCLUSION AND RECOMMENDATIONS

The majority of the study cohort had heard about osteoporosis. Female respondents were more knowledgeable. Age was negatively correlated with the level of awareness. Awareness levels and the main sociodemographic determinants were significantly associated. The study recommended that health authorities and physicians should have better involvement in patient education efforts to improve and maintain the information provided on osteoporosis.

A cross-sectional study to estimate associations between education level and osteoporosis in a Chinese postmenopausal women sample

BACKGROUND

Our research aims to investigate the associations between education level and osteoporosis (OP) in Chinese postmenopausal women.

METHODS

A large-scale, community-based, cross-sectional study was conducted to examine the associations between education level and OP. A self-reported questionnaire was used to access the demographical information and medical history of the participants. A total of 1905 postmenopausal women were available for data analysis in this study. Multiple regression models controlling for confounding factors to include education level were performed to investigate the relationship with OP.

RESULTS

The prevalence of OP was 28.29% in our study sample. Multivariate linear regression analyses adjusted for relevant potential confounding factors detected significant associations between education level and T-score (β = 0.025, P-value = 0.095, 95% CI: -0.004-0.055 for model 1; and β = 0.092, P-value = 0.032, 95% CI: 0.008-0.175 for model 2). Multivariate logistic regression analyses detected significant associations between education level and OP in model 1 (P-value = 0.070 for model 1, Table 5), while no significant associations was reported in model 2 (P value = 0.131). In participants with high education levels, the OR for OP was 0.914 (95% CI: 0.830-1.007).

CONCLUSION

The findings indicated that education level was independently and significantly associated with OP. The prevalence of OP was more frequent in Chinese postmenopausal women with low educational status.

Chosen risk factors for osteoporosis and the level of knowledge about the disease in peri- and postmenopausal women

Introduction

Osteoporosis as a chronic disease, affecting especially women in postmenopausal age, is an important, social and economic health problem especially of women of today's world. The aim of the study was to assess the level of knowledge of women in the peri- and postmenopausal period about the prevention of osteoporosis and show the influence of chosen risk factors on the level of this knowledge.

Material and methods

A group of 300 women aged 45-65, being patients of healthcare centres in Chełm, Lublin and Zamość (Lublin voivodeship, south-eastern Poland) were included in the study. The purposive sampling was used. Osteoporosis Knowledge Test (OKT) 2011 was the research tool. Gathered material was subjected to descriptive and statistical analysis. Tukey's test, t-student test and variance analysis (ANOVA) were all applied. An accepted p materiality level was < 0.05 and p < 0.01.

Results

Respondents presented the average level of knowledge about the role of physical activity in the prevention of osteoporosis (M = 13.93) and a low level of knowledge about well-balanced diet rich in calcium (M = 9.77). The knowledge about risk factors, screening and treatment remained on the average level (M = 8.00). An influence of socio-demographic factors on the level of knowledge was shown. Also some behaviours, associated with the lifestyle indeed influenced the level of this knowledge.

Conclusions

Professional educational programs on osteoporosis should be implemented in the population of Polish peri- and postmenopausal women.

A descriptive study of knowledge, beliefs and practices regarding osteoporosis among female medical school entrants in Sri Lanka

BACKGROUND

Osteoporosis is a significant problem in rapidly ageing populations in Asian regions. It causes a significant personal and societal impact and increases the burden on health care services.

OBJECTIVES

Aim of this study is to determine the knowledge, beliefs and practices regarding osteoporosis among young females entering medical schools in Sri Lanka.

METHODS

This is a descriptive cross sectional study conducted amongst 186 female medical school entrants of the Faculties of Medicine, Universities of Colombo and Kelaniya from September to December 2010. A self administered questionnaire was used to assess knowledge, beliefs and practices on osteoporosis, including a food frequency chart to assess the calcium intake.

RESULTS

The mean age was 20.7 +/- 2.1 years. Majority of the participants (51.6%, n = 96) had an average score (40-60) on the knowledge test, while 40.8% (n = 76) had a poor score (<40). However, in depth knowledge on risk factors, and protective factors was lacking. Perceived susceptibility for osteoporosis was low with only 13.9% (n = 26) of women agreeing that their chances of getting osteoporosis are high. The mean calcium intake was 528 mg/day and only 18.8% (n = 35) of the participants achieved the Recommended Daily Allowances (RDA) for Calcium. Exercise was grossly inadequate in the majority and only 13.6%( n = 23) engaged in the recommended exercises. Only 3.8% (n =7) of the participants currently engaged in specific behaviours to improve bone health while 10.8% (n = 20) had thought of routinely engaging in such behaviours.

CONCLUSIONS

Although majority of participants had a modest level of knowledge on osteoporosis, there were gaps in their knowledge in relation to risk factors, protective factors and on the insidious nature of osteoporosis. Perceived susceptibility for osteoporosis was low. Practices towards preventing Osteoporosis were inadequate.

The impact of adding weight-bearing exercise versus nonweight bearing programs to the medical treatment of elderly patients with osteoporosis

BACKGROUND

Osteoporosis is a major public health problem affecting the elderly population, particularly women. The objective of the study was to evaluate the effects of adding weight-bearing exercise as opposed to nonweight-bearing programs to the medical treatment of bone mineral density (BMD) and health-related quality of life (HRQoL) of elderly patients with osteoporosis.

MATERIALS AND METHODS

Participating in the study were 40 elderly osteoporotic patients (27 females and 13 males), with ages ranging from 60 to 67 years, who were receiving medical treatment for osteoporosis. They were assigned randomly into two groups: Group-I: Twenty patients practiced weight-bearing exercises. Group-II: Twenty patients did nonweight-bearing exercises. All patients trained for 45-60 min/session, two sessions/week for 6 months. BMD of the lumbar spine, right neck of femur, and right distal radial head of all patients were measured by dual-energy X-ray absorptiometry before and after both treatment programs. In addition, the QoL was measured by means of the HRQoL "ECOS-16" questionnaire.

RESULTS

T-tests proved that mean values of BMD of the lumbar spine, right neck of femur and right distal radial head were significantly increased in both groups with greater improvement in the weight-bearing group. The QoL was significantly improved in both groups, but the difference between them was not significant.

CONCLUSION

Addition of weight-bearing exercise program to medical treatment increases BMD more than nonweight-bearing exercise in elderly subjects with osteoporosis. Furthermore, both weight-bearing and nonweight-bearing exercise programs significantly improved the QoL of patients with osteoporosis.

Osteoporosis: a study of knowledge, attitude and practice among adults in Riyadh, Saudi Arabia

Osteoporosis is a growing chronic health problem that could result in mortalities and poor living quality. This study aimed at assessing the awareness of adults in Riyadh about this disease and its associated factors as well as compare KAP levels of men and women. A cross sectional study including 505 participants was conducted in several malls of Riyadh city during March 2012, selected by stratified random sampling technique. Self-administered questionnaire was used for data collection. 86% of the participants had heard of osteoporosis. Media was the main source for Participants' knowledge; the mean knowledge score was 56.6% of the maximum achievable score. There was significant differences in knowledge scores by educational level, employment, income and residence (P = 0.005), (P = 0.008) (P = 0.0122) and (P = 0.009), respectively. Participants had low frequencies of preventive practices, especially females who had a mean total score equivalent to 48.8% of the maximum score, while males' mean score was 54.7% (P = 0.000). Perceived susceptibility was higher among females (83 vs. 74%, P = 0.000), and thus had less perception of the barriers to preventive actions, than men (49.6 vs. 55.5%, P = 0.000). Self-efficacy and perceived benefits had the highest scores (95% of the maximum achievable scores). Considerable number of adult males and females are unaware about osteoporosis. Since there is deficiency in the knowledge, and poor application of the preventive actions. Therefore, Education programs are needed to improve awareness and motivating healthy behaviours.

Knowledge and health literacy are not associated with osteoporotic medication adherence, however income is, in Arab postmenopausal women

OBJECTIVE

To investigate the association between adherence with oral bisphosphonate treatment, income, health literacy, knowledge, and receiving instructions from a pharmacist or doctor, among Arab postmenopausal women diagnosed with osteoporosis in Israel.

METHODS

Arab osteoporotic women treated with oral bisphosphonates were interviewed (303 women). The questionnaire included socio-demographic characteristics, knowledge about osteoporosis and health literacy. Adherence was measured by the Medication Possession Ratio (MPR) according to the number of prescription refills registered in the database of Clalit Health Services.

RESULTS

Forty-one percent of the women were adherent according to the MPR. The main predictor of adherence in a multivariate logistic regression was income. Health literacy and knowledge were not associated with adherence after adjustment for income. Neither was the health care provider's counseling regarding the medication.

CONCLUSIONS

Lower income seems to be a barrier to adherence with osteoporotic medication, over and above other known barriers. Policy makers should take into account that medication funding may be a barrier to treatment. Practical implications Income may be a major barrier to adherance with osteoporosis medication and calls for attention of practiciner.

Osteoporosis knowledge and attitudes: a cross-sectional study among female nursing school students in Damascus

SUMMARY

This study was conducted to determine the level of osteoporosis knowledge and beliefs among nursing college students in Damascus. A worrying deficit of knowledge was found. They believed osteoporosis to be a serious disease but did not feel susceptible to or concerned about it. Innovative educational interventions should be considered.

PURPOSE

Increasing awareness, knowledge, and promoting healthy behaviors about osteoporosis and related risk factors are effective prevention measures for building and maintaining strong bone throughout the life-span. We hypothesized a lack of knowledge and unhealthy beliefs about osteoporosis among young women in our setting. The level of osteoporosis knowledge, beliefs, and behavior among nursing college students in Damascus was evaluated in this study.

METHODS

A cross-sectional study was conducted on a convenience sample of female young students seen at the nursing school. All students registered for the year 2011-2012 were included in the study. A self-administered questionnaire was implemented. The questionnaire included background information and both osteoporosis-related tools (Arabic version), namely the Osteoporosis Knowledge Assessment Tool (OKAT) and the Osteoporosis Health Belief Scale.

RESULTS

A total of 353 female students answered the questionnaire with a response rate of 98.3%. A worrying deficit of knowledge was found among surveyed Syrian young adult females with a total mean score of 7.9 (2.7) out of possible 20 points, being 39.6% of possible maximum score on the OKAT. Those young women believed osteoporosis to be a serious disease but did not feel susceptible to or concerned about the illness. Perceived moderate to high barriers to exercises and calcium intake indicated negative health beliefs.

CONCLUSIONS

The findings generally reveal poor knowledge about osteoporosis among nursing school female students at Damascus. Integration of osteoporosis in school curricula and public education efforts is urgently needed.

Relationship of knowledge about osteoporosis with education level and life habits

AIM: To assess possible relationships of knowledge and related factors with educational level and osteoporosis-related life habits.

METHODS: This was a cross sectional study conducted on 268 women (≥ 35 years old) from June 2011 to August 2011. The sample collection was done in outpatient clinics in three university hospitals in Isfahan, Iran. We used a demographic questionnaire containing questions that evaluated osteoporosis-related life habits, including exercise, smoking, intake of calcium and vitamin D supplements and so on. We also used the Osteoporosis Knowledge Assessment Tool to measure osteoporosis knowledge of women.

RESULTS: The mean level of knowledge about awareness of osteoporosis, its risk factors and preventive factors were 56, 55 and 22, respectively. The relationship of education level and awareness of osteoporosis, its risk factors and preventive factors was significant, with R = 0.76, R = 0.73 and R = 0.83, respectively (P < 0.001). The relationship of education level and osteoporosis-related life habits was not significant (R = 0.03 and P = 0.56). The relationship of osteoporosis-related life habits and awareness of osteoporosis and its risk factors was significant, with R = 16%, P = 0.006 and R = 16%, P = 0.008, respectively, but the relationship of osteoporosis-related life habits and preventive factors was not significant (R = 0, P = 0.99).

CONCLUSION: Iranian women with a higher education level have significantly better knowledge about osteoporosis than women with a lower educational level but they do not use this knowledge in their life.

Food habits related to osteoporosis in women in iran

BACKGROUND

Osteoporosis is an important public health problem. The aim of this study was to investigate food habits and some factors related to osteoporosis in women in Iran.

METHODS

This cross-sectional study was conducted on 399 childbearing age women who were attending health centers and 200 healthcare providers in 2007. Food habits and dietary calcium intake was evaluated by food frequency questionnaire and 24-hour recall method. Weight and height of subjects were also measured. Independent t-test, Mann-withney U test, Pearson, Spearman and Partial correlation coefficient tests were used for analyzing of data.

RESULTS

Two groups of women had calcium intake deficiency. Daily frequency of milk, cheese, fruit and coffee consumptions in healthcare providers (0.82±0.82, 0.94±0.49, 2.01±1.28 and 0.84±2.05, P<0.02)  were significantly higher than those of women attending health centers(0.58±0.72, 0.84±0.32, 1.50±0.99 and 0.48±1.25).  Mean frequency use of dark vegetables, cola and pickles were significantly (P<0.004) higher in women who attending health centers (0.67±0.50, 1.55±2.36 and 1.92±2.03) than those of the other group (0.50±0.44, 1.09±2.65 and 1.49±1.72). In women who were attending health centers, negative and posi-tive significant relationship was found between daily calcium intake with age (P<0.04) and educational level (P<0.001). No significant relationship was found between body mass index with studied variables.

CONCLUSION

Women of health care providers had healthier food habits compared to women who attending health centers. Educational programs are suggested to improve food habits among women to prevent osteoporosis in later life.

Knowledge about osteoporosis in a Malaysian population

To determine the depth and sources of knowledge about osteoporosis (OP) among the public in Malaysia. A self-administered questionnaire was distributed to attendees of health-related public forums. A total of 87.1% of the attendees had heard of OP. Of these, 89.5% were concerned about getting OP. Significantly more women than men (P = .015), those with more than 10 years of schooling (P < .001), and those earning more than $US285 per month (P = .022) had heard of OP. Knowledge of OP risk factors was good: 97.1% identified low calcium intake, 87.8% lack of exercise, 80.0% family history of OP, and 75.8% postmenopausal status. A total of 38.7% of the attendees thought that OP was more serious than cancer and 35.1% more serious than heart disease; 55.7% obtained information about OP from newspapers and 46.4% from magazines. In this self-selected population, women, the better educated, and those earning higher incomes were more aware of OP. Knowledge of OP was obtained mainly from printed materials.

Dietary habit and bone mineral density in Korean postmenopausal women

SUMMARY

Postmenopausal women were assessed to determine the association between dietary intake of various food groups and low bone mineral density. Among dietary factors, high consumption of protein-containing food and dairy products was associated with a reduced risk for low bone mineral density.

INTRODUCTION

There have been several studies regarding the correlation between bone mineral density and dietary intake. In this study, we assessed the association between dietary habit and low bone mineral density among Korean postmenopausal women.

METHODS

Bone mineral density of the lumbar spine was measured by dual energy X-ray absorptiometry in 2,501 subjects. A brief food frequency questionnaire, which included 16 food items, was used in this cross-sectional survey.

RESULTS

After adjusting for other risk factors related to low bone mineral density, a high intake frequency of protein-source food was associated with a lower risk for osteopenia (odds ratio (OR), 0.68; 95% confidence interval (CI), 0.54-0.87 for high vs. low intake frequency; p for trend, 0.02) and osteoporosis (OR, 0.76; 95% CI, 0.39-0.83 for high vs. low intake frequency; p for trend, 0.003), and a high intake frequency of dairy food was associated with a decreased risk for osteopenia (OR, 0.73; 95% CI, 0.57-0.94 for high vs. low intake frequency; p for trend, 0.018).

CONCLUSION

These results suggest that adequate nutrient intake is essential to maintain bone health in postmenopausal women.

Sociodemographic variation in knowledge of osteoporosis and locally available calcium-rich foods among urban women living on low incomes in Davao, Philippines

We explored knowledge of osteoporosis and locally available calcium-rich foods among 1,151 urban women in the Philippines and analyzed the cross-sectional associations of their responses to questions about knowledge with their age, educational background, and family income status. In total, 80.3% of the women had heard about osteoporosis; a higher educational background independently predicted this awareness. For knowledge about locally available calcium-rich foods, older age was a positive predictor, whereas higher educational background was a negative predictor. We believe that more emphasis should be placed on locally available foods as part of nutritional education for young urban Filipinos.

Establishment of ethical oversight of human research in El Salvador: lessons learned

Human research is necessary for establishing the best approaches to health care, and should be overseen by a functional research ethics committee. However, in most low-income countries these committees are inadequate in providing the guidelines needed to ensure that ethics remain a prominent feature of human research. We developed a model of interaction with key institutions in low-income countries that had an interest in improving the infrastructure of human participant research. As a result, a research ethics committee was established at three hospitals in El Salvador. The skills gained from developing these committees and the interest shown by the Salvadoran government in rigorous ethical oversight of research involving human participants has allowed the creation of a national ethics committee, which serves as an entity to establish norms and guidelines for further development of research ethics committees in El Salvador. This model of interaction can also be used by institutions in high-income countries to create and strengthen the capacity for ethics in human research in low-income countries.