Knowledge change regarding osteoporosis prevention: translating recommended guidelines into user-friendly messages within a community forum

Curcumin regulates EZH2/Wnt/β-Catenin pathway in the mandible and femur of ovariectomized osteoporosis rats

Osteoporosis (OP) behaves in different manners in different parts of the skeleton. This study aims to investigate the effects of curcumin on bone mass of the mandibular and femur from ovariectomized OP rats and to validate whether enhancer of zeste homolog 2 (EZH2)/Wnt/β-Catenin pathway is involved in this process. Curcumin was administered intragastrically into ovariectomized rats for 12 weeks. The bone parameters and the morphology of the trabecular bone of the left mandible and left femur were assessed by micro-computed tomography assay. Morphological changes of the left mandible and left femur were evaluated by hematoxylin and eosin staining. The mRNA levels of EZH2, β-Catenin, and Runx2 in the right mandible and right femur were examined by quantitative real-time polymerase chain reaction. Immunohistochemistry was performed to assess EZH2 expression. Both the mandible and femur exhibited OP-like changes in ovariectomized rats, while the mandible bone resorption was less than the femur bone resorption. Curcumin intragastric administration improved bone microstructure and promoted bone formation in the mandible and femur. Curcumin inhibited EZH2 mRNA level and induced that of β-Catenin and Runx2 in the mandible and femur. Collectively, curcumin exerts protective effects against OP, possibly by regulating the EZH2/Wnt/β-Catenin pathway.

Developing and refining behaviour-change messages based on the Brazilian dietary guidelines: use of a sequential, mixed-methods approach

Background

Dietary Guidelines are an important tool for population health promotion efforts. However, current surveillance data suggest that only a small minority of the population meet the 2014 Brazilian Dietary Guidelines (BDG) recommendations. Translating recommendations into practice may not be immediately clear and behavior-change messages guiding the behaviors that need to be changed and identifying substitute practices to meet a specific recommendation, are required. This study details the methods undertaken to develop and refine messages supporting the adoption of healthy dietary choices and behaviors in adults, as outlined in the BDG.

Methods

A sequential, five-step, mixed-methods approach, determined a priori, was followed for designing and refining messages. These included: (1) content extraction; (2) audience analysis; (3) input from an expert review panel; (4) message development and message refinement; and a (5) test of content validity.

Results

The content extraction process led to the identification of 63 excerpts from the BDG, organized into themes. The audience analysis highlighted barriers to healthy eating that included lack of time (to eat, to cook), difficulty in accessing healthy food, the convenience and the ubiquitous marketing of ultra-processed foods. Twenty of the 63 DG excerpts reviewed by the expert panel were identified as being a priority for message development and total of 111 messages were developed. Messages were short, structured to be one-sided, conveyed the most important information at the beginning (anticlimactic), used simple language and were explicit in the information they relayed. They were positive and gain-framed and used an empathetic, solution- or substitution-based tone and were presented in the active voice. The messages focused on goals and skill development, behavior regulation, incentivized positive practices as time and/or cost saving. Content validity testing helped further messages and reduced the number of messages from 111 to 40.

Conclusions

This study provides the blue-print for the phase-wise development of messages that synthesize the key recommendations of the food-based BDG and communicate the adoption of behaviors and goals that are consistent with it’s message. It details methods which could be adapted and replicated for message development in other contexts.

Physical exercises and fat burners – the easy road to severe consequences?

The aim of the study is to identify the features of the regular aerobic exercise effect, dietary diet with the intake of dietary supplements with plant components, intended for weight loss, on the reduction of body weight, fat mass, and glycemic profile of overweight women. The article presents the results of two groups of women (22 people in each) in a three-month physical fitness program to reduce excess weight, including regular exercise and adherence to dietary nutrition. Women of the first group additionally took an active substance for weight loss, containing a mixture of carnitine, chromium, arginine and guarana, green tea, citrus fruits and willow extract, women of the second group without placebo. It was found that participation in the program led to approximately the same reduction in body weight, BMI, total body fat, visceral fat and waist circumference in women of both groups. The use of a dietary supplement (fat burner) had a negative effect on glucose metabolism and insulin resistance. We attribute this result to the presence of caffeine and an especially inappropriate combination of substances in the mixture. The negative influence of a fat burner on carbohydrate metabolism revealed by us in the process of physical culture and health-improving fitness must be taken into account when organizing sports nutrition with the use of biologically active additives.

Effect of health literacy among students on the adoption of osteoporosis-preventive behaviors in Iran

BACKGROUND

In chronic diseases such as osteoporosis, understanding the factors that improve prevention, such as health literacy (HL), is essential in reducing the incidence of these diseases. This study aimed to determine the association between HL and adoption of osteoporosis-preventive behaviors among students in Qazvin.

SUBJECTS AND METHODS

This is a cross-sectional study in which 375 female students (aged 15-18 years) at high schools (grades 10^th, 11^th, and 12^th) in Qazvin city were selected, in 2019. Sampling method was multistage. To collect data, the standardized questionnaire for measuring HL in adolescents (health literacy measure in adolescents), in addition to another questionnaire for assessing osteoporosis-preventive behaviors, was used. Data were analyzed using SPSS 22 by descriptive statistics and logistic regression. The association considered significant when P < 0.05.

RESULTS

The mean scores of adoption of osteoporosis-preventive behaviors and HL were 22.43 ± 5.60 and 70.84 ± 12.58, respectively. Logistic regression showed that there was a significant association between the adoption of osteoporosis-preventive behaviors and HL (P = 0.001). In addition, the association between the adoption of osteoporosis-preventive behaviors and age was also significant (P = 0.048 and odds ratio = 3.35).

CONCLUSIONS

Young students and those of low HL showed less adoption of osteoporosis-preventive behaviors. Therefore, it is necessary to pay more attention to design educational programs that may raise the knowledge and awareness of those students about such these diseases, mainly prevention.

Epigallocatechin‑3‑gallate protects against secondary osteoporosis in a mouse model via the Wnt/β‑catenin signaling pathway

Epigallocatechin‑3‑gallate (EGCG) is a polyphenolic compound extracted and isolated from green tea, which has a variety of important biological activities in vitro and in vivo, including anti‑tumor, anti‑oxidation, anti‑inflammation and lowering blood pressure. The aim of the present study was to investigate the protective effect of EGCG against secondary osteoporosis in a mouse model via the Wnt/β‑catenin signaling pathway. Reverse transcription‑quantitative polymerase chain reaction (RT‑qPCR) and western blotting were used to analyze runt‑related transcription factor 2 and osterix mRNA expression, and the protein expression of cyclin D1, Wnt and β‑catenin, and suppressed peroxisome proliferator‑activated receptor γ protein expression. The protective effect of EGCG against secondary osteoporosis was examined and its potential mechanism was analyzed. Treatment with EGCG significantly decreased serum calcium, urinary calcium, body weight and body fat, and increased leptin levels in mice with secondary osteoporosis. In addition, EGCG treatment significantly inhibited the structure score of articular cartilage and cancellous bone in proximal tibia metaphysis in mice with secondary osteoporosis. Treatment also significantly decreased alkaline phosphatase activity, runt‑related transcription factor 2 and osterix mRNA expression. EGCG also significantly induced the protein expression of cyclin D1, Wnt and β‑catenin, and suppressed peroxisome proliferator‑activated receptor γ protein expression in mice with secondary osteoporosis. Taken together, these results suggest that EGCG may be a possible new drug in clinical settings.

Prevalence of and factors associated with adopting bone health promoting behaviours among people with osteoporosis in Taiwan: a cross-sectional study

OBJECTIVES

To detect osteopenia, osteoporosis, treatments received and bone health promoting behaviours early among postmenopausal women and elderly men, and to explore the associated factors.

DESIGN

A community-based cross-sectional study.

SETTINGS

Two rural townships in Yunlin County, Taiwan.

PARTICIPANTS

A total of 941 adults including 651 postmenopausal women and 290 elderly men aged >65 years.

OUTCOME MEASURES

Bone mineral density was measured using dual-energy X-ray absorptiometry. Adults with a T-score <-1.0 for bone mineral density were classified as having osteopenia, and those with a T-score <-2.5 as having osteoporosis. The main outcome measures were prevalence of osteopenia, osteoporosis, receiving medication and bone health promoting behaviours. A logistic regression model was used to analyse the factors associated with adopting bone health promoting behaviours.

RESULTS

Across both genders, 63.7% of participants were identified as having osteopenia (46.9%) or osteoporosis (16.8%). A high proportion of participants reported never or seldom performing regular exercise, or having sunlight exposure, a diet containing calcium/vitamin D or taking medications/supplements for bone health. Although 34.8% reported taking supplements, 92.4% were inadequate. The logistic regression model indicated that older age (OR 1.03, 95% CI 1.01 to 1.05, p=0.006) and a high education level (OR 1.07, 95% CI 1.03 to 1.11, p<0.001) were significant factors associated with bone health promoting behaviours.

CONCLUSION

The prevalence of osteopenia and osteoporosis among postmenopausal women and elderly men is worryingly high and most of them receive inadequate treatment and perform few bone health promoting behaviours. Interventions are therefore urgently required to address the right methods for delaying osteoporosis among postmenopausal women and elderly men in rural areas.