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Rivas-Tumanyan S, Pacheco LS, Haslam DE, Morou-Bermudez E, Liang L, Tucker KL, Joshipura KJ, Bhupathiraju SN. Branched-Chain and Aromatic Amino Acids, Type 2 Diabetes, and Cardiometabolic Risk Factors among Puerto Rican Adults. Nutrients 2024; 16:2562. [PMID: 39125441 PMCID: PMC11313859 DOI: 10.3390/nu16152562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2024] [Revised: 07/17/2024] [Accepted: 08/01/2024] [Indexed: 08/12/2024] Open
Abstract
(1) Background: Branched-chain and aromatic amino acids (BCAAs/AAAs) have been considered as markers of type 2 diabetes (T2D); however, studies on associations between these metabolites and T2D and cardiometabolic traits in Hispanic populations are limited. The aim of this study was to examine the associations between baseline BCAAs (isoleucine, leucine, valine)/AAAs (phenylalanine, tyrosine) and prevalent and incident T2D, as well as baseline and longitudinal (2 year) changes in cardiometabolic traits (measures of glycemia, dyslipidemia, inflammation, and obesity) in two large cohorts of adults of Puerto Rican descent. (2) Methods: We included participants of the Boston Puerto Rican Health Study (BPRHS, n = 670) and San Juan Overweight Adult Longitudinal study (SOALS, n = 999) with available baseline metabolite and covariate data. T2D diagnosis was defined based on American Diabetes Association criteria. Multivariable logistic (for baseline T2D), Poisson (for incident T2D), and linear (for cardiometabolic traits) regression models were used; cohort-specific results were combined in the meta-analysis and adjusted for multiple comparisons. (3) Results: Higher baseline BCAAs were associated with higher odds of prevalent T2D (OR1SD BCAA score = 1.46, 95% CI: 1.34-1.59, p < 0.0001) and higher risk of incident T2D (IRR1SD BCAA score = 1.24, 95% CI: 1.13-1.37, p < 0.0001). In multivariable longitudinal analysis, higher leucine and valine concentrations were associated with 2-year increase in insulin (beta 1SD leucine = 0.37 mcU/mL, 95% CI: 0.11-0.63, p < 0.05; beta 1SD valine = 0.43 mcU/mL, 95% CI: 0.17-0.68, p < 0.01). Tyrosine was a significant predictor of incident T2D (IRR = 1.31, 95% CI: 1.09-1.58, p < 0.05), as well as 2 year increases in HOMA-IR (beta 1SD tyrosine = 0.13, 95% CI: 0.04-0.22, p < 0.05) and insulin concentrations (beta 1SD tyrosine = 0.37 mcU/mL, 95% CI: 0.12-0.61, p < 0.05). (4) Conclusions: Our results confirmed the associations between BCAAs and prevalent and incident T2D, as well as concurrent measures of glycemia, dyslipidemia, and obesity, previously reported in predominantly White and Asian populations. Baseline leucine, valine, and tyrosine were predictors of 2 year increases in insulin, whereas tyrosine was a significant predictor of deteriorating insulin resistance over time. Our study suggests that BCAAs and tyrosine could serve as early markers of future glycemic changes in Puerto Ricans.
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Affiliation(s)
- Sona Rivas-Tumanyan
- Department of Surgical Sciences and the Office of the Assistant Dean for Research, School of Dental Medicine, University of Puerto Rico, San Juan, PR 00936, USA; (S.R.-T.)
| | - Lorena S. Pacheco
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
| | - Danielle E. Haslam
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
- Channing Division of Network Medicine, Brigham and Women’s Hospital and Harvard Medical School, 181 Longwood Ave, Boston, MA 02115, USA
| | - Evangelia Morou-Bermudez
- Department of Surgical Sciences and the Office of the Assistant Dean for Research, School of Dental Medicine, University of Puerto Rico, San Juan, PR 00936, USA; (S.R.-T.)
| | - Liming Liang
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
| | - Katherine L. Tucker
- Department of Biomedical and Nutritional Sciences and Center for Population Health, University of Massachusetts, Lowell, MA 01854, USA
| | - Kaumudi J. Joshipura
- Dean, School of Public Health, Ahmedabad University, Central Campus, Navrangpura, Ahmedabad 380009, Gujarat, India
| | - Shilpa N. Bhupathiraju
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
- Channing Division of Network Medicine, Brigham and Women’s Hospital and Harvard Medical School, 181 Longwood Ave, Boston, MA 02115, USA
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Dietary Acid Load Was Positively Associated with the Risk of Hip Fracture in Elderly Adults. Nutrients 2022; 14:nu14183748. [PMID: 36145124 PMCID: PMC9503794 DOI: 10.3390/nu14183748] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 09/06/2022] [Accepted: 09/07/2022] [Indexed: 11/19/2022] Open
Abstract
Previous studies have shown that dietary acid load (DAL) harms bone health, but the evidence is inconsistent and insufficient. This study examined the relationships between DAL and the risk of hip fracture. This case−control study contained 1070 pairs of 1:1 age-, city-, and gender-matched incident cases and controls (mean age, 71 years) recruited in Guangdong, China. Dietary information was collected using a validated 79-item food frequency questionnaire through face-to-face interviews. DAL was estimated based on established algorithms for the potential renal acid load (PRAL) and net endogenous acid production (NEAP). Higher PRAL and NEAP were dose-dependently associated with a higher risk of hip fracture in both the conditional logistic regression model and restricted cubic spline analysis after adjusting for potential covariates. The multivariate-adjusted odds ratios and 95% CI of hip fracture for tertiles 2 and 3 (vs. 1) of DAL were 1.63 (1.18, 2.25) and 1.92 (1.36, 2.71) for PRAL and 1.81 (1.30, 2.53) and 2.55 (1.76, 3.71) for NEAP in all participants (all p-trends < 0.001), respectively. Subgroup analyses showed more pronounced associations in participants with a lower body mass index. Our findings suggested positive associations between the estimated DAL and the risk of hip fractures in the elderly Chinese population.
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Deng YY, Liu YP, Ling CW, Li YH, Wu YY, Ke YB, Chen YM. Higher healthy lifestyle scores are associated with greater bone mineral density in middle-aged and elderly Chinese adults. Arch Osteoporos 2020; 15:129. [PMID: 32804253 DOI: 10.1007/s11657-020-00758-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Accepted: 05/11/2020] [Indexed: 02/06/2023]
Abstract
UNLABELLED This study examined the association between healthy lifestyle score (HLS), which contained 7 items (smoking, BMI, physical activity, diet, alcohol, sleep and anxiety) and BMD. Results showed HLS was positively associated with BMD at all studied sites, suggesting that healthier lifestyle patterns might be beneficial to bone health. PURPOSE Previous studies have reported favourable associations of individual healthy lifestyle factors with bone mineral density (BMD), but limited evidence showed the relationship of a combined healthy lifestyle score (HLS) with BMD. This study examined the association between the HLS and BMD. METHODS This community-based cross-sectional study included 3051 participants aged 40-75 years. The HLS contained 7 items (smoking, BMI, physical activity, diet quality, alcohol intake, sleep and anxiety). BMD values of whole body (WB), lumbar spine 1-4 (L1-4), total hip (TH) and femur neck (FN) were measured using dual-energy X-ray absorptiometry. RESULTS After adjusting for potential covariates, HLS was positively associated with BMD at all studied sites (P-trend < 0.01). The mean BMDs were 2.69% (WB), 5.62% (L1-4), 6.13% (TH) and 5.71% (FN) higher in participants with HLS of 6-7 points than in those with HLS of 0-2 points. The per 1 of 7 unit increase in the HLS was associated with increases of 7.63 (WB)-13.4 (TH) mg/cm2 BMD levels at all sites. These favourable associations tended to be more pronounced in men than in women. Among the 7 items, physical activity contributed most to the favourable associations, followed by BMI, non-smoking and diet; the other three items played little roles. Sensitivity analyses showed that the significant associations remained after excluding any one of the 7 components or excluding fracture subjects at all sites. CONCLUSION Higher HLS was associated with greater BMD in middle-aged and elderly Chinese, suggesting that healthier lifestyle patterns might be beneficial to bone health.
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Affiliation(s)
- Yun-Yang Deng
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, No. 74 Zhongshan Road 2, Guangzhou, 510080, People's Republic of China
| | - Yu-Ping Liu
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, No. 74 Zhongshan Road 2, Guangzhou, 510080, People's Republic of China
| | - Chu-Wen Ling
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, No. 74 Zhongshan Road 2, Guangzhou, 510080, People's Republic of China
| | - Yi-Hong Li
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, No. 74 Zhongshan Road 2, Guangzhou, 510080, People's Republic of China
| | - Yan-Yan Wu
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, No. 74 Zhongshan Road 2, Guangzhou, 510080, People's Republic of China
| | - Yue-Bin Ke
- Key Laboratory of Molecular Epidemiology of Shenzhen, Shenzhen Center for Disease Control and Prevention, Shenzhen, 518055, China.
| | - Yu-Ming Chen
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, No. 74 Zhongshan Road 2, Guangzhou, 510080, People's Republic of China.
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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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Noel SE, Mangano KM, Griffith JL, Wright NC, Dawson-Hughes B, Tucker KL. Prevalence of Osteoporosis and Low Bone Mass Among Puerto Rican Older Adults. J Bone Miner Res 2018; 33:396-403. [PMID: 29044768 PMCID: PMC5840013 DOI: 10.1002/jbmr.3315] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Revised: 10/10/2017] [Accepted: 10/16/2017] [Indexed: 11/08/2022]
Abstract
Historically, osteoporosis has not been considered a public health priority for the Hispanic population. However, recent data indicate that Mexican Americans are at increased risk for this chronic condition. Although it is well established that there is heterogeneity in social, lifestyle, and health-related factors among Hispanic subgroups, there are currently few studies on bone health among Hispanic subgroups other than Mexican Americans. The current study aimed to determine the prevalence of osteoporosis and low bone mass (LBM) among 953 Puerto Rican adults, aged 47 to 79 years and living on the US mainland, using data from one of the largest cohorts on bone health in this population: The Boston Puerto Rican Osteoporosis Study (BPROS). Participants completed an interview to assess demographic and lifestyle characteristics and bone mineral density measures. To facilitate comparisons with national data, we calculated age-adjusted estimates for osteoporosis and LBM for Mexican American, non-Hispanic white, and non-Hispanic black adults, aged ≥50 years, from the National Health and Nutrition Examination Survey (NHANES). The overall prevalence of osteoporosis and LBM were 10.5% and 43.3% for participants in the BPROS, respectively. For men, the highest prevalence of osteoporosis was among those aged 50 to 59 years (11%) and lowest for men ≥70 years (3.7%). The age-adjusted prevalence of osteoporosis for Puerto Rican men was 8.6%, compared with 2.3% for non-Hispanic white, and 3.9% for Mexican American men. There were no statistically significant differences between age-adjusted estimates for Puerto Rican women (10.7%), non-Hispanic white women (10.1%), or Mexican American women (16%). There is a need to understand specific factors contributing to osteoporosis in Puerto Rican adults, particularly younger men. This will provide important information to guide the development of culturally and linguistically tailored interventions to improve bone health in this understudied and high-risk population. © 2017 American Society for Bone and Mineral Research.
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Affiliation(s)
- Sabrina E Noel
- Department of Biomedical and Nutritional Sciences, University of Massachusetts Lowell, Lowell, MA, USA
| | - Kelsey M Mangano
- Department of Biomedical and Nutritional Sciences, University of Massachusetts Lowell, Lowell, MA, USA
| | - John L Griffith
- Bouvé College of Health Sciences, Northeastern University, Boston, MA, USA
| | - Nicole C Wright
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Bess Dawson-Hughes
- Bone Metabolism Laboratory, Jean Mayer US Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA
| | - Katherine L Tucker
- Department of Biomedical and Nutritional Sciences, University of Massachusetts Lowell, Lowell, MA, USA
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Blekkenhorst LC, Hodgson JM, Lewis JR, Devine A, Woodman RJ, Lim WH, Wong G, Zhu K, Bondonno CP, Ward NC, Prince RL. Vegetable and Fruit Intake and Fracture-Related Hospitalisations: A Prospective Study of Older Women. Nutrients 2017; 9:nu9050511. [PMID: 28524097 PMCID: PMC5452241 DOI: 10.3390/nu9050511] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Revised: 05/12/2017] [Accepted: 05/15/2017] [Indexed: 12/03/2022] Open
Abstract
The importance of vegetable and fruit intakes for the prevention of fracture in older women is not well understood. Few studies have explored vegetable and fruit intakes separately, or the associations of specific types of vegetables and fruits with fracture hospitalisations. The objective of this study was to examine the associations of vegetable and fruit intakes, separately, and specific types of vegetables and fruits with fracture-related hospitalisations in a prospective cohort of women aged ≥70 years. Vegetable and fruit intakes were assessed at baseline (1998) in 1468 women using a food frequency questionnaire. The incidence of fracture-related hospitalisations over 14.5 years of follow-up was determined using the Hospital Morbidity Data Collection, linked via the Western Australian Data Linkage System. Fractures were identified in 415 (28.3%) women, of which 158 (10.8%) were hip fractures. Higher intakes of vegetables, but not fruits, were associated with lower fracture incidence. In multivariable-adjusted models for vegetable types, cruciferous and allium vegetables were inversely associated with all fractures, with a hazard ratio (HR) (95% confidence interval) of 0.72 (0.54, 0.95) and 0.66 (0.49, 0.88), respectively, for the highest vs. lowest quartiles. Increasing vegetable intake, with an emphasis on cruciferous and allium vegetables, may prevent fractures in older postmenopausal women.
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Affiliation(s)
- Lauren C Blekkenhorst
- School of Medicine and Pharmacology, Royal Perth Hospital Unit, University of Western Australia, Perth, WA 6000, Australia.
| | - Jonathan M Hodgson
- School of Medicine and Pharmacology, Royal Perth Hospital Unit, University of Western Australia, Perth, WA 6000, Australia.
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA 6027, Australia.
| | - Joshua R Lewis
- Centre for Kidney Research, Children's Hospital at Westmead, Sydney, NSW 2145, Australia.
- School of Public Health, Sydney Medical School, University of Sydney, Sydney, NSW 2006, Australia.
| | - Amanda Devine
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA 6027, Australia.
| | - Richard J Woodman
- Centre for Epidemiology and Biostatistics, School of Public Health, Flinders University of South Australia, Adelaide, SA 5042, Australia.
| | - Wai H Lim
- School of Medicine and Pharmacology, QEII Medical Centre Unit, University of Western Australia, Perth, WA 6009, Australia.
| | - Germaine Wong
- Centre for Kidney Research, Children's Hospital at Westmead, Sydney, NSW 2145, Australia.
| | - Kun Zhu
- School of Medicine and Pharmacology, QEII Medical Centre Unit, University of Western Australia, Perth, WA 6009, Australia.
- Department of Endocrinology and Diabetes, and Department of Renal Medicine, Sir Charles Gairdner Hospital, Perth, WA 6009, Australia.
| | - Catherine P Bondonno
- School of Medicine and Pharmacology, Royal Perth Hospital Unit, University of Western Australia, Perth, WA 6000, Australia.
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA 6027, Australia.
| | - Natalie C Ward
- School of Medicine and Pharmacology, Royal Perth Hospital Unit, University of Western Australia, Perth, WA 6000, Australia.
- School of Biomedical Sciences & Curtin Health Innovation Research Institute, Curtin University, Perth, WA 6102, Australia.
| | - Richard L Prince
- School of Medicine and Pharmacology, QEII Medical Centre Unit, University of Western Australia, Perth, WA 6009, Australia.
- Department of Endocrinology and Diabetes, and Department of Renal Medicine, Sir Charles Gairdner Hospital, Perth, WA 6009, Australia.
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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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Maghbooli Z, Emamgholipour S, Hossein-Nezhad A, Shirzad M, Gorgani Firuzjaee S. Suitable bone markers assessing bone status in patients with both coronary artery disease and diabetes. J Diabetes Metab Disord 2016; 15:35. [PMID: 27602333 PMCID: PMC5012061 DOI: 10.1186/s40200-016-0259-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Accepted: 08/28/2016] [Indexed: 01/10/2023]
Abstract
Background We aimed to investigate the bone turnover markers in coronary artery disease (CAD) patients with and without type 2 diabetes (T2DM) in comparison with control subjects without CAD and T2DM. Methods This cross-sectional study was performed on 45 subjects undergoing elective heart surgery; either for coronary artery bypass grafting or for valve surgery. According to angiographic results, participants were grouped in two groups with CAD (n = 33) and without CAD (n = 12). The serum levels of osteocalcin (OC), procollagen I aminoterminal propeptide (P1NP) and carboxy-terminal collagen crosslinks (CTX), as bone turnover markers, as well as serum levels of 25 (OH) vitamin D3, PTH, and common metabolic factors were analyzed in all participants. Results Serum levels of bone markers did not differ in patients with CAD compared to non-CAD subjects. Regarding metabolic factors, serum levels of FBG had invert correlation with OC in CAD patients (p = 0.004). The data of subgroup analysis showed serum levels of OC and CTX were statistically significant lower in CAD-DM than CAD-non DM (p < 0.05). There were not any significant differences in the P1NP levels between groups. Conclusions Our data suggest that CTX and OC would be used as suitable bone markers in CAD patients with T2DM. However, further clinical studies need to establish the role of these markers in CAD patients with diabetes.
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Affiliation(s)
- Zhila Maghbooli
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Solaleh Emamgholipour
- Clinical Biochemistry Department, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Arash Hossein-Nezhad
- Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran ; EMRI, 5th floor, Shariati Hospital, North Karegar Avenue, P.O Box: 1411413137, Tehran, Iran
| | - Mahmood Shirzad
- Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Sattar Gorgani Firuzjaee
- Department of Medical Laboratory Sciences, School of Allied Health Medicine, AJA University of Medical Sciences, Tehran, Iran
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Ward KA, Prentice A, Kuh DL, Adams JE, Ambrosini GL. Life Course Dietary Patterns and Bone Health in Later Life in a British Birth Cohort Study. J Bone Miner Res 2016; 31:1167-76. [PMID: 26817442 PMCID: PMC4982044 DOI: 10.1002/jbmr.2798] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2015] [Revised: 01/20/2016] [Accepted: 01/22/2016] [Indexed: 01/16/2023]
Abstract
Evidence for the contribution of individual foods and nutrients to bone health is weak. Few studies have considered hypothesis-based dietary patterns and bone health. We investigated whether a protein-calcium-potassium-rich (PrCaK-rich) dietary pattern over the adult life course, was positively associated with bone outcomes at 60 to 64 years of age. Diet diaries were collected at ages 36, 46, 53, and 60 to 64 years in 1263 participants (661 women) from the MRC National Survey of Health and Development. DXA and pQCT measurements were obtained at age 60 to 64 years, including size-adjusted bone mineral content (SA-BMC) and volumetric bone mineral density (vBMD). A food-based dietary pattern best explaining dietary calcium, potassium, and protein intakes (g/1000 kcal) was identified using reduced rank regression. Dietary pattern Z-scores were calculated for each individual, at each time point. Individual trajectories in dietary pattern Z-scores were modeled to summarize changes in Z-scores over the study period. Regression models examined associations between these trajectories and bone outcomes at age 60 to 64 years, adjusting for baseline dietary pattern Z-score and other confounders. A consistent PrCaK-rich dietary pattern was identified within the population, over time. Mean ± SD dietary pattern Z-scores at age 36 years and age 60 to 64 years were -0.32 ± 0.97 and 2.2 ± 1.5 (women) and -0.35 ± 0.98 and 1.7 ± 1.6 (men), respectively. Mean trajectory in dietary pattern Z-scores ± SD was 0.07 ± 0.02 units/year. Among women, a 0.02-SD unit/year higher trajectory in dietary pattern Z-score over time was associated with higher SA-BMC (spine 1.40% [95% CI, 0.30 to 2.51]; hip 1.35% [95% CI, 0.48 to 2.23]), and vBMD (radius 1.81% [95% CI, 0.13 to 3.50]) at age 60 to 64 years. No statistically significant associations were found in men. During adulthood, an increasing score for a dietary pattern rich in protein, calcium, and potassium was associated with greater SA-BMC at fracture-prone sites in women. This study emphasizes the importance of these nutrients, within the context of the whole diet, to bone health. © 2016 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals, Inc. on behalf of American Society for Bone and Mineral Research (ASBMR).
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Affiliation(s)
| | | | - Diana L Kuh
- MRC Unit for Lifelong Healthy Ageing at University College London, London, UK
| | - Judith E Adams
- Manchester Academic Health Sciences & University of Manchester, Central Manchester University Hospitals NHS Foundation Trust, Manchester, UK
| | - Gina L Ambrosini
- MRC Human Nutrition Research, Cambridge, UK.,School of Population Health, The University of Western Australia, Perth, Australia
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Viljakainen HT, Valta H, Lipsanen-Nyman M, Saukkonen T, Kajantie E, Andersson S, Mäkitie O. Bone Characteristics and Their Determinants in Adolescents and Young Adults with Early-Onset Severe Obesity. Calcif Tissue Int 2015; 97:364-75. [PMID: 26139232 DOI: 10.1007/s00223-015-0031-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2015] [Accepted: 06/23/2015] [Indexed: 12/26/2022]
Abstract
Childhood obesity is associated with compromised bone health. We studied bone characteristics and their determinants in obese young adults. The study included 68 subjects with early-onset severe obesity and 73 normal-weight controls. Data on physical activity (PA), diet and smoking were collected. Bone characteristics were measured using peripheral QCT. The obese and control subjects were similar in age (mean 19.6 ± 2.6 years) and height but BMIs differed (39.7 and 22.6 kg/m(2)). A clustering of unhealthy lifestyles was marked: Obese subjects reported less supervised PA in childhood, adolescence and currently (p < 0.03) and were more likely to smoke (p = 0.005), and had a lower healthy eating index (HEI) (p = 0.007) but similar alcohol consumption compared with controls. In obese women, all crude bone characteristics were higher than in controls; in men, the differences were smaller. Associations of lifestyle factors with bone characteristics were tested using partial correlations. Independently of BMI, supervised PA in adolescence and alcohol consumption were related positively to bone characteristics in both groups. HEI associated positively with bone characteristics only in controls, while smoking was a positive determinant of bone characteristics only in obese subjects. The multivariate model showed that the contribution of lifestyle factors to bone characteristics was minimal compared with BMI. Early-onset obesity is accompanied by poor dietary quality, sedentary lifestyle, and more frequent smoking, but the overall contribution of these lifestyle factors to bone strength is limited. Bone strength is more likely to be compromised in men and in unloaded bone sites in subjects with early-onset severe obesity. The impact of obesity-related endocrine changes on bone characteristics need to be evaluated in future studies.
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Affiliation(s)
- H T Viljakainen
- Children's Hospital, Helsinki University Central Hospital, University of Helsinki, Biomedicum Helsinki 2, P.O.Box 705, 00029, Helsinki, Finland.
| | - H Valta
- Children's Hospital, Helsinki University Central Hospital, University of Helsinki, Biomedicum Helsinki 2, P.O.Box 705, 00029, Helsinki, Finland
| | - M Lipsanen-Nyman
- Children's Hospital, Helsinki University Central Hospital, University of Helsinki, Biomedicum Helsinki 2, P.O.Box 705, 00029, Helsinki, Finland
| | - T Saukkonen
- Children's Hospital, Helsinki University Central Hospital, University of Helsinki, Biomedicum Helsinki 2, P.O.Box 705, 00029, Helsinki, Finland
- Novo Nordisk Pharma Oy, Espoo, Finland
| | - E Kajantie
- Children's Hospital, Helsinki University Central Hospital, University of Helsinki, Biomedicum Helsinki 2, P.O.Box 705, 00029, Helsinki, Finland
- Diabetes Prevention Unit, National Institute for Health and Welfare, Helsinki, Finland
- Department of Obstetrics and Gynecology, MRC Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - S Andersson
- Children's Hospital, Helsinki University Central Hospital, University of Helsinki, Biomedicum Helsinki 2, P.O.Box 705, 00029, Helsinki, Finland
| | - O Mäkitie
- Children's Hospital, Helsinki University Central Hospital, University of Helsinki, Biomedicum Helsinki 2, P.O.Box 705, 00029, Helsinki, Finland
- Folkhälsan Research Center, Helsinki, Finland
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
- Department of Clinical Genetics, Karolinska University Hospital, Stockholm, Sweden
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Development of a Food Group-Based Diet Score and Its Association with Bone Mineral Density in the Elderly: The Rotterdam Study. Nutrients 2015; 7:6974-90. [PMID: 26295256 PMCID: PMC4555156 DOI: 10.3390/nu7085317] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2015] [Revised: 07/31/2015] [Accepted: 08/11/2015] [Indexed: 11/28/2022] Open
Abstract
No diet score exists that summarizes the features of a diet that is optimal for bone mineral density (BMD) in the elderly. Our aims were (a) to develop a BMD-Diet Score reflecting a diet that may be beneficial for BMD based on the existing literature, and (b) to examine the association of the BMD-Diet Score and the Healthy Diet Indicator, a score based on guidelines of the World Health Organization, with BMD in Dutch elderly participating in a prospective cohort study, the Rotterdam Study (n = 5144). Baseline dietary intake, assessed using a food frequency questionnaire, was categorized into food groups. Food groups that were consistently associated with BMD in the literature were included in the BMD-Diet Score. BMD was measured repeatedly and was assessed using dual energy X-ray absorptiometry. The BMD-Diet Score considered intake of vegetables, fruits, fish, whole grains, legumes/beans and dairy products as “high-BMD” components and meat and confectionary as “low-BMD” components. After adjustment, the BMD-Diet Score was positively associated with BMD (β (95% confidence interval) = 0.009 (0.005, 0.012) g/cm2 per standard deviation). This effect size was approximately three times as large as has been observed for the Healthy Diet Indicator. The food groups included in our BMD-Diet Score could be considered in the development of future dietary guidelines for healthy ageing.
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12
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Liu ZM, Wong CKM, Wong SYS, Leung J, Tse LA, Chan R, Woo J. A Healthier Lifestyle Pattern for Cardiovascular Risk Reduction Is Associated With Better Bone Mass in Southern Chinese Elderly Men and Women. Medicine (Baltimore) 2015; 94:e1283. [PMID: 26252299 PMCID: PMC4616577 DOI: 10.1097/md.0000000000001283] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2015] [Revised: 06/02/2015] [Accepted: 07/08/2015] [Indexed: 01/03/2023] Open
Abstract
Lifestyle factors have been linked to bone health, however little is known about their combined impact on bone. Cardiovascular disease (CVD) and osteoporosis are 2 major public health problems that share some common pathophysiology. We aimed to assess whether higher adherence to American Heart Association diet and lifestyle recommendations (AHA-DLR) was associated with better bone health in Chinese elderly.This was a cross-sectional study using data from the largest population-based study on osteoporosis in Asia (Mr and Ms Os, Hong Kong). The study recruited 4000 independent walking Chinese men and women aged ≥65 year. Information on demographic, health, and lifestyle factors was obtained by standardized questionnaires. An overall lifestyle score was estimated based on a modified adherence index of AHA-DLR. Bone mineral measurements of the whole body, total hip, lumbar spine, and femoral neck were made by dual-energy X-ray absorptiometry.Most lifestyle factors alone were not significantly associated bone mass. Overall lifestyle score in the highest quartile compared with the lowest quartile had significantly better bone mass at all sites in a dose-response manner. Every 10-unit of lifestyle score increase was associated with 0.005, 0.004, and 0.007 g/cm increases of bone mineral density (BMD) at whole body, femur neck, and total hip, respectively (all P < 0.05), and 13.2% (odds ratio 0.868; 95% CI 0.784, 0.961) decreased risk of osteoporosis at total hip after adjustment for potential covariates.Our study suggested that greater adherence to an overall healthy lifestyle for CVD risk reduction was associated with better bone mass among Chinese elderly.
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Affiliation(s)
- Zhao-Min Liu
- From the Division of Family Medicine and Primary Care (ZmL, CKMW, SYsW); Division of Occupational and Environmental Health, Jockey Club School of Public Health and Primary Care (LAT); Jockey Club Centre for Osteoporosis Care and Control, The Chinese University of Hong Kong, Shatin (JL); and Department of Medicine and Therapeutics, the Chinese University of Hong Kong, Hong Kong SAR (RC, JW)
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Sotos-Prieto M, Bhupathiraju SN, Falcón LM, Gao X, Tucker KL, Mattei J. A Healthy Lifestyle Score Is Associated with Cardiometabolic and Neuroendocrine Risk Factors among Puerto Rican Adults. J Nutr 2015; 145:1531-40. [PMID: 25948783 PMCID: PMC4478944 DOI: 10.3945/jn.114.206391] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2014] [Accepted: 04/06/2015] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Although individual healthy lifestyle behaviors may reduce cardiovascular disease risk, few studies have analyzed the combined effect of multiple lifestyle components as one all-inclusive measure on such outcomes, much less in minority populations. OBJECTIVE We aimed to develop a Healthy Lifestyle Score (HLS) that included several lifestyle recommendations and to test its association with metabolic syndrome (MetS) and allostatic load (AL) and their cardiometabolic and neuroendocrine factors in Puerto Ricans. METHODS In a cross-sectional study in 787 Puerto Ricans living in Boston (aged 45-75 y), we developed an HLS that ranged from 0 to 190 (higher score indicative of healthier lifestyle) and included 5 components (diet, physical activity and sedentary behaviors, smoking, social support and network, and sleep). Multivariable-adjusted models were used to test associations between the HLS and biomarkers of dysregulation and odds of MetS and high AL (≥4 out of 10 components). RESULTS The HLS showed adequate internal consistency (ρ = 0.31-0.69) and was inversely associated with urinary cortisol (β ± SE = -0.22 ± 0.11; P = 0.042), epinephrine (-0.20 ± 0.09; P = 0.017), and norepinephrine (-0.26 ± 0.11; P = 0.016); waist circumference (-0.014 ± 0.004; P = 0.003); and serum insulin (-0.30 ± 0.13; P = 0.028) and positively associated with plasma HDL cholesterol (0.007 ± 0.003; P = 0.021) after adjustment for potential confounders. For each 20-unit increase in HLS, participants had 19% (95% CI: 2%, 33%) and 25% (11%, 36%) lower odds of MetS or AL, respectively. Healthier scores for social support and network and smoking components were associated with lower odds of high AL (P < 0.005). No significant associations were observed for other individual lifestyle components. CONCLUSIONS Following an overall healthy lifestyle that comprises a combination of multiple behaviors may provide stronger protection against MetS and AL in Puerto Rican adults than individual components. The HLS may be a useful tool for examining health-related outcomes. This trial was registered at clinicaltrials.gov as NCT01231958.
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Affiliation(s)
| | | | - Luis M Falcón
- Center for Population Health and Health Disparities,,College of Fine Arts, Humanities, and Social Sciences, and
| | - Xiang Gao
- Department of Nutritional Sciences, The Pennsylvania State University, State College, PA
| | - Katherine L Tucker
- Center for Population Health and Health Disparities,,Department of Clinical Laboratory and Nutritional Sciences, University of Massachusetts, Lowell, MA; and
| | - Josiemer Mattei
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA;
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Byberg L, Bellavia A, Orsini N, Wolk A, Michaëlsson K. Fruit and vegetable intake and risk of hip fracture: a cohort study of Swedish men and women. J Bone Miner Res 2015; 30:976-84. [PMID: 25294687 DOI: 10.1002/jbmr.2384] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2014] [Revised: 09/25/2014] [Accepted: 10/03/2014] [Indexed: 01/11/2023]
Abstract
Dietary guidelines recommend a daily intake of 5 servings of fruits and vegetables. Whether such intakes are associated with a lower risk of hip fracture is at present unclear. The aim of the present study was to investigate the dose-response association between habitual fruit and vegetable intake and hip fracture in a cohort study based on 40,644 men from the Cohort of Swedish Men (COSM) and 34,947 women from the Swedish Mammography Cohort (SMC) (total n = 75,591), free from cardiovascular disease and cancer, who answered lifestyle questionnaires in 1997 (age 45 to 83 years). Intake of fruits and vegetables (servings/day) was assessed by food frequency questionnaire and incident hip fractures were retrieved from the Swedish Patient Register (1998 to 2010). The mean follow-up time was 14.2 years. One-third of the participants reported an intake of fruits and vegetables of >5 servings/day, one-third reported >3 to ≤5 servings/day, 28% reported >1 to ≤3 servings/day, and 6% reported ≤1 serving/day. During 1,037,645 person-years we observed 3644 hip fractures (2266 or 62% in women). The dose-response association was found to be strongly nonlinear (p < 0.001). Men and women with zero consumption had 88% higher rate of hip fracture compared with those consuming 5 servings/day; adjusted hazard ratio (HR) was 1.88 (95% CI, 1.53 to 2.32). The rate was gradually lower with higher intakes; adjusted HR for 1 versus 5 servings/day was 1.35 (95% CI, 1.21 to 1.58). However, more than 5 servings/day did not confer additionally lower HRs (adjusted HR for 8 versus 5 servings/day was 0.96; 95% CI, 0.90 to 1.03). Similar results were observed when men and women were analyzed separately. We conclude that there is a dose-response association between fruit and vegetable intake and hip fracture such that an intake below the recommended five servings/day confers higher rates of hip fracture. Intakes above this recommendation do not seem to further lower the risk.
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Affiliation(s)
- Liisa Byberg
- Department of Surgical Sciences, Orthopedics, Uppsala University, Uppsala, Sweden
| | - Andrea Bellavia
- Institute of Environmental Medicine, Unit of Nutritional Epidemiology, Karolinska Institutet, Solna, Sweden
| | - Nicola Orsini
- Institute of Environmental Medicine, Unit of Nutritional Epidemiology, Karolinska Institutet, Solna, Sweden
| | - Alicja Wolk
- Institute of Environmental Medicine, Unit of Nutritional Epidemiology, Karolinska Institutet, Solna, Sweden
| | - Karl Michaëlsson
- Department of Surgical Sciences, Orthopedics, Uppsala University, Uppsala, Sweden
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15
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Alagiakrishnan K, Hsueh J, Zhang E, Khan K, Senthilselvan A. Small vessel disease/white matter disease of the brain and its association with osteoporosis. J Clin Med Res 2015; 7:297-302. [PMID: 25780476 PMCID: PMC4356088 DOI: 10.14740/jocmr2119w] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/18/2015] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Evidence now suggests the role of neural effect on bone mass control. The effect of small vessel disease of the brain on osteoporosis has not been studied. The aim of this study was to investigate the association of white matter disease (WMD) of the brain with osteoporosis in the elderly. METHODS In this retrospective cross-sectional study, 780 consecutive patient charts between 2010 and 2011 were reviewed in the Senior's Outpatient Clinic at the University of Alberta Hospital. Subjects with brain computerized tomography (CT) were included in the study. Subjects with incomplete information, intracranial hemorrhage, acute stroke, cerebral edema, and/or normal pressure hydrocephalus on the CT were excluded. WMD was quantified on CT using Wahlund's scoring protocol. Osteoporosis information was obtained from the chart, which has been diagnosed based on bone mineral density (BMD) information. Logistic regression analysis was done to determine the association of WMD severity with osteoporosis after controlling for confounding vascular risk factors. RESULTS Of the 505 subjects who were included in the study, 188 (37%) had osteoporosis and 171 (91%) of these osteoporotic subjects were females. The mean age was 79.8 ± 7.04 years. The prevalence of WMD in osteoporosis subjects was 73%. In the unadjusted logistic regression analysis, there was a significant association between WMD severity and osteoporosis (odds ratio (OR): 1.10; 95% confidence interval (CI): 1.05 - 1.14; P < 0.001) and the significance remained in the adjusted model, after correcting for age, sex and all vascular risk factors (OR: 1.11; 95% CI: 1.05 - 1.18; P < 0.001). CONCLUSION WMD severity of the brain was associated with osteoporosis in the elderly.
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Affiliation(s)
| | - Jenny Hsueh
- Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Edwin Zhang
- Department of Radiology and Diagnostic Imaging, University of Alberta, Edmonton, Alberta, Canada
| | - Khurshid Khan
- Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
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Pirilä S, Taskinen M, Turanlahti M, Kajosaari M, Mäkitie O, Saarinen-Pihkala UM, Viljakainen H. Bone health and risk factors of cardiovascular disease--a cross-sectional study in healthy young adults. PLoS One 2014; 9:e108040. [PMID: 25310090 PMCID: PMC4195604 DOI: 10.1371/journal.pone.0108040] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2014] [Accepted: 08/25/2014] [Indexed: 12/20/2022] Open
Abstract
Objective Both osteoporosis and cardiovascular disease (CVD) are diseases that comprise a growing medical and economic burden in ageing populations. They share many risk factors, including ageing, low phy-sical activity, and possibly overweight. We aimed to study associations between individual risk factors for CVD and bone mineral density (BMD) and turnover markers (BTMs) in apparently healthy cohort. Design A cross-sectional assessment of 155 healthy 32-year-old adults (74 males) was performed for skeletal status, CVD risk factors and lifestyle factors. Methods We analysed serum osteocalcin, procollagen I aminoterminal propeptide (P1NP), collagen I carboxy-terminal telopeptide (ICTP) and urine collagen I aminoterminal telopeptide (U-NTX), as well as serum insulin, plasma glucose, triglyceride and HDL-cholesterol levels. BMD, fat and lean mass were asses-sed using DXA scanning. Associations were tested with partial correlations in crude and adjusted mo-dels. Bone status was compared between men with or without metabolic syndrome (defined according to the NCEP-ATPIII criteria) with multivariate analysis. Results Osteocalcin and P1NP correlated inversely with insulin (R = −0.243, P = 0.003 and R = −0.187, P = 0.021) and glucose (R = −0.213, P = 0.009 and R = −0.190, P = 0.019), but after controlling for fat mass and lifestyle factors, the associations attenuated with insulin (R = −0.162, P = 0.053 and R = −0.093, P = 0.266) and with glucose (R = −0.099, P = 0.240 and R = −0.133, P = 0.110), respectively. Whole body BMD associated in-versely only with triglycerides in fully adjusted model. In men with metabolic syndrome, whole body BMD, osteocalcin and P1NP were lower compared to healthy men, but these findings disappeared in fully adjusted model. Conclusions In young adults, inverse associations between BTM/BMD and risk factors of CVD appeared in crude models, but after adjusting for fat mass, no association continued to be present. In addition to fat mass, lifestyle factors, especially physical activity, modified the associations between CVD and bone charac-teristics. Prospective studies are needed to specify the role of mediators and lifestyle factors in the prevention of CVD and osteoporosis.
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Affiliation(s)
- Satu Pirilä
- Children's Hospital, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland
- * E-mail:
| | - Mervi Taskinen
- Children's Hospital, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland
| | - Maila Turanlahti
- Children's Hospital, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland
| | - Merja Kajosaari
- Children's Hospital, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland
| | - Outi Mäkitie
- Children's Hospital, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland
- Folkhälsan Research Centre, Helsinki, Finland
| | - Ulla M. Saarinen-Pihkala
- Children's Hospital, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland
| | - Heli Viljakainen
- Children's Hospital, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland
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Schwenke DC. Nutrient-rich fruits and vegetables: key for preventing cardiovascular and all-cause mortality in those with pre-existing cardiovascular disease? Curr Opin Lipidol 2014; 25:317-8. [PMID: 25003739 DOI: 10.1097/mol.0000000000000102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Dawn C Schwenke
- aResearch Health Scientist, Research Service, Phoenix VA Healthcare System, Phoenix, Arizona bResearch Professor, College of Nursing and Health Innovation, Arizona State University, Phoenix, Arizona, USA
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18
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Fardet A, Rock E. Toward a new philosophy of preventive nutrition: from a reductionist to a holistic paradigm to improve nutritional recommendations. Adv Nutr 2014; 5:430-46. [PMID: 25022992 PMCID: PMC4085191 DOI: 10.3945/an.114.006122] [Citation(s) in RCA: 102] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
The reductionist approach has been predominant to date in human nutrition research and has unraveled some of the fundamental mechanisms at the basis of food nutrients (e.g., those that involve deficiency diseases). In Western countries, along with progress in medicine and pharmacology, the reductionist approach helped to increase life expectancy. However, despite 40 y of research in nutrition, epidemics of obesity and diabetes are growing each year worldwide, both in developed and developing countries, leading to a decrease in healthy life years. Yet, interactions between nutrition-health relations cannot be modeled on the basis of a linear cause-effect relation between 1 food compound and 1 physiologic effect but rather from multicausal nonlinear relations. In other words, explaining the whole from the specific by a bottom-up reductionist approach has its limits. A top-down approach becomes necessary to investigate complex issues through a holistic view before addressing any specific question to explain the whole. However, it appears that both approaches are necessary and mutually reinforcing. In this review, Eastern and Western research perspectives are first presented, laying out bases for what could be the consequences of applying a reductionist versus holistic approach to research in nutrition vis-à-vis public health, environmental sustainability, breeding, biodiversity, food science and processing, and physiology for improving nutritional recommendations. Therefore, research that replaces reductionism with a more holistic approach will reveal global and efficient solutions to the problems encountered from the field to the plate. Preventive human nutrition can no longer be considered as "pharmacology" or foods as "drugs."
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Affiliation(s)
- Anthony Fardet
- Department of Human Nutrition, INRA, UMR 1019, UNH, CRNH Auvergne, Clermont-Ferrand, France; and Clermont Université, Université d'Auvergne, Unité de Nutrition Humaine, Clermont-Ferrand, France
| | - Edmond Rock
- Department of Human Nutrition, INRA, UMR 1019, UNH, CRNH Auvergne, Clermont-Ferrand, France; and Clermont Université, Université d'Auvergne, Unité de Nutrition Humaine, Clermont-Ferrand, France
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19
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Dai Z, Butler LM, van Dam RM, Ang LW, Yuan JM, Koh WP. Adherence to a vegetable-fruit-soy dietary pattern or the Alternative Healthy Eating Index is associated with lower hip fracture risk among Singapore Chinese. J Nutr 2014; 144:511-8. [PMID: 24572035 PMCID: PMC3952624 DOI: 10.3945/jn.113.187955] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Data on overall dietary pattern and osteoporotic fracture risk from population-based cohorts are limited, especially from Asian populations. This study examined the relation between overall diet and hip fracture risk by using principal components analysis (PCA) to identify dietary pattern specific to the study population and by using the Alternative Healthy Eating Index (AHEI) 2010 to assess dietary quality. The Singapore Chinese Health Study is a prospective population-based cohort that enrolled 63,257 Chinese men and women (including both pre- and postmenopausal women) aged 45-74 y between 1993 and 1998 in Singapore. Habitual diet was assessed by using a validated food-frequency questionnaire. Two dietary patterns, the vegetable-fruit-soy (VFS) pattern and the meat-dim-sum (MDS) pattern, were derived by PCA. Overall dietary quality was assessed according to the AHEI 2010, which was defined a priori for chronic disease prevention. A Cox regression model was applied with adjustment for potential confounders. In both genders, higher scores for the VFS pattern and the AHEI 2010 were associated with lower risk of hip fracture in a dose-dependent manner (all P-trend ≤ 0.008). Compared with the lowest quintile, participants in the highest quintile had a 34% reduction in risk (HR: 0.66; 95% CI: 0.55, 0.78) for the VFS pattern and a 32% reduction in risk (HR: 0.68; 95% CI: 0.58, 0.79) for the AHEI 2010. The MDS pattern score was not associated with hip fracture risk. An Asian diet rich in plant-based foods, namely vegetables, fruit, and legumes such as soy, may reduce the risk of hip fracture.
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Affiliation(s)
- Zhaoli Dai
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore,To whom correspondence should be addressed. E-mail: (Z. Dai), (W.-P. Koh)
| | - Lesley M. Butler
- Division of Cancer Control and Population Sciences and,Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA
| | - Rob M. van Dam
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
| | - Li-Wei Ang
- Epidemiology & Disease Control Division, Ministry of Health, Singapore; and
| | - Jian-Min Yuan
- Division of Cancer Control and Population Sciences and,Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA
| | - Woon-Puay Koh
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore,Duke-National University of Singapore Graduate Medical School Singapore, Singapore,To whom correspondence should be addressed. E-mail: (Z. Dai), (W.-P. Koh)
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