Maintaining Bone Health Research Articles

The Role of Macronutrients, Micronutrients and Flavonoid Polyphenols in the Prevention and Treatment of Osteoporosis.

Osteoporosis is considered an age-related disorder of the skeletal system, characterized primarily by decreased bone mineral density (BMD), microstructural quality and an elevated risk of fragility fractures. This silent disease is increasingly becoming a global epidemic due to an aging population and longer life expectancy. It is known that nutrition and physical activity play an important role in skeletal health, both in achieving the highest BMD and in maintaining bone health. In this review, the role of macronutrients (proteins, lipids, carbohydrates), micronutrients (minerals—calcium, phosphorus, magnesium, as well as vitamins—D, C, K) and flavonoid polyphenols (quercetin, rutin, luteolin, kaempferol, naringin) which appear to be essential for the prevention and treatment of osteoporosis, are characterized. Moreover, the importance of various naturally available nutrients, whether in the diet or in food supplements, is emphasized. In addition to pharmacotherapy, the basis of osteoporosis prevention is a healthy diet rich mainly in fruits, vegetables, seafood and fish oil supplements, specific dairy products, containing a sufficient amount of all aforementioned nutritional substances along with regular physical activity. The effect of diet alone in this context may depend on an individual’s genotype, gene-diet interactions or the composition and function of the gut microbiota.

The Relationship of Osteoporosis with Menopause: Review of Article

Osteoporosis is the most problem of women's bone disease, it has a multitude of causes, including menopause. It affects about one in three women. Before a fracture, osteoporosis does not exhibit any clinical symptoms. Important pathology is brought on by fractures. Postmenopausal osteoporosis can be avoided with early diagnosis of this condition before fractures happen; Menopausal hormone therapy (MHT) significantly reduces the fracture risk in all body bones by halting bone loss and degeneration of bone microstructure. The fast bone loss brought on by declining estrogen peaks in the first two to three years following menopause. Even in women with modest fracture risk, MHT is the only antiosteoporosis medication that has been shown to be effective regardless of baseline risk . There is no rationale for using specific, efficient drugs to treat osteoporosis, making MHT the first option for maintaining bone health in women. It is also advisable to evaluate the advantages and risks of MHT. MHT has become the leading therapeutic choice for preserving bone health in early postmenopausal women.

Evidence and consensus-based clinical practice guidelines for management of overweight and obesity in midlife women: An AIIMS-DST initiative.

Evidence and consensus-based clinical practice guidelines for management of overweight and obesity in midlife women: An AIIMS-DST initiative.

How Much Calcium Does an Indian Postmenopausal Woman Need?

Calcium is needed for many biological processes. The serum concentration is of calcium is regulated very finely. The absorption of calcium and excretion maintains the calcium balance. Net calcium excretion must be replaced, but the amount of calcium needed has been debated for decades. The debate is what is the adequate calcium in Indian postmenopausal women to maintain bone health and as an intervention to prevent and treat osteoporosis. In this article experts give their opinion on the increase in the Recommended Dietary Allowance (RDA) of the ICMR 2020 committee. Based on the present evidence, the Indian menopause Society guidelines 2020, retains the ICMR 2010 recommendation of 800 mg of calcium as RDA until new Indian data emerges. The positive impact of increasing calcium and vitamin D intake is most evident in calcium-deficient individuals.

Adherence to bone health guidelines in patients with hormone receptor-positive early breast cancer: Status and clinical impact in a Swiss cohort experience

AimIn patients with postmenopausal hormone receptor-positive breast cancer (ER + eBC), aromatase inhibitors (AIs) are widely used for effective relapse prevention. However, AIs reduce bone density and increase bone-related events (BREs). Alongside calcium and vitamin D3 supplementation, bisphosphonates and denosumab are well-known options for improving outcomes in bone health and breast cancer prognosis. This study aimed to evaluate the practice patterns of bone health guideline-based management in real-world patients with ER + eBC. Material and methodsIn total, 68 patients with ER + eBC treated between 2009 and 2014 at the University Hospital Basel were included in this retrospective cohort study. Chart reviews were analyzed. Baseline, clinicopathological, treatment, and BRE data were extracted. Each patient was specifically reviewed for therapy adherence to the Swiss bone health guidelines (Swiss Association against Osteoporosis 2010 [SVGO]). ResultsThe mean patient age was 66.5 (range, 56–74) years, all post-menopausal. The most frequent tumor characteristics were tumor size of pT1–pT2 (N = 53, 77.9%) and treatment with letrozole (N = 35, 51.5%), followed by tamoxifen as a switch strategy (N = 27, 40.3%). The median treatment time with AIs was 47 (range, 30–60) months. Five patients (7.8%) experienced a fracture during or after AI treatment. Moreover, 51 (75%) patients were treated according to the SVGO recommendations. ConclusionThe fracture rate in our retrospective cohort was comparable to that in the larger phase III randomized trials. The adherence to bone health guidelines was satisfactory but still suboptimal. Clinicians should strictly adhere to the current bone health guidelines to ensure the best possible prevention of BREs and maintain bone health and cancer prognosis in patients with ER + eBC.

Effects of 12 Months of Vitamin D Supplementation on Physical Fitness Levels in Postmenopausal Women with Type 2 Diabetes

Introduction: It is common for postmenopausal women to receive a vitamin D supplementation prescription to assist in preventing future falls and to maintain bone health. However, the association between vitamin D supplementation and physical fitness components has not been studied in older women with diabetes. Objective: We examined the influence of 12 months of vitamin D supplementation on the components of physical fitness in postmenopausal women with type 2 diabetes mellitus (T2DM). Methods: Thirty-five postmenopausal women (62.48 ± 7.67 years; 154.6 ± 5.11 cm; 73.93 ± 15.43 kg; 31.13 ± 5.82 BMI) with a diagnosis of T2DM participated in this longitudinal study where participants were supplemented with 1000 IU/day of vitamin D over 12 months. Subjects performed fasting blood samples, anthropometric assessments, body composition, clinical exams, and physical tests at 6-month intervals (P0, P6, and P12). Results and Conclusion: Vitamin D supplementation alone was effective in postmenopausal women in increasing serum vitamin D levels, altering muscle strength levels, promoting improvements in muscle function, as well as preventing and controlling fragility caused by T2DM and aging.

The effectiveness of home-based physical activity on osteoporosis: a narrative review of possible intervention

Physical activity plays a key role in prevention and treatment of several chronic conditions. Moreover, exercise seems to induce improvements in the bone turnover of osteopenic and osteoporotic subjects, increasing bone health. Incidence of osteoporosis increases in postmenopausal women due to hormonal factors that lead to an imbalance in bone remodeling. Unfortunately, the COVID-19 pandemic period induced general population to decrease the level of physical activity, increasing the incidence of several diseases, including osteoporosis. During this year, the use of technology has been applied to continue rehabilitation program, as well as the gym session, to reduce the sedentary level both in healthy population and in patients. Therefore, the focus of this review is to verify the effectiveness of home-based protocols, feasible to be performed during confinement situation, on bone health and functional parameters of postmenopausal women, generally at high-risk of osteoporosis. According to the studies analyzed home-based exercises seem effectiveness to maintain bone health in postmenopausal women, despite the protocol attendance seems to decrease over the 12 months.

Osteoporosis Preventive Behavior Among Female Healthcare Students in Da Nang, Vietnam

Background: Osteoporosis prevention at young ages is crucial to diminish the risk of the disease and its complication in later years of life. Having good osteoporosis knowledge and positive health belief may lead to better preventive behavior which then contributes to build and maintain bone health throughout life.
 Objective: To investigate knowledge, health belief, and behavior of osteoporosis prevention among female healthcare students.
 Methods: The descriptive cross-sectional study was conducted in a public medical university in Da Nang of Vietnam. Four hundred participants were selected by applying the multistage sampling technique. Data were collected from May 2020 to June 2020 through the questionnaire that consists of 4 parts including the demographic data form, the osteoporosis knowledge assessment tool, the osteoporosis health belief scale, and the exercise and calcium behaviors scale. Data were analyzed using descriptive statistics and Pearson correlation test.
 Results: Participants had poor osteoporosis knowledge (mean [SD], 37.8 [16.0]; range, 0 - 75) and low preventive behavior (mean [SD], 5.7 [3.5]; range, 0 - 25). Osteoporosis health belief was found at a moderate level with a mean (SD) of 126.7 (12.9) (range, 84 - 187). There were positive significant correlations between knowledge and health belief, knowledge and behavior of osteoporosis prevention (P < .05).
 Conclusions: Osteoporosis preventive behavior of female healthcare students was low. Osteoporosis education programs should be developed for female healthcare students to improve their knowledge and health belief that would then lead to their better preventive behavior.

Antioxidant and Bone; Protect Your Future: A Brief Review.

The global campaign of osteoporosis has been organized by the International Osteoporosis Foundation (IOF) and them introducing World Osteoporosis Day (WOD) in 1997. The day is celebrated on October 20th each year and aimed to improve the awareness of the population about disease prevention. We present some aspects of bone health and the prevention of osteoporosis related to the use of vitamins. The presenting mini-review covers a variety of sources including PubMed, Embase, Scopus, and directory of open access journals (DOAJ) from 10 years ago (Oct 2009 to Oct 2019) for recent developments in the prevention of bone loss. The search was performed by using combinations of the following keywords and or their equivalents; osteoporosis, bones health, bone loss, and vitamin to find related articles about the prevention of osteoporosis by nutritional factors. The factors affecting bone are various and could begin from fetal periods to the end of life. Some of them are not changeable including age, and genetic; however, it is possible to modify some others such as poor nutrition and vitamin deficiency. Beyond vitamin D deficiency, consumption of other vitamins also is beneficial to maintain bone health. By considering the nutritional factors especially vitamins that affect bones, it is possible to have stronger bones to enjoy life in the elderly and protect your future.

HUBUNGAN OBESITAS DENGAN KEJADIAN OSTEOARTHRITIS LUTUT PADA LANSIA DI WILAYAH KERJA PUSKESMAS BATU AJI KOTA BATAM 2020

Osteoarthritis is a group of rheumatic diseases that most often causes joint disorders, causes pain and disorders in the elderly which generally attacks weight-bearing joints, especially the knee joints. Being overweight can cause damage to joint cartilage. populations with overweight or obesity have greater risk factors for knee osteoarthritis than populations with normal negative weight. excess body weight can reach four to five times greater, thereby accelerating damage to joint cartilage structures. The purpose of this study was to find out the relationship between obesity and knee osteoarthritis in the Working Area of the Batu Aji Health Center, Batam City in 2020. The type of research was analytic with a cross-sectional design, using purposive sampling by looking at secondary data. There were 67 respondents in this study. The results of this study obtained the results of the statistical test chi suare p value = 0.001 (0.05), this indicates that there is a significant relationship between obesity and the incidence of knee osteoarthritis in the elderly in the Batu Aji Health Center Work Area, Batam City in 2020. It is recommended for the elderly to can do physical activities such as gymnastics, morning walks and consume foods and drinks rich in calcium such as milk and fruits in order to maintain bone health in the elderly

Effects of backhand stroke styles on bone mineral content and density in postmenopausal recreational tennis players: a cross-sectional pilot investigation

BackgroundOne-handed backhand (OB) and two-handed backhand (TB) styles are commonly used in tennis, but only TB generates loadings on the non-dominant arm and a greater extension torque on the rear leg, leading to a greater axial torque involving rotation of the hip and trunk. The current study investigated whether those effects can further affect bone area (BA), bone mineral content (BMC) and density (BMD) in postmenopausal recreational tennis players.MethodsBA, BMC and BMD of the lumbar spine, hip and distal radius were assessed using dual-energy X-ray absorptiometry in TB, OB, and swimmers’ group as a control (SG) (all participants self-reported for at least 5 years of exercise history, n = 14 per group). Muscular strength was assessed with a hand dynamometer. Among these three groups, the BA, BMC and BMD of distal radius and muscle strength were assessed using one-way ANOVA, and those of the lumbar region and the hip joint were tested by one-way ANCOVA.ResultsTB showed higher BMC and BMD for both lumbar spine and femoral neck than SG (all, p < 0.05). Both OB and TB showed greater BMD inter-trochanter than SG (both, p < 0.05). OB demonstrated greater inter-arm differences in the distal radius, which involved 1/3 distal for BMC and mid-distal radius for BMD compared to the TB and SG (all, p < 0.05). In addition, greater inter-arm asymmetry of grip strength was found in OB compared to TB and SG (both, p < 0.05).ConclusionFor postmenopausal women, performing two-handed backhand strokes, leads to higher BMC and BMD in the non-dominant arm, the lumbar region, and hips, indicating potential benefit to maintain bone health and strength. Whether this result leads to reducing the risk of osteoporosis needs to be investigated in further research.

Last Word on Viewpoint: Fragile bones of elite cyclists: to treat or not to treat?

Last Word on Viewpoint: Fragile bones of elite cyclists: to treat or not to treat?

Maintaining Bone Health in the Lumbar Spine: Routine Activities Alone Are Not Enough.

Public health organisations typically recommend a minimum amount of moderate intensity activities such as walking or cycling for two and a half hours a week, combined with some more demanding physical activity on at least 2 days a week to maintain a healthy musculoskeletal condition. For populations at risk of bone loss in the lumbar spine, these guidelines are particularly relevant. However, an understanding of how these different activities are influential in maintaining vertebral bone health is lacking. A predictive structural finite element modelling approach using a strain-driven algorithm was developed to study mechanical stimulus and bone adaptation in the lumbar spine under various physiological loading conditions. These loading conditions were obtained with a previously developed full-body musculoskeletal model for a range of daily living activities representative of a healthy lifestyle. Activities of interest for the simulations include moderate intensity activities involving limited spine movements in all directions such as, walking, stair ascent and descent, sitting down and standing up, and more demanding activities with large spine movements during reaching and lifting tasks. For a combination of moderate and more demanding activities, the finite element model predicted a trabecular and cortical bone architecture representative of a healthy vertebra. When more demanding activities were removed from the simulations, areas at risk of bone degradation were observed at all lumbar levels in the anterior part of the vertebral body, the transverse processes and the spinous process. Moderate intensity activities alone were found to be insufficient in providing a mechanical stimulus to prevent bone degradation. More demanding physical activities are essential to maintain bone health in the lumbar spine.

Effect of Adding Different Levels of Grapes (Vitis vinifera L.) Seeds and Leaf Powder or their Extracts on Some Bone Characteristics and Total Ash Content in Broiler Chickens

Background: Some natural sources of polyphenols like grape seed, leaf or extracts, have many benefits in maintaining bone health in animals. This study aimed to investigate the efficacy of grape seeds, grape leaves powder, or their extracts on some bone characteristics and total ash content in broiler chickens. Methods: Three hundred and twenty four one-day-old broilers were allocated to nine treatments with three replicates containing 12 chicks each. Chicks were fed nine experimental diets for 35 days; as a control diet without supplementation (T1), control diets supplemented with 15 and 30 g/kg grape seeds powder (GSP) (T2, T3), 15 and 30 g/kg grape leaf powder (GLP) (T4, T5), grape seed extract (GSE) at levels 2 and 4 ml/l added in drinking water (T6, T7) and with grape leaf extract (GLE ) at levels 2 and 4 ml/l (T8 and T9), respectively. Result: Significant increase (p≤0.05) in the bone length was recorded with GSP (30 g/kg), GLP (15 g/kg), GSE or GLE and calcium percent with GLE as compared with control. Furthermore, significant improvement was recorded in predictive skeletal weight of broilers fed GSE (T6 α T7) as compared to the other treatments. The study concluded that the best results were achieved at the 2 or 4 ml/l of grape seed extract in improving femur length, predicted skeletal weight and from grape leaf extract in improving calcium percentage in broiler bone ash.

Botanicals in Postmenopausal Osteoporosis.

Osteoporosis is a systemic bone disease characterized by reduced bone mass and the deterioration of bone microarchitecture leading to bone fragility and an increased risk of fractures. Conventional anti-osteoporotic pharmaceutics are effective in the treatment and prophylaxis of osteoporosis, however they are associated with various side effects that push many women into seeking botanicals as an alternative therapy. Traditional folk medicine is a rich source of bioactive compounds waiting for discovery and investigation that might be used in those patients, and therefore botanicals have recently received increasing attention. The aim of this review of literature is to present the comprehensive information about plant-derived compounds that might be used to maintain bone health in perimenopausal and postmenopausal females.

Static magnetic field of 0.2–0.4 T promotes the recovery of hindlimb unloading-induced bone loss in mice

Purpose Bone loss is one of the most serious medical problem associated with prolonged weightlessness in long-term spaceflight mission. Skeletal reloading after prolonged spaceflight have indicated incomplete recovery of lost bone, which may lead to an increased risk of fractures in astronauts when returning to Earth. Substantial studies have revealed the capacity of static magnetic fields (SMFs) on treating various bone disorders, whereas it is unknown whether SMFs have the potential regulatory effects on bone quality in unloaded mice during unloading. This study was conducted to investigate the potential effects of whole-body SMF exposure with 0.2–0.4 T on the recovery of unloading-induced bone loss. Materials and methods Eight‐week‐old male C57BL/6J mice were subjected to hindlimb unloading (HLU) for 4 weeks, following the mice were reloaded for 4 weeks under geomagnetic field (GMF) and SMF of 0.2–0.4 T. Bone quality indexes, including bone mineral density (BMD) and bone mineral content (BMC), bone microarchitecture, and bone mechanical properties were examined by the measurement of dual energy X-ray absorptiometry (DEXA), micro-computed tomography (Micro-CT), and 3-point bending. Bone turnover was evaluated by bone histomorphometric and serum biochemical assay. Results We found that SMF exposure for 4 weeks significantly promoted the recovery in HLU-induced decrease of BMD and BMC, deterioration of bone microarchitecture, and reduction of bone strength. The results from bone turnover determination revealed that SMF exposure for 4 weeks induced lower osteoclast number of trabecular bone and serum TRAP-5b levels in reloaded mice, whereas SMF showed no significant alteration in skeletal osteoblast number and serum osteocalcin levels. Conclusions Together, our findings suggest that SMF of 0.2–0.4 T facilitated the recovery of unloading-induced bone loss by inhibiting the increase of bone resorption in reloaded mice, and indicate that SMF might become a promising biophysical countermeasure for maintaining bone health in astronauts after landing.

Bone targeting nanocarrier-assisted delivery of adenosine to combat osteoporotic bone loss

Extracellular adenosine has been shown to play a key role in maintaining bone health and could potentially be used to treat bone loss. However, systemic administration of exogenous adenosine to treat bone disorders remains a challenge due to the ubiquitous presence of adenosine receptors in different organs and the short half-life of adenosine in circulation. Towards this, we have developed a bone-targeting nanocarrier and determined its potential for systemic administration of adenosine. The nanocarrier, synthesized via emulsion suspension photopolymerization, is comprised of hyaluronic acid (HA) copolymerized with phenylboronic acid (PBA), a moiety that can form reversible bonds with adenosine. The bone binding affinity of the nanocarrier was achieved by alendronate (Aln) conjugation. Nanocarriers functionalized with the alendronate (Aln-NC) showed a 45% higher accumulation in the mice vertebrae in vivo compared to those lacking alendronate molecules (NCs). Systemic administration of adenosine via bone-targeting nanocarriers (Aln-NC) attenuated bone loss in ovariectomized (OVX) mice. Furthermore, bone tissue of mice treated with adenosine-loaded Aln-NC displayed trabecular bone characteristics comparable to healthy controls as shown by microcomputed tomography, histochemical staining, bone labeling, and mechanical strength. Overall, our results demonstrate the use of a bone-targeting nanocarrier towards systemic administration of adenosine and its application in treating bone degenerative diseases such as osteoporosis.

Nanoliposomes for encapsulation and calcium delivery of egg white peptide-calcium complex.

Nanoliposomes and crude liposomes loaded with egg white peptide-calcium complex (EWP-Ca) were fabricated by thin-film dispersion with or without dynamic high-pressure microfluidization. Their physiochemical properties, in vitro stability, and calcium release profiles were investigated in this study. Results showed that the EWP-Ca-loaded nanoliposomes exhibited spherical structures with a lower particle size and polydispersity index as well as a higher thermal stability as compared to the corresponding crude liposomes. Further investigations revealed that EWP-Ca was embedded into the liposomes mainly through hydrogen bonding and present in an amorphous form within the liposomes. Additionally, the EWP-Ca-loaded nanoliposomes effectively slowed the release of calcium in gastric digestion, allowing more soluble calcium to enter the intestinal tract; in the subsequent intestinal digestion, the EWP-Ca-loaded nanoliposomes were more electrically and physically stable than the crude liposomes. Therefore, the EWP-Ca-loaded nanoliposomes could be used as a favorable dietary calcium delivery system to promote calcium bioavailability. PRACTICAL APPLICATION: Nanoliposomes were fabricated in this study to encapsulate the egg white peptide-calcium complex (EWP-Ca) for calcium delivery. The EWP-Ca-loaded nanoliposomes effectively slowed the release of calcium in gastric digestion, allowing more soluble calcium to enter the intestinal tract, and were more electrically and physically stable in the subsequent intestinal digestion. Therefore, the EWP-Ca-loaded nanoliposomes may be incorporated in calcium-fortified food to enhance calcium delivery for maintaining bone health.

Evidence of a Positive Link between Consumption and Supplementation of Ascorbic Acid and Bone Mineral Density

In animal models it has been shown that ascorbic acid (AA) is an essential cofactor for the hydroxylation of proline in collagen synthesis. However, there are still no precise indications regarding the role of AA in maintaining bone health in humans, so the aim of this narrative review was to consider state of the art on correlation between bone mineral density (BMD), AA dietary intake and AA blood levels, and on the effectiveness of AA supplement in humans. This review included 25 eligible studies. Fifteen studies evaluated correlations between AA intake and BMD: eight studies demonstrated a positive correlation between AA dietary intake and BMD in 9664 menopausal women and one significant interaction between effects of AA intake and hormone therapy. These data were also confirmed starting from adolescence (14,566 subjects). Considering studies on AA blood concentration and BMD, there are four (337 patients) that confirm a positive correlation. Regarding studies on supplementation, there were six (2671 subjects), of which one was carried out with AA supplementation exclusively in 994 postmenopausal women with a daily average dose of 745 mg (average period: 12.4 years). BMD values were found to be approximately 3% higher in women who took supplements.

Radium-223 in the Modern Treatment of Metastatic Castration-resistant Prostate Cancer

The objective: is to determine the current role of radium-223 in the emergence of new options in the treatment of patients with metastatic castration-resistant prostate cancer.&#x0D; Materials and methods. Studies of ERA-223 and ALSYMPCA have identified the role of radium-223 in the treatment of prostate cancer and its impact on human health.&#x0D; Results. In one such study, ERA-223, it was shown that the combination of abiraterone with radium-223 did not increase survival without symptomatic skeletal events compared with abiraterone plus placebo. In addition, a higher incidence of bone fractures was observed with the combination of abiraterone and radium-223, especially in patients not receiving osteomodulators (denosumab or zoledronic acid). These results have led to some changes in the indications for the use of radium-223 in Europe and more careful attention to the state of bone structure in patients with prostate cancer.&#x0D; An overview of expert recommendations for the prevention and treatment of bone events, as well as the consequences of prolonged targeted therapy in patients with metastatic prostate cancer, which may improve the results of general and cancer-specific survival. Radium-223 has been shown to be an important option for patients with castration-resistant prostate cancer with bone metastases, and monitoring and maintaining bone health is an important factor in prostate cancer patients. It is established that the treatment of this category of patients should begin with androge n deprivation therapy.&#x0D; Conclusions. A review of the recommendations of urologists, oncologists and radiation oncologists in Europe, who specialize in the treatment of patients with advanced prostate cancer, to maintain bone health, treatment consequences and the role of radium-223 in the treatment of prostate cancer. Based on the analysis of the use of radium-223 in the current treatment of CRPD, preventive measures to maintain bone health are recommended, as well as side effects based on clinical experience.