scholarly journals Minerals and vitamins in bone health: the potential value of dietary enhancement

2009 ◽  
Vol 101 (11) ◽  
pp. 1581-1596 ◽  
Author(s):  
Jean-Philippe Bonjour ◽  
Léon Guéguen ◽  
Cristina Palacios ◽  
Martin J. Shearer ◽  
Connie M. Weaver
Keyword(s):  
Vitamin D ◽  
Bone Health ◽  
Dietary Supplementation ◽  
Fragility Fractures ◽  
Bone Diseases ◽  
Community Studies ◽  
Populations At Risk ◽  
Average Intake ◽  
Hard Evidence

Nutrition is important to bone health, and a number of minerals and vitamins have been identified as playing a potential role in the prevention of bone diseases, particularly osteoporosis. Despite this, there is currently no consensus on maximum levels to allow in food or as dietary supplements. The benefits of supplementation of populations at risk of osteoporosis with Ca and vitamin D are well established. Prolonged supplementation of Ca and vitamin D in elderly has been shown to prevent bone loss, and in some intervention studies to prevent fragility fractures. Although P is essential to bone health, the average intake is considered to be more than sufficient and supplementation could raise intake to adverse levels. The role of vitamin K in bone health is less well defined, though it may enhance the actions of Ca and vitamin D. Sr administered in pharmacological doses as the ranelate salt was shown to prevent fragility fractures in postmenopausal osteoporosis. However, there is no hard evidence that supplementation with Sr salts would be beneficial in the general population. Mg is a nutrient implicated in bone quality, but the benefit of supplementation via foodstuffs remains to be established. A consensus on dietary supplementation for bone health should balance the risks, for example, exposure of vulnerable populations to values close to maximal tolerated doses, against evidence for benefits from randomised clinical trials, such as those for Ca and vitamin D. Feedback from community studies should direct further investigations and help formulate a consensus on dietary supplementation for bone health.

scholarly journals Bone Health, Fragility and Fractures

2021 ◽  
pp. 115-134
Author(s):  
Helen Wilson ◽  
Diana Calcraft ◽  
Cai Neville ◽  
Susan Lanham-New ◽  
Louise R. Durrant
Keyword(s):  
Vitamin D ◽  
Bone Health ◽  
Dietary Protein ◽  
Fragility Fractures ◽  
Vitamin D Supplementation ◽  
Bone Diseases ◽  
Acid Base Balance ◽  
Skeletal Health ◽  
Feasible Option ◽  
Base Balance

AbstractAchieving and maintaining skeletal health throughout the life trajectory is essential for the prevention of bone diseases such as rickets, osteomalacia and osteoporosis. Rickets and osteomalacia are usually a result of calcium and/or vitamin D deficiency, causing softening of bones and bone pain, and both conditions are treatable with calcium and vitamin D supplementation. Osteoporosis is a multifaceted disease mainly affecting older people, and its pathogenesis (and hence treatment) is more complex. Untreated osteoporosis results in fragility fractures causing morbidity and increased mortality.Nutrition is one of many factors that influence bone mass and risk of bone disease. Developing a nutritional sciences approach is a feasible option for improving bone health.The importance of adequate calcium and vitamin D in ensuring skeletal integrity throughout the life course has a sound evidence base. Poor vitamin D status in population groups of all ages is widespread across many countries (including affluent and non-affluent areas). Public health approaches are required to correct this given the fact that vitamin D is not just required for musculoskeletal health but also for other health outcomes.Dietary protein may be beneficial for bone due to its effect of increasing insulin-like growth-factor-1 (IGF-1). Recent meta-analyses show that dietary protein has a beneficial role to play in bone health at all ages.Other nutritional factors and nutrients (such as potassium, magnesium, vitamin K and acid-base balance) are also likely to have an important role in bone health, though the literature is less clear in terms of the association/relationship and more research is required.

Vitamin D in older people

2008 ◽  
Vol 18 (4) ◽  
pp. 287-298 ◽  
Author(s):  
Ian C Logan ◽  
Miles D Witham
Keyword(s):  
Vitamin D ◽  
Older People ◽  
Bone Health ◽  
Cardiovascular Health ◽  
Physiological Role ◽  
Fragility Fractures ◽  
Vitamin D Supplementation ◽  
Review Article ◽  
Clinical Use

Vitamin D has been known to play a key role in calcium homeostasis and bone health for almost a century. Its main current clinical use is as an agent to prevent osteomalacia and reduce fragility fractures in older people. Vitamin D may however play a wider physiological role, with effects on cancer prevention, cardiovascular health and immune function. This review article will outline the physiological role of vitamin D, the disease processes that have been associated with insufficiency and examine whether vitamin D supplementation can ameliorate these disease processes in older people.

scholarly journals The Alkaline Diet: Is There Evidence That an Alkaline pH Diet Benefits Health?

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
Gerry K. Schwalfenberg
Keyword(s):  
Growth Hormone ◽  
Vitamin D ◽  
Back Pain ◽  
Chronic Diseases ◽  
Bone Health ◽  
Medical Literature ◽  
Muscle Growth ◽  
Morbidity And Mortality ◽  
Alkaline Ph

This review looks at the role of an alkaline diet in health. Pubmed was searched looking for articles on pH, potential renal acid loads, bone health, muscle, growth hormone, back pain, vitamin D and chemotherapy. Many books written in the lay literature on the alkaline diet were also reviewed and evaluated in light of the published medical literature. There may be some value in considering an alkaline diet in reducing morbidity and mortality from chronic diseases and further studies are warranted in this area of medicine.

Role of Dietary Calcium and Vitamin D in Alveolar Bone Health

1985 ◽  
pp. 591-595
Author(s):  
Gary S. Rogoff ◽  
Roger B. Galburt ◽  
Abraham E. Nizel
Keyword(s):  
Vitamin D ◽  
Bone Health ◽  
Alveolar Bone ◽  
Dietary Calcium

Calcium and Vitamin D Involvement in the Fragility Fracture of the Pelvis

2019 ◽  
Vol 70 (10) ◽  
pp. 3674-3677
Author(s):  
Alexandru Filip ◽  
Ovidiu Alexa ◽  
Paul Dan Sirbu ◽  
Cristiana Filip ◽  
Elena Cojocaru ◽  
...  
Keyword(s):  
Vitamin D ◽  
Fracture Healing ◽  
Fragility Fracture ◽  
Healing Process ◽  
Recovery Period ◽  
Fragility Fractures ◽  
Positive Influence ◽  
Vitamin D Supplementation ◽  
Pharmacological Therapy ◽  
Bone Diseases

The fragility fracture is the widest spread of the bone diseases, in elderly. It particularly affects the vertebrae, the femur, the proximal humerus, the distal radius, the pelvis, thus preventing the patient�s free movement. The most debilitating of all these fractures is the fragility fracture of the pelvis. This type of fracture raises supplementary problems compared to the other fractures due to the difficulties of diagnosis, surgical approach and to the longer recovery period. Choosing the right treatment for FFP is difficult due to health and comorbidities in elderly patients. Both conservative and surgical therapy involve equally large risks: prolonged immobilization or surgical risks. Therefore, pharmacological therapy is an alternative to surgery. Bisphosphonates prove their utility in the fracture-healing outcome, but the influence of calcium and vitamin D were overlooked. The aim of our study was to evaluate the role of calcium and vitamin D in the healing process of patients with pelvic fragility fracture in osteoporotic patients with and without calcium and vitamin D supplementation. Our study shows that calcium and vitamin D exert a positive influence on the healing process of the fragility fractures and strongly emphasizes the need to educate patients to comply with the prescription to supplement calcium and vitamin D in order to improve fracture healing and prevent additional fractures.

Bone Health in Adults Treated with Endocrine Therapy for Early Breast or Prostate Cancer

2015 ◽  
pp. e567-e574 ◽  
Author(s):  
Catherine H. Van Poznak
Keyword(s):  
Prostate Cancer ◽  
Vitamin D ◽  
Bone Resorption ◽  
Endocrine Therapy ◽  
Sex Hormones ◽  
Bone Health ◽  
Estrogen Therapy ◽  
Fragility Fractures ◽  
Mineral Density ◽  
Increased Risk

Bone is a hormonally responsive organ. Sex hormones and calcium regulating hormones, including parathyroid hormone, 1–25 dihydroxy vitamin D, and calcitonin, have effects on bone resorption and bone deposition. These hormones affect both bone quality and bone quantity. The sex hormone estrogen inhibits bone resorption, and estrogen therapy has been developed to prevent and treat osteoporosis. Androgens are an important source of estrogen through the action of the enzyme aromatase and may themselves stimulate bone formation. Hence, the sex steroids play a role in bone metabolism. Breast cancer and prostate cancer are frequently hormonally responsive and may be treated with antiestrogens or antiandrogens respectfully. In addition, chemotherapy and supportive medications may alter the patient's endocrine system. In general, the suppression of sex hormones has a predictable affect on bone health, as seen by loss of bone mineral density and increased risk of fragility fractures. The bone toxicity of cancer-directed endocrine therapy can be mitigated through screening, counseling on optimization of calcium and vitamin D intake, exercise, and other lifestyle/behavioral actions, as well as the use of medications when the fracture risk is high. Maintaining bone health in patients who are treated with endocrine therapy for breast and prostate cancer is the focus of this review.

scholarly journals Essential Nutrients for Bone Health and a Review of their Availability in the Average North American Diet

2012 ◽  
Vol 6 (1) ◽  
pp. 143-149 ◽  
Author(s):  
Charles T Price ◽  
Joshua R Langford ◽  
Frank A Liporace
Keyword(s):  
Vitamin D ◽  
Bone Health ◽  
Calcium Metabolism ◽  
Dietary Supplementation ◽  
Nutritional Supplements ◽  
Mineral Density ◽  
Essential Nutrients ◽  
Nutritional Factors ◽  
Nutritional Components ◽  
Typical American Diet

Osteoporosis and low bone mineral density affect millions of Americans. The majority of adults in North America have insufficient intake of vitamin D and calcium along with inadequate exercise. Physicians are aware that vitamin D, calcium and exercise are essential for maintenance of bone health. Physicians are less likely to be aware that dietary insufficiencies of magnesium, silicon, Vitamin K, and boron are also widely prevalent, and each of these essential nutrients is an important contributor to bone health. In addition, specific nutritional factors may improve calcium metabolism and bone formation. It is the authors’ opinion that nutritional supplements should attempt to provide ample, but not excessive, amounts of factors that are frequently insufficient in the typical American diet.In contrast to dietary insufficiencies, several nutrients that support bone health are readily available in the average American diet. These include zinc, manganese, and copper which may have adverse effects at higher levels of intake. Some multivitamins and bone support products provide additional quantities of nutrients that may be unnecessary or potentially harmful.The purpose of this paper is to identify specific nutritional components of bone health, the effects on bone, the level of availability in the average American diet, and the implications of supplementation for each nutritional component. A summary of recommended dietary supplementation is included.

scholarly journals Bone biology in the elderly: clinical importance for fracture treatment

2016 ◽  
Vol 1 (2) ◽  
pp. 49-55
Author(s):  
Tim Rolvien ◽  
Michael Amling
Keyword(s):  
Risk Factors ◽  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Fragility Fractures ◽  
The Elderly ◽  
Bone Diseases ◽  
Local Health ◽  
Bone Density Measurement ◽  
Secondary Fracture ◽  
Metabolic Bone Diseases

AbstractAge-related bone impairment often leads to fragility fractures in the elderly. Although excellent surgical care is widely provided, diagnosis and treatment of the underlying bone disorder are often not kept in mind. The interplay of the three major bone cells – osteoblasts, osteoclasts, and osteocytes – is normally well regulated via the secretion of messengers to control bone remodeling. Possible imbalances that might occur in the elderly are partly due to age, genetic risk factors, and adverse lifestyle factors but importantly also due to imbalances in calcium homeostasis (mostly due to vitamin D deficiency or hypochlorhydria), which have to be eliminated. Therefore, the cooperation between the trauma surgeon and the osteologist is of major importance to diagnose and treat the respective patients at risk. We propose that any patient suffering from fragility fractures is rigorously screened for osteoporosis and metabolic bone diseases. This includes bone density measurement by dual-energy X-ray absorptiometry, laboratory tests for calcium, phosphate, vitamin D, and bone turnover markers, as well as additional diagnostic modalities if needed. Thereby, most risk factors, including vitamin D deficiency, can be identified and treated while patients who meet the criteria for a specific therapy (i.e. antiresorptive and osteoanabolic) receive such. If local health systems succeed to manage this process of secondary fracture prevention, morbidity and mortality of fragility fractures will decline to a minimum level.

scholarly journals Evaluation of risk factors associated with fragility fractures and recommendations to optimise bone health in children with long-term neurological condition

2021 ◽  
Author(s):  
XYJ Leow ◽  
JTC Tan ◽  
TH Yeo ◽  
KPL Wong ◽  
A Mahadev ◽  
...  
Keyword(s):  
Risk Factors ◽  
Vitamin D ◽  
Bone Health ◽  
Fragility Fractures ◽  
Neurological Condition ◽  
Factors Associated ◽  
Fractures In Children ◽  
Neurology Clinic

Introduction: The growing years are paramount for bone growth and mineral accrual. Children with long-term neurological condition (LTNC) have multiple risk factors for poor bone health and fragility fractures. In Singapore, this has not been studied systematically therefore we aim to evaluate the risk factors associated with fragilty fractures in children with LTNC. Methods: In this study, the search for fragility fractures was done by a retrospective review of patients with LTNC who are under follow-up in the Paediatric Neurology clinic and of patients who presented with fracture to the Paediatric Orthopaedic clinic. Information on patient’s demographics, medical history, intervention, biochemical bone markers and fracture history were collected. Results: In a tertiary clinic population of 136 patients with LTNC, 65% were dependent on mobility (GMFCS V), 60% were underweight and 60% were fed via gastrostomy or nasogastric tube, or on oral pureed diet. Furthermore, 60% were on anticonvulsants. The fracture rate was 3% in this population and was associated with low-impact activities such as transfer and dressing. Only 7.4% had a vitamin D level measured and 33% had calcium measured. Conclusion: The local prevalence of fragility fractures in children with LTNC who are under follow-up at the Neurology clinic was found to be 3%. Risk factors identified were limited ambulation and compromised nutritional status associated with feeding difficulty. Recommendations to optimize bone health in children with LTNC were made. These include promoting weight-bearing activities, looking out for underweight, avoiding vitamin D deficiency and ensuring adequate calcium intake.

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