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Expert Pearls

Bone Loss - adominal fat - 50084

Abdominal fat mass in adults was inversely associated with bone mass at the femur and spine in women. For a given body weight, those with higher fat mass near the abdomen has a lower bone mineral density. Cytokines are involved in the balance between formation and resorption. Centrally located body fat is more metabolically active than fat located elsewhere in the body as it releases a variety of pro-inflammatory cytokines that cause local inflammation. Systemic inflammation can increase osteoclast formation, the cells responsible for bone resorption. Abdominal fat mass was associated with lower serum concentrations of osteocalcin.

[Am J Clin Nutr, 2011 Oct;94(4):1063-70. Epub 2011 Aug 24. 50084 (5/2012)] Interview PubMed

Bone Loss - calcium, inulin, isoflavones, vitamin d - 49713

Calcium (500 mg/d), vit D (300 IU/d), inulin (3 g/d) and soy isoflavones (40 mg/d) improved calcium absorption; reduced parathormone levels; increased of IGF1 levels and reduced CTx. The improvement of calcium absorption was likely due to the presence of inulin in supplementation with the positive effects on bone biomarkers probably do to the soy isoflavone supplementation. Calcium supplementation should result in calciuria between 200 and 250 mg/d with overall improvement of bone biomarkers. Calcium supplementation should not bring daily calciuria to levels exceeding 250 mg/d in women (300 mg/d in men). [Aging Clin Exp Res, 2013 Aug 2; [Epub ahead of print]. 49713 (9/2013)] Summary Interview PubMed

Bone Loss - alpha linolenic acid - 44995 / 45647

Alpha linolenic acid (ALA) enriched diets from walnuts; walnut and flax oil reduce markers of bone loss and inflammation (NTX and inflammatory cytokines). [Nutr J, 2007 Jan 16;6(1):2 [Epub ahead of print] 44995 / 45647 (3/2007)] Summary Interview PubMed

Bone Loss - anions - 31858

Anions - substitution of metabolizable organic anions (e.g., bicarbonate, acetate, citrate) for the inorganic, or “hard” anions (e.g., chloride, sulfate) leads to a reduction in urinary calcium loss. [J Nutr, 1998;128: 1054-1057. 31858 (1999)] Summary Interview PubMed

Bone Loss - antioxidant therapy - 46840

Antioxidant therapy - vitamin C 1000 mg/d and vitamin E 600 mg/d with breakfast. [Osteoporos Int, 2008 Nov 20; [Epub ahead of print]. 46840 (1/2009)] Summary

Bone Loss - antioxidant therapy - 46840

Antioxidant therapy - vitamin C 1000 mg/d and vitamin E 600 mg/d with breakfast. [Osteoporos Int, 2008 Nov 20; [Epub ahead of print]. 46840 (1/2009)] Summary Interview PubMed

Bone Loss - bisphosphonate - 49827

Bisphosphonate (nitrogen) (N-BP) use in postmenopausal women with osteoporosis can reduce both CoQ10 and gamma tocopherol levels, more severely in those receiving intravenous forms of N-BP. Those on N-BP, especially with IV use, are candidates for assessment of CoQ10 and gamma-tocopherol and possible supplementation. Those on both statins and N-BP medications may be at enhanced risk of CoQ10 deficiency and the clinical consequences and should be monitored for CoQ10 and gamma-tocopherol levels. [J Clin Endocrinol Metab, 2014 Jan 13; [Epub ahead of print]. 49827 (4/2014)] Summary Interview PubMed

Bone Loss - boron - 21766

Boron supplementation modestly affects mineral status, and exercise modifies the effects of boron supplementation on serum minerals. [Am J Clin Nutr, 1995;61:341-345. 21766 (1996)] Summary Interview PubMed

Bone Loss - caffeine - 21095

Caffeine without adequate calcium intake may be a risk factor for bone loss while caffeine with adequate calcium is probably not a risk factor. [Am J Clin Nutr, 1994;60:573-578. 21095 (1996)] Summary Interview PubMed

Bone Loss - caffeine - 22386

Caffeine intake is inversely associated with calcium intake and calcium absorption efficiency (coffee supplied about 93 percent of all the caffeine consumed by study subjects). [Osteoporosis International, 1995;5:97-102. 22386 (1996)] Summary Interview PubMed

Bone Loss - caffeine - 22386

Caffeine increases individual’s requirement for calcium. About 40 mg of additional calcium (equal to 1 fl oz of milk) would offset the negative effect of 6 fl oz of caffeine-containing coffee. [Osteoporosis International, 1995;5:97-102. 22386 (1996)] Summary Interview PubMed

Bone Loss - caffeine - 22386

Caffeine’s effect on calcium balance - for every 6 fl oz serving of caffeine-containing coffee, calcium balance was more negative by 4.6 mg. [Osteoporosis International, 1995;5:97-102. 22386 (1996)] Summary Interview PubMed

Bone Loss - calcium - 18815

Calcium 1000 mg/d (calcium citramalate), zinc 15 mg/d, copper 2.5 mg/d and manganese 5.0 mg/d. [J Nutr,1994;124:1060-1064. 17018,18815; J Am Coll Nutr, 1993;12(4):383-389. 18815 (1995)] Summary Interview PubMed

Bone Loss - calcium - 21766

Calcium - maximize bone calcium stores starting in infancy, or preconceptually, continuing well into the 25 to 35 year age bracket, may help optimized bone mineral density well into the later years of life. [Am J Clin Nutr, 1995;61:341-345. 21766 (1996)] Summary Interview PubMed

Bone Loss - calcium - 21849

Calcium (from dairy products) and phosphorus were positively associated with bone density. [American Journal of Epidemiology, 1995;141:342-51. 21849 (1996)] Summary Interview PubMed

Bone Loss - calcium - 34927

Calcium bioavailability from foods or supplements averages about 30%; maybe calcium citrate malate is a little better absorbed than other forms. [J Am Coll Nutr, 2000;19(2):119S-136S. 34927 (2000)] Summary Interview PubMed

Bone Loss - calcium - 39257

Calcium 1000 mg/d plus 2 mg estriol increased BMD. [J Am Geriatri Soc, April 2002;50(4):777-778. 39257 (2002)] Summary Interview PubMed

Bone Loss - calcium - 43262

Calcium 1000 gm/d (from carbonate) increased bone mass. [J Clin Endocrinol Metab, 2005;90(6):3153-3161. 43262 (8/2005)] Summary Interview PubMed

Bone Loss - calcium - 43866 / 44434

Calcium 800 mg/d plus vitamin D 800 iu/d. [JAMA, 2005 Nov 9;294(18):2336-41. 43866/44434 (3/2006)] Summary Interview PubMed

Bone Loss - calcium - 45133

Calcium 1000 mg/d, vitamin D3 400 IU/d and vitamin K1 200 mcg/d increased radial bone mineral density. [J Bone Miner Res, 2007; 22(4): 509-519. 45133 (8/2007)] Summary Interview PubMed

Bone Loss - dairy - 34929

Dairy products are as good a source of calcium as supplements and contain additional bone forming nutrients such as potassium, phosphorus and protein. [J Am Coll Nutr, 2000;19(2):83S-99S. 34929 (2000)] Summary Interview PubMed

Bone Loss - dhea - 29205

DHEA cream (per 100 gms of cream:10 gms of DHEA; 16 gms of emulsifying wax; 10 gms of light mineral oil; 1 gm of benzyl alcohol; 33.4 gms of purified water; and 29.6 gms of ethanol 95%, patent pending). [J Clin Endocrinol Metab, 1997;82:3498-3505. 29205 (1998)] Summary Interview PubMed

Bone Loss - dhea - 34102 / 34012

DHEA 25-50 mg/d (men and women). [Endocrine, August 1999;11(1):1-11. 34102/34012 (2000)] Summary Interview PubMed

Bone Loss - dhea - 47092

DHEA 50 mg/d in a.m.. [Am J Clin Nutr, March 25, 2009;89(5):1459-67 [Epub ahead of print]. 47092 (7/2009)] Summary Interview PubMed

Bone Loss - diet - 39552

Diet - fruit, vegetable and cereal diet had greater bone mineral density than the meat and dairy diet; diets containing the greatest amounts of sweets had the lowest bone density. [Am J Clin Nutr, 2002;76:245-252. 39552 (2002)] Summary Interview PubMed

Bone Loss - diet - 44428 / 44929

Diet - too much animal (except for fish) and dairy products; relatively low intake of green and dark yellow vegetables and beans (probably soybeans) may be bone loss risk factors in the Western diet. [Am J Clin Nutr. 2006 May;83(5):1185-92. 44428/44929 (6/2006)] Summary Interview PubMed

Bone Loss - diet - 44428 / 44929

Diet - vegetables, fruits, fish, and soy products (benefit). [Am J Clin Nutr. 2006 May;83(5):1185-92. 44428/44929 (6/2006)] Summary Interview PubMed

Bone Loss - dietary acid load, fruit, vegetables - 50217

Higher dietary acid load (DAL) (i.e. low fruit and vegetable intake)increases calcium loss. Eating a diet that is moderate in protein for the anabolic effect and high in fruits and vegetables may be ideal to maintain or build bone. Meats (poultry and fish), dairy and grains increase acid load while fruit and vegetables reduce acid load. [Bone 2012 May;50(5):1026-31. 50217 (5/2013)] Interview PubMed

Bone Loss - estrogen - 12247 / 22386

Estrogen withdrawal (natural or surgical menopause, or with ovarian failure) leads to 15% loss of skeletal bone over a 2 or 3 year period and slightly less efficient calcium absorption. [Osteoporosis International, 1995;5:97-102. 12247/22386 (1996)] Summary Interview PubMed

Bone Loss - exercise - 26348

Exercise with resistance (bands, weights, etc.) is better than weight bearing exercise for bone strength and health though both are beneficial. [Spine, 1996;21:2809-2813. 26348 (1997)] Summary Interview PubMed

Bone Loss - fruit - seafood - 44437

Fruit and seafood intake is associated with increased bone density. [Maturitas, 2006 June 26; [Epub ahead of print]. 44437 (9/2006)] Summary Interview PubMed

Bone Loss - fruit - vegetable - 42591 / 45037

Fruit and vegetable intake is associated with increased bone density. [Am J Clin Nutr, 2006 Jun;83(6):1420-8. 42591/45037 (10/2005)] Summary Interview PubMed

Bone Loss - fruit - vegetable - 43791

Fruit and vegetable intake is associated with increased bone density. [Am J Clin Nutr. 2005 Sep; 82(3):700-6. 43791 (10/2005)] Summary Interview PubMed

Bone Loss - genistein - 45456

Genistein 54 mg/d in divided doses irregardless of meals increased BMD at 24 months. [Ann Intern Med, 2007; 146(12): 839-47. 45456 (9/2008)] Summary Interview PubMed

Bone Loss - green tea, tai chi - 49070

Green tea polyphenols (GTPs) at 500 mg per day (to mimic human consumption equivalent to 4-6 cups of green tea per day) taken in 250 mg capsules 2 times daily after meals by itself or with Tai Chi 3 times weekly at 60 minutes per session. [Osteoporos Int, 2011 July 16; [Epub ahead of print]. 49070 (4/2012)] Summary Interview PubMed

Bone Loss - homocysteine - 43680 / 43772

Homocysteine is elevated in serum. [Bone, 2005 Aug;37(2):234-42. 43680/ 43772 (10/2005)] Summary Interview PubMed

Bone Loss - inulin-type fructan - 43542

Inulin-type fructan 8 g/d (Raftilose® Synergy1®, Orafti, N.V., Tienen, Belgium). [Am J Clin Nutr. 2005 Aug;82(2):471-6. 43542 (9/2005)] Summary Interview PubMed

Bone Loss - isoflavones - 36989

Isoflavones in soy containing foods such as tofu, kinako and natto, etc. are protective. [Osteoporos Int, 2000;11:721-724. 36989 (2001)] Summary Interview PubMed

Bone Loss - magnesium - 30545

Magnesium 350 mg/d (elemental from magnesium carbonate and oxide in a dissolvable powder) reduced bone turnover in health males. [J Clin Endocrinol Metab, 1998;83:2742-2748. 30545 (1998)] Summary Interview PubMed

Bone Loss - Menaquinone-7, MK-7, vitamin k2 - 49581

Vitamin K2 (Menaquinone-7/MK-7)at 180 ug/d in healthy postmenopausal women in a single dose with the main meal for 3 years showed significantly Menaquinone-7/MK-7improved vitamin K status and decreased age-related decline in bone mineral content (BMC) and bone mineral density (BMD) at the lumbar spine and femoral neck, but not at the total hip. Bone strength was also benefitted by MK-7. MK-7 significantly decreased the loss in vertebral height of the lower thoracic region at the mid-site of the vertebrae. No side effects were noted. [Osteoporos Int, 2013 March 23; [Epub ahead of print]. 49581 (5/2103)] Summary Interview PubMed

Bone Loss - methylmalonic acid - 43680 / 43772

Methylmalonic acid elevated in serum. [Bone, 2005 Aug;37(2):234-42. 43680/ 43772 (10/2005)] Summary Interview PubMed

Bone Loss - milk - 43791

Milk intake inversely related to bone loss. [Am J Clin Nutr. 2005 Sep;82(3):700-6. 43791 (10/2005)] Summary Interview PubMed

Bone Loss - minerals - 32023

Minerals - higher intakes of magnesium and potassium were significantly associated with greater bone mineral density in both men and women (may buffer the acid load from standard diet, creating a more alkaline environment slowing mineral removal from bone). [Am J Clin Nutr 1999;69:727-736. 32023 (1999)] Summary Interview PubMed

Bone Loss - natto - 44310

Natto 1-4 servings per week (350 microgram of menaquinone-7 per serving; isoflavones). [J Nutr, 2006; 136(5):1323-8. 44310 (6/2006)] Summary Interview PubMed

Bone Loss - omega-6:omega-3 fatty acid - 43033 / 934-938

Omega-6:omega-3 fatty acid ratio - increased ratio is associated with increased risk to bone loss. Reduce ratio by increasing omega-3's from fish, flax, walnuts, etc. and decrease omega-6's from vegetable oils and animal fat. [Am J Clin Nutr, 2005;81:934-938. 43033/934-938 5/2005] Summary Interview PubMed

Bone Loss - plant protein - 22584

Plant protein leads to less excretion of calcium and achieves calcium balance with lower calcium intake than an animal protein-rich diet. [Nutrition Research, 1994;14(12):1853-1895. 22584 (1996)] Summary Interview PubMed

Bone Loss - premature delivery, vitamin d - 49003

Hypovitaminosis D in perinatal Japanese females (25-OHD concentration ≤ 20 ng/ml), was found in 85 mothers (89.5%). Serum 25-OHD levels were negatively associated with serum type I collagen NTx and bone-specific alkaline phosphatase. Mothers with threatened premature delivery had significantly lower 25-OHD levels (11.2 ± 3.2 ng/ml) than those in mothers with normal delivery (15.6 ± 5.1 ng/ml). [J Bone Miner Metab, 2011 Sept; 29(5): 615-20. 49003 (2/2012)] Summary Interview PubMed

Bone Loss - protein - 22386

Protein - for every 1 gm of protein ingested, about 1 mg of calcium is lost in the urine. [Osteoporosis International, 1995;5:97-102. 22386 (1996)] Summary Interview PubMed

Bone Loss - protein - 31858

Protein either from animal or plant is necessary for bone health with an alkaline diet from plant food reducing the sulfur amino acids which are metabolized to sulfuric acid which pulls calcium from bone when excreted. [J Nutr, 1998;128:1054-1057. 31858 (1999)] Summary Interview PubMed

Bone Loss - protein - 36705

Protein - a high animal:vegetable protein ratio (4 x as much protein from animal than vegetable) had three times the rate of bone loss and 3.7 times as many hip fractures as the women in the low animal:vegetable protein ratio (equal amounts of protein from animal and vegetable foods). [Am J Clin Nutr, 2001;73:118-122. 36705 (2001)] Summary Interview PubMed

Bone Loss - resistance training - 46840

Resistance training. [Osteoporos Int, 2008 Nov 20; [Epub ahead of print]. 46840 (1/2009)] Summary

Bone Loss - resistance training - 46840

Resistance training. [Osteoporos Int, 2008 Nov 20; [Epub ahead of print]. 46840 (1/2009)] Summary Interview PubMed

Bone Loss - sodium - 22386

Sodium - for every 2,300 mg of sodium ingested, 52 mg of calcium is lost in the urine. [Osteoporosis International, 1995;5:97-102. 22386 (1996)] Summary Interview PubMed

Bone Loss - soy protein - 35987

Soy protein isolate containing genistein (50.7 mg/day), daidzein (26.9 mg/day), and glycitein (2.8 mg/day) incorporated into muffins, common foods or beverages with a total protein intake of 40 gm/d from soy prevented spinal bone loss in estrogen deficient-postmenopausal women. [Am J Clin Nutr, 2000;72:844-852. 35987 (2001)] Summary Interview PubMed

Bone Loss - testosterone - 43124

Testosterone enanthate 200 mg I.M. alone every 2 weeks or testosterone with finasteride 5 mg/d for 3 years significantly improved bone mineral density of the lumbar spine and hip in males 65 years of age and older. [J Clin Endocrinol Metab, 2004;89(2):503-510. 43124 (6/2005)] Summary Interview PubMed

Bone Loss - vegan diet - 48956

Vegan diets had a non-significant lower rate of bone loss than non-vegans, with lower calcium intake and vitamin D levels. [Eur J Clin Nutr, 2011 Aug 3; [Epub ahead of print]. 48956 (1/2012)] Summary Interview PubMed

Bone Loss - vitamin b12 - 43680 / 43772

Vitamin B12 low in serum. [Bone. 2005 Aug;37(2):234-42. 43680/43772 (10/2005)] Summary Interview PubMed

Bone Loss - vitamin d - 43720

Vitamin D (1 α-hydroxycholecalciferol 0.5 μg/d) plus K2 15 mg t.i.d.. [Maturitas, 2002 Mar 25;41(3):211-21. 43720 (12/2005)] Summary Interview PubMed

Bone Loss - vitamin d - 43866 / 44434

Vitamin D (25 dihydroxy vitamin D) ≥ 20 ng/mL or 50 nmol/L. [JAMA, 2005 Nov 9;294(18):2336-41. 43866/44434 (3/2006)] Summary Interview PubMed

Bone Loss - vitamin k - 15206 / 23088

Vitamin K is a cofactor in formation of Gla-residues in 3 bone proteins: osteocalcin, matrix Gla-protein and protein S synthesized by bone forming osteoblasts. These Gla-proteins increase the calcium-binding capacity of the organic matrix of the bone. Vitamin K may stimulate osteoblast differentiation and reduce osteoclast activity (bone resorption). [Ann Rev Nutr, 1995;15:1-22. 15206/23088 (1995)] Summary Interview PubMed

Bone Loss - vitamin k - 15206 / 23088

Vitamin K intake increased circulating osteocalcin and bone-derived alkaline phosphatase, both markers of bone formation. [Ann Rev Nutr, 1995;15: 1-22. 15206/23088 (1995)] Summary Interview PubMed

Bone Loss - vitamin k - 15206 / 23088

Vitamin K administration decreased 2-h fasting urinary hydroxyproline/creatinine and calcium/creatinine ratios, both markers of bone resorption. [Ann Rev Nutr, 1995;15:1-22. 15206/23088 (1995)] Summary Interview PubMed

Bone Loss - vitamin k - 24458

Vitamin K is present in the bone matrix in high concentrations; inhibits osteoclasts and stimulates osteoblasts. [Challenges of Modern Medicine, 1995;7:357-366. 24458 (1996)] Summary Interview

Bone Loss - vitamin k - 26239 / 26230

Vitamin K insufficiency is a potential risk factor. [Calcif. Tissue Int., 1996;59: 352-356. 26239/26230 (1997)] Summary Interview PubMed

Bone Loss - vitamin k - 39149

Vitamin K is a cofactor in formation of Gla-residues in 3 bone proteins: osteocalcin, matrix Gla-protein and protein S synthesized by bone forming osteoblasts. These Gla-proteins increase the calcium-binding capacity of the organic matrix of the bone. Vitamin K may stimulate osteoblast differentiation and reduce osteoclast activity (bone resorption). [Curr Opin Clin Nutr Metab Care, 2001;4:483-487. 39149 (2002)] Summary Interview PubMed

Bone Loss - vitamin k - 48617

Vitamin K in the diet improved status of bone properties, including markers of strength and porosity rather than bone mineral density. [Bone, 2011 April 4; [Epub ahead of print]. 48617 (5/2011)] Summary Interview PubMed

Bone Loss - vitamin k1 - 15206 / 23088

Vitamin K1 (phylloquinone) 1 mg/d. [Ann Rev Nutr, 1995;15:1-22. 15206/ 23088 (1995)] Summary Interview PubMed

Bone Loss - vitamin k2 - 15206 / 23088

Vitamin K2 (menaquinone) 45 mg/d. [Ann Rev Nutr, 1995;15:1-22. 15206/ 23088 (1995)] Summary Interview PubMed

Bone Loss - vitamin k2 - 36989

Vitamin K2 90 mg/d. [Osteoporos Int, 2000;11:721-724. 36989 (2001)] Summary Interview PubMed

Bone Loss - vitamin k2 - 39149

Vitamin K2 15 mg t.i.d.. [Curr Opin Clin Nutr Metab Care, 2001;4:483-487. 39149 (2002)] Summary Interview PubMed

Bone Loss - vitamin k2 - 43635 / 41865

Vitamin K2 (menaquinone) 45 mg/d reduced bone loss and incidence of hepatic carcinoma in patients with viral cirrhosis. [JAMA, July 21, 2004;292(3):358-361. 43635/41865 (10/2004)] Summary Interview PubMed

Bone Loss - vitamin k2 - 43720

Vitamin K2 15 mg t.i.d.. [Maturitas, 2002 Mar 25;41(3):211-21. 43720 (12/2005)] Summary Interview PubMed
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