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Osteoporoses
Bone solutions
Disease in which the bone substance becomes porous and brittle. It is common in older people, affecting more women than men. It may be treated with calcium supplements and vitamin D3 or sunlight.Very important is vitamin K2. Approximately 1.7 million people worldwide, mostly women, suffer hip fractures, mainly due to osteoporosis. A single gene was discovered in 1993 to have a major influence on bone thinning. Osteoporosis may occur in women whose ovaries have been removed, unless hormone-replacement therapy is instituted; it may also occur in Cushing's syndrome and as a side effect of long-term treatment with corticosteroids. Early menopause in women, childlessness, small body build, lack of exercise, heavy drinking, smoking, and hereditary factors may be contributory factors.
Bone is living tissue, with a turnover time of about 3 months. The process is done by the osteoclasts and osteoblasts. Important is enough collagen type 1 and enough vitamin K2 and D3 plus sufficient amounts of well absorbable calcium.
Risk Factors for Osteoporosis
The following widely accepted risk factors can help identify patients at increased risk for osteoporosis:Female gender
Advancing age
Family history of osteoporosis
Caucasian or Asian descent
Low body mass
Slender body build
Early estrogen deficiency
Smoking
Excessive use of alcohol
Low-calcium diet
Sedentary lifestyle
Products to avoid or reverse osteoporoses: OmegaMatrix, PhytoMatrix, TerreMatrix, VitalityMatrix and SkinPro.
Osteoporoses and Dairy Foods
A large body of scientific evidence collected in recent decades demonstrates that an adequate intake of calcium and other nutrients from dairy foods reduces the risk of osteoporosis by increasing bone acquisition during growth, slowing age-related bone loss, and reducing osteoporotic fractures. These results have culminated in the new (2005) Dietary Guidelines for Americans that now recommend 3 servings of milk products per
day to reduce the risk of low bone mass and contribute important amounts of many nutrients that may have additional health attributes beyond bone health.
A number of animal, observational, and clinical studies have shown that dairy food consumption can help reduce the risk of hypertension. Clinical trials indicate that the consumption of recommended levels of dairy products, as part of a healthy diet, can contribute to lower blood pressure in individuals with normal and elevated blood pressure. Emerging data also indicate that specific peptides associated with casein and whey proteins can significantly lower blood pressure. In addition, a growing body of evidence has provided support for a beneficial effect of dairy foods on body weight and fat loss.
Clinical studies have demonstrated that during caloric restriction, body weight and body fat loss occurs when adequate calcium is provided by supplements and that this effect is further augmented by an equivalent amount of calcium supplied from dairy foods.
Several studies support a role for calcium, vitamin D, and dairy foods against colon cancer. Additionally, conjugated linoleic acid, a fatty acid found naturally in dairy fat and shark liver oil, confers a wide range of anticarcinogenic benefits in experimental animal models and is especially consistent for protection against breast cancer.
Calcium, gamma-linolenic acid and eicosapentaenoic acid supplementation in senile osteoporosis.
Kruger MC, Coetzer H, de Winter R, Gericke G, van Papendorp DH. Aging (Milano). 1998 Oct;10(5):385-94. Department of Physiology, University of Pretoria, South Africa.
Recent animal work suggests that gamma-linolenic acid (GLA) and eicosapentaenoic acid (EPA) enhance calcium absorption, reduce excretion and increase calcium deposition in bone. A pilot study was set up to test the interactions between calcium and GLA + EPA in humans. Sixty-five women (mean age 79.5), taking a background diet low in calcium, were randomly assigned to GLA + EPA or coconut oil placebo capsules; in addition, all received 600 mg/day calcium as the carbonate.
Markers of bone formation/degradation and bone mineral density (BMD) were measured at baseline, 6, 12 and 18 months. Twenty-one patients were continued on treatment for a second period of 18 months, after which BMD (36 months) was measured. At 18 months, osteocalcin and deoxypyridinoline levels fell significantly in both groups, indicating a decrease in bone turnover, whereas bone specific alkaline phosphatase rose indicating beneficial effects of calcium given to all the patients. Lumbar and femoral BMD, in contrast, showed different effects in the two groups.
Over the first 18 months, lumbar spine density remained the same in the treatment group, but decreased 3.2% in the placebo group. Femoral bone density increased 1.3% in the treatment group, but decreased 2.1% in the placebo group. During the second period of 18 months with all patients now on active treatment, lumbar spine density increased 3.1% in patients who remained on active treatment, and 2.3% in patients who switched from placebo to active treatment; femoral BMD in the latter group showed an increase of 4.7%. This pilot controlled study suggests that GLA and EPA have beneficial effects on bone in this group of elderly patients, and that they are safe to administer for prolonged periods of time.
Coffee, tea and caffeine consumption in relation to osteoporotic fracture risk in a cohort of Swedish women.
Hallström H, Wolk A, Glynn A, Michaëlsson K.
Department of Toxicology, National Food Administration, P. O. Box 622, 75126 Uppsala, Sweden. heha@slv.se
INTRODUCTION: Consumption of coffee and tea, and total intake of caffeine has been claimed to be associated with osteoporotic fracture risk. However, results of earlier studies lack consistency.
METHODS: We examined this relation in a cohort of 31,527 Swedish women aged 40-76 years at baseline in 1988. The consumption of coffee, caffeinated tea and the intake of caffeine were estimated from a self-administered food frequency questionnaire (FFQ). Multivariate-adjusted hazards ratios (HRs) of fractures with 95% confidence intervals (95% CIs) were estimated by Cox proportional hazards models.
RESULTS: During a mean follow-up of 10.3 years, we observed 3,279 cases with osteoporotic fractures. The highest (>330 mg/day) compared with the lowest (<200 mg/day) quintile of caffeine intake was associated with a modestly increased risk of fracture: HR 1.20 (95% CI: 1.07-1.35). A high coffee consumption significantly increased the risk of fracture (p for trend 0.002), whereas tea drinking was not associated with risk. The increased risk of fracture with both a high caffeine intake and coffee consumption was confined to women with a low calcium intake (<700 mg/day): HR 1.33 (95% CI: 1.07-1.65) with > or =4 cups (600 ml)/day of coffee compared to <1 cup (150 ml)/day. The same comparison but risk estimated for women with a high propensity for fractures (> or =2 fracture types) revealed a HR of 1.88 (95% CI: 1.17-3.00).
CONCLUSIONS: In conclusion, our results indicate that a daily intake of 330 mg of caffeine, equivalent to 4 cups (600 ml) of coffee, or more may be associated with a modestly increased risk of osteoporotic fractures, especially in women with a low intake of calcium.
Trophic factors in aging. Should older people receive hormonal replacement therapy?
> Villareal DT, Morley JE. Geriatric Research Education and Clinical Center, St Louis Veterans Administration Medical Center, Missouri. Drugs Aging. 1994 Jun;4(6):492-509.
The aging process is associated with significant declines in the levels of many hormones and trophic factors including estrogen, testosterone, growth hormone (somatropin, somatotropin) and insulin-like growth factor-1 (IGF-1, somatomedin-1, somatomedin-C). Since the classic age-related changes resemble the signs and symptoms of endocrine deficiency, it has been hypothesised that some of the negative effects of aging are due to these hormonal deficits.
Consequently, the potential role of hormonal replacement in reversing the deleterious effects of aging deserves investigation. In old hypogonadal men, preliminary studies have shown that testosterone replacement not only improves libido but also significantly increases musculoskeletal mass and strength. However, adverse effects have included increases in haematocrit and prostate specific antigen. Similarly, short term studies with growth hormone replacement have shown substantial bodyweight gain, particularly in severely malnourished older adults, but longer studies have been limited by adverse effects such as gynaecomastia and carpal tunnel syndrome in a few people. Thus, though both testosterone and growth hormone may have potential roles for frailty syndromes in the elderly, long term clinical trials are needed to confirm these positive effects and assess their safety.
On the other hand, the multiple beneficial effects of estrogen replacement in older women such as relieving acute menopausal symptoms and preventing postmenopausal osteoporosis are well recognised. Observational studies also suggest that estrogen may decrease cardiovascular disease. However, the optimum duration of treatment and the best way to administer this hormone are still unknown. Also, estrogen may be less effective in senile osteoporosis which primarily results from age-related bone loss. Traditionally, age-related bone loss has been attributed to impaired vitamin D activation and decreased calcium absorption. Thus, it was thought that such bone losses may be ameliorated by calcium supplementation.
However, recent studies suggest that alterations in local factors affecting bone cell function may also be important in the pathogenesis of osteoporosis. An increase in potent bone resorbing factors, such as the cytokines interleukin-1 and interleukin-6, has been recently demonstrated in elderly patients with osteoporosis. In these patients, it has been suggested that there may also be a decrease in bone growth factors such as IGF-1 and transforming growth factor-beta. Accordingly, studies are underway to determine whether these factors may be useful in the prevention of osteoporosis. Other growth factors recently identified which may be important in aging include epidermal growth factor, nerve growth factor and fibroblast growth factor.
Osteoporoses and Milk