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Nutrients Jul 2020Osteoporosis is a common chronic disease characterized by a decrease in bone mineral density, impaired bone strength, and an increased risk of fragility fractures.... (Review)
Review
Osteoporosis is a common chronic disease characterized by a decrease in bone mineral density, impaired bone strength, and an increased risk of fragility fractures. Fragility fractures are associated with significant morbidity, mortality and disability and are a major public health problem worldwide. The influence of nutritional factors on the development and progression of this disease can be significant and is not yet well established. Calcium intake and vitamin D status are considered to be essential for bone metabolism homeostasis. However, some recent studies have questioned the usefulness of calcium and vitamin D supplements in decreasing the risk of fractures. The adequate intake of protein, vegetables and other nutrients is also of interest, and recommendations have been established by expert consensus and clinical practice guidelines. It is important to understand the influence of nutrients not only in isolation but also in the context of a dietary pattern, which is a complex mixture of nutrients. In this review, we evaluate the available scientific evidence for the effects of the main dietary patterns on bone health. Although some dietary patterns seem to have beneficial effects, more studies are needed to fully elucidate the true influence of diet on bone fragility.
Topics: Bone Density; Bone and Bones; Calcium, Dietary; Chronic Disease; Diet; Diet, Healthy; Dietary Supplements; Humans; Nutritional Status; Osteoporosis; Osteoporotic Fractures; Vitamin D
PubMed: 32635394
DOI: 10.3390/nu12071986 -
Nutrients Dec 2021This article reviews physicochemical aspects of calcium absorption from foods. Notable differences are observed between different food products in relation to calcium... (Review)
Review
This article reviews physicochemical aspects of calcium absorption from foods. Notable differences are observed between different food products in relation to calcium absorption, which range from <10% to >50% of calcium in the foods. These differences can be related to the interactions of calcium with other food components in the food matrix, which are affected by various factors, including fermentation, and how these are affected by the conditions encountered in the gastrointestinal tract. Calcium absorption in the intestine requires calcium to be in an ionized form. The low pH in the stomach is critical for solubilization and ionization of calcium salts present in foods, although calcium oxalate complexes remain insoluble and thus poorly absorbable. In addition, the rate of gastric transit can strongly affect fractional absorption of calcium and a phased release of calcium into the intestine, resulting in higher absorption levels. Dairy products are the main natural sources of dietary calcium in many diets worldwide, which is attributable to their ability to provide high levels of absorbable calcium in a single serving. For calcium from other food products, lower levels of absorbable calcium can limit contributions to bodily calcium requirements.
Topics: Calcium; Calcium, Dietary; Eating; Food; Food Analysis; Gastric Acid; Gastrointestinal Tract; Hydrogen-Ion Concentration; Intestinal Absorption; Ions; Nutritional Physiological Phenomena; Nutritional Requirements; Solubility
PubMed: 35011055
DOI: 10.3390/nu14010180 -
Aging Clinical and Experimental Research Jan 2022Bone mineral mass, geometry and microstructure, hence determinants of fracture risk, result bone accrual during growth and bone loss later in life. Peak bone mass, which... (Review)
Review
Bone mineral mass, geometry and microstructure, hence determinants of fracture risk, result bone accrual during growth and bone loss later in life. Peak bone mass, which is reached by the end of the second decade of life, is mainly determined by genetic factors. Among other factors influencing bone capital, dietary intakes, particularly calcium and protein, play a significant role in peak bone mass attainment. Both nutrients are provided in dairy products, which accounts for 50-60% and 20-30% of the daily calcium and protein intakes, respectively. Children avoiding dairy products are at higher risk of fracture, as are adults or older individuals following a diet devoid of dairy products, like vegans. Various intervention trials have shown some beneficial effects of dairy products on bone capital accumulation during growth and on bone turnover in adults. In observational studies, dairy products intake, particularly the fermented ones, which also provide probiotics in addition to calcium, phosphorus and protein, appear to be associated with a lower risk of hip fracture.
Topics: Bone Density; Bone and Bones; Calcium, Dietary; Dairy Products; Humans; Osteoporosis
PubMed: 34494238
DOI: 10.1007/s40520-021-01970-4 -
Sports Medicine (Auckland, N.Z.) Dec 2019Athletes should pay more attention to their bone health, whether this relates to their longer-term bone health (e.g. risk of osteopenia and osteoporosis) or their... (Review)
Review
Athletes should pay more attention to their bone health, whether this relates to their longer-term bone health (e.g. risk of osteopenia and osteoporosis) or their shorter-term risk of bony injuries. Perhaps the easiest way to do this would be to modify their training loads, although this advice rarely seems popular with coaches and athletes for obvious reasons. As such, other possibilities to support the athletes' bone health need to be explored. Given that bone is a nutritionally modified tissue and diet has a significant influence on bone health across the lifespan, diet and nutritional composition seem like obvious candidates for manipulation. The nutritional requirements to support the skeleton during growth and development and during ageing are unlikely to be notably different between athletes and the general population, although there are some considerations of specific relevance, including energy availability, low carbohydrate availability, protein intake, vitamin D intake and dermal calcium and sodium losses. Energy availability is important for optimising bone health in the athlete, although normative energy balance targets are highly unrealistic for many athletes. The level of energy availability beyond which there is no negative effect for the bone needs to be established. On the balance of the available evidence it would seem unlikely that higher animal protein intakes, in the amounts recommended to athletes, are harmful to bone health, particularly with adequate calcium intake. Dermal calcium losses might be an important consideration for endurance athletes, particularly during long training sessions or events. In these situations, some consideration should be given to pre-exercise calcium feeding. The avoidance of vitamin D deficiency and insufficiency is important for the athlete to protect their bone health. There remains a lack of information relating to the longer-term effects of different dietary and nutritional practices on bone health in athletes, something that needs to be addressed before specific guidance can be provided.
Topics: Bone Density; Bone and Bones; Calcium, Dietary; Dietary Carbohydrates; Dietary Proteins; Energy Intake; Energy Metabolism; Humans; Nutritional Requirements; Sports Nutritional Physiological Phenomena; Vitamin D; Vitamin D Deficiency
PubMed: 31696454
DOI: 10.1007/s40279-019-01161-2 -
International Journal of Molecular... Jun 2021Skin injury is quite common, and the wound healing is a complex process involving many types of cells, the extracellular matrix, and soluble mediators. Cell... (Review)
Review
Skin injury is quite common, and the wound healing is a complex process involving many types of cells, the extracellular matrix, and soluble mediators. Cell differentiation, migration, and proliferation are essential in restoring the integrity of the injured tissue. Despite the advances in science and technology, we have yet to find the ideal dressing that can support the healing of cutaneous wounds effectively, particularly for difficult-to-heal chronic wounds such as diabetic foot ulcers, bed sores, and venous ulcers. Hence, there is a need to identify and incorporate new ideas and methods to design a more effective dressing that not only can expedite wound healing but also can reduce scarring. Calcium has been identified to influence the wound healing process. This review explores the functions and roles of calcium in skin regeneration and reconstruction during would healing. Furthermore, this review also investigates the possibility of incorporating calcium into scaffolds and examines how it modulates cutaneous wound healing. In summary, the preliminary findings are promising. However, some challenges remain to be addressed before calcium can be used for cutaneous wound healing in clinical settings.
Topics: Animals; Bandages; Calcium; Calcium, Dietary; Fibroblasts; Humans; Keratinocytes; Nanoparticles; Neovascularization, Physiologic; Regeneration; Skin; Theranostic Nanomedicine; Tissue Engineering; Tissue Scaffolds; Wound Healing
PubMed: 34204292
DOI: 10.3390/ijms22126486 -
Nutrients Aug 2022Vitamin D is a critical regulator of calcium and bone homeostasis. While vitamin D has multiple effects on bone and calcium metabolism, the regulation of intestinal... (Review)
Review
Vitamin D is a critical regulator of calcium and bone homeostasis. While vitamin D has multiple effects on bone and calcium metabolism, the regulation of intestinal calcium (Ca) absorption efficiency is a critical function for vitamin D. This is necessary for optimal bone mineralization during growth, the protection of bone in adults, and the prevention of osteoporosis. Intestinal Ca absorption is regulated by 1,25 dihydroxyvitamin D (1,25(OH) D), a hormone that activates gene transcription following binding to the intestinal vitamin D receptor (VDR). When dietary Ca intake is low, Ca absorption follows a vitamin-D-regulated, saturable pathway, but when dietary Ca intake is high, Ca absorption is predominately through a paracellular diffusion pathway. Deletion of genes that mediate vitamin D action (i.e., VDR) or production (CYP27B1) eliminates basal Ca absorption and prevents the adaptation of mice to low-Ca diets. Various physiologic or disease states modify vitamin-D-regulated intestinal absorption of Ca (enhanced during late pregnancy, reduced due to menopause and aging).
Topics: Animals; Calcium; Calcium, Dietary; Female; Intestinal Absorption; Mice; Pregnancy; Receptors, Calcitriol; Vitamin D; Vitamins
PubMed: 36014856
DOI: 10.3390/nu14163351 -
Annals of the New York Academy of... Jun 2022Dietary calcium deficiency is considered to be widespread globally, with published estimates suggesting that approximately half of the world's population has inadequate...
Dietary calcium deficiency is considered to be widespread globally, with published estimates suggesting that approximately half of the world's population has inadequate access to dietary calcium. Calcium is essential for bone health, but inadequate intakes have also been linked to other health outcomes, including pregnancy complications, cancers, and cardiovascular disease. Populations in low- and middle-income countries (LMICs) are at greatest risk of low calcium intakes, although many individuals in high-income countries (HICs) also do not meet recommendations. Paradoxically, many LMICs with lower calcium intakes show lower rates of osteoporotic fracture as compared with HICs, though data are sparse. Calcium intake recommendations vary across agencies and may need to be customized based on other dietary factors, health-related behaviors, or the risk of calcium-related health outcomes. The lack of standard methods to assess the calcium status of an individual or population has challenged efforts to estimate the prevalence of calcium deficiency and the global burden of related adverse health consequences. This paper aims to consolidate available evidence related to the global prevalence of inadequate calcium intakes and associated health outcomes, with the goal of providing a foundation for developing policies and population-level interventions to safely improve calcium intake and status where necessary.
Topics: Calcium; Calcium, Dietary; Female; Humans; Malnutrition; Outcome Assessment, Health Care; Pregnancy; Prevalence
PubMed: 35247225
DOI: 10.1111/nyas.14758 -
Archivos Espanoles de Urologia Jan 2021Nutrition is tightly associated with the risk of stone events. A part from genetic predisposition, a correct and balanced diet might prevent incident kidney stones....
Nutrition is tightly associated with the risk of stone events. A part from genetic predisposition, a correct and balanced diet might prevent incident kidney stones. Several studies analyzed each dietary component and different diets to better understand their impact on stone recurrence. Fluids: High fluids intake is the most important factor for preventing kidney stones disease and for every 200 mL of water, the risk of stones is reduced by 13%. Soft drinks seems to be associated to a greater risk of stone events, whereas caffeine and citrus fruits juice are not. Calcium: Normally calcium intake with diet does not exceed 1.2 g/day. A balanced consumption of dairy products is capable of reducing oxalate intestinal absorption and urinary excretion compared to low calcium diet, being protective for stone disease. Oxalate: The exact amount of oxalate contained in different foods is difficult to estimate for its variability, even in the same aliment. In addition, the amount of oxalate consumed was shown to be only a minor risk factor for stone disease, whereas its intestinal absorption is strongly influenced by external factors, such as calcium intake. Dietary oxalate restriction is advisable only in patients with known elevated consumption. Sodium: High sodium intake is both associated with hypertension, heart disease and stone risk. Increased sodium consumption is directly associated to hypercalciuria in both calcium stone formers and healthy subjects. Although dietary sodium restriction to recommended values is always desirable in stone formers, it is difficult to achieve for its broad use in food preparation. Proteins: Animal proteins are associated to increased risk for stone formation, whereas vegetable and dairy proteins are not. Increased meat intake was associated to acidic urine pH, negative calcium balance and reduced anti-lithogenic urinary solutes excretion.Fruits and vegetables: Alkalizing foods are one of the most important factors for stone protection. Their consumption increases anti-lithogenic solutes as citrate, potassium and magnesium. A diet rich in fruits and vegetables is strongly recommended for stone formers. Uric acid: Elevated meat consumption is either associated to increased purine metabolism and acid load, favoring uric acid nephrolithiasis by reducing urine pH and increasing urinary excretion of uric acid, especially in patients affected by metabolic syndrome and diabetes.In conclusion, the most effective diet for stone protection is rich in fruits and vegetables, low in animal proteins and salt, with balanced dairy product consumption and obviously, with elevated fluid intake. These characteristics make vegetarian and Mediterranean diets protective and useful for stone formers, whereas western diet is at risk for stone formation.
Topics: Calcium; Calcium, Dietary; Dietetics; Humans; Kidney Calculi; Life Style; Sodium, Dietary
PubMed: 33459627
DOI: No ID Found -
Journal of Bone and Mineral Research :... Dec 2022This clinical practice guideline addresses the prevention, diagnosis, and management of hypoparathyroidism (HypoPT) and provides evidence-based recommendations. The...
This clinical practice guideline addresses the prevention, diagnosis, and management of hypoparathyroidism (HypoPT) and provides evidence-based recommendations. The HypoPT task forces included four teams with a total of 50 international experts including representatives from the sponsoring societies. A methodologist (GG) and his team supported the taskforces and conducted the systematic reviews. A formal process following the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) methodology and the systematic reviews provided the structure for seven of the guideline recommendations. The task force used a less structured approach based on narrative reviews for 20 non-GRADEd recommendations. Clinicians may consider postsurgical HypoPT permanent if it persists for >12 months after surgery. To predict which patients will not develop permanent postsurgical HypoPT, we recommend evaluating serum PTH within 12 to 24 hours post total thyroidectomy (strong recommendation, moderate quality evidence). PTH > 10 pg/mL (1.05 pmol/L) virtually excludes long-term HypoPT. In individuals with nonsurgical HypoPT, genetic testing may be helpful in the presence of a positive family history of nonsurgical HypoPT, in the presence of syndromic features, or in individuals younger than 40 years. HypoPT can be associated with complications, including nephrocalcinosis, nephrolithiasis, renal insufficiency, cataracts, seizures, cardiac arrhythmias, ischemic heart disease, depression, and an increased risk of infection. Minimizing complications of HypoPT requires careful evaluation and close monitoring of laboratory indices. In patients with chronic HypoPT, the panel suggests conventional therapy with calcium and active vitamin D metabolites as first-line therapy (weak recommendation, low-quality evidence). When conventional therapy is deemed unsatisfactory, the panel considers the use of PTH. © 2022 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research (ASBMR).
Topics: Humans; Hypoparathyroidism; Bone and Bones; Nephrocalcinosis; Calcium, Dietary
PubMed: 36054621
DOI: 10.1002/jbmr.4691 -
Nutrients Apr 2021Osteoporosis affects women twice as often as men. Additionally, it is estimated that 0.3 million and 1.7 million people have hip fractures in the USA and Europe,... (Review)
Review
Osteoporosis affects women twice as often as men. Additionally, it is estimated that 0.3 million and 1.7 million people have hip fractures in the USA and Europe, respectively. Having a proper peak bone mass and keeping it as long as possible is especially important for osteoporosis prevention. One of the most important calcium sources is milk and dairy products. Breast milk is the best infant food, but milk should not be avoided later in life to prevent losing bone mass. On the other hand, more and more people limit their milk consumption and consume other dairy or non-dairy products. For example, they are usually replaced with plant beverages, which should be consumed carefully in several age groups. Additionally, an important element of milk and dairy products, as well as plant beverages, are probiotics and prebiotics, which may modulate bone turnover. Dietary recommendations focused on milk, and dairy products are an important element for the prevention of osteoporosis.
Topics: Animals; Bone Density; Bone Remodeling; Calcium, Dietary; Dairy Products; Diet; Female; Humans; Male; Milk; Osteoporosis; Recommended Dietary Allowances
PubMed: 33920532
DOI: 10.3390/nu13041329