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|Br J Biomed Sci 1994 Sep;51(3):228-40
The role of nutrition in osteoporosis.
School of Pharmacy and Biomedical Sciences, University of Portsmouth,
Osteoporosis-related bone fractures are a significant cause of mortality and
morbidity, with women being particularly affected. Osteoporosis is a
condition of bone fragility resulting from micro-architectural deterioration
and decreased bone mass; adult bone mass depends upon the peak attained and
the rate of subsequent loss; each depends on the interaction of genetic,
hormonal, environmental and nutritional factors. An adequate supply of
calcium is essential to attain maximum bone mass, and adult intakes below
about 500 mg/day may predispose to low bone mass. Supplementation with
calcium may conserve bone at some skeletal sites, but whether this
translates into reduced fracture rates is not clear. Chronically low intakes
of vitamin D--and possibly magnesium, boron, fluoride and vitamins K, B12,
B6 and folic acid (particularly if co-existing)--may pre-dispose to
osteoporosis. Similarly, chronically high intakes of protein, sodium
chloride, alcohol and caffeine may also adversely affect bone health. The
typical Western diet (high in protein, salt and refined, processed foods)
combined with an increasing sedentary lifestyle may contribute to the
increasing incidence of osteoporosis in the elderly.
Drinking tea is associated with a higher bone mineral density in women
even though high caffeine consumption is associated with osteoporosis.
I believe the reason is the high levels of gallium compounds found in
tea. Gallium is an extremely potent promoter of bone growth--see the
gallium file for additional information.
|Am J Clin Nutr 2000 Apr;71(4):1003-7
Tea drinking and bone mineral density in older women.
Hegarty VM, May HM, Khaw KT
Clinical Gerontology Unit, University of Cambridge School of Medicine,
Addenbrooke's Hospital, Cambridge, United Kingdom.
BACKGROUND: High caffeine intake is reportedly a risk factor for reduced
bone mineral density (BMD) in women. Most studies, however, are from
populations in which coffee drinking predominates and is the major caffeine
source. Tea contains caffeine but also has other nutrients, such as
flavonoids, that may influence bone mass in different ways. OBJECTIVE: We
examined the relation between tea drinking and BMD in older women in
Britain, where tea drinking is common. METHODS: We measured BMD at the
lumbar spine, femoral neck, greater trochanter, and Ward's triangle in 1256
free-living women aged 65-76 y in Cambridge, United Kingdom. Tea drinking
was assessed by self-completed questionnaire and women were categorized as
tea drinkers or non-tea drinkers. RESULTS: There were 1134 tea drinkers
(90.3%) and 122 non-tea drinkers (9.7%). Compared with non-tea drinkers, tea
drinkers had significantly greater ( approximately 5%) mean BMD
measurements, adjusted for age and body mass index, at the lumbar spine
(0.033 g/cm(2); P = 0.03), greater trochanter (0.028 g/cm(2); P = 0.004),
and Ward's triangle (0.025 g/cm(2); P = 0.02). Differences at the femoral
neck (0.013 g/cm(2)) were not significant. These findings were independent
of smoking status, use of hormone replacement therapy, coffee drinking, and
whether milk was added to tea. CONCLUSIONS: Older women who drank tea had
higher BMD measurements than did those who did not drink tea. Nutrients
found in tea, such as flavonoids, may influence BMD. Tea drinking may
protect against osteoporosis in older women.
PMID: 10731510, UI: 20197843
|Ther Umsch 2000 Mar;57(3):152-60
[Article in German]
Morselli B, Neuenschwander B, Perrelet R, Lippuner K
Bone requires a wide variety of nutrients to develop normally and to
maintain itself after growth. Most important--in the sense that bony
abnormalities are associated with their deficiencies--are protein, calcium,
phosphorus, vitamin D, C and K, zinc, manganese and copper. The nutrients
most likely to be deficient in citizens of industrialized countries are
calcium and vitamin D. In this review of the current literature about
nutritional aspects of osteoporosis, we have focused on factors influencing
calcium requirement: the principal interacting nutrients are sodium,
protein, caffeine, fiber, oxalate, phytate, and the acid/alkaline ash
character of the overall diet. Fiber and caffeine decrease calcium
absorption from the gut and typically exert relatively minor effects, while
sodium, protein and the acid/alkaline balance of the diet increase urinary
excretion of calcium and are of much greater significance for the calcium
homeostasis. Alkali buffers, whether vegetables or fruits reverse this
urinary calcium loss. As long as accompanied by adequate calcium intake,
protein-rich diet is not deleterious to bone: a calcium-to-protein ratio of
20:1 (mg calcium/g protein) is recommended. Whether a nutrition-based
therapeutic approach to osteoporosis is feasible in the near future is yet
unclear: at least there are some recent promising data from in-vitro as well
as from rat studies showing that extracts taken from various vegetables,
mainly from the onion family inhibit bone resorption in a dose-dependent
The following study shows that cadmium interferes with calcium metabolism
and may therefore be a contributor to osteoporosis. This is very likely
the mechanism by which smokers, especially female smokers (from estrogen
acceleration of cadmium uptake) develop osteoporosis.
|Biomed Environ Sci 2000 Mar;13(1):19-25
Changes in tissue metals after cadmium intoxication and
intervention with chlorpromazine in male rats.
Yang XF, Wang SY, Zhao RC, Ao SQ, Xu LC, Wang XR
Institute of Applied Toxicology, Nanjing Medical University, China. email@example.com
[Medline record in process]
Cadmium (Cd), one of the most dangerous heavy metals, has a very similar
ionic radius to calcium (Ca). The interference of cadmium in calcium
homeostasis may play an important role in cadmium toxicity. Recent reports
indicate that calmodulin (CaM) inhibitors such as trifluoperazine and
chlorpromazine (CPZ) could protect rodents against cadmium toxicity. It was
also reported that pretreatment of mice with zinc (Zn) could reduce the
adverse effects induced by cadmium. The aim of this study is to determine
whether Cd changes the balance of other essential metals such as Zn and
copper (Cu) in rat tissues, and whether CPZ can reverse these changes which
are induced by cadmium intoxication. Adult male Sprague-Dawley (SD) rats
were injected intraperitoneally (i.p.) with cadmium chloride (CdCl2) (0.2,
0.4, 0.8 mg Cd/kg body weight) alone and 0.4 mg Cd/kg in association with
CPZ (5 mg/kg) daily for a week. The control animals were injected with
normal saline only. The results showed that the cadmium content in the
liver, kidney and testis increased significantly with a dose-response
relationship. Cadmium treatment markedly increased the Zn and Ca content in
some of the tissues. Hepatic and renal metallothionein (MT) increased
significantly after cadmium intoxication. CPZ treatment, however, reduced
cadmium content in liver, but not blood and kidney. CPZ seemed to decrease
the content of MT in liver and significantly increase the amounts of MT in
kidney. These data suggest that the intervention of cadmium with tissue
essential metals may play a role in cadmium toxicity in rats, and calmodulin
inhibitors to some extent can reduce the adverse effect of cadmium by
decreasing the cadmium load in tissues and reversing the unbalance of
- The following study shows that vanadium supplementation can increase
bone mineral levels and that there is an interaction between vanadium and
vitamin C in cholesterol metabolism.
|Magnes Trace Elem 1991-92;10(5-6):327-38
Vanadium and ascorbate effects on
3-hydroxy-3-methylglutaryl coenzyme A reductase, cholesterol and tissue
minerals in guinea pigs fed low-chromium diets.
Seaborn CD, Mitchell ED, Stoecker BJ
Department of Nutritional Sciences, Oklahoma State University, Stillwater.
Vanadium has been reported to affect numerous physiological processes;
however, a demonstration that vanadium deficiency consistently impairs
biological function is lacking. The purpose of this study was to determine
if the activity of hepatic 3-hydroxy-3-methylglutaryl coenzyme A (HMG CoA)
reductase, the rate-limiting enzyme in cholesterol synthesis, is affected by
dietary supplementation of vanadate and/or chronic ascorbic acid deficiency.
To determine if vanadium and/or ascorbic acid affected mineral metabolism,
tissue minerals also were analyzed. Weanling male guinea pigs were assigned
randomly to groups of 10 in a 2 x 2 factorial design. The dietary variables
were ascorbate, 0.5 or 10 mg/day, and vanadium < 0.01 microgram or 0.5
microgram/g diet as NH4VO3 in a low Cr diet containing < 0.07 microgram
Cr/g diet. After 21 weeks on this diet, guinea pigs receiving more ascorbate
had lower liver weight/body weight ratios and increased bone copper. Testes
weight/body weight ratios, hepatic glycogen and bone copper decreased while
hepatic lipids, fecal bile acids, plasma cortisol and bone calcium and
magnesium were increased by vanadium supplementation. An interaction between
vanadium and ascorbate affected cholesterol excretion in feces, hepatic
iron, plasma cholesterol concentration and the activity of HMG CoA reductase.
This study provides evidence of increased bone mineral concentrations
with vanadium supplementation and of an interaction between vanadium and
ascorbate which affected cholesterol metabolism.
Girl Bone Breaks Linked To Cola
|June 15, 2000
CHICAGO (AP) - Teen-age girls who drink soda - particularly cola - are
far more likely to break a bone, a Harvard study found.
Grace Wyshak, an associate professor at the Harvard School of Public
Health and Harvard Medical School, speculated that girls drinking soda
aren't getting enough milk, which contains calcium that strengthens bones.
But she also suggested that a chemical in colas - phosphoric acid - may
actually weaken bones.
The study, published in this month's Archives of Pediatrics &
Adolescent Medicine, was based on questionnaires filled out by 460 ninth-
and 10th-grade girls in a Boston-area high school.
The risk of broken bones was three times greater for girls who drank
carbonated beverages in general and five times greater for active girls
who drank colas. The study did not specify how much soda the girls drank.
Five of the 57 active girls who didn't drink colas suffered fractures,
compared with 38 of the 107 active girls who reported drinking colas.
A spokesman for the National Soft Drink Association, Sean McBride,
said: "We strongly question the results of the journal article."
He said there is no scientific evidence that anything in colas causes
The study comes amid growing concern among experts, who say Americans
are not getting nearly as much calcium as they need, in part because they
are drinking soft drinks instead of milk.
"This should be a wake-up call for parents and health care
professionals alike," said Bonnie Liebman, director of nutrition at
the Center For Science in the Public Interest, a consumer advocacy group.
In an accompanying editorial, Dr. Neville H. Golden, director of the
Eating Disorders Center in the Division of Adolescent Medicine at
Schneider Children's Hospital in New Hyde Park, N.Y., said the study
suggests that "osteoporosis is a pediatric disease as opposed to a
disease of older people and that we can have some impact on it
In a previous study, Wyshak found increased bone fractures among adult
women who drank carbonated beverages.
Stronger Bones, More Breast Cancer?
|June 19, 2001
By Lisa Ellis
Elderly women with strong bones are less likely to break them,
but it appears they may face a different risk — breast cancer.
InteliHealth News Service
A study published in the June 20, 2001, issue of the Journal
of the National Cancer Institute adds to a volume of evidence
that postmenopausal women with low bone-mineral density — the
"brittle bones" disease called osteoporosis — are
less likely to get breast cancer, but women with healthy bones
may be at least twice as likely to do so.
The research points to one of the paradoxes of women's health
care — that risk factors for some diseases may be protective
against others. Moderate alcohol consumption, for instance, can
provide some protection against heart disease in women after
menopause, but it simultaneously may increase their
What does the research on bone-mineral density mean for women
trying to protect their health?
"It's not clear what the real implication of this is for
most patients," says Harold Burstein, M.D., Ph.D., an
instructor in medicine at Harvard Medical School and a
breast-cancer researcher at Dana-Farber Cancer Institute.
He says the increased risk is relatively small. "Most
older women do not get breast cancer," he notes.
"While the data show an association between bone mineral
density and breast cancer risk, it is by no means clear that
changing bone mineral density — up or down — changes that
Indeed, the study's authors caution that the association
between bone density and breast cancer does not mean that strong
bones cause cancer or that women should stop trying to maintain
bone mass through taking calcium or medications.
Rather, the cancer and the bone-mineral density both are
likely to be related to a long-term, complex relationship among
hormones and certain other body chemicals, the authors say.
Many researchers believe the chief cause may be "a
shared risk factor, lifetime exposure to estrogen," Dr.
Burstein says. Osteoporosis, a thinning of the bones that can
lead to fractures, tends to develop after menopause, when
women's estrogen production drops. Breast-cancer risk is higher
among women who have greater lifetime exposure to estrogen,
including early menstruation and late menopause.
Some women take estrogen supplements after menopause to ease
the symptoms of this life change or to help protect against
osteoporosis. But there are many other means of preventing or
treating osteoporosis that do not involve estrogen, Dr. Burstein
Calcium and Vitamin D supplements, weight-bearing exercise
and quitting smoking all reduce the risk of osteoporosis, and
certain medications can help to slow the rate of bone loss, he
The study published in the Journal of the National Cancer
Institute enrolled more than 8,900 women, ages 65 and older, who
were examined at medical centers in Pittsburgh, Minneapolis,
Baltimore and Portland, Ore., between 1986 and 1988. During an
average of 6.5 years of follow-up, 315 women developed breast
Those who had the highest bone-mineral density, a measure of
bone mass or thickness, at all three sites measured — the
wrist, arm and heel — were 2.7 times more likely to develop
breast cancer than those who had the lowest bone-mineral density
at all sites.
What is more, the women with the highest bone-mineral density
were even more likely to get advanced cancer — 5.6 times more
likely than the women with the most brittle bones.
The relationship between bone-mineral density and
breast-cancer risk is well established at this point, Dr.
"The novel finding (in the new study) is that women who
have higher bone mass seem to have a more advanced tumor stage,
so it seems to increase your risk of having a slightly more
advanced breast cancer," Dr. Burstein says.
But he noted that only 74 of the 315 women who developed
cancer had these more advanced tumors. He says larger studies
would be needed to prove that women with stronger bones have
higher risk not only for breast cancer, but also for more
invasive forms of the cancer.
The multi-center study, which used data from the long-term
Study of Osteoporotic Fractures, reinforces similar results from
a shorter-term study involving the same group of participants
and a much smaller study of about 1,300 women in Framingham,
Mass. Other studies have found that women who have bone
fractures are less likely to get breast cancer.
Researchers in the current study found that the association
between high bone density and breast cancer persisted even when
they allowed for certain factors that are associated with a
greater chance of breast cancer — obesity, use of estrogen
supplements, and record of fewer screening mammograms.