scholarly journals Nutritional Support and Physical Modalities for People with Osteoporosis: Current Opinion

Nutrients ◽  
2019 ◽  
Vol 11 (12) ◽  
pp. 2848 ◽  
Author(s):  
Li-Ru Chen ◽  
Peng-Hsuan Hou ◽  
Kuo-Hu Chen
Keyword(s):  
Bone Mass ◽  
Nutritional Support ◽  
Bone Mineralization ◽  
Weight Bearing ◽  
Effective Prevention ◽  
Gradual Loss ◽  
Modifiable Factors ◽  
Hormonal Milieu ◽  
Pharmacologic Agents ◽  
Physical Modalities

Osteoporosis is a vital healthcare issue among elderly people. During the aging process, a gradual loss of bone mass results in osteopenia and osteoporosis. Heritable factors account for 60–80% of optimal bone mineralization, whereas modifiable factors such as nutrition, weight-bearing exercise, body mass, and hormonal milieu affect the development of osteopenia and osteoporosis in adulthood. Osteoporosis substantially increases the risk of skeletal fractures and further morbidity and mortality. The effective prevention of fractures by reducing the loss of bone mass is the primary goal for physicians treating people with osteoporosis. Other than pharmacologic agents, lifestyle adjustment, nutritional support, fall prevention strategies, exercise, and physical modalities can be used to treat osteoporosis or prevent further osteoporotic fracture. Each of these factors, alone or in combination, can be of benefit to people with osteoporosis and should be implemented following a detailed discussion with patients. This review comprises a systematic survey of the current literature on osteoporosis and its nonpharmacologic and nonsurgical treatment. It provides clinicians and healthcare workers with evidence-based information on the assessment and management of osteoporosis. However, numerous issues regarding osteoporosis and its treatment remain unexplored and warrant future investigation.

scholarly journals Medical Treatment for Osteoporosis: From Molecular to Clinical Opinions

2019 ◽  
Vol 20 (9) ◽  
pp. 2213 ◽  
Author(s):  
Li-Ru Chen ◽  
Nai-Yu Ko ◽  
Kuo-Hu Chen
Keyword(s):  
Estrogen Receptor ◽  
Medical Treatment ◽  
Bone Mineralization ◽  
Weight Bearing ◽  
Receptor Complexes ◽  
Estrogen Receptor Modulators ◽  
Gradual Loss ◽  
Modifiable Factors ◽  
New Treatments ◽  
Hormonal Milieu

Osteoporosis is a major concern all over the world. With aging, a gradual loss of bone mass results in osteopenia and osteoporosis. Heritable factors account for 60–80% of optimal bone mineralization. Modifiable factors, such as weight-bearing exercise, nutrition, body mass, and hormonal milieu, play an important role in the development of osteopenia and osteoporosis in adulthood. Currently, anti-resorptive agents, including estrogen, bisphosphonates, and selective estrogen receptor modulators (SERMs), are the drugs of choice for osteoporosis. Other treatments include parathyroid hormone (PTH) as well as the nutritional support of calcium and vitamin D. New treatments such as tissue-selective estrogen receptor complexes (TSECs) are currently in use too. This review, which is based on a systematic appraisal of the current literature, provides current molecular and genetic opinions on osteoporosis and its medical treatment. It offers evidence-based information to help researchers and clinicians with osteoporosis assessment. However, many issues regarding osteoporosis and its treatment remain unknown or controversial and warrant future investigation.

Protein Intake and Bone Growth

2001 ◽  
Vol 26 (S1) ◽  
pp. S153-S166 ◽  
Author(s):  
Jean-Philippe Bonjour ◽  
Patrick Ammann ◽  
Thierry Chevalley ◽  
René Rizzoli
Keyword(s):  
Bone Mass ◽  
Protein Intake ◽  
Bone Growth ◽  
Bone Mineralization ◽  
Weight Bearing ◽  
Positive Association ◽  
Healthy Children ◽  
Low Protein ◽  
Bone Response ◽  
Igf I

Among osteotrophic nutrients, proteins play an important role in bone development, thereby influencing peak bone mass. Consequently, protein malnutrition during development can increase the risk of osteoporosis and of fragility fracture later in life. Both animal and human studies indicate that low protein intake can be detrimental for both the acquisition of bone mass during growth and its conservation during adulthood. Low protein intake impairs both the production and action of IGF-I (Insulin-like growthfactor-I). IGF-I is an essential factorf or bone longitudinal growth, as it stimulates proliferation and difef rentiation of chondrocytes in the epiphyseal plate, and also for bone formation. It can be considered as a key factor in the adjustments of calcium-phosphate metabolism required for normal skeletal development and bone mineralization during growth. In healthy children and adolescents, a positive association between the amount of ingested proteins and bone mass gain was observed in both sexes at the level of the lumbar spine, the proximal femur and the midfemoral shaft. This association appears to be particularly significant in prepubertal children. This suggests that, like for the bone response to either the intake of calcium or weight-bearing exercise, the skeleton would be particularly responsive to the protein intake during the years preceding the onset of pubertal maturation.

Aging and the Osteogenic Response to Mechanical Loading

2001 ◽  
Vol 11 (s1) ◽  
pp. S137-S142 ◽  
Author(s):  
Wendy M. Kohrt
Keyword(s):  
Growth Factors ◽  
Bone Mass ◽  
Mechanical Loading ◽  
Bone Cells ◽  
Weight Bearing ◽  
Bone Modeling ◽  
Mineral Density ◽  
Increase Bone Mass ◽  
Age Related ◽  
Osteogenic Response

The osteogenic response to mechanical stress is blunted with aging. It has been postulated that this decline in responsiveness is related to (a) a limited ability to engender the strain necessary to reach the bone modeling threshold, due to decreased muscle mass and strength, and/or (b) a decline in certain hormones or growth factors that may interact with mechanical signals to change the sensitivity of bone cells to strain. There is reason to believe that both of these factors contribute to the reduced ability to increase bone mass through exercise with advancing age. Weight-bearing endurance exercise and resistance exercise have both been found to increase bone mass in older women and men. However, exercise training studies involving older individuals have generally resulted in increased bone mineral density only when the exercise is quite vigorous. There is also evidence that the osteogenic response to mechanical loading is enhanced by estrogens. Whether age-related changes in other factors (e.g., other hormones, growth factors, cytokines) also contribute to the reduced responsiveness of the aged skeleton to mechanical loading remains to be investigated.

The Effect of Hormonal Oral Contraception on Acquisition of Peak Bone Mineral Density of Adolescents and Young Women

2012 ◽  
Vol 25 (3) ◽  
pp. 331-340 ◽  
Author(s):  
Susan Ziglar ◽  
Tracy S. Hunter
Keyword(s):  
Bone Mineral Density ◽  
Bone Mass ◽  
Bone Mineral ◽  
Young Women ◽  
Bone Mineralization ◽  
Critical Time ◽  
Health Concern ◽  
Mineral Density ◽  
Peak Bone Mineral Density ◽  
Bone Mass Accrual

Maximizing bone mass in youth is touted as the best strategy to offset the natural losses of aging and the menopausal transition. Not achieving maximum peak bone mineral density (BMD) is an independent risk factor for osteoporosis and thus a public health concern. Adolescence is a critical time of bone mineralization mediated by endogenous estradiol. Research has shown that the highest velocity of bone mass accrual occurs 1 year before menarche and after the first 3 years. Low-peak attainment of BMD in young women is associated with contributing factors such as diets low in calcium, eating disorders, lack of exercise, smoking, and low estrogen states. Oral contraceptives (OCs) suppress endogenous estradiol production by suppressing the hypothalamic–pituitary–ovarian axis. Thus, OCs, by replacing endogenous estradiol with ethinyl estradiol (EE), establish and maintain new hormone levels. The early initiation and the use of very low dose of EE raises the possibility that bone mass accrual at a critical time of bone mineralization in young women or adolescents may be jeopardized. This review examines the studies of BMD in adolescents and young women that use combination hormonal contraception. Some studies had inherent limitations, such as small trial, poor control of confounders, failure to exclude women with prior use of hormonal contraceptives, or prior pregnancy from control groups. The vast majority of reviewed studies showed OCs containing 20 to 30 µg of EE interfere with acquisition of peak BMD. Limited numbers of studies examine the effects of OCs containing 35 µg on adolescents and young adults. Additionally, studies are needed evaluating the progestin component of OCs as their differing androgenic properties may affect bone mineralization as well.

Enteral nutrition for pediatric Crohn’s disease: significance and basic principles

2021 ◽  
Vol 19 (3) ◽  
pp. 70-82
Author(s):  
T.E.Borovik T.E.Borovik ◽  
◽  
A.S.Potapov A.S.Potapov ◽  
E.A.Roslavtseva E.A.Roslavtseva ◽  
A.I.Khavkin A.I.Khavkin ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Enteral Nutrition ◽  
Nutritional Support ◽  
Intestinal Inflammation ◽  
Bone Mineralization ◽  
Standard Diet ◽  
Newly Diagnosed ◽  
Basic Principles ◽  
Inflammatory Bowel

The characteristics of the diet traditionally recommended for Crohn’s disease often reduce patients’ consumption of essential nutrients. Therefore, an important role belongs to nutritional support with specialized formulas, the effectiveness of which has been proven both for inducing remission and optimizing the parameters of physical development and puberty, bone mineralization. Nutritional support should be provided for patients with newly diagnosed Crohn’s disease in the form of full enteral nutrition, and subsequently in remission, exacerbation, in the pre- and postoperative periods as an addition to the standard diet. Of particular interest is the CDED ModuLife program, which is based on a combination of enteral nutrition with specially selected foods aimed at reducing the activity of intestinal inflammation in Crohn’s disease. Key words: inflammatory bowel disease, Crohn’s disease, full enteral nutrition, partial enteral nutrition, enteral nutrition formulas

scholarly journals EXERCISE AND PEAK BONE MASS: RECOMMENDATION FOR BUILDING HEALTHY BONES IN CHILDREN

2016 ◽  
Vol 1 (2) ◽  
pp. 137
Author(s):  
A Andi Kurniawan
Keyword(s):  
Physical Activity ◽  
Bone Mass ◽  
Bone Health ◽  
Weight Status ◽  
Bone Development ◽  
Weight Bearing ◽  
Well Being ◽  
Vital Role ◽  
High Impact ◽  
Childhood And Adolescence

Regular Physical activity (PA) and exercise plays a vital role in the health and well-being of people of all ages, and its associated with positive outcomes relating to weight status, cardiometabolic markers, chronic disease prevention, bone health and mental health. Genetic factors are the strongest determinants of bone mass, but PA and exercise with loading of the bone also has a major impact on bone mass as well as on bone strength. Physical activity has been proposed as a key factor for developing healthy bones in childhood and adolescence, mainly when high-impact and weight-bearing exercise above a certain intensity and duration. It has been associated with bone accretion showing an important osteogenic effect, mainly when high-impact and weight bearing physical activity occur. Muscle mass is also a determinant of bone development. Several studies have examined the association between PA and bone health among youths.

scholarly journals The Effectiveness of Physical Exercise on Bone Density in Osteoporotic Patients

2018 ◽  
Vol 2018 ◽  
pp. 1-10 ◽  
Author(s):  
Maria Grazia Benedetti ◽  
Giulia Furlini ◽  
Alessandro Zati ◽  
Giulia Letizia Mauro
Keyword(s):  
Bone Density ◽  
Physical Exercise ◽  
Bone Mass ◽  
Weight Bearing ◽  
Reaction Force ◽  
Whole Body Vibration ◽  
Whole Body ◽  
Body Vibration ◽  
Body Regions ◽  
Resistance Exercises

Physical exercise is considered an effective means to stimulate bone osteogenesis in osteoporotic patients. The authors reviewed the current literature to define the most appropriate features of exercise for increasing bone density in osteoporotic patients. Two types emerged: (1) weight-bearing aerobic exercises, i.e., walking, stair climbing, jogging, and Tai Chi. Walking alone did not appear to improve bone mass; however it is able to limit its progressive loss. In fact, in order for the weight-bearing exercises to be effective, they must reach the mechanical intensity useful to determine an important ground reaction force. (2) Strength and resistance exercises: these are carried out with loading (lifting weights) or without (swimming, cycling). For this type of exercise to be effective a joint reaction force superior to common daily activity with sensitive muscle strengthening must be determined. These exercises appear extremely site-specific, able to increase muscle mass and BMD only in the stimulated body regions. Other suggested protocols are multicomponent exercises and whole body vibration. Multicomponent exercises consist of a combination of different methods (aerobics, strengthening, progressive resistance, balancing, and dancing) aimed at increasing or preserving bone mass. These exercises seem particularly indicated in deteriorating elderly patients, often not able to perform exercises of pure reinforcement. However, for these protocols to be effective they must always contain a proportion of strengthening and resistance exercises. Given the variability of the protocols and outcome measures, the results of these methods are difficult to quantify. Training with whole body vibration (WBV): these exercises are performed with dedicated devices, and while it seems they have effect on enhancing muscle strength, controversial findings on improvement of BMD were reported. WBV seems to provide good results, especially in improving balance and reducing the risk of falling; in this, WBV appears more efficient than simply walking. Nevertheless, contraindications typical of senility should be taken into account.

Defining the pathophysiology of the paclitaxel-acute pain syndrome

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 19613-19613
Author(s):  
S. L. Wolf ◽  
C. L. Loprinzi ◽  
K. Maddocks-Christianson ◽  
R. D. Rao ◽  
P. B. Dyck ◽  
...  
Keyword(s):  
Acute Pain ◽  
Weight Bearing ◽  
Treatment Strategies ◽  
Pain Syndrome ◽  
Structured Interview ◽  
Cellular Injury ◽  
Effective Prevention ◽  
Increased Sensitivity ◽  
Structural Injury ◽  
Positive Step

19613 Background: Paclitaxel therapy often results in a unique sub-acute pain syndrome, whose pathophysiology is unknown. While this syndrome is often termed as a ‘myalgia’ or ‘arthralgia’, it has not been demonstrated to be associated with any structural injury of muscles or joints. Identifying the pathophysiology mechanisms that result in the paclitaxel-acute pain syndrome might be a positive step in the development of effective prevention and/or treatment strategies. With the hypothesis that the paclitaxel-acute pain syndrome occurs as a result of nerve injury, an observational study to clarify the clinical characteristics of this syndrome was initiated. Methods: Oncology patients who were treated with at least one dose of paclitaxel and reported developing sub-acute pain were questioned using a detailed structured interview. Various aspects of the pain, including the time of onset, duration, location, severity, and exacerbating factors were evaluated. Data were tabulated descriptively. Results: Eighteen patients were interviewed. The onset of pain typically occurred 1–2 days after therapy and lasted for a median of 4–5 days. Pain was most commonly located in the back, hips, shoulders, thighs, legs and feet, with the most common descriptors used being ‘aching’ or ‘deep pain’. Commonly used adjectives to describe the pain were: ‘radiating’, ‘shooting’, ‘aching’, ‘stabbing’ and ‘pulsating’. Some patients described increased pain with weight bearing or walking. Fifteen of 18 patients specifically denied localization of pain to either joints or muscles. Conclusions: The nature of the pain, i.e. , generalized, deep aching pain, the notation of increased sensitivity with weight bearing (mechanical hyperalgesia) and the lack of localization to joints or muscles, support the hypothesis that the paclitaxel-acute pain syndrome results from a hyperalgesic dysfunction of nociceptive receptors, their fibers, or the spinothalamic system. These clinical conclusions are supported by the recent findings that markers of cellular injury can be identified in peripheral nerve tissues shortly following paclitaxel administration in an animal model (Peters CM, et al., Exp Neurol. 2007 Jan;203(1):42- 54). No significant financial relationships to disclose.

scholarly journals The growing years and prevention of osteoporosis in later life

2000 ◽  
Vol 59 (2) ◽  
pp. 303-306 ◽  
Author(s):  
Connie M. Weaver
Keyword(s):  
Bone Mass ◽  
Peak Bone Mass ◽  
Weight Bearing ◽  
Later Life ◽  
Adolescent Females ◽  
The Body ◽  
Risk Of Fracture ◽  
Skeletal Mass ◽  
Lifestyle Choices ◽  
Prevention Of Osteoporosis

Ca is the major mineral in bone, and 99 % of the Ca in the body resides in the skeleton. Skeletal mass is a determinant of risk of fracture in childhood as well as adulthood. Over 40 % of adult peak bone mass is acquired during adolescence. This period is when lifestyle choices, including ensuring adequate dietary Ca, regular weight-bearing exercise and avoiding hormonal insufficiency, are especially important. Current Ca intakes for adolescent females are woefully inadequate.

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