The protective effect of calcium on bone mass in postmenopausal women with high selenium intake

The Role of Copper Intake in Bone Health: A Quantitative Analysis in Postmenopausal Spanish Women

(1) Background: Copper is a crucial trace element which is vital to growth and development and is especially important in bone health. Copper intake is now the focus of much broader research beyond its associations with nail growth, looking at copper's potential in contributing to bone integrity to prevent a high risk of osteoporosis as well. (2) Methods: This study included postmenopausal women from a larger longitudinal study conducted between 2019 and 2022. Bone health was assessed using three quantitative techniques: heel QUS, DXA and pQCT. Copper intake was evaluated using a 131-item, 7-day food frequency questionnaire. Data from these assessments were used to analyze the relationship between copper intake and bone health. (3) Results: In the unadjusted multiple linear regression model, associations were found between copper intake levels and both BUA (dB/MHz) and pQCT cortical + subcortical density (mg/cm3), with copper intake acting as a negative predictor in both instances. However, these associations lost statistical significance after adjusting for participant age and weight. No further associations were identified for the other parameters assessed. (4) We conclude that our study does not reveal an association between copper intake and bone health in postmenopausal Spanish women.

Dietary consumption of selenium inversely associated with osteoporosis in postmenopausal women

Background

Osteoporosis is a skeletal disease characterized by reduced bone mineral density (BMD), which increases the risk of falls and fractures and reduces mobility. Some nutrients have a well-established role in maintaining bone health and preventing osteoporosis, while selenium (Se) has aroused interest in bone health possibly because of its anti-inflammatory and antioxidant capacity. The aim of this study was to evaluate the association between dietary Se consumption and BMD in postmenopausal women.

Materials and methods

Cross-sectional, observational, analytical study carried out with women in menopause for at least 12 months, aged ≥ 50 years. Sociodemographic, lifestyle, and clinical data variables were studied. BMD was assessed using Dual Energy X-ray Absorptiometry (DXA) and the participants classified as having normal BMD, osteopenia, or osteoporosis. Dietary consumption of Se was assessed by the food frequency questionnaire (FFQ) and classified into quartiles of consumption. Multivariate logistic regression with three fit models was applied to investigate the association of BMD with Se consumption quartiles. The significance level adopted for all tests was 5.0%.

Results

The final sample consisted of 124 women aged in average 66.8 ± 6.1 years and with a time since menopause of 19.6 ± 8.8 years. According to the BMD, 41.9% of the women had osteopenia and 36.3% osteoporosis. The mean consumption of Se was 154.4 ± 88.7 μg/day. The highest consumption of Se was observed among women with normal BMD (51.9%), whereas lower consumption levels were found in 57.7% of women with osteopenia and in 60.0% of women with osteoporosis (p = 0.003). In the multivariate analysis, after adjusting for possible confounding variables, Se remained associated with the group of women with osteoporosis. Postmenopausal women in the highest quartile (≥94.0 μg/day) of Se consumption had an OR of 0.02 (95%CI: 0.001-0.41; p = 0.012) of having osteoporosis when compared with women in the lowest quartile.

Conclusion

Se consumption was associated with BMD and postmenopausal women with higher Se consumption were less likely to have osteoporosis.

Reactive sulfur and selenium species in the regulation of bone homeostasis

Reactive oxygen species (ROS) are important modulators of physiological signaling and play important roles in bone tissue regulation. Both reactive sulfur species (RSS) and reactive selenium species (RSeS) are involved in ROS signaling, and recent work suggests RSS and RSeS involvement in the regulation of bone homeostasis. For example, RSS can promote osteogenic differentiation and decrease osteoclast activity and differentiation, and the antioxidant activity of RSeS play crucial roles in balancing bone remodeling. Here, we outline current research progress on the application of RSS and RSeS in bone disease and regeneration. Focusing on these investigations, we highlight different methods, tools, and sources of RSS and RSeS, and we also highlight future opportunities for delivery of RSS and RSeS in biological environments relating to bone.

The Role of Selenium in Pathologies: An Updated Review

Selenium is an essential microelement required for a number of biological functions. Selenium—and more specifically the amino acid selenocysteine—is present in at least 25 human selenoproteins involved in a wide variety of essential biological functions, ranging from the regulation of reactive oxygen species (ROS) concentration to the biosynthesis of hormones. These processes also play a central role in preventing and modulating the clinical outcome of several diseases, including cancer, diabetes, Alzheimer’s disease, mental disorders, cardiovascular disorders, fertility impairments, inflammation, and infections (including SARS-CoV-2). Over the past years, a number of studies focusing on the relationship between selenium and such pathologies have been reported. Generally, an adequate selenium nutritional state—and in some cases selenium supplementation—have been related to improved prognostic outcome and reduced risk of developing several diseases. On the other hand, supra-nutritional levels might have adverse effects. The results of recent studies focusing on these topics are summarized and discussed in this review, with particular emphasis on advances achieved in the last decade.

The Effects of Selenium on Bone Health: From Element to Therapeutics

Osteoporosis, characterized by low bone mass and a disruption of bone microarchitecture, is traditionally treated using drugs or lifestyle modifications. Recently, several preclinical and clinical studies have investigated the effects of selenium on bone health, although the results are controversial. Selenium, an important trace element, is required for selenoprotein synthesis and acts crucially for proper growth and skeletal development. However, the intake of an optimum amount of selenium is critical, as both selenium deficiency and toxicity are hazardous for health. In this review, we have systematically analyzed the existing literature in this field to determine whether dietary or serum selenium concentrations are associated with bone health. In addition, the mode of administration of selenium as a supplement for treating bone disease is important. We have also highlighted the importance of using green-synthesized selenium nanoparticles as therapeutics for bone disease. Novel nanobiotechnology will be a bridgehead for clinical applications of trace elements and natural products.

Associations between Dietary Inflammatory Index (DII) and bone health among postmenopausal women in the United States

OBJECTIVE

The purpose of this study was to determine the relationship between the Dietary Inflammatory Index (DII^® ) score and the bone health of menopausal women.

METHODS

A total of 2461 participants were included in the analysis from the NHANES database 2009-2018 and 2005-2006. The association between the DII and Bone mineral density (BMD) and bone mineral content (BMC) was evaluated through a multiple linear regression model.

RESULTS

The mean DII in this study was +0.89 (SD 0.18) and the scores ranged from -5.46 (most anti-inflammatory) to +4.58 (most pro-inflammatory). After adjusting for confounding factors, higher DII is associated with an increased risk of decreased total bone density (Model III, β -0.012; 95% CI -0.023, -0.001). There is a similar correlation found in bone density content and other indicators of bone mineral density. At the same time, we used BMI as a stratified variable for subgroup analysis, we found that higher DII (continuous) was associated with a significantly higher risk of decreased total bone density in overweight/obese postmenopausal women (β -0.018; 95% CI -0.025, -0.006).

CONCLUSION

A higher DII score is significantly associated with lower bone density and bone density in postmenopausal women, especially women who are overweight/obese.

Factors Associated with Bone Mineral Density and Bone Resorption Markers in Postmenopausal HIV-Infected Women on Antiretroviral Therapy: A Prospective Cohort Study

The study aimed to determine factors associated with changes in bone mineral density (BMD) and bone resorption markers over two years in black postmenopausal women living with human immunodeficiency virus (HIV) on antiretroviral therapy (ART). Women (n = 120) aged > 45 years were recruited from Potchefstroom, South Africa. Total lumbar spine and left femoral neck (LFN) BMD were measured with dual energy X-ray absorptiometry. Fasting serum C-Telopeptide of Type I collagen (CTx), vitamin D and parathyroid hormone were measured. Vitamin D insufficiency levels increased from 23% at baseline to 39% at follow up. In mixed linear models serum CTx showed no change from baseline to end (p = 0.363, effect size = 0.09). Total and LFN BMD increased significantly over two years, but effect sizes were small. No significant change in spine BMD over time was detected (p = 0.19, effect size = 0.02). Age was significantly positively associated with CTx over time, and negatively with total and LFN BMD. Physical activity (PA) was positively associated with LFN BMD (p = 0.008). Despite a decrease in serum vitamin D, BMD and CTx showed small or no changes over 2 years. Future studies should investigate PA interventions to maintain BMD in women living with HIV.

Do Only Calcium and Vitamin D Matter? Micronutrients in the Diet of Inflammatory Bowel Diseases Patients and the Risk of Osteoporosis

Osteoporosis is one of the most common extraintestinal complications among patients suffering from inflammatory bowel diseases. The role of vitamin D and calcium in the prevention of a decreased bone mineral density is well known, although other nutrients, including micronutrients, are also of extreme importance. Despite the fact that zinc, copper, selenium, iron, cadmium, silicon and fluorine have not been frequently discussed with regard to the prevention of osteoporosis, it is possible that a deficiency or excess of the abovementioned elements may affect bone mineralization. Additionally, the risk of malnutrition, which is common in patients with ulcerative colitis or Crohn's disease, as well as the composition of gut microbiota, may be associated with micronutrients status.

Relationship between Selected Trace Elements in Human Milk and Psychosocial Characteristics in Korean Early Postpartum Women

This study aimed to identify the relationship between selected trace elements in human milk and depression, breastfeeding self-efficacy, sleep satisfaction, and the demographic and obstetric characteristics of lactating mothers. Forty lactating mothers recovering after birth in two postpartum care centers located in Changwon, South Korea, were studied. Calcium, sodium, iron, and selenium concentrations in human milk were analyzed using inductively coupled plasma mass spectrometry at the analysis center of Kyungnam University. Data were analyzed using descriptive statistics, the Kruskal-Wallis test, the Mann-Whiney U test, and Spearman's correlation coefficients using an SPSS 23.0 program. There were no significant differences in concentration of selected trace elements (calcium, sodium, iron, and selenium) in human milk according to demographic and obstetric characteristics. Sodium concentration was negatively correlated with breastfeeding self-efficacy (r = -0.51, CI = -0.71 to -0.24). Selenium concentration was negatively correlated with calcium concentration (r = -0.34, CI = -0.58 to 0.38). Postpartum depression was negatively correlated with sleep satisfaction (r = -0.46, CI = -0.67 to -0.17) and with breastfeeding self-efficacy (r = -0.41, CI = -0.64 to -0.11). Breastfeeding self-efficacy was positively correlated with sleep satisfaction (r = 0.48, CI = 0.20 to 0.69). This study suggests that sodium concentration in human milk is associated with breastfeeding self-efficacy.

Effects of Virgin Olive Oil on Bone Health in Ovariectomized Rats

Osteoporosis is a pressing concern facing public health, thus making research into the effects of nutrients on bone health particularly important. Evidence from preclinical studies using animal models and a limited number of studies in human suggests that olive oil (OO) is a protective agent for bone. The aim of this work is to study the effects of virgin olive oil (VOO) consumption by ovariectomized rats on bone health. A total of 48 6-month-old female Wistar rats weighing 320 ± 10 g (mean ± SD) were divided into the following groups: SHAM (n = 12), simulated intervention; OVX (n = 12), ovariectomized; OVX + 100 (n = 12), ovariectomized and treated with VOO (100 µL/day by oral gavage); and OVX + 200 (n = 12) ovariectomized and treated with VOO (200 µL/day by oral gavage), all over 3 months. Femoral (F) and lumbar (L) bone mineral density (FBMD and LBMD), microtomographic parameters, fractal dimension D2D and D3D, and biomechanical properties were studied. After 3 months of VOO treatment, although FBMD and LBMD were not affected, bone quality was improved, as the elasticity of bone and fractal dimension (complexity of bone) were more similar to healthy bone. Our results support the findings of previous research suggesting that dietary intake of olive oil may exert beneficial effect on some bone characteristics.

Association between dietary selenium intake and the prevalence of osteoporosis: a cross-sectional study

Objective

To examine the correlation between dietary selenium (Se) intake and the prevalence of osteoporosis (OP) in the general middle-aged and older population in China.

Methods

Data for analyses were collected from a population based cross-sectional study performed at the Xiangya Hospital Health Management Centre. Dietary Se intake was evaluated using a validated semi-quantitative food frequency questionnaire. OP was diagnosed on the basis of bone mineral density scans using a compact radiographic absorptiometry system. The correlation between dietary Se intake and the prevalence of OP was primarily examined by multivariable logistic regression.

Results

This cross-sectional study included a total of 6267 subjects (mean age: 52.2 ± 7.4 years; 42% women), and the prevalence of OP among the included subjects was 9.6% (2.3% in men and 19.7% in women). Compared with the lowest quartile, the energy intake, age, gender and body mass index (BMI)-adjusted odds ratios of OP were 0.72 (95% confidence interval [CI] 0.55–0.94), 0.72 (95% CI 0.51–1.01) and 0.47 (95% CI 0.31–0.73) for the second, third and fourth quartiles of dietary Se intake, respectively (P for trend = 0.001). The results remained consistent in male and female subjects. Adjustment for additional potential confounders (i.e., smoking status, drinking status, physical activity level, nutritional supplements, diabetes, hypertension, fibre intake, and calcium intake) did not cause substantial changes to the results.

Conclusions

In the middle-aged and older humans, participants with lower levels of dietary Se intake have a higher prevalence of OP in a dose-response manner.

Evaluation of the Dietary Intake of Cadmium, Lead and Mercury and Its Relationship with Bone Health among Postmenopausal Women in Spain

BACKGROUND

Heavy metals, such as lead, cadmium, and mercury, are absorbed through contaminated food sources and water. Few studies have investigated the extent to which dietary heavy metals are associated with low bone mineral density.

AIMS

We aimed to characterize the dietary intake of the heavy metals lead, cadmium and mercury among healthy, non-smoking postmenopausal women in Spain. Furthermore, we sought to establish a putative relationship between bone health and the intake of these heavy metals in this population.

STUDY DESIGN

The daily intake of the heavy metals considered for the different food groups was calculated by accounting for food content and consumption in 281 postmenopausal women. Bone measurements were performed using a Quantitative Bone Ultrasound (QUS), a Dual-Energy X-ray Absorptiometry (DXA) and a Peripheral Quantitative Computed Tomography (pQCT).

RESULTS

The average estimated dietary cadmium exposure among the 281 women studied was 29.87 μg/day (20.41-41.04) and 3.03 μg/kg body weight (b.w.; 2.17-4.40). Dietary lead exposure was 46.24 μg/day (38.11-54.77) and 4.87 μg/kg b.w. (4.00-6.14). The estimated dietary mercury exposure was 11.64 μg/day and 1.19 μg/kg b.w. (0.82-1.76). Participants were classified according to their heavy metal intake (above or below the respective medians). After further adjustment for potential confounding factors, no significant differences were found in all the measured parameters (p > 0.05).

CONCLUSIONS

We did not find associations between bone health and the dietary intake of three heavy metals in postmenopausal women. Dietary intake of the measured heavy metals were within the recommended values.

Population data on calcium in drinking water and hip fracture: An association may depend on other minerals in water. A NOREPOS study

BACKGROUND

The Norwegian population has among the highest hip fracture rates in the world. The incidence varies geographically, also within Norway. Calcium in drinking water has been found to be beneficially associated with bone health in some studies, but not in all. In most previous studies, other minerals in water have not been taken into account. Trace minerals, for which drinking water can be an important source and even fulfill the daily nutritional requirement, could act as effect-modifiers in the association between calcium and hip fracture risk. The aim of the present study was to investigate the association between calcium in drinking water and hip fracture, and whether other water minerals modified this association.

MATERIALS AND METHODS

A survey of trace metals in 429 waterworks, supplying 64% of the population in Norway, was linked geographically to the home addresses of patients with incident hip fractures (1994-2000). Drinking water mineral concentrations were divided into "low" (below and equal waterworks average) and "high" (above waterworks average). Poisson regression models were fitted, and all incidence rate ratios (IRRs) were adjusted for age, geographic region, urbanization degree, type of water source, and pH of the water. Effect modifications were examined by stratification, and interactions between calcium and magnesium, copper, zinc, iron and manganese were tested both on the multiplicative and the additive scale. Analyses were stratified on gender.

RESULTS

Among those supplied from the 429 waterworks (2,110,916 person-years in men and 2,397,217 person-years in women), 5433 men and 13,493 women aged 50-85 years suffered a hip fracture during 1994-2000. Compared to low calcium in drinking water, a high level was associated with a 15% lower hip fracture risk in men (IRR=0.85, 95% CI: 0.78, 0.91) but no significant difference was found in women (IRR=0.98, 95%CI: 0.93-1.02). There was interaction between calcium and copper on hip fracture risk in men (p=0.051); the association between calcium and hip fracture risk was stronger when the copper concentration in water was high (IRR=0.52, 95% CI: 0.35, 0.78) as opposed to when it was low (IRR=0.88, 95% CI: 0.81, 0.94). This pattern persisted also after including potential confounding factors and other minerals in the model. No similar variation in risk was found in women.

CONCLUSION

In this large, prospective population study covering two thirds of the Norwegian population and comprising 19,000 hip fractures, we found an inverse association between calcium in drinking water and hip fracture risk in men. The association was stronger when the copper concentration in the water was high.

Lean Mass Appears to Be More Strongly Associated with Bone Health than Fat Mass in Urban Black South African Women

OBJECTIVES

To examine the association between body composition (fat mass, lean mass and body mass index, BMI) and bone health (bone mineral density, BMD and fracture risk) in urban black South African women.

DESIGN

A cross sectional study examining associations between body composition, dietary intake (food frequency questionnaire), habitual physical activity (Activity energy expenditure (AEE) measured using an accelerometer with combined heart rate monitor and physical activity questionnaire) and bone health (BMD using dual-energy X ray absorptiometry, DXA and fracture risk).

SETTING

Urban community dwellers from Ikageng in the North-West Province of South Africa.

PARTICIPANTS

One hundred and eighty nine (189) healthy postmenopausal women aged ≥43 years.

RESULTS

Fat mass and lean mass were significantly associated with BMD and fracture risk when adjusted for potential confounders. However, lean mass and not fat mass remained significantly associated with femoral neck BMD (β = 0.49, p <0.001), spine BMD (β = 0.48, p< 0.0001) and hip BMD (β = 0.59, p< 0.0001). Lean mass was also negatively associated with fracture risk (β = -0.19 p =0.04) when both lean and fat mass were in the same model.

CONCLUSION

Lean mass and fat mass were positively associated with femoral neck, spine and hip BMDs and negatively associated with fracture risk in urban black South African women. Our finding suggests that increasing lean mass rather than fat mass is beneficial to bone health. Our study emphasises the importance of positive lifestyle changes, intake of calcium from dairy and adequate weight to maintain and improve bone health of postmenopausal women.

The effect of olive oil on osteoporosis prevention

The incidence of osteoporosis and associated fractures is found to be lower in countries where the Mediterranean diet is predominant. These observations might be mediated by the active constituents of olive oil and especially phenolic compounds.

OBJECTIVE

To review current knowledge by searching for all relevant publications since 2001 in the MEDLINE, EMBASE and Cochrane Library databases, using the descriptors: Mediterranean diet, virgin olive oil, phenols, bone, osteoblast and osteoporosis.

RESULTS AND CONCLUSIONS

Published evidence suggests that olive oil phenols can be beneficial by preventing the loss of bone mass. It has been demonstrated that they can modulate the proliferative capacity and cell maturation of osteoblasts by increasing alkaline phosphatase activity and depositing calcium ions in the extracellular matrix. Further research on this issue is warranted, given the prevalence of osteoporosis and the few data available on the action of olive oil on bone.

Low Testosterone Levels Are Associated With Poor Peripheral Bone Mineral Density and Quantitative Bone Ultrasound at Phalanges and Calcaneus in Healthy Elderly Men

Variations in sex hormones influence bone health in men. Aging in men is associated with a decrease in testosterone (T) levels. We examined the relationship between T levels and changes in bone health status as measured by quantitative ultrasound (QUS) at the phalanges and the os calcis and by peripheral bone mineral density (pBMD) at the phalanges in healthy elderly Spanish men. We examined 162 men aged 65–88 years and assessed total serum T concentrations. Total serum T < 300 ng/dL was used as the threshold for biochemical T deficiency. The sample was divided into low ( n = 66) or normal ( n = 96) T levels; both groups were matched for age, weight, height, and body mass index ( p > .05 for all the comparisons). All measured bone parameters were higher in the normal serum T group ( p < .05). Multiple regression analysis revealed that serum T was an independent predictor of both QUS at the calcaneus and phalangeal pBMD. Our data indicate that T is an independent determinant of QUS at the os calcis and pBMD at the phalanges in elderly Spanish men.

Selenium in bone health: roles in antioxidant protection and cell proliferation

Selenium (Se) is an essential trace element for humans and animals, and several findings suggest that dietary Se intake may be necessary for bone health. Such findings may relate to roles of Se in antioxidant protection, enhanced immune surveillance and modulation of cell proliferation. Elucidation of the mechanisms by which Se supports these cellular processes can lead to a better understanding of the role of this nutrient in normal bone metabolism. This article reviews the current knowledge concerning the molecular functions of Se relevant to bone health.