Lifestyle factors influencing bone health in young adult women in Saudi Arabia

Is there an Association between Dietary Micronutrients Intake and Bone Fractures among Malaysian Reproductive-Age Women? The PURE Malaysia Study

Background: Bone fractures represent a significant health issue and impose a considerable burden on healthcare systems globally. However, data pertaining to bone fractures, especially among reproductive-age women in Malaysia, are very limited. Micronutrients like calcium, magnesium and phosphorus play vital roles in bone health, influencing bone mineral density and fracture risk. The objective of this study was to determine the prevalence of bone fractures among reproductive-age women and the association with dietary micronutrient intakes. Methods: In this cross-sectional study, a total of 1,730 participants of reproductive-age women from the Malaysia Prospective Urban and Rural Epidemiological (PURE) study were recruited. The participants' dietary intakes were assessed using a validated semi-quantitative food frequency questionnaire (FFQ). Selected micronutrients in the participants' diets were calculated using the Malaysian food composition and the US Department of Agriculture food composition databases. The association between micronutrient intakes, comorbidities and physical activity levels with bone fractures were evaluated to identify predictors of bone fractures among reproductive-age women. Results: The prevalence of bone fractures among Malaysian reproductive-age women was low (3.7%). The multiple logistic regression analysis showed that none of the micronutrients was associated with bone fractures. However, factors of diabetes and passive smoking in this study showed 2.6- and 4.0-times-higher odds of having bone fractures, respectively (AOR 2.580; 95% CI: 1.173-5.672) and (AOR 4.012; 95% CI: 2.265-7.107). Conclusions: It was found that the majority of women in this study were taking lower micronutrient intakes of calcium, magnesium, and vitamin K than the Malaysia recommended nutrient intakes (RNI). Although this study showed that a low micronutrient intake is not significantly associated with bone fractures, it is recommended that future studies focus on controlled trials or prospective data analyses to establish causal relationships and the optimal micronutrient requirements for maintaining strong and healthy bones in women of reproductive age.

Prevalence and risk factors of osteopenia and osteoporosis among postmenopausal women: A cross-sectional study from Jordan

OBJECTIVES

Our aim was to predict the prevalence of osteopenia and osteoporosis and their associated risk factors among postmenopausal women from Jordan.

METHODOLOGY

In this cross-sectional study, a total of 368 postmenopausal women were recruited from King Abdullah University Hospital (KAUH) in the North of Jordan between September 2022 and April 2023. Bone mineral density (BMD) was measured using a dual-energy X-ray absorptiometry scan. T-score was used for osteoporosis diagnosis in accordance with the International Society for Clinical Densitometry (ISCD) guidelines. Data about sociodemographic and lifestyle variables were collected using face-to-face interviews. Medical records were used to retrieve participants' BMD information. Predictors of osteoporosis were identified using logistic regression.

RESULTS

Prevalence of osteoporosis was 40.5%, while 44.6% of participants were diagnosed with osteopenia. The lumbar spine had the highest frequency of osteoporosis (30.4%), while the left femoral neck had the highest prevalence of osteopenia (46.3%). Postmenopausal women's age (p-value = .024), and history of chronic diseases (p-value = .038) were significant factors associated with increased osteoporosis risk.

CONCLUSIONS

Postmenopausal women from Jordan had high prevalence of osteoporosis and osteopenia. It is therefore necessary to target risk factors leading to osteoporosis and to improve patients' lifestyles through patient education. Healthcare systems should consider early screening approaches for osteoporosis at the age of menopause and thereafter. Supplements of calcium and vitamin D may be routinely considered for this age group depending on their serum levels.

Relationship between Maternal Prenatal Vitamin D Status and Early Childhood Caries in Their Children: A Cross-sectional Survey

Background

Vitamin D deficiency in expectant mothers is very common in India. As a consequence, the possibility of hypoplasia of teeth and resultant propensity for faster progression of early childhood caries (ECC) is expected to be higher in Indian children.

Aim

This study aimed to determine the relationship between prenatal vitamin D intake of mothers and dental caries experience in their preschool children, and whether vitamin D deficiency in mothers could be a risk factor for tooth decay in their children.

Design

This cross-sectional study included 120 mothers of children aged up to 71 months with dental caries attending the Department of Pediatric Dentistry in India. Mothers were surveyed about their prenatal vitamin D intake and their practices regarding vitamin D and sunlight exposure. Children were clinically examined, and their caries status was recorded using the decayed, extracted, filled teeth (deft) index.

Results

Data were analyzed descriptively and correlated using an independent t-test. Binary logistic regression was employed to predict the effects of the duration of sun exposure and vitamin D deficiency on dental decay. The correlation of mothers' prenatal vitamin D intake was significantly associated weekly with children's caries experience. Their sun exposure (p = 0.002) and practices adopted (p = 0.0001) regarding vitamin D levels were statistically significant for children's caries status. Improper brushing frequency was also significantly associated with higher deft scores.

Conclusion

The association between mothers' prenatal vitamin D intake and health practices related to vitamin D with dental caries was not confirmed. Subjects with vitamin D deficiency and their children had significantly higher odds of developing dental decay. However, our findings suggest that 25-hydroxyvitamin D insufficiency may be a risk factor for developing dental caries in children.

How to cite this article

Kalra G, Kumar Y, Langpoklakpam C, et al. Relationship between Maternal Prenatal Vitamin D Status and Early Childhood Caries in Their Children: A Cross-sectional Survey. Int J Clin Pediatr Dent 2024;17(8):860-863.

Is Adherence to the Saudi Healthy Plate Dietary Guidelines Associated with Eating Concerns Symptoms among Saudi Young Females?

BACKGROUND

Food-based dietary guidelines (FBDGs) offer broad recommendations based on scientific evidence, focusing on food groups rather than nutrients that should be included in the diet. Emerging adulthood (18-30 years) is a critical period for poor dietary quality and mental health. Eating habits (EHs) are formed early in life and are influenced by various factors, such as emotional state, which can lead to either binge or restricted eating, ultimately increasing the risk of eating disorders (EDs). This cross-sectional study aimed to investigate the extent of adherence to the Saudi Healthy Plate Dietary Guidelines (SHPDGs) and its potential association with Eating Concerns (ECs) among Saudi females (aged 18-30 years) from all provinces in the Kingdom of Saudi Arabia.

METHODS

A validated online questionnaire was used to assess eating behaviors (EBs) using the Starting The Conversation (STC) instrument and EC symptoms using the Eating Disorders Screen for Primary Care (ESP) screening tool.

RESULTS

The total sample size was 1092 participants with a mean age of 23.02 ± 3.47. Only 0.7% of the participants adhered to the SHPDGs and were free of EC symptoms. Conversely, 50.4% of participants who exhibited EC symptoms had poor adherence to the SHPDGs. Across Saudi Arabian provinces, high adherence to the SHPDGs was more prominent in both the Eastern and Western provinces (37.5%) than in the Central and Southern provinces (0%). The most striking result was that the Central province exhibited a high percentage of poor adherence to the SHPDGs (25.6%). Moreover, high adherence to SHPDGs was not associated with the probability of ECs.

CONCLUSIONS

The present study revealed a trend of poor adherence to SHPDGs among Saudi females, with a large proportion also experiencing EC symptoms. Accordingly, the authors recommend increasing awareness within the Saudi community about SHPDGs using educational campaigns on social media platforms to enhance the importance of adopting a healthy diet, especially among females, and demonstrate that the impact on their health and well-being is that they are experiencing multiple phases that involve pregnancy and giving birth involves specific nutritional requirements.

Soft drinks, tea and coffee consumption in relation to risk of fracture: evidence from china health and nutrition survey

INTRODUCTION

To investigate the association between soft drinks, tea and coffee consumption, and risk of fracture in the China Health and Nutrition Survey.

MATERIALS AND METHODS

A cross-sectional study with multi-stage random cluster sampling was conducted in nine Chinese provinces in 2004, 2006, 2009 and 2011. A total of 36,740 participants were included the data analyses. Self-administered questionnaires and physical examinations provided data on beverages consumption, fracture history, and other potential risk factors. Binary logistic regression models were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) adjusted for potentially confounding variables.

RESULTS

The prevalence of fracture increased over the 7-year period of the surveys, with 1833 (5.3%) participants reporting a fracture history. Soft drink consumption increased over this time period, and tea consumption was relatively stable, whereas coffee consumption tended to increase sharply. Consumers of soft drinks ≥ 3 times/week (versus never) had a higher risk of fracture (OR = 1.86, 95% CI = 1.43-2.32, p < 0.001, p for trend = 0.039). Consumers of tea ≥ 5 cups/day (versus never) also had a higher risk of fracture (OR = 1.21, 95% CI = 1.09-1.45, p = 0.028, p for trend < 0.001). Similarly, consumers of coffee ≥ 2 cups/day (versus never) had a higher risk of fracture (OR = 1.84, 95% CI = 1.01-3.34, p = 0.045, p for trend = 0.002). Subgroup analyses by gender suggested that coffee consumption increased risk of fracture in females (OR = 1.84, 95% CI = 1.32-2.63, p = 0.001).

CONCLUSION

Our findings suggest that high consumption of soft drinks, tea and coffee is associated with an increased risk of fracture in the Chinese population. Which has important public health implications given the widespread consumption of these beverages.

Association Between Vitamin D Level and Z-Score Changes of Bone Density in College-Age Saudi Girls: A Cross-Sectional Study

Objective

Vitamin D (VD) deficiency is a worldwide health problem. VD plays a crucial role in calcium homeostasis, phosphorus metabolism and bone health. Still much remain to understand the effect of VD deficiency on bone mass. This study aimed to evaluate the relationship between VD levels and bone mass density (BMD) among college-age Saudi females.

Methods

In a cross-sectional study, 460 females with a median age of 21 years, were enrolled, completed a comprehensive, structured questionnaire which was validated by experienced endocrinologist, a dietician, and a statistician. Body mass indexes (BMI) were calculated, and BMD was estimated through quantitative ultrasound to ankle. Serum VD, calcium, phosphate, parathyroid hormone, and alkaline phosphatase were measured using chemiluminescent immunoassay technique.

Results

VD deficiency reached up to 83.3% (66.9% insufficiency and 16.4% deficiency). Lower than normal BMD was detected in 18.3% of subjects, with only 1.1% having a non-age-matched high risk for osteoporosis. The significant independent predictors of Z-score were age of menarche, menstrual irregularities, dairy products consumption, physical activity, BMI, alkaline phosphatase, and history of previous VD supplementation.

Conclusion

VD deficiency and low BMD are highly prevalent among college-age Saudi females. Low BMD is not linked to serum level of VD but to its previous use as a supplementation. Early lifestyle changes, attention to gynecological problems, and prevention of VD deficiency are all needed to support BMD among these girls.

Impact of Whole Body Vibration and Zoledronic Acid on Femoral Structure after Ovariectomy: Morphological Evaluation

Our study aimed to evaluate the effect of whole body vibration (WBV) treatment as an non-pharmacological method of treatment for early osteopenia in ovariectomized female rats. In total, 48 female Wistar rats were assigned to two groups: sham-operated control (SHAM, n = 12) and ovariectomized (n = 36). Four weeks after ovariectomy, the animals were divided into three experimental groups (n = 12 each): ovariectomized (OVX), ovariectomized subjected to whole body vibration with acceleration level of 0.3 g (OVX + WBV), or ovariectomized subjected to i.m. injection of Zoledronic acid at a dose of 0.025 mg/kg (OVX + ZOL). After the 8th and 16th week of treatment n = 6 rats from each group were euthanized and isolated femora were subjected to histological examination of trabecular bone and analysis of the expression of collagen 1 (Col1), osteoprotegerin (OPG), and receptor activator of nuclear factor kappa-Β ligand (RANKL) involved in bone turnover. The obtained results indicated that widespread vibration therapy can provide negative outcomes such as deterioration of trabecular bone histomorphometry.

The Predictive Role of Vitamin D Deficiency in Urinary Tract Infection at Reproductive Age in Women

BACKGROUND: Urinary tract infections (UTIs) are common health infections in pregnant women with high complications. Many of the worldwide population suffer from vitamin D deficiency (VDD) due to insufficient exposure to sunlight. The relationship between VDD and UTI and giving vitamin D supplementation contributes to preventing UTI. AIM: The present study aims to find the effect of VDD and UTIs in women of reproductive age as risk factors during pregnancy. METHODS: The samples were collected from May 2020 to February 2021 from gynecology clinic outpatients and private clinics in Basrah city. A 104 sample was collected from females of reproductive age between 15 and 45 years divided into three age groups suffering recurrent UTI and VDD. RESULTS: Of 104 women who followed up with UTIs during the study period, the deficiency of vitamin D levels in women was 62.5%. The levels of deficiency were significantly higher in the age group 25-34y is 71.1%, followed by 15-24y is 63.2%, and 35-45 y is 50% with mean 24 ± 6.8 years. In addition, the results showed the vitamin D levels at an insufficient level (30.8%) higher in the age group 35-45 y is 42.9% with a mean of 10 ± 1.2. Furthermore, the results showed that the vitamin D levels at an insufficient level (30.8%) higher in the age group 35–45 years are 42.9% with a mean of 10 ± 1.2. CONCLUSION: Our current study revealed that there is a clear correlation between women who suffer from VDD and UTIs, whether severe or frequent infection at reproductive age and this affects their fertility and pregnancy. In addition, the study concluded that adolescent girls and young women are the most vulnerable to VDD and UTIs.

The Impact of Vitamin D Level on the Severity and Outcome of Hospitalized Patients with COVID-19 Disease

PURPOSE

The world is experiencing a life-altering and extraordinary situation in response to the COVID-19 pandemic. There are limited data and controversies regarding the relationship between vitamin D (Vit D) status and COVID-19 disease. Thus, this study was designed to investigate the association between Vit D levels and the severity or outcomes of COVID-19 disease.

METHODS

A cross-sectional observational study was conducted in the Eastern province of Saudi Arabia from January to August 2021. All the admitted patients who were diagnosed with COVID-19 infection were distributed into three groups depending on their Vit D levels: normal, insufficiency, and deficiency. For the three groups, demographic data, and laboratory investigations as well as data regarding the severity of COVID-19 were collected and analysed.

RESULTS

A total of 203 diagnosed cases of COVID-19 were included in this study. The Vit D level was normal (>30) in 31 (15.3%) cases, insufficient in 45 (22.2%) cases and deficient in 127 (62.6%) cases. Among the included cases, 58 (28.6%) were critical cases, 109 (53.7%) were severe and 36 (17.7%) had a mild-moderate COVID-19 infection. The most prevalent comorbidity of patients was diabetes mellitus 117 (57.6%), followed by hypertension 70 (34.5%), cardiac disease 24 (11.8%), chronic kidney disease 19 (9.4%) and chronic respiratory disease in 17 (8.4%) cases. Importantly, the current study did not detect any significant association between Vit D status and COVID-19 severity (p-value=0.371) or outcomes (hospital stay, intensive care units admission, ventilation, and mortality rate) (p-value > 0.05), even after adjusting the statistical model for the confounders.

CONCLUSION

In hospital settings, Vit D levels are not associated with the severity or outcomes of COVID-19 disease. Further, well-designed studies are required to determine whether Vit D status provides protective effects against worse COVID-19 outcomes.

Using X-ray diffraction in characterization of bone remodeling and nanocomposites in ovariectomized rats osteopenia model

Sedentary lifestyle and physiological menopause are among the risk factors of osteopenia, especially in elderly people. However, bone mineral density decrease can also be observed in young individuals, for instance, due to deficiency of female sex hormones after surgical interventions, particularly ovariectomy. Our research enabled us to assess the efficacy of whole-body vibration in preventing the loss of bone mineral density in the ovariectomy rat osteopenia model. Thus, whole-body vibration with acceleration level 0.3 g and frequency 50 Hz was used on young female rats, which had been subjected to ovariectomy (n = 18). It had been conducted for 24 weeks, exposure time – 30 minutes per day, 5 times a week. Assessment of mineral component loss of the tibia was performed by means of X-ray diffraction. Bone remodeling was assessed by determining hormones: parathyroid hormone and calcitonin, Ca and P in the blood. X-ray diffraction is an effective method, which enables the evaluation a nanocomposites structure of the bone tissue in the experiment. In the article, we applied this method to determine the loss of bone mineral mass after ovariectomy and the impact of whole-body vibration under such conditions. In the ovariectomy group, the volume of a mineral component significantly decreased starting already from the 16th week (р<0.05) versus control. However, in the group with ovariectomy + whole-body vibration, the loss of a mineral component was insignificant during 8-16 weeks of the investigation, compared with the control group. On the 24th day, the spectrums almost did not differ from ovariectomized rats group. Meanwhile, hormone levels changed in ovariectomized rats group. It should be emphasized that the aforementioned whole-body vibration parameters do not cause severe bone damage or further negative consequences.

Sugar-sweetened beverage consumption and bone health: a systematic review and meta-analysis

BACKGROUND

Current evidence demonstrate that sugar-sweetened beverages (SSBs) and bone health are related; however, there has been only a few reviews on the link between SSBs and bone health. A systematic review and meta-analysis was performed to investigate the association between SSBs consumption and bone health in chidren and adults.

METHODS

Relevant studies of SSBs and bone health published up to 15 March 2021 were searched using PubMed, the Web of Science, Cochrane Library, and a reference search. A random-effects meta-analysis was conducted to estimate the standardized mean difference (SMD). Subgroup analyses were performed to identify whether effects were modified by age, sex, measured skeletal sites, type of SSBs, and SSBs intake questionnaire.

RESULTS

Twenty-six publications including 124,691 participants were selected on the review. The results from this meta-analysis showed a significant inverse association between SSBs intake and bone mineral density (BMD) in adults (ES: -0.66, 95% CI: - 1.01, - 0.31, n = 4312). Eighteen of the 20 studies included in the qualitative-only review in children and adults supported the findings from the meta-analysis. When subgroup analysis was performed according to skeletal site, a large effect was found on whole body BMD (ES: -0.97, 95% CI: - 1.54, - 0.40). There was a moderate effect on BMD in females (ES: -0.50, 95% CI: - 0.87, - 0.13). There was a moderate or large effect on BMD in individuals aged under 50 years (under 30 years: ES: -0.57, 95% CI: - 0.97, - 0.17; 30 to 50 years: ES: -1.33, 95% CI: - 1.72, - 0.93). High consumption of carbonated beverages had a moderate effect on BMD (ES: -0.73, 95% CI: - 1.12, - 0.35).

CONCLUSION

The meta-analysis showed that SSBs consumption such as carbonated beverages were inversely related to BMD in adults. Qualitative review supported the results of meta-analysis.

TRIAL REGISTRATION

This review was registered in the PROSPERO database under identifier CRD42020164428 .

Attitudes toward sweetened soft drinks and consumption patterns among Saudi women: A cross-sectional study

Although sweetened soft drink consumption (SDC) has negative consequences on health, this dietary habit is common among the Saudi population (Saudi Arabia). Food selection and consumption are complex behaviors and associated with several constructs described by social cognitive theory. This study assessed the pattern of sweetened SDC and its associated behavioral and theoretical factors, with focus on attitude and expectations related to SDC among Saudi women. Participants (n = 773) answered an online questionnaire on SDC patterns (frequency of consumption and quantity) and attitudes influencing those patterns. Association of attitudes with frequency of sweetened SDC was assessed using Spearman's test that revealed a positive and significant association between frequency and quantity of SDC (Spearman's rho = 0.34, df = 771, p < .0001). Highest correlations were observed between frequency of consumption and positive attitudes toward the perception of sweetened soft drinks as indispensable while eating, enjoyable, and value indispensable during social gathering (Spearman's rho = 0.58, 0.55 and 0.40, respectively, df = 771, p < .0001). Multiple regression analysis of attitudes showed considering soft drinks enjoyable and essential at eating were positively associated with consumption. Saudi Women are consuming soft drinks at high rates despite self-reporting this behavior as unhealthy. Social cognitive factors could potentially be predictors of unhealthy dietary behaviors among Saudi women. Designing nutrition education campaigns and culture-tailored information is warranted.

Effect of Education on Preventive Behaviors of Osteoporosis in Adolescents: A Systematic Review and Meta-Analysis

BACKGROUND

Osteoporosis is one of the diseases that can be prevented by correcting health behaviors during adolescence.

OBJECTIVE

This study was conducted to evaluate the effect of education on preventive behaviors of osteoporosis including physical activity, calcium intake and practice (primary outcomes) and knowledge and attitude related to osteoporosis (secondary outcomes) in adolescents.

METHOD

A search was done in Cochrane Library, PubMed, Embase, Web of Sciences, Scopus, Google Scholar, SID and Magiran regardless of the time limit. To evaluate the quality of selected controlled trials, Cochrane collaboration' instrument was used for assessing the risk of bias. RevMan software was used to analysis and report the data.

RESULTS

Of 2159 articles retrieved, 20 of them were reviewed and 18 of them entered the mete-analysis. The meta-analysis showed significant differences between the education and control groups in terms of calcium intake (SMD = 0.78, 95%CI = 0.55 to 1.02, P < 0.00001), practice (SMD = 0.54, 95%CI = 0.41 to 0.68, P < 0.0001), knowledge (SMD = 1.76, 95%CI = 1.10 to 2.42, P < 0.00001) and attitude (SMD = 0.96, 95%CI = 0.53 to 1.40, P < 0.0001) mean score in adolescents but education is not effective on average minute/week of physical activity per week (MD = 31.94, 95%CI = -6.53 to 70.40, P = 0.10), mean score of physical activity (MD = 2.66, 95%CI = -0.55 to 5.88, P = 0.10) and percent of students participated in the physical activity (OR = 1.45, 95%CI = 0.30 to 6.91, P = 0.64).

CONCLUSION

Education is effective in improving their knowledge and attitudes toward osteoporosis. It can also improve some health-related behaviors for bone health such as sufficient dairy calcium intake but it has not been effective in establishing a regular exercise program.

Development of a cost-effective CVD prediction model using lifestyle factors. A cohort study in Pakistan

Background:

Cardiovascular diseases (CVD) such as hypertension and ischemic heart diseases cause 35 to 40% of deaths every year in Pakistan. Several lifestyle factors such as dietary habits, lack of exercise, mental stress, body habitus (i.e., body mass index, waist), personal habits (smoking, sleep, fitness) and clinical conditions (i.e., diabetes, dyslipidemia and hypertension) have been shown to be strongly associated with the etiology of CVD. Epidemiological studies in Pakistan have shown poor adherence of people to healthy lifestyle and lack of knowledge in adopting healthy alternatives. There are well validated cardiovascular risk estimation tools (QRISK model) that cn predict the probability of future cardiac events. The existing tools are based on laboratory investigations of biochemical test but there is no widely accepted tool available that predicts the CVD risk probability based on lifestyle factors.

Aims:

Aim of the current study was to develop alternative CVD risk estimation model based on lifestyle factors and physical attributes (without using laboratory investigation) using QRISK model as the gold standard.

Study Design:

Clinical and lifestyle data of one hundred and sixty subjects were collected to formulate a regression model for predicting CVD risk probability.

Methods:

Lifestyle factors as independent variables (IV) include BMI, waist circumference, physical activities (stamina, strength, flexibility, posture), smoking, general illnesses, dietary intake, stress and physical characteristics. CVD risk probability of QRISK Intervention computed through clinical variables was used as a dependent variable (DV) in present research. Chronological age was also included in analysis in addition to selected lifestyle factors. Regression analysis, principal component analysis and bivariate correlations were applied to assess the relationship among predictor variables and cardiovascular risk score.

Results:

Chronological age, waist circumference, BMI and strength showed significant effect on CVD risk probability. The proposed model can be used to calculate CVD risk probability with 72.9% accuracy for the targeted population.

Conclusion:

The model involves only those features which can be measured without any clinical test. The proposed model is rapid and less costly hence appropriate for use in developing countries like Pakistan.

Vitamin D Deficiency and Associated Risk Factors in Women from Riyadh, Saudi Arabia

Vitamin D deficiency is an epidemic public health problem worldwide. It is common in the Middle East and is more severe in women. This cross-sectional study was conducted to assess vitamin D deficiency and associated risk factors in women living in Riyadh, Saudi Arabia. Serum 25-hydroxyvitamin D (25(OH)D) was measured in 166 women aged 30-65 years. Socio-demographic, lifestyle and health status characteristics, as well as intake of selected dietary supplements, were collected. Weight and height were measured. Vitamin D deficiency (25(OH)D < 20 ng/mL) was reported in 60.2% of participants. Mean of serum 25(OH)D was 20.7 ng/mL. Older age and taking the supplements of vitamin D, multi-vitamins or calcium were identified as factors that associated with a lower risk of hypovitaminosis D. A national strategy is needed to control a hypovitaminosis D crisis in Saudi Arabia. This could be accomplished by raising public awareness regarding vitamin D, regulating and enhancing vitamin D fortification and supplementation and screening vitamin D status among women at high risk.

Quantitative Ultrasound and Dual X-Ray Absorptiometry as Indicators of Bone Mineral Density in Young Women and Nutritional Factors Affecting It

Young adulthood is an important stage in the accrual of bone mass. Young women are often unaware of the need, and how to optimize modifiable risk factors, particularly intake of nutrients associated with good bone health. In this study, an accessible way to estimate osteoporosis risk, quantitative ultrasound (QUS), is compared to the gold-standard technique dual X-ray absorptiometry (DXA) in a group of 54 healthy young women (18–26 years) from Manawatu, New Zealand, and the relationship with nutrient intake is investigated. Broadband ultrasound attenuation and speed of sound (BUA, SOS) were assessed by QUS calcaneal scans and bone mineral concentration/density (BMC/BMD) were determined by DXA scans of the lumbar spine and hip (total and femoral neck). Dietary intake of energy, protein, and calcium was estimated using three-day food diaries and questionnaires. DXA mean Z-scores (>−2.0) for the hip (0.19) and spine (0.2) and QUS mean Z-scores (>−1.0) (0.41) were within the expected ranges. DXA (BMD) and QUS (BUA, SOS) measurements were strongly correlated. Median intakes of protein and calcium were 83.7 g/day and 784 mg/day, respectively. Protein intake was adequate and, whilst median calcium intake was higher than national average, it was below the Estimated Average Requirement (EAR). No significant relationship was found between dietary intake of calcium or protein and BMD or BMC. To conclude, QUS may provide a reasonable indicator of osteoporosis risk in young women but may not be an appropriate diagnostic tool. Increased calcium intake is recommended for this group, regardless of BMD.

A Review of Knowledge, Belief and Practice Regarding Osteoporosis among Adolescents and Young Adults

Osteoporosis is a major public health problem affecting millions of people worldwide. Increasing knowledge, correcting health belief and promoting osteoprotective practices are effective measures for building and maintaining strong bone throughout ones’ life-span. This review aims to summarize the contemporary evidence on the knowledge, beliefs and practice of adolescents and young adults on bone health. We performed literature searches using the PubMed and Scopus databases to identify original studies from 2008 to May 2018 using the search terms “(knowledge OR beliefs OR attitude OR practice OR behaviours OR physical activity OR exercise OR diet OR nutrition) AND (young OR youth OR adolescents OR children OR young adults OR students OR teenager) AND (osteoporosis OR bone health)”. Of the 3206 articles found, 34 met the inclusion criteria. Studies showed that most adolescents and young adults had poor knowledge and expressed disinterest in osteoporosis. They believed that other diseases were more serious than osteoporosis, contributing to low perceived susceptibility and seriousness towards this disease. Popular media emerged as a platform to obtain information regarding osteoporosis. The lack of knowledge and misconceptions about osteoporosis led to poor osteoprotective practices. As a conclusion, the current evidence revealed a lack of awareness about osteoporosis among adolescents and young adults. Educational interventions may be useful to improve the awareness of osteoporosis among this population.