Modulation of the cell membrane lipid milieu by peroxisomal β-oxidation induces Rho1 signaling to trigger inflammatory responses

Phagocytosis, signal transduction, and inflammatory responses require changes in lipid metabolism. Peroxisomes have key roles in fatty acid homeostasis and in regulating immune function. We find that Drosophila macrophages lacking peroxisomes have perturbed lipid profiles, which reduce host survival after infection. Using lipidomic, transcriptomic, and genetic screens, we determine that peroxisomes contribute to the cell membrane glycerophospholipid composition necessary to induce Rho1-dependent signals, which drive cytoskeletal remodeling during macrophage activation. Loss of peroxisome function increases membrane phosphatidic acid (PA) and recruits RhoGAPp190 during infection, inhibiting Rho1-mediated responses. Peroxisome-glycerophospholipid-Rho1 signaling also controls cytoskeleton remodeling in mouse immune cells. While high levels of PA in cells without peroxisomes inhibit inflammatory phenotypes, large numbers of peroxisomes and low amounts of cell membrane PA are features of immune cells from patients with inflammatory Kawasaki disease and juvenile idiopathic arthritis. Our findings reveal potential metabolic markers and therapeutic targets for immune diseases and metabolic disorders.

The Nitric Oxide Donor, S-Nitrosoglutathione, Rescues Peroxisome Number and Activity Defects in PEX1G843D Mild Zellweger Syndrome Fibroblasts

Peroxisome biogenesis disorders (PBDs) are a group of metabolic developmental diseases caused by mutations in one or more genes encoding peroxisomal proteins. Zellweger syndrome spectrum (PBD-ZSS) results from metabolic dysfunction caused by damaged or non-functional peroxisomes and manifests as a multi-organ syndrome with significant morbidity and mortality for which there is no current drug therapy. Mild PBD-ZSS patients can exhibit a more progressive disease course and could benefit from the identification of drugs to improve the quality of life and extend the lifespan of affected individuals. Our study used a high-throughput screen of FDA-approved compounds to identify compounds that improve peroxisome function and biogenesis in human fibroblast cells carrying the mild PBD-ZSS variant, PEX1G843D. Our screen identified the nitrogen oxide donor, S-nitrosoglutathione (GSNO), as a potential therapeutic for this mild form of PBD-ZSS. Further biochemical characterization showed that GSNO enhances both peroxisome number and function in PEX1G843D mutant fibroblasts and leads to increased survival and longer lifespan in an in vivo humanized Drosophila model carrying the PEX1G843D mutation. GSNO is therefore a strong candidate to be translated to clinical trials as a potential therapeutic for mild PBD-ZSS.

Effect of soluble corn fiber supplementation for 1 year on bone metabolism in children, the MetA-bone trial: Rationale and design

Calcium intake is critical for adequate bone mineralization in adolescence, but it is usually inadequate in US adolescents. A strategy to maximize bone mineralization is to increase calcium absorption, which could be achieved by soluble corn fiber (SCF). There are no studies determining the long-term effects of SCF on bone mass in children.

OBJECTIVES

To determine the effect of one-year SCF supplementation compared to placebo on bone mass and bone biomarkers in children with low habitual calcium intake. We hypothesize that SCF supplementation will result in a higher bone mineral content and higher levels of bone formation and lower bone resorption biomarkers.

METHODS

240 healthy children (10-13 years), with usual low calcium intake, will be randomized to four experimental groups for 1 year: (1) SCF (12 g/d); (2) SCF (12 g/d) + 600 mg/d of calcium; (3) Placebo (maltodextrin); and (4) Placebo +600 mg/d of calcium. The supplements have been pre-mixed with a flavored powder beverage and participants will only need to dilute it in water and drink this twice per day. Bone will be measured using dual energy x-ray absorptiometry (DXA) at baseline, 6 and 12 months. Serum bone biomarkers will be measured at baseline and at 12 months.

CONCLUSIONS

If supplementing diets with SCF lead to higher bone mass during adolescence, this could help achieve the genetic potential for PBM and to start adult life with stronger bones. If successful, SCF can be incorporated into diets for promoting bone health in adolescents.

Whole egg consumption and cortical bone in healthy children

Eggs contain bioactive compounds thought to benefit pediatric bone. This cross-sectional study shows a positive link between childhood egg intake and radius cortical bone. If randomized trials confirm our findings, incorporating eggs into children's diets could have a significant impact in preventing childhood fractures and reducing the risk of osteoporosis.

INTRODUCTION

This study examined the relationships between egg consumption and cortical bone in children.

METHODS

The cross-sectional study design included 294 9-13-year-old black and white males and females. Three-day diet records determined daily egg consumption. Peripheral quantitative computed tomography measured radius and tibia cortical bone. Body composition and biomarkers of bone turnover were assessed using dual-energy X-ray absorptiometry and ELISA, respectively.

RESULTS

Egg intake was positively correlated with radius and tibia cortical bone mineral content (Ct.BMC), total bone area, cortical area, cortical thickness, periosteal circumference, and polar strength strain index in unadjusted models (r = 0.144-0.224, all P < 0.050). After adjusting for differences in race, sex, maturation, fat-free soft tissue mass (FFST), and protein intakes, tibia relationships were nullified; however, egg intake remained positively correlated with radius Ct.BMC (r = 0.138, P = 0.031). Egg intake positively correlated with total body bone mineral density, BMC, and bone area in the unadjusted models only (r = 0.119-0.224; all P < 0.050). After adjusting for covariates, egg intake was a positive predictor of radius FFST (β = 0.113, P < 0.050) and FFST was a positive predictor of Ct.BMC (β = 0.556, P < 0.050) in path analyses. There was a direct influence of egg on radius Ct.BMC (β = 0.099, P = 0.035), even after adjusting for the mediator, FFST (β = 0.137, P = 0.020). Egg intake was positively correlated with osteocalcin in both the unadjusted (P = 0.005) and adjusted (P = 0.049) models.

CONCLUSION

If the positive influence of eggs on Ct.BMC observed in this study is confirmed through future randomized controlled trials, whole eggs may represent a viable strategy to promote pediatric bone development and prevent fractures.

Calcium-41: a technology for monitoring changes in bone mineral

The rare, long-lived radiotracer, ⁴¹Ca, measured by accelerator mass spectrometry in the urine or serum following incorporation into the bone provides an ultra-sensitive tool to assess changes in bone calcium balance in response to an intervention. Changes in bone balance can be followed for years with one small dose that is both radiologically and biologically non-invasive. Sequential interventions can be compared, with greater precision than they can with biochemical markers of bone turnover and with greater power than with bone densitometry. This method is especially useful to screen interventions over a period of weeks. The development and validation of this tool and its applications are reviewed. Mini abstract: Use of ⁴¹Ca measured in the urine or blood by accelerator mass spectrometry to assess bone balance provides a tool to compare the relative efficacy of multiple interventions. This perspective provides insights in the use of this novel method and comparisons with more traditional methods for evaluating the efficacy of interventions.

The National Osteoporosis Foundation's position statement on peak bone mass development and lifestyle factors: a systematic review and implementation recommendations

Lifestyle choices influence 20-40 % of adult peak bone mass. Therefore, optimization of lifestyle factors known to influence peak bone mass and strength is an important strategy aimed at reducing risk of osteoporosis or low bone mass later in life. The National Osteoporosis Foundation has issued this scientific statement to provide evidence-based guidance and a national implementation strategy for the purpose of helping individuals achieve maximal peak bone mass early in life. In this scientific statement, we (1) report the results of an evidence-based review of the literature since 2000 on factors that influence achieving the full genetic potential for skeletal mass; (2) recommend lifestyle choices that promote maximal bone health throughout the lifespan; (3) outline a research agenda to address current gaps; and (4) identify implementation strategies. We conducted a systematic review of the role of individual nutrients, food patterns, special issues, contraceptives, and physical activity on bone mass and strength development in youth. An evidence grading system was applied to describe the strength of available evidence on these individual modifiable lifestyle factors that may (or may not) influence the development of peak bone mass (Table 1). A summary of the grades for each of these factors is given below. We describe the underpinning biology of these relationships as well as other factors for which a systematic review approach was not possible. Articles published since 2000, all of which followed the report by Heaney et al. [1] published in that year, were considered for this scientific statement. This current review is a systematic update of the previous review conducted by the National Osteoporosis Foundation [1]. [Table: see text] Considering the evidence-based literature review, we recommend lifestyle choices that promote maximal bone health from childhood through young to late adolescence and outline a research agenda to address current gaps in knowledge. The best evidence (grade A) is available for positive effects of calcium intake and physical activity, especially during the late childhood and peripubertal years-a critical period for bone accretion. Good evidence is also available for a role of vitamin D and dairy consumption and a detriment of DMPA injections. However, more rigorous trial data on many other lifestyle choices are needed and this need is outlined in our research agenda. Implementation strategies for lifestyle modifications to promote development of peak bone mass and strength within one's genetic potential require a multisectored (i.e., family, schools, healthcare systems) approach.

Calcium plus vitamin D supplementation and risk of fractures: an updated meta-analysis from the National Osteoporosis Foundation

The aim was to meta-analyze randomized controlled trials of calcium plus vitamin D supplementation and fracture prevention. Meta-analysis showed a significant 15 % reduced risk of total fractures (summary relative risk estimate [SRRE], 0.85; 95 % confidence interval [CI], 0.73-0.98) and a 30 % reduced risk of hip fractures (SRRE, 0.70; 95 % CI, 0.56-0.87).

INTRODUCTION

Calcium plus vitamin D supplementation has been widely recommended to prevent osteoporosis and subsequent fractures; however, considerable controversy exists regarding the association of such supplementation and fracture risk. The aim was to conduct a meta-analysis of randomized controlled trials [RCTs] of calcium plus vitamin D supplementation and fracture prevention in adults.

METHODS

A PubMed literature search was conducted for the period from July 1, 2011 through July 31, 2015. RCTs reporting the effect of calcium plus vitamin D supplementation on fracture incidence were selected from English-language studies. Qualitative and quantitative information was extracted; random-effects meta-analyses were conducted to generate summary relative risk estimates (SRREs) for total and hip fractures. Statistical heterogeneity was assessed using Cochran's Q test and the I (2) statistic, and potential for publication bias was assessed.

RESULTS

Of the citations retrieved, eight studies including 30,970 participants met criteria for inclusion in the primary analysis, reporting 195 hip fractures and 2231 total fractures. Meta-analysis of all studies showed that calcium plus vitamin D supplementation produced a statistically significant 15 % reduced risk of total fractures (SRRE, 0.85; 95 % confidence interval [CI], 0.73-0.98) and a 30 % reduced risk of hip fractures (SRRE, 0.70; 95 % CI, 0.56-0.87). Numerous sensitivity and subgroup analyses produced similar summary associations. A limitation is that this study utilized data from subgroup analysis of the Women's Health Initiative.

CONCLUSIONS

This meta-analysis of RCTs supports the use of calcium plus vitamin D supplements as an intervention for fracture risk reduction in both community-dwelling and institutionalized middle-aged to older adults.

Validation of urinary calcium isotope excretion from bone for screening anabolic therapies for osteoporosis

SUMMARY

Urinary excretion of calcium tracers in labeled individuals decreases in response to antiresorptive therapy, providing a tool to rapidly screen potential therapies. Using teriparatide, we demonstrate in this study that anabolic therapy also decreases tracer excretion, confirming that this method can also be used to screen potential anabolic therapies.

INTRODUCTION

Changes in urinary excretion of calcium tracers from a labeled skeleton may be a rapid and sensitive method to screen potential therapies for osteoporosis. This method has been used to screen antiresorptive therapies, but the effect of anabolic therapies on tracer excretion is unknown.

METHODS

Eight-month-old female Sprague Dawley rats (n = 11) were given 50 μCi (45)Ca iv. After a 1-month equilibration period, baseline urinary (45)Ca excretion and total bone mineral content (BMC) were measured. Rats were then treated with 30 μg/kg teriparatide sc per day, a bone anabolic agent, for 80 days. Urine was collected throughout the study and analyzed for (45)Ca and total Ca, and BMC was measured at the beginning and end of the study.

RESULTS

Teriparatide decreased urinary (45)Ca excretion by 52.1 % and increased BMC by 21.7 %. The change in bone calcium retention as determined by the ratio of (45)Ca to total Ca excretion in urine from day 6 through 15 of teriparatide treatment was significantly correlated (p = 0.036) with the change in BMC after 80 days of teriparatide treatment.

CONCLUSION

Urinary excretion of calcium tracers from labeled bone is an effective method to rapidly screen potential anabolic therapies for osteoporosis.

Association of adenovirus 36 infection with adiposity and inflammatory-related markers in children

CONTEXT

Although animal studies suggest that adenovirus 36 (Ad36) infection is linked to obesity and systemic inflammation, human data are scant and equivocal.

OBJECTIVE

Associations of Ad36 infection with total body adiposity and inflammatory-related markers were determined in 291 children aged 9-13 years (50% female, 49% black).

DESIGN

Fasting blood samples were measured for presence of Ad36-specific antibodies and TNF-α, IL-6, vascular endothelial growth factor (VEGF), and monocyte chemoattractant protein-1 (MCP-1). Fat mass and fat-free soft tissue mass were measured by dual-energy X-ray absorptiometry.

RESULTS

The overall prevalence of Ad36 seropositivity [Ad36(+)] was 42%. There was a higher percentage of Ad36(+) children in the highest tertiles of TNF-α and IL-6 compared with their respective middle and lowest tertiles (both P < .03). There was also a trend toward a higher prevalence of Ad36(+) children in the highest tertile of VEGF compared with tertiles 1 and 2 (P = .05). Multinomial logistic regression, adjusting for age, race, sex, and fat-free soft tissue mass, revealed that compared with children with the lowest TNF-α, IL-6, and VEGF levels (tertile 1), the adjusted odds ratios for Ad36(+) were 2.2 [95% confidence interval (CI) 1.2-4.0], 2.4 (95% CI 1.4-4.0), and 1.8 (95% CI 1.0-3.3), respectively, for those in the highest TNF-α, IL-6, and VEGF levels (tertile 3). No association was observed between Ad36(+) and greater levels of fat mass or MCP-1 (all P > .05).

CONCLUSIONS

In children, our data suggest that Ad36(+) may be associated with biomarkers implicated in inflammation but not with greater levels of fat mass.

Calcium and vitamin D intake maintained from preovariectomy independently affect calcium metabolism and bone properties in Sprague Dawley rats

The interaction of habitual Ca and vitamin D intake from preovariectomy to 4 months postovariectomy on bone and Ca metabolism was assessed. Higher Ca intake suppressed net bone turnover, and both nutrients independently benefitted trabecular structure. Habitual intake of adequate Ca and ~50 nmol/L vitamin D status is most beneficial.

INTRODUCTION

Dietary strategies to benefit bone are typically tested prior to or after menopause but not through menopause transition. We investigated the interaction of Ca and vitamin D status on Ca absorption, bone remodeling, Ca kinetics, and bone strength as rats transitioned through estrogen deficiency.

METHODS

Sprague Dawley rats were randomized at 8 weeks to 0.2 or 1.0 % Ca and 50, 100, or 1,000 IU (1.25, 2.5, or 25 μg) vitamin D/kg diet (2 × 3 factorial design) and ovariectomized at 12 weeks. Urinary (45)Ca excretion from deep-labeled bone was used to assess net bone turnover weekly. Ca kinetics was performed between 25 and 28 weeks. Rats were killed at 29 weeks. Femoral and tibiae structure (by μCT), dynamic histomorphometry, and bone Ca content were assessed.

RESULTS

Mean 25(OH)D for rats on the 50, 100, 1,000 IU vitamin D/kg diet were 32, 54, and 175 nmol/L, respectively. Higher Ca intake ameliorated net bone turnover, reduced fractional Ca absorption and bone resorption, and increased net Ca absorption. Tibial and femoral trabecular structures were enhanced independently by higher Ca and vitamin D intake. Tibial bone width and fracture resistance were enhanced by higher vitamin D intake. Dynamic histomorphometry in the tibia was not affected by either nutrient. A Ca × vitamin D interaction existed in femur length, tibial Ca content, and mass of the soft tissue/extracellular fluid compartment.

CONCLUSIONS

Adequate Ca intake and serum 25(OH)D level of 50 nmol/L provided the most benefit for bone health, mostly through independent effects of Ca and vitamin D.

A randomized trial of vitamin D₃ supplementation in children: dose-response effects on vitamin D metabolites and calcium absorption

CONTEXT

Changes in serum vitamin D metabolites and calcium absorption with varying doses of oral vitamin D₃ in healthy children are unknown.

OBJECTIVE

Our objective was to examine the dose-response effects of supplemental vitamin D₃ on serum vitamin D metabolites and calcium absorption in children living at two U.S. latitudes.

DESIGN

Black and white children (n = 323) participated in a multisite (U.S. latitudes 34° N and 40° N), triple-masked trial. Children were randomized to receive oral vitamin D₃ (0, 400, 1000, 2000, and 4000 IU/d) and were sampled over 12 weeks in winter. Serum 25-hydroxyvitamin D (25(OH)D) and 1,25-dihydroxyvitamin D (1,25(OH)₂D) were measured using RIA and intact PTH (iPTH) by immunoradiometric assay. Fractional calcium absorption was determined from an oral stable isotope ⁴⁴Ca (5 mg) in a 150-mg calcium meal. Nonlinear and linear regression models were fit for vitamin D metabolites, iPTH, and calcium absorption.

RESULTS

The mean baseline 25(OH)D value for the entire sample was 70.0 nmol/L. Increases in 25(OH)D depended on dose with 12-week changes ranging from -10 nmol/L for placebo to 76 nmol/L for 4000 IU. Larger 25(OH)D gains were observed for whites vs blacks at the highest dose (P < .01). Gains for 1,25(OH)₂D were not significant (P = .07), and decreases in iPTH were not dose-dependent. There was no dose effect of vitamin D on fractional calcium absorption when adjusted for pill compliance, race, sex, or baseline 25(OH)D.

CONCLUSION

Large increases in serum 25(OH)D with vitamin D₃ supplementation did not increase calcium absorption in healthy children living at 2 different latitudes. Supplementation with 400 IU/d was sufficient to maintain wintertime 25(OH)D concentrations in healthy black, but not white, children.

Soft tissue calcification in the Ossabaw miniature pig: experimental and kinetic modeling studies

Calcium (Ca) deposition into vascular tissue was measured in Ossabaw miniature pigs with and without metabolic syndrome (MetS) using Ca tracer kinetics and coronary atherosclerosis measured with intravascular ultrasound. Pigs with MetS had higher Ca uptake into coronary arteries than lean pigs.

INTRODUCTION

Ca deposition into arteries is a common disease in humans. The Ossabaw pig develops MetS when fed an atherogenic diet. The aim of this study was to measure Ca deposition into arteries of lean vs. MetS pigs.

METHODS

Male pigs were fed for 5 months with chow diet (healthy, lean; n = 7) or atherogenic diet (n = 8) consisting of chow supplemented with 2 % cholesterol, 43 % kcal from fat, and 20 % kcal from fructose. Pigs were verified to have MetS by obesity, insulin resistance, impaired glucose tolerance, dyslipidemia, and hypertension. Two pigs received 50 nCi of (41)Ca i.v. and blood was drawn frequently for 24 h, and 2, 3, 6, 8, 10, 15, 20, and at sacrifice at 28 days after injection. Peripheral arteries were biopsied four times per pig over the 28th day and coronary artery sampled at sacrifice. Tissues were analyzed for (41)Ca:Ca. A compartmental model was used to estimate rates of Ca deposition into the arteries.

RESULTS

The MetS swine had higher (41)Ca and atherosclerosis in coronary arteries than lean pigs.

CONCLUSIONS

This pig model is a suitable model for studying vascular calcification in humans.

Racial differences in cortical bone and their relationship to biochemical variables in Black and White children in the early stages of puberty

Osteoporotic fracture rates differ according to race with Blacks having up to half the rate of Whites. The current study demonstrates that racial divergence in cortical bone properties develops in early childhood despite lower serum 25-hydroxyvitamin D in Blacks.

INTRODUCTION

Racial differences in bone structure likely have roots in childhood as bone size develops predominantly during growth. This study aimed to compare cortical bone health within the tibial diaphysis of Black and White children in the early stages of puberty and explore the contributions of biochemical variables in explaining racial variation in cortical bone properties.

METHODS

A cross-sectional study was performed comparing peripheral quantitative computed tomography-derived cortical bone measures of the tibial diaphysis and biochemical variables in 314 participants (n = 155 males; n = 164 Blacks) in the early stages of puberty.

RESULTS

Blacks had greater cortical volumetric bone mineral density, mass, and size compared to Whites (all p < 0.01), contributing to Blacks having 17.0 % greater tibial strength (polar strength-strain index (SSIP)) (p < 0.001). Turnover markers indicated that Blacks had higher bone formation (osteocalcin (OC) and bone-specific alkaline phosphatase) and lower bone resorption (N-terminal telopeptide) than Whites (all p < 0.01). Blacks also had lower 25-hydroxyvitamin D (25(OH)D) and higher 1,25-dihydroxyvitamin D (1,25(OH)2D) and parathyroid hormone (PTH) (all p < 0.05). There were no correlations between tibial bone properties and 25(OH)D and PTH in Whites (all p ≥ 0.10); however, SSIP was negatively and positively correlated with 25(OH)D and PTH in Blacks, respectively (all p ≤ 0.02). Variation in bone cross-sectional area and SSIP attributable to race was partially explained by tibial length, 25(OH)D/PTH, and OC.

CONCLUSIONS

Divergence in tibial cortical bone properties between Blacks and Whites is established by the early stages of puberty with the enhanced cortical bone properties in Black children possibly being explained by higher PTH and OC.

Body size and pubertal development explain ethnic differences in structural geometry at the femur in Asian, Hispanic, and white early adolescent girls living in the U.S

Variation in structural geometry is present in adulthood, but when this variation arises and what influences this variation prior to adulthood remains poorly understood. Ethnicity is commonly the focus of research of skeletal integrity and appears to explain some of the variation in quantification of bone tissue. However, why ethnicity explains variation in skeletal integrity is unclear.

METHODS

Here we examine predictors of bone cross sectional area (CSA) and section modulus (Z), measured using dual-energy X-ray absorptiometry (DXA) and the Advanced Hip Analysis (AHA) program at the narrow neck of the femur in adolescent (9-14 years) girls (n=479) living in the United States who were classified as Asian, Hispanic, or white if the subject was 75% of a given group based on parental reported ethnicity. Protocols for measuring height and weight follow standardized procedures. Total body lean mass (LM) and total body fat mass (FM) were quantified in kilograms using DXA. Total dietary and total dairy calcium intakes from the previous month were estimated by the use of an electronic semi-quantitative food frequency questionnaire (eFFQ). Physical activity was estimated for the previous year by a validated self-administered modifiable activity questionnaire for adolescents with energy expenditure calculated from the metabolic equivalent (MET) values from the Compendium of Physical Activities. Multiple regression models were developed to predict CSA and Z.

RESULTS

Age, time from menarche, total body lean mass (LM), total body fat mass (FM), height, total calcium, and total dairy calcium all shared a significant (p<0.05), positive relationship with CSA. Age, time from menarche, LM, FM, and height shared significant (p<0.05), positive relationships with Z. For both CSA and Z, LM was the most important covariate. Physical activity was not a significant predictor of geometry at the femoral neck (p≥0.339), even after removing LM as a covariate. After adjusting for covariates, ethnicity was not a significant predictor in regression models for CSA and Z.

CONCLUSION

Variability in bone geometry at the narrow neck of the femur is best explained by body size and pubertal maturation. After controlling for these covariates there were no differences in bone geometry between ethnic groups.

Dendritic spine changes associated with normal aging

Given the rapid rate of population aging and the increased incidence of cognitive decline and neurodegenerative diseases with advanced age, it is important to ascertain the determinants that result in cognitive impairment. It is also important to note that much of the aged population exhibit 'successful' cognitive aging, in which cognitive impairment is minimal. One main goal of normal aging studies is to distinguish the neural changes that occur in unsuccessful (functionally impaired) subjects from those of successful (functionally unimpaired) subjects. In this review, we present some of the structural adaptations that neurons and spines undergo throughout normal aging and discuss their likely contributions to electrophysiological properties and cognition. Structural changes of neurons and dendritic spines during aging, and the functional consequences of such changes, remain poorly understood. Elucidating the structural and functional synaptic age-related changes that lead to cognitive impairment may lead to the development of drug treatments that can restore or protect neural circuits and mediate cognition and successful aging.

Simple isotopic method using oral stable or radioactive tracers for estimating fractional calcium absorption in adult women

We extended a simple oral method for estimating fractional calcium absorption determined by double isotopic methods using radioactive or stable isotope across wide age of adult women. Fractional calcium absorption can be estimated by using either a radioactive or stable oral isotope across the entire age spectrum of adult women.

INTRODUCTION

A method for estimating fractional calcium absorption using a single serum collection following a single oral radioactive isotopic tracer has been validated against a classical double isotopic tracer ratio method in adults. Our goal was to extend this simplified method to include use of stable isotopes and a broad age range.

METHODS

We used our database of 56 observations from 26 white adult women aged 19-67 years receiving either radioactive or stable isotopes. Reference values for fractional calcium absorption were determined from 24-h double isotopic ratios in serum and urine and from full kinetic modeling.

RESULTS

Equations for estimating fractional calcium absorption were developed from isotopic enrichment in serum and urine from an oral tracer and measures of body size using the multiple linear regression analysis. Equations using a 4- to 6-h sample following an oral dose of either a stable or radioactive isotope corrected for body size were highly correlated with the reference values for fractional calcium absorption across different aged populations (r > 0.8, p < 0.001).

CONCLUSION

Fractional calcium absorption can be estimated by a single oral tracer method using either radioactive or stable calcium isotopes across the entire age spectrum in healthy white adult women.

Validation of a simple isotope method for estimating true calcium fractional absorption in adolescents

We validated a single oral isotope method for estimating fractional calcium absorption determined by double isotope methods in adolescents. Developed equations with an oral isotope including a single blood draw or spot urine collection can be used to evaluate fractional calcium absorption in adolescents which allows flexibility in developing protocols.

INTRODUCTION

This study was designed to develop and validate a simpler, less expensive single oral isotope method for determining fractional calcium (Ca) absorption in adolescents.

METHODS

We used our database of 31 observations from ten white and 12 black adolescent girls aged 10-15 years who participated in metabolic and kinetic studies. Tracer data following oral ((44)Ca) and intravenous (IV, (42)Ca) administration of calcium stable isotopes and samples in serum and urine from various time points up to 4 days were used to develop methods using multiple regression analysis based on a single measurement of enriched stable isotope/tracee defined as tracer/tracee (TT) in serum (TT(serum)) or urine (TT(urine)). Reference values for fractional calcium absorption were from oral/IV stable isotope ratios in 24-h serum or urine and full kinetic modeling.

RESULTS

The strongest equation using a single blood sample had R (2) = 0.94 (p < 0.001): fractional Ca absorption = 1.3340(4-h TT(serum))(0.7872) BSA(1.7132)e ((-0.01652 PMA)), where BSA is body surface area and PMA is post-menarcheal age. The strongest equation using a single urine sample had R (2) = 0.95 (p < 0.001): fractional Ca absorption = 2.3088 (5-12 h TT(urine))(0.8208) BSA(1.5260)e ((-0.01850 PMA)). Equations were also developed with Tanner score. An external data set of Asian adolescent boys and girls was used to validate the equations.

CONCLUSION

Equations using an oral isotope and a single blood draw or urine collection for determining fractional calcium absorption were successfully validated in healthy, non-obese white and black adolescent girls aged 10-15 years. The equations well-predicted fractional calcium absorption in Asian adolescent boys and girls.

Bone-seeking labels as markers for bone turnover: validation of urinary excretion in rats

Urinary excretion of tritiated tetracycline ((3)H-TC) and (41)Ca tracers was validated as reflecting skeletal disappearance of these bone-seeking tracers as a direct measure of bone turnover following ovariectomy in rats.

INTRODUCTION

Tritiated tetracycline ((3)H-TC) and Ca tracers have been used to measure bone resorption in animal models, but urinary excretion of these labels has not been directly compared to skeletal turnover. We aimed to evaluate the use of bone-seeking labels by comparing label release into urine with label in the skeleton when bone turnover was perturbed following ovariectomy.

METHODS

Sixty-four 6-month-old ovariectomized (OVX) rats were randomized to one of eight groups in a 2 × 4 design that differed in time of (3)H-TC and (41)Ca administration following ovariectomy (1 month, when bone turnover would be accelerated following estrogen depletion or 3 months when bone loss due to OVX had slowed down) and time of euthanasia (1 week, 1 month, 3 months, and 6 months post-dose). Twenty-four-hour urine pools over two to four consecutive days and total skeleton were collected and recovered for the assessment of (3)H-TC and (41)Ca.

RESULTS

Urinary (3)H-TC levels reflected skeletal (3)H-TC levels (r = 0.93; p < 0.0001) over a wide range of bone turnover rates in response to an intervention. Urinary (41)Ca and (3)H-TC excretion were highly correlated (r = 0.95, p < 0.0001).

CONCLUSION

This study confirms that bone-seeking label excretion into the urine directly measures bone turnover.

Antiresorptive effects of phytoestrogen supplements compared with estradiol or risedronate in postmenopausal women using (41)Ca methodology

INTRODUCTION

Reduction of ovarian estrogen secretion at menopause increases net bone resorption and leads to bone loss. Isoflavones have been reported to protect bone from estrogen deficiency, but their modest effects on bone resorption have been difficult to measure with traditional analytical methods.

METHODS

In this randomized-order, crossover, blinded trial in 11 healthy postmenopausal women, we compared four commercial sources of isoflavones from soy cotyledon, soy germ, kudzu, and red clover and a positive control of oral 1 mg estradiol combined with 2.5 mg medroxyprogesterone or 5 mg/d oral risedronate (Actonel) for their antiresorptive effects on bone using novel (41)Ca methodology.

RESULTS

Risedronate and estrogen plus progesterone decreased net bone resorption measured by urinary (41)Ca by 22 and 24%, respectively (P < 0.0001). Despite serum isoflavone profiles indicating bioavailability of the phytoestrogens, only soy isoflavones from the cotyledon and germ significantly decreased net bone resorption by 9% (P = 0.0002) and 5% (P = 0.03), respectively. Calcium absorption and biochemical markers of bone turnover were not influenced by interventions.

CONCLUSIONS

Dietary supplements containing genistein-like isoflavones demonstrated a significant but modest ability to suppress net bone resorption in postmenopausal women at the doses supplied in this study over a 50-d intervention period.

Calcium absorption from commonly consumed vegetables in healthy Thai women

The absorbability of calcium from ivy gourd, a green leafy vegetable (Coccinia grandix Voigt.) and winged bean young pods (Psophocarpus tetragonolobus [L] DC) were measured in 19 healthy adult women aged 20 to 45 y, in a 3-way, randomized-order, crossover design with an average calcium load of 100 mg and milk as the referent. The test meals were extrinsically labeled with 44Ca and given with rice as breakfast after an overnight fast. Absorption of calcium was determined on a blood sample drawn 5 h after ingestion of the test meal. Fractional calcium absorption (X+/- SD) was 0.391 +/- 0.128 from winged beans, 0.476 +/- 0.109 from ivy gourd, and 0.552 +/- 0.119 from milk. The difference in fractional calcium absorption for these 2 vegetables was significant (P < 0.05) and the fractional calcium absorption from these 2 vegetables were both significantly lower than from milk. The difference was partly accounted for by the phytate, oxalate, and dietary fiber content of the vegetables. However, calcium bioavailability of these 2 vegetables, commonly consumed among Thais, was relatively good compared to milk (71% to 86% of milk) and could be generally recommended to the public as calcium sources other than milk and Brassica vegetables.

A soybean cultivar lacking lipoxygenase 2 and 3 has similar calcium bioavailability to a commercial variety despite higher calcium absorption inhibitors

The aim of this study was to evaluate calcium bioavailability of a new soybean variety without 2 lipoxygenases with better taste and flavor than a commercial variety containing all 3 isozymes. Using the femur (45)Ca uptake method, calcium absorption from a new Brazilian variety, UFV-116, was compared to a common Brazilian variety, OCEPAR 19. Male Sprague-Dawley growing rats weighing 150 to 170 g (10/group) received test meals of whole fat soy flour prepared from UFV-116 or OCEPAR-19 seeds labeled with 10 microCi of (45)Ca. Femurs were removed after 48 h for determination of (45)Ca uptake. Calcium fractional absorption was equivalent between the 2 varieties. The higher oxalate:calcium molar ratio and the higher content of oxalate and phytate (P < 0.05) found in the UFV-116 variety did not affect calcium absorption. Therefore, the new variety is a comparable source of high bioavailable calcium.

High impact exercise is more beneficial than dietary calcium for building bone strength in the growing rat skeleton

The benefits of impact exercise and dietary calcium on bone development are controversial. We used inbred rats under highly controlled conditions to test the independent and combined effects of impact exercise and physiological levels of calcium intakes on the growing skeleton. Forty growing F-344 female rats were fed diets containing either 100% (Ca+; 0.5% Ca) or 40% (Ca(-); 0.2% Ca) of their calcium requirements. Half of each dietary group was subjected to either 10 impacts per day from 45 cm freefall drops (Impact+), or no impact (Impact(-)). All rats received a free choice of physical activity period daily. After 8 weeks, the mechanical strength, volumetric density, geometry, and microarchitecture of their ulnae were measured. Body weight and bone length did not differ among groups. On both diets, freefall impact resulted in greater bone strength, cross-sectional moments of inertia, and endosteal and periosteal circumferences in the shaft. Only Ca+ resulted in greater shaft volumetric bone mineral density (vBMD) but that did not affect shaft breaking strength. In the bone ends, both Impact+ and Ca+ positively affected density and structure of both cortical and trabecular bone but the effects of Impact+ were more pervasive. In the proximal end, Impact+ resulted in greater bone volume fraction (BV/TV) in the trabecular bone due to greater trabecular thickness, and cortical thickness was greater due to a smaller endosteal circumference. Impact+ exerted a compensatory effect on vBMD and BV/TV in Ca(-) rats at the proximal site. In Impact(-) rats only, Ca+ resulted in greater total and cortical vBMD and BV/TV in the proximal ulna. Impact+ and Ca+ exerted additive effects on cortical bone area (BA) in the proximal ulna and on total BA, periosteal circumference, and trabecular vBMD in the distal ulna. In conclusion, impact exercise was more beneficial than adequate dietary calcium to growing bones, although sufficient dietary calcium was beneficial in rats not subjected to impact exercise.

Zinc and iron bioavailability of genetically modified soybeans in rats

The aim of this work was to evaluate zinc and iron bioavailability of UFV-116, a new variety without 2 lipoxygenases, with better taste and flavor than a commercial variety OCEPAR 19, containing all 3 isozymes. To evaluate zinc absorption using 65Zn whole body retention and femur 65Zn uptake, rats were given 3 g of a 65ZnCl2 labeled test meal (0.25 microCi). The 2 varieties were tested at the level of 9 and 30 ppm of zinc as defatted soy flour. Two other groups (control) received egg white as source of protein and ZnS04.H20 as the zinc source. To evaluate iron absorption, using 59Fe whole body retention, animals were given a 3 g 59FeCl3 labeled test meal (0.2 microCi). The 2 varieties were tested at 12 and 25 ppm iron as defatted soy flour. Whole fat soy flour of variety 1 (UFV-116) was higher (P < 0.05) in Ca, K, Mg, phytic acid, and oxalate than variety 2 (OCEPAR-19). No difference was observed among the soybean varieties (P > 0.05) for femur 65Zn retention, at different levels of zinc. However, whole body retention was lower (P < 0.05) for UFV-116 than for OCEPAR-19. Femur 65Zn uptake was correlated with the whole body retention; however, whole body retention was more sensitive. Whole body 59Fe retention from UFV-116 was lower (P < 0.05) than from OCEPAR-19. Zinc and iron bioavailability was lower for UFV-116, possibly due to its higher content of antinutrient factors, especially phytate.

Bone mineral and predictors of bone mass in white, Hispanic, and Asian early pubertal girls

Differences in bone among racial/ethnic groups may be explained by differences in body size and shape. Previous studies have not completely explained differences among white, Asian, and Hispanic groups during growth. To determine racial/ethnic differences and predictors of bone mass in early pubertal girls, we measured bone mineral content (BMC) in white, Hispanic, and Asian sixth-grade girls across six states in the United States. We developed models for predicting BMC for the total-body, distal radius, total-hip, and lumbar spine for 748 subjects. For each of the bone sites, the corresponding area from dual-energy X-ray absorptiometry (DXA) was a strong predictor of BMC, with correlations ranging 0.78-0.98, confirming that larger subjects have more BMC. Anthropometric measures of bone area were nearly as effective as bone area from DXA at predicting BMC. For total-body, distal radius, lumbar spine, and total-hip BMC, racial/ethnic differences were explained by differences in bone area, sexual maturity, physical activity, and dairy calcium intake. Bone size explained most of the racial/ethnic differences in BMC, although behavioral indicators were also significant predictors of BMC.

Soy isoflavones do not affect bone resorption in postmenopausal women: a dose-response study using a novel approach with 41Ca

INTRODUCTION

The purpose of this 3-way crossover study was to identify the effective dose of soy protein isolate enriched with isoflavones for suppressing bone resorption in postmenopausal women using a novel, rapid assessment of antibone resorbing treatments.

METHODS

Thirteen postmenopausal women (>or=6 yr since menopause) were predosed with 41Ca iv. After a 200-d baseline period, subjects were given 43 g soy protein/d that contained 0, 97.5, or 135.5 mg total isoflavones in randomized order. The soy protein isolate powder was incorporated into baked products and beverages. Each 50-d intervention phase was preceded by a 50-d pretreatment phase for comparison. Serum isoflavone levels and biochemical markers were measured at the end of each phase. Twenty-four-hour urine samples were collected approximately every 10 d during each phase for 41Ca/Ca analysis by accelerator mass spectrometry.

RESULTS

Serum isoflavone levels reflected the amount of isoflavones consumed in a dose-dependent manner. None of the isoflavone levels had a significant effect on biochemical markers of bone turnover, urinary cross-linked N teleopeptides of type I collagen and serum osteocalcin, or bone turnover as assessed by urinary 41Ca/Ca ratios.

CONCLUSIONS

Soy protein with isoflavone doses of up to 135.5 mg/d did not suppress bone resorption in postmenopausal women. This is the first efficacy trial using the novel technique of urinary 41Ca excretion from prelabeled bone.

Parathyroid hormone is associated with decreased fat mass in young healthy women

OBJECTIVE

To investigate the relationship of parathyroid hormone (PTH) with dietary calcium and changes in body composition.

DESIGN

Cross-sectional and 1-year longitudinal trial.

SUBJECTS

Normal-weight young women (age: 18-31), 155 subjects analyzed at baseline, and data for 41 subjects analyzed prospectively between baseline and 12 months.

MEASUREMENTS

Levels of fasting serum calcium and PTH, intakes of calcium (3-day diet records), and total body weight and body composition (dual energy X-ray absorptiometry).

RESULTS

Baseline dietary calcium, regardless of whether unadjusted or adjusted for energy intake, did not predict baseline levels of fasting serum PTH. Change in dietary calcium also did not predict change in serum PTH. However, log PTH was significantly correlated with body fat mass (R = 0.27), but not lean mass at baseline (n = 155), independent of serum calcium (corrected R = 0.25). Further, 12-month changes (n = 41) in log PTH positively predicted the 12-month change in body weight (R = 0.32) and body fat (R = 0.32), but not lean mass even when controlled for age or change in serum calcium.

CONCLUSION

Fasting serum PTH was associated with increased fat mass, in both cross-sectional and prospective analysis. Thus, serum PTH may play a role in the regulation of body fat mass in young women.

Adaptations to free-fall impact are different in the shafts and bone ends of rat forelimbs

Impact exercise can have beneficial effects on the growing skeleton. To understand what changes it promotes in the shafts and ends of weight-bearing bones, we measured the effects of impact from repetitive free falls in growing rats. Fischer 344 female rats, 6.5 wk old, were assigned to one of three groups ( n = 10 each). Controls were not dropped, whereas those subjected to impact were dropped from 30 or 60 cm. Rats in both free-fall groups were dropped 10 times per day for 8 wk. Leg bones were mechanically tested, and their cross-sectional area (CSA), cross-sectional moments of inertia, and volumetric bone mineral density (BMD) were measured by peripheral quantitative computed tomography. In the shafts of the forelimbs, but not the hindlimbs, free-fall impact resulted in greater ultimate breaking force, minimum and maximum second moments of area, and CSA but not BMD. In the bone ends of the forelimb and tibial bones, trabecular BMD increased but CSA did not. Landing from 30 and 60 cm produced peak impact forces of 12.0 and 16.7 times the standing forefoot weight for each front leg and of 4.5 and 7.7 times the standing hind foot weight for each hind foot. Overall, free-fall impact affected the forelimbs by increasing trabecular bone density in the bone ends and improving the strength at the shaft as a result of geometric improvements. These results indicate that adaptation to impact may occur by different mechanisms in bone end and shaft regions.

Peak spine and femoral neck bone mass in young women

Achievement of higher peak bone mass early in life may play a critical role against postmenopausal bone loss. Bone mineral density (BMD) of the spine, femoral neck, greater trochanter, Ward's triangle, and spine bone mineral content (BMC) and bone surface area (BSA) were assessed by dual energy x-ray absorptiometry in 300 healthy females (age 6-32 years). Bone measurements were described by using nonlinear models with age, weight, height, or dietary calcium intake as the explanatory variables. At the spine, femoral neck, greater trochanter, and Ward's triangle, the highest BMD level was observed at 23.0 +/- 1.4, 18.5 +/- 1.6, 14.2 +/- 2.0, and 15.8 +/- 2.1 years, respectively. The age of attaining peak spine BMC and BSA cannot be estimated, as significant increases in these two measures were observed through this age group. Age, weight, and height were all significant predictors of all these bone measurements. Weight was a stronger predictor than age for all sites. Dietary calcium intake was not a significant predictor for any of these bone measurements. We conclude that age of attaining peak bone mass at the hip is younger than at the spine, and BMC and BSA at the spine continue to increase through the early thirties in females.

Racial differences in bone turnover and calcium metabolism in adolescent females

Blacks develop a higher peak bone mass than whites which is associated with a reduced risk for bone fracture. The physiological basis for the difference in bone mass was investigated by metabolic balance and calcium kinetic studies in adolescent black and white girls. The hypothesis that the greater peak bone mass in blacks compared with whites is due to suppressed bone resorption was tested. Subjects were housed in a supervised environment for 3 wk during which time they consumed a controlled diet and collected all excreta. Subjects were given stable calcium isotopes orally and intravenously after 1 wk adaptation. Blacks have greater calcium retention (mean +/- SD, 11.5 +/- 6.1 vs. 7.3 +/- 4.1 mmol/d, P < 0.05) consistent with greater bone formation rates (49.4 +/- 13.5 vs. 36.5 +/- 13.6 mmol/d, P < 0.05) relative to bone resorption rates (37.4 +/- 13.2 vs. 29.4 +/- 10.9 mmol/d, P = 0.07), increased calcium absorption efficiency (54 +/- 19 vs. 38 +/- 18%, P < 0.05) and decreased urinary calcium (1.15 +/- 0.95 vs. 2.50 +/- 1.35 mmol/d, P < 0.001), compared with whites. The racial differences in calcium retention in adolescence can account for the racial differences in bone mass of adults.

Impact of exercise on bone health and contraindication of oral contraceptive use in young women

PURPOSE

The effect of quantified resistance and high impact exercise training on bone mass as modified by age and oral contraceptive (OCont) use in young women was studied.

METHODS

Women were categorized by age (18-23 vs 24-31 yr) and OCont use, and were then randomized into either three sessions of resistance exercise plus 60 min.wk-1 of jumping rope or a control group for 24 months. Total body, spine, femoral neck, greater trochanter, Ward's area, and radial bone mineral density (BMD) and/or content (BMC), biochemical markers of bone turnover, dietary intake of calcium, lean body mass, maximal oxygen uptake, and strength were determined at baseline and every 6 months.

RESULTS

Total body (TB) BMC percent change from baseline was higher in exercisers compared with nonexercisers at 6 and 24 months. OCont users had lower bone turnover at baseline and a decrease in TBBMC from baseline compared with non-OCont users at 24 months. Spine BMC and BMD decreased in the exercise and OCont group at 6 months and remained significantly below nonexercisers who used oral contraceptives at 2 yr. Femoral neck BMD also decreased in the exercise and oral contraceptive group at 6 months.

CONCLUSIONS

Exercise prevented a decline in TBBMC seen in the nonexercisers. On the other hand, exercise in oral contraceptive users prevented the increase observed in the spine of the nonexercise plus OCont group.

Evaluation of dual energy x-ray absorptiometry for in situ measurement of bone mineral density of equine metacarpi

OBJECTIVE

To determine the accuracy and precision of dual energy x-ray absorptiometry (DEXA) for measuring bone mineral density in horses in situ. Sample Population-12 randomly selected forelimbs from 12 horses.

PROCEDURE

Metacarpi were scanned in 2 planes and DEXA measurements obtained for 6 regions of interest (ROI). Each ROI was isolated and bone density measured by Archimedes' principle. Linear regression analysis was used to determine the correlation between the 2 measurements at each ROI. An additional metacarpus was measured 10 times to determine the coefficient of variation for both techniques.

RESULTS

Dual energy x-ray absorptiometry and bone density were significantly associated at multiple ROI. The addition of age, weight, and soft tissue or bone thickness improved these associations. Repeated measurements had a low coefficient of variation.

CONCLUSIONS AND CLINICAL RELEVANCE

Dual energy x-ray absorptiometry can be used to accurately and precisely measure the bone density in the equine metacarpus. Dual energy x-ray absorptiometry appears suitable for serial in vivo measurement of bone density of the equine metacarpus. Dual energy x-ray absorptiometry may be used for studies to evaluate the effects of diet or drugs on bone density or density changes from bone remodeling that develop prior to stress fractures.

Changes in calcium kinetics in adolescent girls induced by high calcium intake

To identify the mechanism/s whereby calcium retention is increased by calcium intake in adolescent girls, kinetic studies were performed using stable calcium isotope tracers. Girls (n = 10; 12 +/- 1 yr old, mean +/- SD) were studied while on a controlled diet containing a low (21.2 mmol/day) and a high (47.4 mmol/day) calcium intake, in randomized order, using a cross-over design. Studies were separated by 1 month. Calcium tracers were administered after 1 week on the study diet, orally and iv; and serum, urine, and feces were collected for the following 14 days. Tracers were measured using fast atom bombardment mass spectrometry, and kinetic data were analyzed by compartmental modeling. Biochemical markers of bone turnover were measured in serum and urine samples. On high (compared with low) calcium intake, fractional absorption did not differ, absorbed calcium increased (19.6 +/- 7.5 vs. 8.0 +/- 2.5 mmol/day, mean +/- SD, P: < 0.001), calcium excreted in urine increased (2.8 +/- 1.7 vs. 2.1 +/- 1.1 mmol/day, P: < 0.01), calcium retained in bone increased (14.5 +/- 8.9 vs. 3.2 +/- 3.6 mmol/day, P: < 0.001), bone formation did not change, and bone resorption decreased by 32%. These changes, measured by kinetics, were corroborated by changes in markers of bone turnover. We conclude that increased bone retention of calcium, with high calcium intake in adolescent girls, is attributable to an increase in absorption and a decrease in bone resorption.

Exercise and oral contraceptive use suppress the normal age-related increase in bone mass and strength of the femoral neck in women 18-31 years of age

Women who exercise during their second and third decades may increase their peak bone mass and lower their eventual risk for postmenopausal fracture. However, the effects of exercise in younger women can be modulated by the use of oral contraceptives, which may prevent the normal accretion of bone mass that would otherwise occur. We hypothesized that exercise intervention in young adult women would significantly increase both bone mass and the bending rigidity of the femoral neck. We further hypothesized that exercise intervention in the presence of oral contraceptive use would have a negative effect on bone mass and bending rigidity. Women 18-31 years of age (n = 123) were classified by oral contraceptive use (OC, NOC) and age (18-23, 24-31 years), and then randomized into exercise or nonexercise groups. The exercise protocol consisted of three sessions/week of aerobic and nonaerobic exercises, and continued for 2 years. Each 6 months, the femoral neck of each subject was scanned using a Lunar dual-energy X-ray absorptiometry (DEXA) scanner, and bone mineral content, density and geometric information were used to calculate estimated stresses and bending rigidity at the hip. Percent changes from baseline were analyzed using two-way analysis of variance (ANOVA) at 6, 12, 18, and 24 months. Women who neither exercised nor took oral contraceptives (NE/NOC) had the greatest percentage increases in cross-sectional area (4.98 +/- 2.29%), cross-sectional moment of inertia (9.45 +/- 2.37%), total bone mineral density (2.07 +/- 2.09%), fracture index (8.03 +/- 2.03%), and safety factor (20.03 +/- 5.79%) over the 24 month exercise program. Women who exercised and did not take oral contraceptives (E/NOC) declined on most variables related to femoral strength and bone mass, whereas those women who took oral contraceptives were usually intermediate between NE/NOC and E/NOC, whether they exercised or not. These data show that either exercise or OC use is associated with a suppression of the normal increase in bone mass and mechanical strength in the femoral neck in women 18-31 years old, but the combination of exercise and OC use appears to have a less suppressive effect.

Dairy calcium is related to changes in body composition during a two-year exercise intervention in young women

OBJECTIVE

Relationships between micronutrients and dairy product intake and changes in body weight and composition over two years were investigated.

DESIGN

Two year prospective non-concurrent analysis of the effect of calcium intake on changes in body composition during a two year exercise intervention.

SUBJECTS

54 normal weight young women, 18 to 31 years of age.

MEASURES OF OUTCOME

Mean intakes of nutrients of interest were determined from three-day diet records completed at baseline and every six months for two years. The change in total body weight and body composition (assessed by dual x-ray absorptiometry) from baseline to two years was also determined.

RESULTS

Total calcium/kilocalories and vitamin A together predicted (negatively and positively, respectively) changes in body weight (R2 = 0.19) and body fat (R2 = 0.27). Further, there was an interaction of calcium and energy intake in predicting changes in body weight, such that, only at lower energy intakes, calcium intake (not adjusted for energy) predicted changes in body weight.

CONCLUSIONS

Regardless of exercise group assignment, calcium adjusted for energy intake had a negative relationship and vitamin A intake a positive relationship with two year changes in total body weight and body fat in young women aged 18 to 31 years. Thus, subjects with high calcium intake, corrected by total energy intake, and lower vitamin A intake gained less weight and body fat over two years in this randomized exercise intervention trial.

Calcium requirements of physically active people

Dietary calcium and physical activity have been independently, but inconsistently, associated with the development of increased peak bone mass and reduced bone loss later in life. An examination of the literature points to important effects of dietary calcium on bone health. During the development of peak bone mass, calcium intakes of <1 g/d are associated with lower bone mineral density. At intakes approaching calcium requirements, physical activity is a more important predictor of bone mineral density than is calcium intake. In studies of postmenopausal women, calcium intakes of 1 g (25 mmol/d) appear to be necessary to effect a positive impact of exercise on bone mineral density in the spine. Calcium intakes recommended for protecting bone health appear to be adequate to protect against other disorders with an etiology that includes inadequate dietary calcium. Calcium requirements as modified by physical activity need to be determined for each population subgroup according to sex, age, race, and cultural environment.

Improved lactose digestion and intolerance among African-American adolescent girls fed a dairy-rich diet

OBJECTIVE

To determine whether African-American adolescent girls who were fed a dairy-rich diet for 21 days could adapt to lactose, experiencing an overall improvement in lactose tolerance as well as a decrease in hydrogen gas production.

DESIGN

Twenty-one-day dietary intervention study.

SUBJECTS/SETTING

Seventeen of 21 African-American girls (aged 11 to 15 years) enrolled in a calcium metabolism study chose to participate in the lactose tolerance study. Subjects were screened for any diseases, conditions, or medications that might alter calcium metabolism or colonic fermentation. Subjects were housed in a fraternity on the Purdue University, West Lafayette, Ind, campus, and were supervised 24 hours a day.

INTERVENTION

Subjects consumed a dairy-based diet averaging 1,200 mg calcium and 33 g lactose per day for 21 days. Lactose digestion was assessed by an 8-hour breath hydrogen test on days 1 and 21, and symptoms of intolerance (abdominal pain, bloating, flatulence, and diarrhea) were evaluated hourly on a ranked scale during the breath hydrogen tests and once each evening during the 21-day feeding period.

MAIN OUTCOME MEASURES

A comparison of breath hydrogen production and gastrointestinal symptoms at the beginning and end of the study.

STATISTICAL ANALYSES PERFORMED

The Wilcoxon signed ranks test was used to compare the area under the curve for the 2 breath hydrogen tests. Spearman's p test for trend was used to determine whether there was a change in symptoms. All statistical analyses were 2-tailed and significance was set at P = .05.

RESULTS

Fourteen of the 17 subjects had lactose maldigestion. Breath hydrogen excretion decreased significantly (P < .03) from the beginning (148.3 +/- 27.0 ppm x hours) to the end (100.7 +/- 19.3 ppm x hours) of the 21-day period. Gastrointestinal symptoms were negligible during both the breath hydrogen tests as were symptoms during the 21-day period.

APPLICATIONS/CONCLUSIONS

The diet was well tolerated by the subjects. Furthermore, the decrease in breath hydrogen suggests colonic adaptation to the high-lactose diet. The results indicate that lactose maldigestion should not be a restricting factor in developing adequate calcium diets for this population. The existence of lactose maldigestion does not result in lactose intolerance in this population when it is fed a dairy-rich diet.

The growing years and prevention of osteoporosis in later life

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.

The new dietary reference intakes for calcium: implications for osteoporosis

The new Dietary Reference Intakes (DRI) for calcium were released August 13, 1997 by the Food and Nutrition Board of the National Academy of Science. Unlike the RDA's which established the minimal amounts of nutrients needed to be protective against possible deficiency, the new values are designed to reflect the latest understanding about nutrient requirements directed at optimizing health in individuals and groups. Adequate calcium intake recommendations were set at levels associated with desirable retention of body calcium since high bone density is known to be less susceptible to fractures. Recommended intake for adults is 1000 to 1200 mg/day. The majority of people do not consume these levels of calcium. The upper tolerable limit for calcium was set at 2.5 g/day.

Choices for achieving adequate dietary calcium with a vegetarian diet

To achieve adequate dietary calcium intake, several choices are available that accommodate a variety of lifestyles and tastes. Liberal consumption of dairy products in the diet is the approach of most Americans. Some plants provide absorbable calcium, but the quantity of vegetables required to reach sufficient calcium intake make an exclusively plant-based diet impractical for most individuals unless fortified foods or supplements are included. Also, dietary constituents that decrease calcium retention, such as salt, protein, and caffeine, can be high in the vegetarian diet. Although it is possible to obtain calcium balance from a plant-based diet in a Western lifestyle, it may be more convenient to achieve calcium balance by increasing calcium consumption than by limiting other dietary factors.

Phosphate-binding capacity of ferrihydrite versus calcium acetate in rats

Calcium salts, such as calcium carbonate and calcium acetate, are the principal compounds used as phosphate binders in patients with chronic renal failure. The dose required is three to six times the normal requirement for calcium. Use of these large doses of calcium salts in the diet can result in hypercalcemia. Other compounds have been investigated as phosphate binders with varying degrees of success. Synthetic ferrihydrite (5Fe(2)O(3).9H(2)O) has a high adsorptive capacity for phosphate and may be an effective phosphate binder. The phosphate-binding capacity of ferrihydrite was compared with that of calcium acetate in 250-g male Sprague Dawley rats. After an overnight fast, rats (n = 5 per group) were gavaged with an American Institute of Nutrition (AIN) 76 formula containing one third the daily phosphorus intake labeled with phosphorus-32 ((32)P). Either two levels of calcium acetate, representing three (1/2X) or six (1X) times the usual calcium intake for one third of the day, or equivalent amounts of ferrihydrite were added to the diet. An additional group received two times (2X) the larger dose, and a sixth control group received no binder in the diet. Phosphorus absorption curves were determined from (32)P appearance in the serum. The 1/2X dose of ferrihydrite reduced (32)P by approximately one half, and the 2X dose nearly completely suppressed (32)P absorption, similar to the 1X dose of calcium acetate. The advantage of using a ferrihydrite binder would be to avoid the hypercalcemia resulting from the use of high-dose calcium salts. An added advantage may result from the small amounts of iron absorbed in these chronically iron-deficient patients.