Programas de educação sobre saúde óssea para idosos: uma revisão integrativa / Bone health education programs for older people: an integrative review

Resumo A osteoporose é uma doença sistêmica caracterizada pela redução da densidade mineral óssea. A difusão do conhecimento sobre à doença, pode ser uma alternativa viável para atitudes preventivas e de autocuidado. Dessa forma, esse artigo procura identificar como são os programas sobre saúde óssea para idosos. Trata-se de uma revisão integrativa de estudos publicados entre 2011 e 2022 nas bases de dados Periódicos Capes, Web of Science, PubMed e Google Scholar em inglês. Foram encontrados 10.093 estudos, sendo selecionados 7 depois dos critérios de inclusão. Foi possível verificar que os programas de educação para saúde óssea possuem o objetivo de empoderar o idoso pelo aumento do conhecimento sobre a doença, conscientizar sobre o consumo de cálcio e vitamina D ou de medicamentos para osteoporose, mudanças de hábitos e a prática de exercícios físicos. Os programas geralmente são realizados com reuniões em grupo ou individualizados, com sessões de 50 a 60 minutos, podendo ou não, delimitar o número de indivíduos em cada uma delas. Nota-se que acompanhar a evolução do processo educativo também é importante. A contextualização dos temas junto a realidade e interesse dos idosos, parece ser outra forma positiva para despertar atitudes de autocuidado.

Abstract Osteoporosis is a systemic disease characterized by a reduction in bone mineral density. The dissemination of knowledge about the disease can be a viable alternative for promoting preventive behavior and self-care. This study sought to identify the main characteristics of bone health programs for older persons. We conducted an integrative review, searching for studies published between 2011 and 2022 in the CAPES periodicals database, Web of Science, PubMed, and Google Scholar using English descriptors. A total of 10,093 studies were retrieved, seven of which were selected after applying the inclusion criteria. The findings show that bone health education programs aim to empower older people by increasing knowledge about the disease and raising awareness about calcium and vitamin D intake, osteoporosis medications, and the importance of changing habits and exercise. Programs generally consist of group or individual meetings, with sessions lasting 50 to 60 minutes. Class sizes may be limited or unrestricted. Follow-up during the educational process was also found to be important. Tailoring topics to the reality and interests of participants appears to be another positive way of promoting the adoption of self-care practices.

Research progress in per- and polyfluoroalkylsubstances （PFASs） exposure and bone health / 上海预防医学

Per- and polyfluoroalkyl substances （PFASs） are a new type of persistent organic pollutants with global attention. They have shown multiple toxic effects due to their persistent accumulation in human body through exposure to environmental media such as drinking water， food， atmosphere， and soil. However， the bone toxicity of PFASs has not attracted enough attention. It is believed that the exposure and accumulation of PFASs in human have a significant impact on the bone health， especially hindering the healthy bone development in infants and adolescents， and aggravating the occurrence of bone loss and fracture in the elder populations. This paper will review the research progress of the effects of PFASs exposure on bone health indicators such as bone mineral density， and discuss the mechanisms of PFAS in bone toxicity. This review will provide references for revealing the effects of PFASs exposure on bone health and their toxic mechanisms.

Incidence of Metabolic Bone Disease After Implementation of Bone Protective Nutritional Strategies: A Prospective Cohort Study

Background: Metabolic bone disease (MBD) is a morbidity of multifactorial etiology with a high incidence in very preterm infants. We planned to study the incidence of MBD after implementation of bone health focussed nutritional strategy (BNS) in those <30 weeks gestation at birth. Methods: This prospective cohort study including preterm newborns (<30 weeks) who received nutrition that incorporated (a) Early initiation of intravenous potassium phosphate; (b) Early enteral supplementation with multicomponent human milk fortifier at enteral feed tolerance of 40 mL/kg/day feeds itself; and (c) Weekly phosphorus measurements with optimization of enteral intakes. Incidence of MBD at 4 weeks of postnatal age and beyond were analyzed. Other relevant safety and clinical outcomes were measured. Results: Of the 67 included neonates receiving BNS, 20.9% were classified as MBD. There was a low rate of hyperphosphatemia (4.5%) and hyperkalemia (2.9%). Full enteral feeds were achieved by median (IQR) of 6 (5,7) postnatal days. Conclusion: In preterm newborns (24-30 weeks) MBD incidence was 20.9% after BNS was implemented. Intravenous potassium salt of phosphorus and early use of HMF were safe and feasible.

Bone Mineral Density in an Urban Hospital in Dhaka City of Bangladesh

Background: Osteoporosis behaves as a silent killer. Therefore, a high percentage of the affected people are not aware they have this chronic condition. In this way, the burden of osteoporosis is the burden of its clinical outcome: osteoporotic fractures, which are generally characterized by low-trauma fractures resulting from low bone mineral density (BMD). Objectives: The present study aimed to assess BMD distribution among urban and rural subjects and its relationship with key foods.Material & Methods:In this study, a total of 140 subjects were studied from the study BMD lab of the study hospital. Data were analyzed using Mean, SD, % and correlation by SPSS 24.Results:Mean盨D value of age (yr), BMI, WHR, Lumber-T score, Lumber-BMD, Right Femur -T score, Right Femur-BMD, Left Femur-T score, Left Femur-BMD, Supplementation of the study participants were 54�, 25� 1.0�25, -1.0�0, 1.0�2, -1� 1�2, -1� 1�15.Age (yrs), BMI, waist (cm), hip (cm), WHR, Lumber T-score, Lumber Z-score, Lumber BMD (g/cm�), Rt. Fem Neck T-score,Rt. Fem Neck Z-score, Rt. Fem Neck BMD (g/cm�), Lt. Fem Neck T-score,Lt. Fem Neck Z-score, Lt. Fem Neck BMD (g/cm�) of the urban study participants were 51�, 30� 88�, 95�, 1�, -1.6�6, -1�6, 0.9�2, -0.9�3, -0.2�9, 0.9�2, -1�2, -0.3� 0.8�1 respectively and for rural participants the values were 54�, 25�5, 86� 92�, 1�2, -2.4�5, 0.8�2, -1.5�3, -0.6� 0.7�2, -1.6�2, -0.7�and 0.8�respectively. About 48.18% rural subjects had osteoporosis, 34.54% had osteopenia and 17.27% had normal bone health. Again, 28.57% of the urban subjects had osteoporosis, 41.40% had osteopenia and 30% had normal bone density. Fish, egg and meat were associated with BMD. Fish intake had a positive association with lumber T score (r=0.194, p=0.009), LumZ (r=0.016, p=0.031), Lumber BMD (r=0.183, p=0.014). Milk intake has positive association with Lumber t and Lumber BMD (p=0.027, 0.049). Similarly, egg intake has positive association with Lumber BMD, Rt BMD, Lt BMD (p= 0.035, 0.01, 0.019).Conclusions:Nearly 48.18% rural subjects have osteoporosis, 34.54% have osteopenia and 17.27% have normal bone health. Again, 28.57% urban subjects have osteoporosis, 41.40% have osteopenia and 30% have normal bone density. The prevalence of osteoporosis is higher in rural area than urban peopleand osteopenia is higher in urban area than rural area. Fish, milk and egg consumption positivelyassociated with BMD.

How some biochemical indexes of apheresis platelet donors were affected by different calcium supplement methods at blood donation intervals / 中国输血杂志

【Objective】 To investigate the effect of two different oral calcium supplementation methods(method 1: bone health basic supplements in the interval plus routine calcium supplement; method 2: only routine calcium supplement on the day of donation)on platelet donors, to improve some biochemical indexes of the body caused by citrate anticoagulant. 【Methods】 A total of 252 long-term regular platelet donors in our station from January 2019 to December 2020 were selected and randomly divided into two groups: experimental group (n=126) were given 10% calcium gluconate oral solution 20 mL before platelet collection, orally. Oral caltrate D3 (containing 600 mg calcium carbonate and 125 international units of vitamin D3) was administered in the interval (20±2 days), 1 tablet per day. Oral alfacalcidol soft capsule (containing alfacalcidol 0.25 μg), 1 tablet per day; control group (n=126) were given routine administration of 10% calcium gluconate oral solution 20 mL before platelet collection. Serum PTH and serum concentrations of calcium, magnesium, phosphorus and 25 hydroxyvitamin D of the two groups were detected at 0 min after injection and 0 min after the end of the last circulation, respectively. Meanwhile, the occurrence of blood donation reactions was observed in the two groups. 【Results】 In the experimental group and control group, serum PTH concentration both increased significantly after donation, while serum calcium, inorganic phosphorus, magnesium and 25 hydroxyvitamin D decreased significantly(P<0.01). After donation, 4 donors in the experimental group and 8 in the control group showed citrate reaction, with the incidence of adverse reactions at 3.17%(4/126)and 6.34%(8/126), respectively. Before blood collection, serum calcium concentration in the experimental group was higher than that in the control group, while PTH concentration was lower than that in the control group (P<0.01), but no significant differences were noticed in serum magnesium, inorganic phosphorus and 25 hydroxyl vitamin D concentrations (P>0.05), and so was in the control group after blood collection. 【Conclusion】 Method 1 can further slow down the increase of serum PTH and the decrease of serum calcium, and can effectively reduce the citrate response of blood donors compared with method 2, which is of great significance to prevent osteoporosis in long-term regular blood donors.

Analysis and research on the key factors of sports in maintaining human health / Análise e pesquisa sobre os fatores-chave do esporte na manutenção da saúde humana / Análisis e investigación sobre los factores clave del deporte para mantener la salud humana

ABSTRACT Introduction The research on the promotion of physical fitness of the human body by exercise has also attracted widespread attention in sports and rehabilitation medicine. Object This article uses ultrasound to study the bone density health of the human body, thereby establishing the relationship between sports and bone density health. We hope to use the research results of this article to improve people's awareness of sports health. Method We used ultrasound to test the bone mineral density of two groups of students (exercise group and non-exercise group) to explore the relationship between different sports items and the students' bone mineral density. Results There is a significant difference in bone density between the two groups of students. There is no gender difference in bone density. Conclusion Students need to strengthen physical exercise in the growth and development stage to improve bone density. Level of evidence II; Therapeutic studies - investigation of treatment results.

RESUMO Introdução A pesquisa sobre a promoção da aptidão física do corpo humano por meio do exercício também tem atraído atenção generalizada na medicina esportiva e de reabilitação. Objeto este artigo usa o ultrassom para estudar a saúde da densidade óssea do corpo humano, estabelecendo assim a relação entre esportes e saúde da densidade óssea. Esperamos usar os resultados da pesquisa deste artigo para aumentar a conscientização das pessoas sobre a saúde no esporte. Método Usamos ultrassom para testar a densidade mineral óssea de dois grupos de alunos (grupo de exercícios e grupo de não exercícios) para explorar a relação entre diferentes itens esportivos e a densidade mineral óssea dos alunos. Resultados Existe uma diferença significativa na densidade óssea entre os dois grupos de alunos. Não há diferença de gênero na densidade óssea. Conclusão Os alunos precisam fortalecer os exercícios físicos na fase de crescimento e desenvolvimento para melhorar a densidade óssea. Nível de evidência II; Estudos terapêuticos - investigação dos resultados do tratamento.

RESUMEN Introducción La investigación sobre la promoción de la aptitud física del cuerpo humano mediante el ejercicio también ha atraído una amplia atención en la medicina deportiva y de rehabilitación. Objeto Este artículo utiliza la ecografía para estudiar la salud de la densidad ósea del cuerpo humano, estableciendo así la relación entre el deporte y la salud de la densidad ósea. Esperamos utilizar los resultados de la investigación de este artículo para mejorar la conciencia de las personas sobre la salud deportiva. Método Utilizamos ultrasonido para probar la densidad mineral ósea de dos grupos de estudiantes (grupo de ejercicio y grupo sin ejercicio) para explorar la relación entre diferentes artículos deportivos y la densidad mineral ósea de los estudiantes. Resultados Existe una diferencia significativa en la densidad ósea entre los dos grupos de estudiantes. No hay diferencia de género en la densidad ósea. Conclusión Los estudiantes necesitan fortalecer el ejercicio físico en la etapa de crecimiento y desarrollo para mejorar la densidad ósea. Nivel de evidencia II; Estudios terapéuticos: investigación de los resultados del tratamiento.

The Female Athlete Triad/Relative Energy Deficiency in Sports (RED-S) / A tríade da atleta feminina/déficit energético relativo no esporte (RED-S)

Abstract In a healthy athlete, the caloric intake is sufficient for sports energy needs and body physiological functions, allowing a balance between energy availability, bone metabolism, andmenstrual cycle.Onthe other hand, an imbalance causedby low energy availability dueto a restrictive diet, eating disorders or long periods of energy expenditure leads to multisystemic deregulation favoring the essential functions of the body. This phenomenon, described as the female athlete triad, occurs in a considerable percentage of high-performance athletes, with harmful consequences for their future. The present review was carried out based on a critical analysis of themost recent publications available and aims to provide a global perception of the topic relative energy deficit in sport (RED-S). The objective is to promote theacquisition ofmore consolidated knowledgeon an undervaluedtheme, enabling the acquisition of preventive strategies, early diagnosis and/or appropriate treatment.

Resumo Emumaatleta saudável, oaporte calórico é suficientepara anecessidade energética esportiva e para as funções fisiológicas corporais, permitindo um equilíbrio entre disponibilidade energética (DE), metabolismo ósseo e função menstrual. Por outro lado, um desequilíbrio devido à baixa disponibilidade energética (BDE) por dieta restritiva, perturbações alimentares ou grandes períodos de gasto energético conduz a uma desregulação multissistêmica priorizando as funções essenciais do corpo. Este fenômeno, descrito inicialmente como tríade da mulher atleta e, atualmente, comodéfice energético relativo no esporte (RED-S, nasigla eminglês) tem como pilares a BDE, disfunção menstrual e alterações na densidade mineral óssea (DMO), estando presente em uma percentagem considerável de atletas de alta competição, com consequências nefastas para o seu futuro a curto, médio e longo prazo. A presente revisão foi realizada a partir da análise crítica das publicações mais recentes disponíveis e pretende proporcionar uma percepção global do tema RED-S. O objetivo é promover a aquisição de um conhecimento mais consolidado sobre uma temática subvalorizada, possibilitando a aquisição de estratégias preventivas, diagnóstico precoce e/ou tratamento adequado.

Associations between serum calcium, 25(OH)D level and bone mineral density in adolescents

Abstract Backgrounds: It is important to improve our understanding of the roles of calcium and vitamin D in bone health for preventing osteoporosis. We aimed at exploring the associations between serum calcium, vitamin D level, and bone mineral density (BMD) in adolescents included in the National Health and Nutrition Examination Survey (NHANES) 2001 - 2006. Methods: Weighted multivariate linear regression models were used to estimate the associations of serum calcium, 25(OH)D level with total BMD. Smooth curve fitting was used to explore the potential non-linear relationship. Results: A total of 5990 individuals aged between 12 and 19 years were included in this study. The fully-adjusted model showed serum calcium positively correlated with total BMD. However, an inverted U-shaped relationship was found when we performed the smooth curve fitting method, and the inflection point was calculated at 9.6 mg/dL using the two-piecewise linear regression model. In contrast, there was a positive correlation between serum 25(OH)D and total BMD after adjusting for potential confounders. Conclusions: The present study revealed a positive correlation between serum 25(OH)D level and total BMD, and an inverted U-shaped relationship between serum calcium and total BMD.(AU)

Kaastu training for muscle fitness in the middle-aged and elderly adults: Effects and strengths / 中国组织工程研究

BACKGROUND: KAASTU training combined with low-load exercise can achieve the same effect as traditional high intensity resistance exercise. Therefore, it has been widely used in competitive sports, sports fitness, medical rehabilitation and other fields in recent years. However, there are few comments on the effects of KAASTU training on muscle fitness of the middle-aged and elderly adults. OBJECTIVE: To further explain and verify the safety, practicability and convenience of KAASTU training in the middle-aged and elderly adults exercise through a comprehensive review of the muscle fitness of middle-aged and elderly adults, and to provide scientific suggestions for the middle-aged and elderly adults to choose a safe and effective exercise. METHODS: Up to October 2019, Elsevier, PubMed, Springer, VIP, CNKI and Taiwan Academic Literature Database were searched for Chinese and English literature about KAASTU training, blood flow restriction, and muscle. Corresponding selection criteria was established according to the needs of the study, followed by literature screening. RESULTS AND CONCLUSION: KAASTU training combined with low-load exercise can effectively increase the muscle mass of the middle-aged and elderly adults, and has a positive effect on the prevention of muscle atrophy in the middle-aged and elderly adults. KAASTU training combined with low-load exercise can effectively improve the muscle strength of the lower extremities, which is beneficial to reduce exercise injury and improve the quality of life. KAASTU training has positive effects on bone health of the middle-aged and elderly adults, improves osteoporosis and increases bone mineral density of the older adults. Compared with traditional resistance training, KAASTU training is characterized by lower load and better effect. Therefore, KAASTU training is easier to be accepted by the middle-aged and elderly adults.

Research on the intervention of Internet+ platform on the whole bone health management of aromatase inhibitors in breast cancer patients / 中国实用护理杂志

Objective@#To explore the influence of nursing intervention on bone health of breast cancer patients in aromatase inhibitors (AIs) treatment.@*Methods@#Totally 120 breast cancer patients receiving AIs treatment were randomly divided into the observation group (60 cases) and the control group (60 cases), and bone mineral density was measured. After that, the control group was routinely instructed to take calcium supplements, given health lectures, and real-time management. The observation group were given whole-process bone health management intervention based on "Internet+" on the basis of routine nursing. After 1 year, osteoporosis knowledge questionnaire and bone mineral density test were conducted in the two groups.@*Results@#Score of Osteoporosis Knowledge Test of observation group was 21.38±3.29, and 12.54±5.03 of control group, comparing the two groups was statistically significant (t=10.27, P < 0.05); before intervention bone mineral density of observation group was (1.042±0.138) g/cm2, and (1.058±0.127) g/cm2 of control group, comparing the two groups has no statistical significance, comparable (t=1.053, P > 0.05); after intervention the bone mineral density of observation group was (0.951±0.108) g/cm2, and (0.854±0.100) g/cm2 of control group, the comparison between the two groups was statistically significant (t=5.937, P<0.05). After intervention, the incidence of osteoporosis in the observation group was 21.67% (13/60), which was significantly higher than 35.00% (21/60) in the control group (χ2=4.279, P<0.05).@*Conclusion@#Whole-course nursing intervention can promote bone health of AIs patients with breast cancer.

Influence of antiretroviral therapy on bone metabolism of patients with chronic hepatitis B: a review

Abstract Hepatitis B is a major public health problem worldwide and associated with significant mortality. To prevent or delay the deleterious effects of chronic infection by the hepatitis B virus, patients should be carefully followed, and antiviral therapy indicated according to specific recommendations. Currently, available drugs inhibit viral replication and slow or stop the progression of inflammation and fibrosis of the liver. However, the drugs for oral use in the treatment of hepatitis B, jointly referred to as nucleoside/nucleotide analogs, are indicated for prolonged use and have potential side effects. The reduction in bone mineral density was associated with the use of tenofovir, already evaluated in patients infected with HIV because the drug is also part of the therapeutic arsenal for this viral infection. There are few studies on the effects of tenofovir in patients with mono hepatitis B. Therefore, this literature review proposes to examine how hepatitis B acts in the body and the mechanisms by which antiretroviral drugs (especially tenofovir) can affect bone metabolism.

The baseline characteristics of School-based Cardiovascular and Bone Health Promotion Program in Beijing / 中华预防医学杂志

Objective@#To describe the baseline characteristics of School-based Cardiovascular and Bone Health Promotion Program(SCVBH) in Beijing.@*Methods@#Children and adolescents were selected in 30 schools (8 primary schools, 21 middle schools and one 12-year education school) from Dongcheng, Tongzhou, Fangshan and Miyun districts of Beijing by using a stratified cluster sampling method. 15 391 students in grade 1 to 4 from primary schools, grade 1 from junior and senior high schools were enrolled in the investigation with an exclusion of students who were not able to participate due to trauma or other uncomfortable physical conditions. The baseline survey including a questionnaire survey, physical examination and blood biochemical test was conducted from September 2017 to January 2018. Obesity, blood pressure, fasting blood glucose, lipid, bone density and grip were evaluated.@*Results@#The prevalence of obesity, hypertension, hyperglycemia (impaired fasting glucose and diabetes), dyslipidemia, lower bone density were 22.3%(3 394), 14.8%(2 248), 10.4%(1 490), 20.3%(2 919) and 2.1%(316) in total respectively, and 27.2%(2 081), 16.3%(1 244), 12.8%(922), 22.2%(1 595) and 1.2%(94) for boys, 17.3%(1 313), 13.3% (1 004), 7.9%(568), 18.4%(1 324) and 2.9%(229) for girls. Boys had higher prevalence of obesity, hypertension, hyperglycemia, and dyslipidemia and lower prevalence of low bone density than girls (all P values <0.05) The mean of body mass index, systolic blood pressure, fasting plasma glucose and grip of boys were significantly higher than that of girls (all P values <0.05).The mean of body mass index, systolic blood pressure, fasting plasma glucose and grip of boys were significantly higher than that of girls (all P values <0.05), the mean of fat mass percentage, total cholesterol, triglyceride, high density lipoprotein-cholesterol and low density lipoprotein-cholesterol of boys were significantly lower than those of girls (all P values <0.05).@*Conclusion@#The prevalence of risk factors of chronic cardiovascular disease was high and the low bone density was appearing in children and adolescents in this study. The promotion of cardiovascular and bone health should be implemented in children and adolescents.

A systemic review on global dietary calcium intake in adults / 中华内分泌代谢杂志

Low calcium intake may impose adverse impacts on bone health. The current paper is the Chinese translation for a systemic review article published in December, 2017 in Osteoporosis International with open access [ Balk EM, Adam GP, Langberg VN, et al. Global dietary calcium intake among adults: a systematic review. Osteoporos Int. 2017;28 ( 12 ):3315-332 ] . Through searching 13 electronic databases and requesting data from domain experts, an interactive global calcium map was developed. Average national dietary calcium intake ranges from 175 to 1233 mg/day. Many Asia countries have average dietary calcium intake less than 500 mg/day. Countries in Africa and South America mostly have low calcium intake between about 400 and 700 mg/day. Only Northern European countries have national calcium intake greater than 1000 mg/day. This review draws attention to regions where measures to increase calcium intake are likely to have skeletal benefits.

Vitamin B12, bone mineral density and fracture risk in adults: A systematic review / Vitamina B12, densidade mineral óssea e risco de fraturas em adultos: uma revisão sistemática

Summary Objective: To consolidate information available on the effect of vitamin B12 on bone mineral density and fracture risk, with emphasis on clinical trials, observational and longitudinal data conducted in humans. Method: A systematic review of the literature of the past decade on the role of vitamin B12 in bone mineral density and fracture risk in subjects of all ages and both sexes was performed by means of a PubMed, Science Direct, Medline and SciELO database search. Articles included in this review were identified using the search terms: B12 Vitamin and Bone Mineral Density and Vitamin B12 and Risk of Fractures. Evidence quality of the included articles was evaluated by GRADE system. Results: A total of 25 original studies were identified. After reviewing the titles and abstracts of articles, only 17 articles met the inclusion criteria. The present review provides evidence that the role of vitamin B12 on bone mineral density or fracture risk should be further elucidated. Controversies are explained by heterogeneity of methodologies used for the diagnosis of vitamin B12 and also by differences among populations investigated on the studies. Conclusion: A real effect of vitamin B12 deficiency in bone health and the mechanisms associated with bone metabolism is not well established yet. It is extremely important to carry out more clarifying studies about this theme, especially with vulnerable groups such as postmenopausal and elderly women, as is well-known that they are greatly affected by deficiency of this vitamin.

Resumo Objetivo: Consolidar as informações disponíveis acerca dos efeitos da vitamina B12 sobre a densidade mineral óssea e o risco de fraturas, com destaque para ensaios clínicos, dados observacionais e longitudinais realizados com humanos. Método: Foi realizada uma revisão sistemática da literatura dos últimos dez anos sobre o papel da vitamina B12 na densidade mineral óssea e no risco de fraturas em populações de todas as idades e para ambos os sexos, com busca de artigos nos bancos de dados eletrônicos: PubMed, Science Direct, Medline e SciELO. Como estratégia de busca de dados incluíram-se os descritores: B12 Vitamin and Bone Mineral Density e B12 Vitamin and Risk of Fractures. A qualidade das evidências dos artigos incluídos foi avaliada pelo sistema GRADE. Resultados: Após a análise dos títulos e dos resumos dos artigos, a estratégia de busca resultou em 25 referências, das quais 17 artigos preencheram os critérios de elegibilidade. Esta revisão fornece evidências de que o papel da vitamina B12 sobre a densidade mineral óssea ou o risco de fraturas ainda precisa ser mais bem elucidado. As controvérsias encontram respaldo na heterogeneidade das metodologias utilizadas para o diagnóstico da vitamina B12 e também na variedade de populações presentes entre os estudos. Conclusão: Ainda não está bem estabelecido o real impacto da deficiência de vitamina B12 na saúde dos ossos e sobre os mecanismos associados ao metabolismo ósseo. É de suma importância a realização de mais estudos esclarecedores, principalmente em grupos vulneráveis como as mulheres pós-menopausa e os idosos, grupos estes bastante afetados pela deficiência dessa vitamina.

Calcaneus quantitative ultrasound and body composition in preschool children: physical activity consideration / Ultrasonido cuantitativo de calcáneo y composición corporal en niños preescolares: consideración de actividad física

SUMMARY: The aim of this research was to determine the difference in Calcaneus quantitative ultrasound (QUS) and body composition according to physical activity in preschool children. We recruited 296 healthy children (112 girls and 184 boys) from different kindergartens in Vojvodina, Serbia. Children were evaluated for body composition. Quantitative ultrasound (QUS) measurements of the heel were performed using the Speed of sound, Broadband Ultrasound Attenuation, Quantitative Ultrasound Index and Estimated bone mineral density for further analysis. Furthermore, children were divided into three groups according to physical activity. Apart from the differences in Body fat % and body mass, there were no significant group differences for BMI, waist circumference and abdominal skinfold (p>0.05). The ANOVA showed significant differences (p<0.05) in all QUS measurements between three different intensities of physical activity. The results show that Body Mass and Body fat % were important predictors that discriminate children according to physical activity. Moreover, the results show that beside BMI and Body fat %, all calcaneus QUS measurements showed differences according to physical activity. In conclusion, our study showed differenses in all calcaneus QUS measurements according to physical activity level.

RESUMEN: El objetivo de esta investigación fue determinar la diferencia entre el ultrasonido cuantitativo (USC) de calcáneo y la composición corporal según la actividad física en niños en edad preescolar. Se estudiaron 296 niños sanos (112 niñas y 184 niños) de diferentes jardines infantiles en Vojvodina, Serbia. Se evaluó la composición corporal de los niños. Las medidas de USC del talón se realizaron utilizando la velocidad del sonido, atenuación de ultrasonido de banda ancha, el índice de ultrasonidos cuantitativos y la densidad mineral ósea estimada para un análisis posterior. Los niños se dividieron en tres grupos según actividad física. Además de las diferencias de porcentaje de grasa corporal y masa corporal, no se observaron diferencias significativas de grupo en el índice de masa corporal (IMC), circunferencia de cintura y el pliegue abdominal (p> 0,05). El test de ANOVA mostró diferencias significativas (p <0,05) en todas las mediciones USC entre tres diferentes intensidades de actividad física. Los resultados muestran que la masa corporal y la grasa corporal fueron indicadores importantes que permiten diferenciar a los niños según la actividad física. Por otra parte, los resultados muestran que además del IMC y el porcentaje de grasa corporal, todas las mediciones de USC del calcáneo mostraron diferencias según el nivel de actividad física. En conclusion, nuestro estudio mostró diferencias en el USC de acuerdo al nivel de actividad física.

Bone modeling, remodeling, and skeletal health in children and adolescents: mineral accrual, assessment and treatment

The modeling and remodeling process of the bone is fundamental to maintaining its integrity and mechanical properties. Many physical and biochemical factors during childhood and adolescence are crucially important for the development of healthy bones. Systemic conditions, such as hormonal status, nutrition, physical inactivity, or many pharmacological treatments, as well as a local variation in the load, can influence bone turnover and, consequently, the attainment of a proper peak bone mass. However, many diseases affecting children and adolescents can be associated with a reduction in bone accrual or a loss of bone mass and quality, which leads to an increased risk of fracture over one's life. In this review, we examine the effects of genetics, physical activity, chronic diseases and pharmacological treatments, and dietary factors on bone integrity in children and adolescents. We also briefly describe the specific tools that are currently used in assessing bone health.

Sports practice and bone mass in prepubertal adolescents and young adults: a cross-sectional analysis

Abstract AIM: To compare bone mass and body composition variables between adolescents engaged in high-impact sports and adults who were sedentary during early life. METHOD: A cross-sectional study with 155 participants (64 adolescents and 91 adults) aged between 11 and 50 years old. Among the adults, history of sports was evaluated during face-to-face interviews, and information regarding the adolescents' training routines was provided by their coaches. Body composition was evaluated using Dual Energy X-Ray Absorptiometry which provided data about bone mineral density (BMD), bone mineral content (BMC), fat mass (FM), and free fat mass (FFM). RESULTS: Adults who engaged in sports practice during early life had higher values of BMC (ES-r = 0.063), FFM (ES-r = 0.391), and lower values of FM (ES-r = 0.396) than sedentary adults. Higher values of BMC (ES-r = 0.063) and BMD in lower limbs (ES-r = 0.091) were observed in active adolescents. Adolescents engaged in sports and adults who were sedentary in early life presented similar values in all bone variables, FM, and FFM. CONCLUSIONS: Sports involvement in early life is related to higher bone mass in adulthood. Adolescents engaged in sports presented similar bone mass to adults who had been sedentary in early life.

Vitamin D: Hormone-like nutrient / 한국영양학회지

PURPOSE: The aim of this review is to comprehensively summarize the definition of vitamin D as a nutrient as well as a hormone-like molecule and its new function in prevention of various chronic diseases. METHODS: The review was written by the method for systematic reivew writing. Literatures from the various sources, including research articles, book chapters, proceedings and electronic materials as appropriate, were screened first and then reviewed and analyzed for the review. RESULTS: Vitamin D was originally considered as the essential nutrient as a vital carbon compound and was first discovered among children with osteomalacia, also known as ricket disease, characterized by poorly calcified bones which were easily bent rather than broken. Since that time, vitamin D has been known as the key nutrient to improve bone health. However, recently emerging study findings have shown that vitamin D acts as the hormone-like nutrient since it is synthesized like a hormone when our body needs and this particular vitamin also acts like a cell signaling ligand which regulates gene expression of various proteins. So far positive effects of vitamin D have been suggested for the action of anticancer, anti-immune function, and anti-cardiovascular disease, as well as antidiabetic function, etc. In this review, the definition for vitamin D as a nutrient vitamin as well as a hormone-like molecule, cell signaling mechanism of vitamin D, and finally the potential role for the prevention of chronic diseases are discussed. CONCLUSION: Vitamin D is now being considered as a vital nutrient as a vitamin and as a potential substance for prevention of several chronic diseases.

Sex- and age group-specific associations between intakes of dairy foods and pulses and bone health in Koreans aged 50 years and older: Based on 2008~2011 Korea National Health and Nutrition Examination Survey / 한국영양학회지

PURPOSE: This study was performed to examine associations of intakes of milk and dairy products, pulses, and soy foods with bone health in Koreans aged 50 yr and older. METHODS: A total of 3,201 men and 3,581 women aged 50 yr and older who participated in the 2008~2011 Korea National Health and Nutrition Examination Survey were grouped by sex and age groups of 50~64 yr and 65 yr and older. Subjects within each sex and age group were divided into three bone health groups: normal, osteopenia, and osteoporosis groups based on bone mineral density. Intakes of nutrients and foods derived from 24-hour recall data were compared among three bone health groups. Associations between intake frequencies of foods, including milk, yogurt, tofu, or soy milk, and osteoporosis risk were evaluated based on confounding risk factor-adjusted logistic regression. RESULTS: Calcium intake was in the order of normal, osteopenia, and osteoporosis in men (p < 0.01) and women (p < 0.05) aged 50~64 yr as well as in men aged 65 yr and older (p < 0.001). In women aged 50~64 yr, intake of milk and dairy products was lower in the osteoporosis group (p < 0.01) as compared with the osteopenia group. Intake of pulses or tofu was not significantly different among bone health groups. Odds ratio (OR) for milk intake frequency (≥ 2 times/week) compared to intake frequency less than 1 time/month was 0.45 (95% CI 0.24~0.85, p for trend = 0.022) in men aged 65 yr and older. The OR for yogurt intake frequency (1 time/month~1 time/week) was 0.47 (95% CI 0.30~0.73, p for trend = 0.019) in women aged 50~64 yr. Intake frequency of tofu or soy milk was not associated with reduced risk of osteoporosis in all groups. CONCLUSION: Dairy food intake was significantly associated with bone health, and its effect was sex- and age group-specific, whereas soy food intake was not. Dietary intervention to prevent osteoporosis would be effective for women aged 50~64 yr old and for men aged 65 yr and older.

Agua alcalinizante y con alto contenido de magnesio: los posibles efectos beneficiosos para la salud / Alkaline water and with high level of magnesium: possible benefits for health

Introducción: el consumo de dietas con un potencial alcalinizante ha sido asociado con varios efectos beneciosos sobre la salud. El potencial alcalinizante de un alimento en particular puede evaluarse mediante el cálculo del PRAL, una fórmula que tiene en cuenta el contenido de sulfato, fosfato, cloruro, sodio, calcio, potasio y magnesio de los alimentos. Objetivos: revisar la literatura para vericar el efecto del magnesio y alimentos/agua con potencial alcalinizante para la salud. También evaluar la capacidad de un filtro comercial para hacer el agua más alcalinizante y aumentar su contenido de magnesio. Materiales y métodos: se utilizaron cuatro filtros y el PRAL se calculó para todas las muestras; los valores se expresaron como media ± desviación estándar. Resultados: se encontró un aumento en el pH (IC 95%: 2,702 a -2,548; p<0,0001) y una reducción en el valor de PRAL (IC 95%: 1,418 a 2,081; p<0,0001). El magnesio fue el mayor predictor de un valor de PRAL alcalinizante dado que hubo un incremento estadísticamente significativo (IC 95%: 54,00 a -39,16; p<0,0001) en el contenido de magnesio después del proceso de filtración independiente de la fuente de agua. Conclusiones: la mayoría de los estudios sugiere que el consumo de alimentos alcalinizantes se asocia con una reducción de la resorción ósea y la inhibición de la actividad de los osteoclastos. El consumo de magnesio se relaciona con un menor riesgo de enfermedad cardiovascular, diabetes tipo II y determinados tipos de demencia como la enfermedad de Alzheimer.

Introduction: the intake of alkalizing potential diets has been associated with various bene¬cial effects on health. The alkalizing potential of a particular food can be evaluated by the PRAL calculation, a formula considering the content of sulfate, Phosphate, chloride, sodium, calcium, potassium and magnesium in food. Objectives: to check the scientific literature to verify the effect of magnesium and food/water with alkalizing potential for health. The capacity of a commercial filter to make water more alkalizing and increase the content of magnesium was also evaluated. Materials and methods: four filters were used and PRAL was calculated for all samples, and the values were reported as mean ± standard deviation. Results: an increase in pH was observed (CI 95%: -2,702 to -2,548; p<0,0001) and a reduction in the PRAL value (CI 95%: 1,418 to 2,081; p<0,0001). Magnesium was the major predictor of an alkalizing PRAL value, since there was a statistically significant increase (CI 95%: -54,00 to -39,16; p<0,0001) in the content of magnesium after the independent filtration process of water source. Conclusions: most of the studies suggest that the consumption of alkalizing water is associated with a reduction in bone resorption and inhibition of osteoclast activity. The consumption of magnesium is associated with a less risk of cardiovascular disease, type II diabetes and certain types of dementia such as Alzheimer.