The role of fluoride in the prevention of osteoporosis.

An ideal battery of tests would include indices of bone resorption and formation. They should be unique to bone, reflect total skeletal activity, and should correlate with traditional measures of bone remodeling activity, such as radiocalcium kinetics, histomorphometry, or changes in bone mass. Factors that confound their measurement, such as circadian rhythms, diet, age, sex, bone mass, liver function, and kidney clearance rates, should be clearly defined (Fig. 9). To date, no bone marker has been established to meet all these criteria, and each marker may have its own specific advantages and limitations. There are still questions that must be answered before there can be complete confidence in the information gained from measurement of any of the bone markers. Furthermore, it should be emphasized that none of the markers are diagnostic for any particular bone disease and cannot be used for this purpose in individual patients. Nevertheless, recent advances in research and development have provided assays with increased specificity, sensitivity, and availability. Because of this, bone markers can be used for a variety of important purposes: as tools for basic bone biology research, for defining general physiological phenomenon in clinical studies or drug trials, and for following individual patients.

/pdf/molecular-basis-and-clinical-application-of-biological-3lbd8am6p2.pdf

Molecular Basis and Clinical Application of Biological Markers of Bone Turnover

The term Dietary Reference Intakes (DRIs) is new to the field of nutrition. It refers to a set of at least four nutrient-based reference values that can be used for planning and assessing diets and for many other purposes. The development of DRIs replaces the periodic revisions of Recommended Dietary Allowances (RDAs), which have been published since 1941 by the National Academy of Sciences. This is a comprehensive effort being undertaken by the Standing Committee on the Scientific Evaluation of Dietary Reference Intakes of the Food and Nutrition Board, Institute of Medicine, National Academy of Sciences, with the involvement of Health Canada.

Dietary Reference Intakes

I. Introduction II. Determinants of Bone Mass III. Inherited Predisposition For and Against Osteoporosis IV. Genetic Factors in Bone Phenotype V. Vitamin D Receptor (VDR) Gene Polymorphisms and Bone Phenotype A. VDR gene polymorphisms and bone phenotype B. VDR gene polymorphisms and calcium homeostatic responses C. VDR gene polymorphisms, body size, and development D. Potential mechanisms for VDR allelic associations VI. Collagen Iα1 Gene VII. Other Candidate Genes and Chromosomal Loci VIII. Gene-Environment Interaction IX. Summary

/pdf/genetics-of-osteoporosis-dn1hrtq3w3.pdf

Genetics of osteoporosis.

Objective: To review the evidence on diet and nutrition relating to osteoporosis and provide recommendations for preventing osteoporosis, in particular, osteopototic fracture. Approach: Firstly, to review the definition, diagnosis and epidemiology of osteoporosis, to discuss the difficulties in using bone mineral density to define osteoporosis risk in a world-wide context and to propose that fragility fracture should be considered as the disease endpoint. Secondly, to provide an overview of the scientific data, the strengths and weaknesses of the evidence and the conceptual difficulties in interpreting studies linking diet, nutrition and osteoporosis. The following were considered: calcium, vitamin D, phosphorus, magnesium, protein and fluorine. Other potential dietary influences on bone health were also discussed, including vitamins, trace elements, electrolytes, acid‐base balance, phyto-oestrogens, vegetarianism and lactose intolerance. Conclusions: There is insufficient knowledge linking bone mineral status, growth rates or bone turnover in children and adolescents to long-term benefits in old age for these indices to be used as markers of osteoporotic disease risk. For adults, the evidence of a link between intakes of any dietary component and fracture risk is not sufficiently secure to make firm recommendations, with the exception of calcium and vitamin D. For other aspects of the diet, accumulating evidence suggests that current healthy-eating advice to decrease sodium intake, to increase potassium intake, and to consume more fresh fruits and vegetables is unlikely to be detrimental to bone health and may be beneficial.

/pdf/diet-nutrition-and-the-prevention-of-osteoporosis-40budtgrth.pdf

Diet, nutrition and the prevention of osteoporosis

The bioavailability, biochemical effects, and safety of a slow-release preparation of sodium fluoride were examined. In 8 normal volunteers, a single administration of slow-release sodium fluoride (25 mg) caused a slow rise and gradual decline in serum fluoride concentration, thus avoiding sharp peaks produced by a rapid-release preparation. In 37 patients with postmenopausal osteoporosis, serum fluoride concentration was kept within the "therapeutic window" (95-100 ng/ml) during long-term intermittent sodium fluoride (slow-release) therapy (25 mg twice/day, given for 3 months in each 5-month cycle over five cycles). Serum fluoride was also kept within the therapeutic window in 64 patients who took sodium fluoride (slow release) continuously over 12 months. Serum osteocalcin concentration increased progressively during fluoride treatment (correlation coefficient of 0.88, p less than .001 for the relationship between serum osteocalcin and duration of therapy). Side effects to slow-release sodium fluoride therapy, assessed in 101 patients at two study sites, were minor and included diarrhea in 2 patients, nausea in 2 patients, abdominal pain and cramping in 2 patients, foot pain in 2 patients, and joint pain in 6 patients. Thus, slow-release sodium fluoride confers desired level of fluoride in serum, while providing safety of usage.

Attainment of therapeutic fluoride levels in serum without major side effects using a slow-release preparation of sodium fluoride in postmenopausal osteoporosis.

/pdf/la-vitamina-d-nutrimento-clave-para-la-salud-humana-y-su-ccz78lu4lz.pdf

La vitamina D, nutrimento clave para la salud humana, y su estado general en la población mexicana

This study was conducted to compare associations between urinary sodium and calcium in elderly men and women, overall and by level of calcium intake, and to examine associations between urinary sodium excretion and bone mineral density in the same population. Healthy men (n = 249) and women (n = 665) over age 65 y had measurements of 24-h urinary sodium and calcium and spine, hip, and whole-body bone mineral density. Urinary sodium and calcium excretion were significantly correlated in men (r = 0.42, P = 0.0001) and women (r = 0.26, P = 0.0001), but the regression coefficient was greater in men than in women (beta = 0.017 vs. 0.010, P = 0.007). Within each gender, associations between 24-h urinary sodium and calcium were similar and significant at intermediate and high calcium intakes but were not significant at very low intake levels. Urinary sodium was not correlated with bone mineral density. In conclusion, in healthy elderly men and women, urinary sodium and calcium excretion are linked at moderate and high dietary calcium intakes but not at low calcium intakes. For a given sodium excretion, elderly men excrete more calcium than women.

/pdf/sodium-excretion-influences-calcium-homeostasis-in-elderly-id1q5h7880.pdf

Sodium Excretion Influences Calcium Homeostasis in Elderly Men and Women

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Attainment of therapeutic fluoride levels in serum without major side effects using a slow-release preparation of sodium fluoride in postmenopausal osteoporosis.

La vitamina D, nutrimento clave para la salud humana, y su estado general en la población mexicana

Sodium Excretion Influences Calcium Homeostasis in Elderly Men and Women