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Osteoporosis

Minerals, Vitamins, and Other Micronutrients

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Preventive Nutrition

Part of the book series: Nutrition and Health ((NH))

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Abstract

Osteoporosis is a condition of skeletal fragility caused by decreased bone mass and by microarchitectural deterioration of bone tissue, with consequent increased risk of fracture. The condition is multifactorial in pathogenesis. Nutrition affects bone health in two dis­tinct ways. First, bone tissue deposition, maintenance, and repair are the result of cellular processes, which are as dependent upon nutrition as are the corresponding processes of any other tissue. The production of bone matrix, for example, requires the synthesis and posttranslational modification of collagen and an array of other proteins. Nutrients in­volved in these cellular activities include vitamins C, D, and K, and the minerals phos­phorus, copper, manganese, and zinc. Additionally, the regulation of calcium homeostasis requires normal magnesium nutrition. Second, the skeleton serves as a very large nutrient reserve for two minerals, calcium and phosphorus, and the size of that reserve (in other words, the strength of the skeletal structures) will be dependent in part upon the daily bal­ance between absorbed intake and excretory loss of these two minerals.

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References

  1. Heaney RP, Recker RR. Distribution of calcium absorption in middle-aged women. Am J Clin Nutr 1986; 43: 299–305.

    CAS  Google Scholar 

  2. Nordin BEC, Polley KJ, Need AG, Morris HA, Marshall D. The problem of calcium requirement. Am J Clin Nutr 1987; 45: 1295–1304.

    CAS  Google Scholar 

  3. Nordin BEC, Need AG, Morris HA, Horowitz M. Sodium, calcium and osteoporosis. In: Burckhardt P, Heaney RP, eds. Nutritional Aspects of Osteoporosis, vol. 85. Raven Press, New York, 1991, pp. 279–295.

    Google Scholar 

  4. Barger-Lux MJ, Heaney RP, Packard P, Lappe JM, Recker RR. Nutritional correlates of low calcium intake. Clin Appl Nutr 1992; 2: 39–44.

    Google Scholar 

  5. Gershon-Cohen J, Jowsey J. The relationship of dietary calcium to osteoporosis. Metabolism 1964; 13: 221.

    Article  CAS  Google Scholar 

  6. Jowsey J, Raisz LG. Experimental osteoporosis and parathyroid activity. Endocrinology 1968; 82: 384–396.

    Article  CAS  Google Scholar 

  7. Forbes RM, Weingartner KE, Parker HM, Bell RR, Erdman JW Jr. Bioavailability to rats of zinc, magnesium and calcium in casein-, egg-and soy protein-containing diets. J Nutr 1979; 109: 1652–1660.

    CAS  Google Scholar 

  8. NIH Consensus Conference: optimal calcium intake. JAMA 1994; 272:1942–1948.

    Google Scholar 

  9. Dietary Reference Intakes for Calcium, Magnesium, Phosphorus, Vitamin D, and Fluoride. Food and Nutrition Board, Institute of Medicine. National Academy Press, Washington, DC, 1997.

    Google Scholar 

  10. Heaney RP. Nutritional factors in osteoporosis. Ann Rev Nutr 1993; 13: 287–316.

    Article  CAS  Google Scholar 

  11. Heaney RP. Calcium, dairy products, and osteoporosis. J Am College Nutr 2000; 19: 835–995.

    Google Scholar 

  12. Dawson-Hughes B, Dallal GE, Krall EA, Sadowski L, Sahyoun N, Tannenbaum S. A controlled trial of the effect of calcium supplementation on bone density in postmenopausal women. N Engl J Med 1990; 323: 878–883.

    Article  CAS  Google Scholar 

  13. Chapuy MC, Arlot ME, Duboeuf F, et al. Vitamin D3 and calcium to prevent hip fractures in elderly women. N Engl J Med 1992; 327: 1637–1642.

    Article  CAS  Google Scholar 

  14. Reid IR, Ames RW, Evans MC, Gamble GD, Sharpe SJ. Effect of calcium supplementation on bone loss in postmenopausal women. N Engl J Med 1993; 328:460.-464.

    Google Scholar 

  15. Johnston CC Jr, Miller JZ, Slemenda CW, et al. Calcium supplementation and in-creases in bone mineral density in children. N Engl J Med 1992; 327: 82–87.

    Article  Google Scholar 

  16. Lloyd T, Andon MB, Rollings N, et al. Calcium supplementation and bone mineral density in adolescent girls. JAMA 1993; 270: 841–844.

    Article  CAS  Google Scholar 

  17. Chevalley T, Rizzoli R, Nydegger V, et al. Effects of calcium supplements on femoral bone mineral density and vertebral fracture rate in vitamin D-replete elderly patients. Osteoporos Int 1994; 4: 245–252.

    Article  CAS  Google Scholar 

  18. Reid IR, Ames RW, Evans MC, Sharpe SJ, Gamble GD. Long-term effects of calcium supplementation on bone loss and fractures in postmenopausal women: a randomized controlled trial. Am J Med 1995; 98: 331–335.

    Article  CAS  Google Scholar 

  19. Aloia JF, Vaswani A, Yeh JK, Ross PL, Flaster E, Dilmanian FA. Calcium supplementation with and without hormone replacement therapy to prevent postmenopausal bone loss. Ann Intern Med 1994; 120: 97–103.

    CAS  Google Scholar 

  20. Heaney RP. The bone remodeling transient: implications for the interpretation of clinical studies of bone mass change. J Bone Miner Res 1994; 9: 1515–1523.

    Article  CAS  Google Scholar 

  21. Recommended Dietary Allowances, 10th ed. National Academy Press, Washington, DC, 1989.

    Google Scholar 

  22. Matkovic V, Heaney RR. Calcium balance during human growth. Evidence for tbreshold behavior. Am J Clin Nutr 1992; 55: 992–996.

    CAS  Google Scholar 

  23. Jackman LA, Millane SS, Martin BR, Wood OB, McCabe GP, Peacock M, et al. Calcium retention in relation to calcium intake and postmenarcheal age in adolescent females. Am J Clin Nutr 1997; 66: 327–333.

    CAS  Google Scholar 

  24. Matkovic V. Calcium metabolism and calcium requirements during skeletal modeling and consolidation of bone mass. Am J Clin Nutr 1991; 54: 245S - 260S.

    CAS  Google Scholar 

  25. Chan GM, Hoffman K, McMurray M. The effect of dietary calcium supplementation on pubertal girls’ growth and bone mineral status. J Bone Miner Res 1991; 6: S240.

    Google Scholar 

  26. Cadogan J, Eastell R, Jones N, Barker ME. Milk intake and bone mineral acquisition in adolescent girls: randomised, controlled intervention trial. BMJ 1997; 315: 1255–1260.

    Article  CAS  Google Scholar 

  27. Recker RR, Davies KM, Hinders SM, Heaney RP, Stegman MR, Kimmel DB. Bone gain in young adult women. JAMA 1992; 268: 2403–2408.

    Article  CAS  Google Scholar 

  28. Heaney RP. The bone remodeling transient: implications for the interpretation of clinical studies of bone mass change. J Bone Miner Res 1994; 9: 1515–1523.

    Article  CAS  Google Scholar 

  29. Welten DC, Kemper HCG, Post GB, van Staveren WA. A meta-analysis of the effect of calcium intake on bone mass in females and males. J Nutr 1995; 2802–2813.

    Google Scholar 

  30. Heaney RP, Recker RR, Saville PD. Menopausal changes in calcium balance performance. J Lab Clin Med 1978; 92: 953–963.

    CAS  Google Scholar 

  31. Recker RR, Lappe JM, Davies KM, Kimmel DB. Change in bone mass immediately before menopause. J Bone Miner Res 1992; 7: 857–862.

    Article  CAS  Google Scholar 

  32. Heaney RP. Estrogen-calcium interactions in the postmenopause: a quantitative description. Bone Miner 1990; 11: 67–84.

    Article  CAS  Google Scholar 

  33. Elders PJM, Netelenbos JC, Lips P, et al. Calcium supplementation reduces vertebral bone loss in perimenopausal women: a controlled trial in 248 women between 46 and 55 years of age. J Clin Endocrinol Metab 1991; 73: 533–540.

    Article  CAS  Google Scholar 

  34. Kanis JA, Melton LJ III, Christiansen C, Johnston CC, Khaltaev N. The diagnosis of osteoporosis. J Bone Miner Res 1994; 9: 1137–1141.

    Article  CAS  Google Scholar 

  35. Heaney RP, Recker RR, Stegman MR, Moy M. Calcium absorption in women: relationships to calcium intake, estrogen status, and age. J Bone Min Res 1989; 4: 469–475.

    Article  CAS  Google Scholar 

  36. Nordin BEC, Need AG, Morris HA, Horowitz M, Robertson WO. Evidence for a renal calcium leak in postmenopausal women. J Clin Endocrinol Metab 1991; 72: 401–407.

    Article  CAS  Google Scholar 

  37. Carroll MD, Abraham S, Dresser CM. Dietary intake source data: US, 1976–80. Vital & Health Statistics, Serv. 11-NO. 231, DRHS. Publ. No. (PHS) 83-PHS, Mar 1983. Wash DC, Gov. Print Office.

    Google Scholar 

  38. Alaimo K, McDowell MA, Briefel RR, et al. Dietary intake of vitamins, minerals, and fiber of persons ages 2 months and over in the United States: Third National Health and Nutrition Examination Survey, Phase 1, 1988–1991. Advance data from vital and health statistics; no. 258. Nat Ctr Health Statist, Hyattsville, MD, 1994.

    Google Scholar 

  39. McKane WR, Khosla S, Egan KS, Robins SP, Burritt MF, Riggs BL. Role of calcium intake in modulating age-related increases in parathyroid function and bone resorption. J Clin Endocrinol Metab 1996; 81: 1699–1703.

    Article  CAS  Google Scholar 

  40. Recker RR, Hinders S, Davies KM. Correcting calcium nutritional deficiency prevents spine fractures in elderly women. J Bone Miner Res 1996; 11: 1961–1966.

    Article  CAS  Google Scholar 

  41. Matkovic V, Kostial K, Simonovic I, Buzina R, Brodarec A, Nordin BEC. Bone status and fracture rates in two regions of Yugoslavia. Am J Clin Nutr 1979; 32: 540–549.

    CAS  Google Scholar 

  42. Holbrook TL, Barrett-Connor E, Wingard DL. Dietary calcium and risk of hip fracture: 14-year prospective population study. Lancet 1988; 2: 1046–1049.

    Article  CAS  Google Scholar 

  43. Pilch SM, ed. Physiological effects and health consequences of dietary fiber. Prepared for the Center for Food Safety and Applied Nutrition, Food and Drug Administration under Contract FDA 22384–2059, Life Sci Res Office, Fed Am Societies for Experiment Biol, available from FASEB Special Publicat Office, Bethesda, MD, 1987.

    Google Scholar 

  44. Barger-Lux MJ, Heaney RP. Caffeine and the calcium economy revisited. Osteoporos Int 1995; 5: 97–102.

    Article  CAS  Google Scholar 

  45. Heaney RP, Recker RR. Effects of nitrogen, phosphorus, and caffeine on calcium balance in women. J Lab Clin Med 1982; 99: 46–55.

    CAS  Google Scholar 

  46. Nordin BEC, Need AG, Moms HA, Horowitz M. The nature and significance of the relationship between urinary sodium and urinary calcium in women. J Nutr 1993; 123: 1615–1622.

    CAS  Google Scholar 

  47. Weaver CM, Heaney RP, Martin BR, Fitzsimmons ML. Human calcium absorption from whole wheat products. J Nutr 1991; 121: 1769–1775.

    CAS  Google Scholar 

  48. Weaver CM, Heaney RP, Proulx WR, Hinders SM, Packard PT. Absorbability of calcium from corn-mon beans. J Food Sci 1993; 58: 1401–1403.

    Article  CAS  Google Scholar 

  49. Heaney RP, Weaver CM. Oxalate in vegetables. Effect on calcium absorbability. J Bone Miner Res 1993; 8: S333.

    Google Scholar 

  50. Barrett-Connor E, Chang JC, Edelstein SL. Coffee-associated osteoporosis offset by daily milk consumption. JAMA 1994; 271: 280–283.

    Article  CAS  Google Scholar 

  51. Matkovic V, Fontana D, Tominac C, Goel P, Chesnut CH III. Factors that influence peak bone mass formation: a study of calcium balance and the inheritance of bone mass in adolescent females. Am J Clin Nutr 1990; 52: 878–888.

    CAS  Google Scholar 

  52. Matkovic V, Ilich JZ, Andon MB, et al. Urinary calcium, sodium, and bone mass of young females. Am J Clin Nutr 1995; 62: 417–425.

    CAS  Google Scholar 

  53. Lau EMC, Cooper C, Woo J. Calcium deficiency-a major cause of osteoporosis in Hong Kong Chinese. In: Burckhardt P, Heaney RP, eds. Nutritional Aspects of Osteoporosis, vol. 85. Raven Press, New York, 1991, pp. 175–180.

    Google Scholar 

  54. Berkelhammer CH, Wood RJ, Sitrin MD. Acetate and hypercalciuria during total parenteral nutrition. Am J Clin Nutr 1988; 48: 1482–1489.

    CAS  Google Scholar 

  55. Sebastian A, Harris ST, Ottaway JH, et al. Improved mineral balance and skeletal metabolism in postmenopausal women treated with potassium bicarbonate. N Engl J Med 1994; 330: 1776–1781.

    Article  CAS  Google Scholar 

  56. Barr SI, Prior JC, Janelle KC, Lentle BC. Spinal bone mineral density in premenopausal vegetarian and nonvegetarian women: cross-sectional and prospective comparisons. J Am Diet Assoc 1998; 98: 760–765.

    Article  CAS  Google Scholar 

  57. Spencer H, Kramer L, Osis D, Norris C. Effect of phosphorus on the absorption of calcium and on the calcium balance in man J Nutr 1978; 108: 447–457.

    CAS  Google Scholar 

  58. Heaney RP, Recker RR. Determinants of endogenous fecal calcium in healthy women. J Bone Miner Res 1994; 9: 1621–1627.

    Article  CAS  Google Scholar 

  59. Spencer H, Kramer L, Norris C, Osis D. Effect of small doses of aluminum-containing antacids on calcium and phosphorus metabolism. Am J Clin Nutr 1982; 36: 32–40.

    CAS  Google Scholar 

  60. The Surgeon General’s Report on Nutrition and Health. DHHS (PHS) Publication No.88–50211, 1988.

    Google Scholar 

  61. Ilich-Ernst JZ, McKenna AA, Badenhop NE, Clairmont AC, Andon MB, Nahhas, RW, et al. Iron status, menarche, and calcium supplementation in adolescent girls. Am J Clin Nutr 1998; 68: 880–887.

    CAS  Google Scholar 

  62. Barger-Lux MJ, Heaney RP, Lanspa SJ, Healy JC, DeLuca HF. An investigation of sources of variation in calcium absorption physiology. J Clin Endocrinol Metab 1995; 80: 406–411.

    Article  CAS  Google Scholar 

  63. Colodro IH, Brickman AS, Coburn JW, Osborn TW, Norman AW. Effect of 25-hydroxy-vitamin D3 on intestinal absorption of calcium in normal man and patients with renal failure. Metabolism 1978; 27: 745–753.

    Article  CAS  Google Scholar 

  64. Heaney RP, Barger-Lux MJ, Dowell MS, Chen TC, Holick MF. Calcium absorptive effects of vitamin D and its major metabolites. J Clin Endocrinol Metab 1997; 82: 4111–4116.

    Article  CAS  Google Scholar 

  65. Francis RM, Peacock M, Storer JH, Davies AEJ, Brown WB, Nordin BEC. Calcium malabsorption in the elderly: the effect of treatment with oral 25-hydroxyvitamin D3. Eur J Clin Invest 1983; 13: 391–396.

    Article  CAS  Google Scholar 

  66. Slovik DM, Adams JS, Neer RM, Holick MF, Potts JT Jr. Deficient production of 1,25-dihydroxyvitarnin D in elderly osteoporotic patients. N Engl J Med 1981; 305: 372–374.

    Article  CAS  Google Scholar 

  67. Francis RM, Peacock M, Taylor GA, Storer JR, Nordin BEC. Calcium malabsorption in elderly women with vertebral fractures: evidence for resistance to the action of vitamin D metabolites on the bowel. Clin Sci 1984; 66: 103–107.

    CAS  Google Scholar 

  68. Lips P, Graafmans WC, Ooms ME, Bezemer D, Bouter LM. Vitamin D supplementation and fracture incidence in elderly persons. Ann Intern Med 1996; 124: 400–406.

    CAS  Google Scholar 

  69. Heikinheimo RJ, Inkovaara JA, Harju EJ, et al. Annual injection of vitamin D and fractures of aged bones. Calcif Tissue Int 1992; 51: 105–110.

    Article  CAS  Google Scholar 

  70. Dawson-Hughes B, Harris SS, Krall EA, Dallal GE. Effect of calcium and vitamin D supplementation on bone density in men and women 65 years of age or older. N Engl J Med 1997; 337: 670–676.

    Article  CAS  Google Scholar 

  71. Thomas MK, Lloyd-Jones DM, Thadhani RI, Shaw AC, Deraska DJ, Kitch BT, et al. Hypovitaminosis D in medical inpatients. N Engl J Med 1998; 338: 777–783.

    Article  CAS  Google Scholar 

  72. LeBoff MS, Kohlmeier L, Hurwitz S, Franklin J, Wright J, Glowacki J. Occult vitamin D deficiency in postmenopausal US women with acute hip fracture. JAMA 1999; 281: 1505–1511.

    Article  CAS  Google Scholar 

  73. Holick MF. Sources of vitamin D. diet and sunlight. In: Burckhardt P, Heaney RP, eds. Challenges of Modern Medicine, Nutritional Aspects of Osteoporosis, (Proc 2nd Int Symp Osteoporosis, Lausanne, May 1994). Ares-Serono Symposia Publications, vol. 7, Rome, Italy, 1995, pp. 289–309.

    Google Scholar 

  74. Vieth R. Vitamin D supplementation, 25-hydroxyvitamin D levels, and safety. Am J Clin Nutr 1999; 69: 842–856.

    CAS  Google Scholar 

  75. Price PA. Role of vitamin-K-dependent proteins in bone metabolism. Ann Rev Nutr 1988; 8: 565–583.

    Article  CAS  Google Scholar 

  76. Szulc P, Delmas PD. Is there a role for vitamin K deficiency in osteoporosis? In: Burckhardt P, Heaney RP, eds. Challenges of Modern Medicine, Nutritional Aspects of Osteoporosis, (Proc 2nd Int Symp Osteoporosis, Lausanne, May 1994). Ares-Serono Publications, vol. 7, Rome, Italy. 1995, pp. 357–366.

    Google Scholar 

  77. Hodges SJ, Pilkington MJ, Stamp TCB, et al. Depressed levels of circulating menaquinones in patients with osteoporotic fractures of the spine and femoral neck. Bone 1991; 12: 387–389.

    Article  CAS  Google Scholar 

  78. Knapen MHJ, Hamulyak K, Vermeer C. The effect of vitamin K supplementation on circulating osteocalcin (bone gla protein) and urinary calcium excretion. Annals Int Med 1989; 111: 1001–1005.

    CAS  Google Scholar 

  79. Shils ME. Magnesium. In: Shils ME, Olson JA, Shike, M, eds. Modern Nutrition in Health and Disease, 8th Ed. Vol. 1: Lea & Febiger, Philadelphia, PA, 1994, pp. 164–184.

    Google Scholar 

  80. Blumenkranz MS, et al. Risk factors in age-related maculopathy complicated by choroidal neovascularization. Ophthalmology 1986; 96: 552–558.

    Google Scholar 

  81. Spencer H, Fuller H, Norris C, Williams D. Effect of magnesium on the intestinal absorption of calcium in man. J Am College Nutr 1994; 13: 485–492.

    CAS  Google Scholar 

  82. Mertz W, ed. Trace Elements in Human and Animal Nutrition, 5th Ed. Academic Press, San Diego, CA, 1987.

    Google Scholar 

  83. Strain JJ. A reassessment of diet and osteoporosis-possible role for copper. Med Hypotheses 1988; 27: 333–338.

    Article  CAS  Google Scholar 

  84. Howard G, Andon M, Bracker M, Saltman P, Strause L. Low serum copper, a risk factor additional to low dietary calcium in postmenopausal bone loss. J Trace Elements Experiment Med 1992; 5: 23–31.

    CAS  Google Scholar 

  85. Oxlund H, Barckman M, 9Jrtoft G, Andreasen TT. Reduced concentrations of collagen cross-links are associated with reduced mechanical strength in bone. J Bone Miner Res 1995; 10: S179.

    Google Scholar 

  86. Strause L, Saltman P, Smith K, Andon M. The role of trace elements in bone metabolism. In: Burckhardt P, Heaney RP, eds. Nutritional Aspects of Osteoporosis, Serono Symposia Publication, vol. 85, Raven Press, New York, 1991, pp. 223–233.

    Google Scholar 

  87. Delmi M, Rapin C-H, Bengoa J-M, Delmas PD, Vasey H, Bonjour J-P. Dietary supplementation in elderly patients with fractured neck of the femur. Lancet 1990; 335: 1013–1016.

    Article  CAS  Google Scholar 

  88. Bastow MD, Rawlings J, Allison SP. Benefits of supplementary tube feeding after fractured neck of femur. Br Med J 1983; 287: 1589–1592.

    Article  CAS  Google Scholar 

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Heaney, R.P. (2001). Osteoporosis. In: Bendich, A., Deckelbaum, R.J. (eds) Preventive Nutrition. Nutrition and Health. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-59259-236-4_11

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  • DOI: https://doi.org/10.1007/978-1-59259-236-4_11

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