Interactive effects of exercise plus calcium-vitamin D3 on bone strength in older men

The findings from this 18-month, community-based study revealed that an exercise program involving strength training and jumping activities was feasible and effective for improving bone density, muscle mass and strength in older men. There were no additional skeletal benefits derived from consuming a high calcium-vitamin D milk drink.

Calcium supplementation: the bare bones

An adequate calcium intake is an essential part of the prevention and treatment of osteoporosis. Two to threeserves of calcium-rich foods each day provides sufficient calcium for most non-pregnant adults. If this target is not achievable, calcium supplementation is generally effective, cheap and safe for most people. Calciumcarbonate(without vitamin and mineral additives) is the preferred supplement in most cases. Problems with calcium absorption arise due to factors including high·fibre vegetarian diets, achlorhydria, long·term glucocorticoid therapy and vitamin D deficiency. Vitamin D deficiency is extremely common in some ethnic groups and the elderly who are housebound or in residential care. These at risk groups generally require vitamin D supplementation to achieve adequate intestinal absorption of calcium.

General practitioners' nutrition promotion among cardiac patients

General practitioners fall into three categories in their pursuit of dietary counselling: little involvement, or provider of referrals, or they have strong involvement. The barriers to dietary counselling are inadequate partnerships with dietitians, patients suffering multiple medical conditions and the view that HMG-CoA-reductase-inhibitors (statins) reduce the need for dietary change.

"They all work...when you stick to them" : a qualitative investigation of dieting, weight loss, and physical exercise, in obese individuals

Background
To explore the extent to which people living with obesity have attempted to lose weight, their attitudes towards dieting, physical exercise and weight loss solutions, why their weight loss attempts have failed, and their opinions about what would be most beneficial to them in their struggle with their weight.

Method
Qualitative study, using open-ended interviews, of 76 people living with obesity in Victoria, Australia in 2006/7. Individuals with a BMI of 30 or over were recruited using articles in local newspapers, convenience sampling, and at a later stage purposive sampling techniques to diversify the sample. Data analysis was conducted by hand using a constant, comparative method to develop and test analytical categories. Data were interpreted both within team meetings and through providing research participants the chance to comment on the study findings.

Results
Whilst participants repeatedly turned to commercial diets in their weight loss attempts, few had used, or were motivated to participate in physical activity. Friends or family members had introduced most individuals to weight loss techniques. Those who took part in interventions with members of their social network were more likely to report feeling accepted and supported. Participants blamed themselves for being unable to maintain their weight loss or 'stick' to diets. Whilst diets did not result in sustained weight loss, two thirds of participants felt that dieting was an effective way to lose weight.

Conclusion
Individuals with obesity receive numerous instructions about what to do to address their weight, but very few are given appropriate long term guidance or support with which to follow through those instructions. Understanding the positive role of social networks may be particularly important in engaging individuals in physical activity. Public health approaches to obesity must engage and consult with those currently living with obesity, if patterns of social change are to occur.

Bone strength and density via pQCT in post-menopausal osteopenic women after 9 months resistive exercise with whole body vibration or proprioceptive exercise

OBJECTIVES: In order to better understand which training approaches are more effective for preventing bone loss in post-menopausal women with low bone mass, we examined the effect of a nine-month resistive exercise program with either an additional whole body vibration exercise (VIB) or balance training (BAL). METHODS: 68 post-menopausal women with osteopenia were recruited for the study and were randomised to either the VIB or BAL group. Two training sessions per week were performed. 57 subjects completed the study (VIB n=26; BAL n=31). Peripheral quantitative computed tomography (pQCT) measurements of the tibia, fibula, radius and ulna were performed at baseline and at the end of the intervention period at the epiphysis (4% site) and diaphysis (66% site). Analysis was done on an intent-to-treat approach. RESULTS: Significant increases in bone density and strength were seen at a number of measurement sites after the intervention period. No significant differences were seen in the response of the two groups at the lower-leg. CONCLUSIONS: This study provided evidence that a twice weekly resistive exercise program with either additional balance or vibration training could increase bone density at the distal tibia after a nine-month intervention period in post-menopausal women with low bone mass.

Application of dried blood spots to determine vitamin D status in a large nutritional study with unsupervised sampling: the Food4Me project

An efficient and robust method to measure vitamin D (25-hydroxy vitamin D3 (25(OH)D3) and 25-hydroxy vitamin D2 in dried blood spots (DBS) has been developed and applied in the pan-European multi-centre, internet-based, personalised nutrition intervention study Food4Me. The method includes calibration with blood containing endogenous 25(OH)D3, spotted as DBS and corrected for haematocrit content. The methodology was validated following international standards. The performance characteristics did not reach those of the current gold standard liquid chromatography-MS/MS in plasma for all parameters, but were found to be very suitable for status-level determination under field conditions. DBS sample quality was very high, and 3778 measurements of 25(OH)D3 were obtained from 1465 participants. The study centre and the season within the study centre were very good predictors of 25(OH)D3 levels (P<0·001 for each case). Seasonal effects were modelled by fitting a sine function with a minimum 25(OH)D3 level on 20 January and a maximum on 21 July. The seasonal amplitude varied from centre to centre. The largest difference between winter and summer levels was found in Germany and the smallest in Poland. The model was cross-validated to determine the consistency of the predictions and the performance of the DBS method. The Pearson's correlation between the measured values and the predicted values was r 0·65, and the sd of their differences was 21·2 nmol/l. This includes the analytical variation and the biological variation within subjects. Overall, DBS obtained by unsupervised sampling of the participants at home was a viable methodology for obtaining vitamin D status information in a large nutritional study.

Vitamin D status of women in the Geelong Osteoporosis Study : association with diet and casual exposure to sunlight

Objective: To assess vitamin D intake and casual exposure to sunshine in relation to serum 25-hydroxyvitamin D (25OHD) levels.

Design: Cross-sectional study of a population-based, random sample of women aged 20-92 years, assessed between 1994 and 1997.

Setting and participants: 861 women from the Barwon Statistical Division (population, 218 000), which includes the city of Geelong (latitude 38° south) in Victoria.

Main outcome measures: Vitamin D intake; serum 25OHD level; season of assessment; exposure to sunshine.

Results: Median intake of vitamin D was 1.2 μg/day (range, 0.0-11.4 μg/day). Vitamin D supplements, taken by 7.9% of participants, increased intake by 8.1% to 1.3 μg/day (range, 0.0-101.2 μg/day) (P < 0.001). A dose-response relationship in serum 25OHD levels was observed for sunbathing frequency before and after adjusting for age (P < 0.05). During winter (May-October), serum 25OHD levels were dependent on vitamin D intake (partial r2 = 0.01; P < 0.05) and were lower than during summer (November-April) (age-adjusted mean, 59 nmol/L [95% CI, 57-62] v 81 nmol/L [95% CI, 78-84]; P < 0.05). No association was detected between serum 25OHD and vitamin D intake during summer. The prevalences of low concentrations of serum 25OHD were, for <28 nmol/L, 7.2% and 11.3% overall and in winter, respectively; and, for <50 nmol/L, 30.0% and 43.2% overall and in winter, respectively.

Conclusions: At latitude 38° south, the contribution of vitamin D from dietary sources appears to be insignificant during summer. However, during winter vitamin D status is influenced by dietary intake. Australia has no recommended dietary intake (RDI) for vitamin D, in the belief that adequate vitamin D can be obtained from solar irradiation alone. Our results suggest that an RDI may be needed.

Hormone therapy and risk of non-vertebral fracture : Geelong Osteoporosis Study

In this population-based study, we evaluated the association between exposure to hormone therapy (HT), bone mineral density (BMD) and the prevalence of non-vertebral fractures. The study was set in a region located in southeastern Australia where complete fracture ascertainment was determined from radiological reports. Current HT use for at least 6 months was ascertained in women with non-vertebral fractures [median age 70.9 years; inter-quartile range (IQR) 66.5–75.9 years] and randomly selected controls (median age 70.8 years; IQR 65.2–75.0 years). Current HT use was documented in 20 of 262 cases and 49 of 364 controls. The odds ratio (OR) for non-vertebral fracture associated with HT use was 0.53 (95% CI 0.31–0.92). HT use was associated with 2.6–7.5% higher BMD at axial and appendicular sites. HT use is associated with a halving of risk for non-vertebral fractures and higher BMD.

Garlic (Allium sativum): diet based therapy of 21st century-a review

Functional and nutraceutical foods provide an opportunity to improve one's health by reducing health care costs and to support economic development in rural communities. For this reason, various phyto-based functional foods are becoming popular worldwide owing to number of evidences for their safer therapeutic applications. Garlic (Allium sativum L.,) is an essential vegetable that has been widely utilized as seasoning, flavoring, culinary and in herbal remedies. The consumption of traditional plants especially garlic has progressively increased worldwide because of their great effectiveness, fewer side effects and relatively low cost. Garlic is well known to contain an array of phytochemicals. These bioactive molecules are playing pivotal role in maintaining human health and having potential to reduce various ailments. It has distinct nutritional profile with special reference to its various bioactive components that can be used in different diet based therapies to cure various life-style related disorders. The present review is an attempt to explore the functional/nutraceutical role of garlic against various threats including dyslipidemia and hyperglycemia, cardiovascular disorders, antioxidant capacity and carcinogenic perspectives.

Decreasing dietary sodium while following a self-selected potassium-rich diet reduces blood pressure

Reducing dietary sodium reduces blood pressure (BP), a major risk factor for cardiovascular disease, but few studies have specifically examined the effect on BP of altering dietary sodium in the context of a high potassium diet. This randomized, crossover study compared BP values in volunteer subjects self-selecting food intake and consuming low levels of sodium (Na+; 50 mmol/d) with those consuming high levels of sodium (> or =20 mmol/d), in the context of a diet rich in potassium (K+). Sodium supplementation (NaSp) produced the difference in Na+ intake. Subjects (n = 108; 64 women, 44 men; 16 on antihypertensive therapy) had a mean age of 47.0 ± 10.1 y. Subjects were given dietary advice to achieve a low sodium (LS) diet with high potassium intake (50 mmol Na+/d, >80 mmol K+/d) and were allocated to NaSp (120 mmol Na+/d) or placebo treatment for 4 wk before crossover. The LS diet decreased urinary Na+ from baseline, 138.7 ± 5.3 mmol/d to 57.8 ± 3.8 mmol/d (P < 0.001). The NaSp treatment returned urinary Na+ to baseline levels 142.4 ± 3.7 mmol/d. Urinary K+ increased from baseline, 78.6 ± 2.3 to 86.6 ± 2.1 mmol/d with the LS diet and to 87.1 ± 2.1 mmol/d with NaSp treatment (P < 0.001). The LS diet reduced home systolic blood pressure (SBP) by 2.5 ± 0.8 mm Hg (P = 0.004), compared with the NaSp treatment. Hence, reducing Na+ intake from 140 to 60 mmol/d significantly decreased home SBP in subjects dwelling in a community setting who consumed a self-selected K+-rich diet, and this dietary modification could assist in lowering blood pressure in the general population.