Effects of oligofructose-enriched inulin on intestinal absorption of calcium and magnesium and bone turnover markers in postmenopausal women

Deficiency of oestrogen at menopause decreases intestinal Ca absorption, contributing to a negative Ca balance and bone loss. Mg deficiency has also been associated with bone loss. The purpose of the present investigation was to test the hypothesis that treatment with a spray-dried mixture of chicory oligofructose and long-chain inulin (Synergy1; SYN1) would increase the absorption of both Ca and Mg and alter markers of bone turnover. Fifteen postmenopausal women (72.2 (SD 6.4) years) were treated with SYN1 or placebo for 6 weeks using a double-blind, placebo-controlled, cross-over design. Fractional Ca and Mg absorption were measured using dual-tracer stable isotopes before and after treatment. Bone turnover markers were measured at baseline, 3 and 6 weeks. Fractional absorption of Ca and Mg increased following SYN1 compared with placebo (P < 0.05). Bone resorption (by urinary deoxypyridinoline cross-links) was greater than baseline at 6 weeks of active treatment (P < 0.05). Bone formation (by serum osteocalcin) showed an upward trend at 3 weeks and an increase following 6 weeks of SYN1 (P < 0.05). Closer examination revealed a variation in response, with two-thirds of the subjects showing increased absorption with SYN1. Post hoc analyses demonstrated that positive responders had significantly lower lumbar spine bone mineral density than non-responders (dual X-ray absorptiometry 0.887 +/- 0.102 v. 1.104 +/- 0.121 g/cm2; P < 0.01), and changes in bone turnover markers occurred only in responders. These results suggest that 6 weeks of SYN1 can improve mineral absorption and impact markers of bone turnover in postmenopausal women. Further research is needed to determine why a greater response was found in women with lower initial spine bone mineral density.     

Successful weight loss reduces endothelial activation in individuals with severe obesity participating in a multimodal weight loss program

IntroductionEndothelial dysfunction is a very common finding in obesity and metabolic syndrome. The aim of our study was to investigate if longterm weight reduction (WR) success may reverse endothelial activation in individuals with severe obesity participating in a multimodal WR program.MethodsParticipants with obesity (øBMI 40.3 ±7.5 kg/m²) underwent a standardized non-surgical 1-year WR program. Carotid artery studies and determination of endothelial function biomarkers were performed at baseline and after 1 year. Individuals were dichotomized in “successful WR” (% WR≥10% of initial body weight) and “failed WR” (% WR<10% of initial body weight).ResultsFrom 191 people with obesity, 115 achieved successful WR. Compared to controls without obesity (n=44) participants with obesity had higher carotid intima media thickness as well as higher sICAM-1, sE-selectin, MMP-9, hsCRP and IL-6 levels. After 12 months follow up delta values of inflammation and endothelial adhesion markers were significantly different between participants with obesity and successful WR and participants with obesity and failed WR, in favour of the successful WR group (mean ± standard deviation): ΔhsCRP (?5.2 mg/L ±7.8 vs. 1.1 mg/L ±5.1, P<0.001; P_adj=0.009), ΔIL-6 (?1.0 pg/mL ±3.4 vs. 0.5 pg/mL ±2.6, P<0.001; P_adj=0.057), ΔsE-selectin (?19.0 ng/mL ±24.4 vs. 39.2 ng/mL ±20.3, P<0.001; P_adj<0.001), ΔsICAM-1 (-26.4 ng/mL ±68.8 vs. 10.6 ng/mL ±73.9, P=0.004; P_adj=0.805) and ΔoxLDL (?4 mg/dL ±30 vs. 5 mg/dL ±25, P=0.004; P_adj=0.473). In linear regression analysis reduction of BMI was significantly associated with improvement of several endothelial dysfunction biomarkers with the strongest effects for ΔsE-selectin and ΔhsCRP.ConclusionOur data corroborate the finding that obesity leads to endothelial dysfunction. Furthermore, successful non-surgical WR may at least partially reverse endothelial activation implicating cardiovascular health benefits of WR in people with severe obesity.     

Effects of calcium and dairy on body composition and weight loss in African-American adults

OBJECTIVE: Our objective was to determine the effects of dairy consumption on adiposity and body composition in obese African Americans. RESEARCH METHODS AND PROCEDURES: We performed two randomized trials in obese African-American adults. In the first (weight maintenance), 34 subjects were maintained on a low calcium (500 mg/d)/low dairy (<1 serving/d) or high dairy (1200 mg Ca/d diet including 3 servings of dairy) diet with no change in energy or macronutrient intake for 24 weeks. In the second trial (weight loss), 29 subjects were similarly randomized to the low or high dairy diets and placed on a caloric restriction regimen (-500 kcal/d). RESULTS: In the first trial, body weight remained stable for both groups throughout the maintenance study. The high dairy diet resulted in decreases in total body fat (2.16 kg, p < 0.01), trunk fat (1.03 kg, p < 0.01), insulin (18.7 pM, p < 0.04), and blood pressure (6.8 mm Hg systolic, p < 0.01; 4.25 mm Hg diastolic, p < 0.01) and an increase in lean mass (1.08 kg, p < 0.04), whereas there were no significant changes in the low dairy group. In the second trial, although both diets produced significant weight and fat loss, weight and fat loss on the high dairy diet were approximately 2-fold higher (p < 0.01), and loss of lean body mass was markedly reduced (p < 0.001) compared with the low dairy diet. DISCUSSION: Substitution of calcium-rich foods in isocaloric diets reduced adiposity and improved metabolic profiles in obese African Americans without energy restriction or weight loss and augmented weight and fat loss secondary to energy restriction.     

Greater weight loss among men participating in a commercial weight loss program: a pooled analysis of 2 randomized controlled trials

Being overweight and obese are significant health concerns for men and women, yet despite comparable needs for effective weight loss and maintenance strategies, little is known about the success of commercial weight loss programs in men. This study tests the hypothesis that men participating in a commercial weight loss program (Weight Watchers) had significantly greater weight loss than men receiving limited support from health professionals for weight loss (controls). A pooled analysis of weight loss and related physiologic parameter data from 2 randomized clinical trials was conducted. After 12 months, analysis of covariance tests showed that men in the commercial program group (n = 85) lost significantly more weight (P < .01) than men in the control group (n = 84); similar significant differences were observed for body mass index and waist circumference. These results suggest that participation in a commercial weight loss program may be a more effective means to lose weight and maintain weight loss.     

Effects of vitamin D metabolites on intestinal calcium absorption and bone turnover in elderly women

BACKGROUND: The relative importance of vitamin D metabolites in the regulation of gut calcium absorption has not been well studied in elderly women living in an environment with abundant sunlight. OBJECTIVE: The objective was to examine the determinants of active gut calcium absorption ( +/- SD: 42 +/- 11%) after an overnight fast with the use of a low (10 mg) calcium load. DESIGN: One hundred twenty elderly women aged 74.7 +/- 2.6 y underwent an active calcium absorption test with a radioactive calcium tracer, dietary analysis, and measurement of markers of bone turnover and calcium metabolism. RESULTS: The mean serum 25-hydroxyvitamin D [25(OH)D] concentration at the time of the calcium absorption test was 68 +/- 29 nmol/L. Gut calcium absorption was correlated with 25(OH)D but not 1,25-dihydroxyvitamin D (calcitriol), the free calcitriol index, or dietary calcium intake. After adjustment for age, calcitriol concentration, and dietary calcium intake, the significant determinant of fractional calcium absorption was the 25(OH)D concentration (r = 0.34, P = 0.001). When body weight was included in the regression, both 25(OH)D (beta = 1.20 x 10(-3)) and calcitriol (beta = 1.00 x 10(-3)) were significantly correlated with calcium absorption. Despite the strong relation between 25(OH)D and gut calcium absorption, there was no relation with other aspects of bone turnover or calcium metabolism. CONCLUSION: These data suggest that at low calcium loads, 25(OH)D is a more important determinant of gut calcium absorption than is calcitriol in elderly women exposed to abundant sunlight, but that this relation has little effect on overall calcium metabolism.     

阿法骨化醇对绝经后妇女骨密度及骨转换标志物的影响

目的探讨阿法骨化醇对绝经后妇女骨密度及骨转换标志物的影响。方法选择2009年9月至2011年12月在本院更年期门诊经骨密度（BDM）测量诊断为骨量减少或骨质疏松症,年龄在55～75岁之间的67例绝经后女性为观察对象,随机分为试验组36例,对照组31例。试验组口服氨基酸螯合钙1 000mg/d,阿法骨化醇0.25μg/次,一天两次;对照组口服氨基酸螯合钙1 000mg/d。两组均连续服药48周。两组治疗前、后采用双能X线吸收法测定股骨颈、大粗隆、Ward三角区及腰椎L2-4骨密度;同时采用酶联免疫法检测血清骨碱性磷酸酶（BALP）、抗酒石酸酸性磷酸酶（TRACP）、25羟维生素D3[25-（OH）D3]结果治疗前试验组与对照组间股骨颈、大粗隆、Ward三角区及L2-4骨密度差异均无统计学意义（P〉0.05）。试验组各部位BMD治疗后均有显著增加（P〈0.05）,而对照组治疗前后仅L2-4有显著增加（P〈0.05）。治疗后试验组与对照组各部位BMD差异均有统计学意义（P〈0.05）。血清BALP、TRACP及25-（OH）D3水平治疗前试验组与对照组间比较,差异均无统计学意义（P〉0.05）,治疗后组间比较差异均有统计学意义（P〈0.05）。试验组治疗前血清BALP、TRACP及25-（OH）D3水平分别为（26.52±6.07）μg/L、（2.84±0.97）U/L、（53.91±19.04）nmol/L,治疗后分别为（21.85±5.96）μg/L、（2.37±0.88）U/L、（57.87±19.24）nmol/L,BALP、TRACP均呈显著降低,25-（OH）D3有显著升高（P〈0.05）;对照组治疗前后各骨代谢指标改变差异无统计学意义（P〉0.05）。结论阿法骨化醇可用于绝经后骨质疏松症的治疗,可增加骨密度、降低骨转换,对治疗骨质疏松症有理论依据和临床意义。     

Bone turnover markers in women participating in a dose-finding trial of a contraceptive vaginal ring releasing Nestorone and estradiol

ObjectiveTo evaluate changes in the bone turnover markers CTx and P1NP during 6 months' use of novel continuous contraceptive vaginal rings delivering Nestorone (NES) 200 mcg/day and three doses of estradiol (E2) (10, 20, and 40 mcg/day).Study designThis randomized trial enrolled 189 women who used two consecutive vaginal rings over 180 days. Frequent blood sampling permitted analysis of NES, E2, CTx and P1NP concentrations. The bone-turnover marker analyses included only women with complete sampling and excluded women with characteristics that might interfere with accurate measurement of bone markers such as afternoon sampling, poor ring compliance or recent pregnancy. We evaluated the change from baseline to 6 months in CTx and P1NP, stratified by ring dose and by average circulating E2 concentrations.ResultsOne hundred fifty-one women completed the study, and 82 women had complete data available for the bone marker analyses; the three dosage groups were balanced with regard to baseline characteristics. E2 concentrations remained low throughout treatment, regardless of which dose ring the participant used. Individual CTx changes from baseline averaged 27±56% (p<.01). Similarly, individual P1NP changes averaged 11±33% (p=.04). These increases were within the premenopausal reference ranges, and unrelated to treatment dose or to circulating E2 concentrations.ConclusionsThe low E2 dose of these rings was associated with low E2 concentrations and modest increases in serum bone turnover makers. Because we have only 6-month bone turnover markers and no direct evidence of bone loss or bone density change, these results must be interpreted with caution.ImplicationsNestorone, a 19-norprogesterone derivative, leads to complete ovarian suppression, which should yield excellent contraceptive effectiveness. To prevent potential adverse effects on bone, the NES contraceptive ring should be combined with higher doses of E2 than were assessed in this study.     

Effects of dietary calcium intake on body weight and prevalence of osteoporosis in early postmenopausal women

BACKGROUND: High calcium intakes seem to be ineffective at reducing bone loss in early postmenopausal women. However, the inverse relation between calcium intake and body weight can attenuate the negative effect of a low dietary calcium intake. OBJECTIVE: The objective was to assess the role of dietary calcium and body mass index (BMI) on osteoporosis, defined according to World Health Organization criteria as a lumbar bone density >2.5 SD below the T score. DESIGN: This was a cross-sectional, retrospective, observational study conducted in 1771 healthy, early postmenopausal women, who were not taking calcium supplements at the first densitometric evaluation. Weekly frequency of dairy food consumption was used to estimate the relative intake of dietary calcium. Total dairy intake was classified into 4 categories by quartile cutoffs. Multiple logistic regression analyses were used to study this sample. RESULTS: BMI and prevalence of overweight showed significant inverse trends with increasing dairy intake. Calcium intake was not associated with osteoporosis when overweight was not considered. However, when overweight was considered in the analysis, women with the lowest calcium intake were more likely to have osteoporosis (odds ratio: 1.46; 95% CI: 1.12, 1.89; P = 0.008) than were women with the highest calcium intake. CONCLUSIONS: In early postmenopausal women, a low dietary calcium intake may increase the risk of osteoporosis, but its negative effect can be offset by the greater BMI found in women with a low calcium intake.     

Blood lead levels and bone turnover with weight reduction in women

High bone turnover states are known to raise blood lead levels (BPb). Caloric restriction will increase bone turnover, yet it remains unknown if weight reduction increases BPb due to mobilization of skeletal stores. We measured whole blood Pb levels ((206)Pb) by inductively coupled plasma mass spectrometry in 73 women (age 24-75 years; BMI 23- 61 kg/m(2)) before and after 6 months of severe weight loss (S-WL), moderate weight loss (M-WL), or weight maintenance (WM). Baseline BPb levels were relatively low at 0.2-6.0 microg/dl, and directly associated with age (r=0.49, P<0.0001). After severe WL (-37.4+/-9.3 kg, n=17), BPb increased by 2.1+/-3.9 microg/dl (P<0.05), resulting in BPb levels of 1.3-12.5 microg/dl. M-WL (-5.6+/-2.7 kg, n=39) and WM (0.3+/-1.3 kg, n=17) did not result in an increase in BPb levels (0.5+/-3.2 and 0.0+/-0.7 microg/dl, M-WL and WM, respectively). BPb levels increased more with greater WL (r=0.24, P<0.05). Bone turnover markers increased only with severe WL and were directly correlated with WL. At baseline, higher calcium intake was associated with lower BPb (r=-0.273, P<0.02), however, this association was no longer present after 6 months. Severe weight reduction in obese women increases skeletal bone mobilization and BPb, but values remain well below levels defined as Pb overexposure.     

Impact of supplementary high calcium milk with additional magnesium on parathyroid hormone and biochemical markers of bone turnover in postmenopausal women

The aim of this study was to investigate the impact of magnesium-enriched, high-calcium milk on serum parathyroid hormone (PTH) and biochemical markers of bone turnover in postmenopausal women. We recruited 50 healthy postmenopausal women to take part in this randomised controlled study. Half of the women consumed two serves of high-calcium skim milk enriched with magnesium (milk group) and half consumed two serves apple drink per day (apple group), each for 4 weeks. The milk provided 1200 mg calcium and an additional 106 mg magnesium. We investigated the responses of serum PTH, as well as the serum and urinary calcium, magnesium and biochemical markers of bone turnover. There was no effect of time or drink on the clinical biochemistry, serum PTH or urine markers of bone resorption (free deoxypyridinoline and N-telopeptides). Serum C-telopeptides (CTX), another marker of bone resorption, did not change with time in the apple group. However, in the milk group, serum CTX deceased significantly from 0.43 +/- 0.04 ng/mL to 0.32 +/- 0.02 at 2 weeks (p < 0.0001) and 0.28 +/- 0.02 at 4 weeks (p < 0.0001). In the milk group, urinary calcium and magnesium each increased during the night but not during the day. Overall, these data suggest that milk has an antiresorptive effect on bone, but that this is not accompanied by measurable changes in serum PTH.     

Effect of calcium fortified milk supplementation with or without vitamin K on biochemical markers of bone turnover in premenopausal women

OBJECTIVE: We compared the effect of supplementation with a fortified skimmed milk product (high calcium skim milk) with or without added phylloquinone (vitamin K(1)) on markers of bone formation and resorption in premenopausal women. METHODS: Eighty-two women 20 to 35 y of age were randomly allocated to three groups. Two groups received two daily servings of high calcium skim milk (1000 mg/d of extra calcium) with or without added phylloquinone (80 microg/d) for 16 wk, and a third control group received no supplementation. Bone density was assessed at baseline and the bone markers, total osteocalcin, type I N-terminal procollagen peptide, and cross-linked C-telopeptide of type I collagen were measured at baseline and at weeks 2, 12, and 16. Serum phylloquinone and undercarboxylated osteocalcin were measured in the control and vitamin K-supplemented groups at weeks 0 and 16. RESULTS: Baseline values for age, body mass index, and bone density did not differ across groups. In vitamin K-supplemented women, mean serum phylloquinone concentrations increased from 0.27 to 0.76 microg/L (P < 0.05) and undercarboxylated osteocalcin concentrations decreased from 9.68 to 4.46 microg/L (P < 0.05) over 16 wk. Plasma cross-linked C-telopeptide of type I collagen, total osteocalcin, and type I N-terminal procollagen peptide levels decreased significantly in both supplemented groups compared with the control group over 16 wk (cross-linked C-telopeptide of type I collagen >30%, total osteocalcin and type I N-terminal procollagen peptide >15%). CONCLUSION: Fortified milk supplementation in premenopausal women reduced bone turnover significantly. Phylloquinone fortification substantially improved vitamin K status but had no demonstrable additive effect on bone turnover in this short-term study.     

Weight loss maintenance in women two to eleven years after participating in a commercial program: a survey

Background  

After 5 years, most reports show that less than 10% of people maintain a 5% loss from initial body weight. Weight maintenance after 10 years is rarely assessed, especially in commercial programs. The current article reports weight maintenance in individuals who had participated 2 to 11 years earlier in a popular commercial weight loss program based on Canada's Food Guide called Mincavi.     

Wheat bran supplementation does not affect biochemical markers of bone turnover in young adult women with recommended calcium intake

We investigated the effect of wheat bran on biochemical indicators of Ca and bone metabolism in nineteen healthy women, aged 25.5 (SE 0.9) years. Subjects received six wheat bran biscuits or six white flour biscuits per day for a period of 4 weeks (crossover). Wheat bran consumption increased fibre intake from 17.7 (SE 1.3) to 29.6 (SE 1.3) g/d (7 d food record) and enhanced P intake from 1225 (SE 59) mg/d to 1663 (SE 65) mg/d; P < 0.001. Mean daily Ca intake during wheat bran consumption (1110 (SE 82) mg/d) significantly (P = 0.008) exceeded Ca ingestion during the white flour period (955 (SE 67) mg/d). Wheat bran increased the number of defecations per week from 7.9 (SE 0.8) to 12.2 (SE 1.4) (P = 0.0018). Urinary Ca excretion over 24 h significantly (P = 0.021) decreased from 473 (SE 53) mumol/mmol creatinine (control period) to 339 (SE 37) mumol/mmol creatinine (wheat bran period). Serum 25-hydroxyvitamin D, 2 h fasting urinary Ca/creatinine excretions and 24 h urinary P excretion remained constant. No differences in serum levels of carboxy-terminal propeptide of type I procollagen (biomarker of bone formation) or in 2 h fasting urinary hydroxyproline/creatinine excretions (biomarker of bone resorption) were observed at the end of the two cycles of dietary supplementation. We conclude that a high fibre intake of approximately 30 g/d has no significant adverse effects on bone turnover in subjects with Ca intakes above 1000 mg/d and that the reduction in 24 h urinary Ca excretion is most probably the result of an adaptation process, induced by a decrease in net absorbed Ca.     

Intention to change dietary habits, and weight loss among Norwegian-Pakistani women participating in a culturally adapted intervention

The aim was to explore the relationships between degree of participation in a culturally adapted lifestyle intervention and stages of change for healthy eating and weight loss among Pakistani immigrant women in Norway. The intervention lasted 7 months and included 198 women, randomized into control and intervention groups. The odds of losing weight from baseline to follow-up, and being in action stages of change (compared to pre-action stages) with regard to intake of amount and type of fat, sugar and white flour at follow-up, increased significantly with number of group sessions attended. Those in action stage of reducing intake of fat and increasing intake of vegetables, as well as of reducing weight, were significantly more likely than others to have experienced weight loss at follow-up. Participation in the culturally adapted intervention was related to increase in intentions to change dietary behaviours and to weight loss.     

Self-reported changes in dietary calcium and energy intake predict weight regain following a weight loss diet in obese women

This study examined relationships between changes in dietary calcium intake, energy intake, and body weight following a weight loss diet. One hundred three overweight or obese women lost weight over 22 wk. Dietary calcium and energy intake were assessed using the Block 98 FFQ (Block) and 5-d food records (FR) at intervention end and 6- and 18-mo follow-up. Pearson correlations were used to relate changes in dietary calcium to energy intake. We used regression analyses to examine relationships between changes in dietary calcium, energy intake, and weight regain. Changes in dietary calcium and energy intake were correlated (r = 0.32; P = 0.033), but neither variable alone predicted weight regain. From 6- to 18-mo follow-up, greater dietary calcium intake inversely predicted weight regain when controlling for changes in energy intake (P = 0.048 Block and 0.025 FR), whereas higher energy intake positively predicted weight regain when controlling for changes in dietary calcium intake (P = 0.009 Block and 0.049 FR) (combined R(2) = 0.153 Block and 0.178 FR). Dietary calcium may oppose weight regain, reducing the effect of greater energy intake. Our results encourage future research on the potential relationship between dietary calcium and weight loss maintenance and suggest that controlling for dietary calcium may increase the ability of energy intake to predict weight change.     

Risk identification of abused women participating in a women,infants, and children program

Demographic characteristics, social and health risk factors, and responses to open‐ended questions regarding health and abuse experiences were analyzed in a study of women participants in a Women, Infants, and Children supplemental food program at a mid‐western county health department. Of the 400 respondents, 124 had experienced physical abuse according to the Partner Abuse Scale: Physical (PASPH) for determining physical abuse (Hudson, 1990). Quantitative and qualitative procedures were applied to the data. A trimmed model indicated that the best predictors of PASPH score were self‐perceived abuse and number of medical/health conditions. Implications for service and program development include strategies for ongoing assessment, intervention, and evaluation to detect and to address physical and nonphysical assault. Epidemiological investigation and follow‐up are recommended for health conditions discovered as prevalent in this population.