ascorbic-acid and Osteoporosis--Postmenopausal

Osteoporosis is a major health disorder associated with an increased risk of fracture. Nutrition is among the modifiable factors that influence the risk of osteoporosis and fracture. Calcium and vitamin D play important roles in improving bone mineral density and reducing the risk of fracture. Other vitamins appear to play a role in bone health as well. In this review, the findings of studies that related the intake and/or the status of vitamins other than vitamin D to bone health in animals and humans are summarized. Studies of vitamin A showed inconsistent results. Excessive, as well as insufficient, levels of retinol intake may be associated with compromised bone health. Deficiencies in vitamin B, along with the consequent elevated homocysteine level, are associated with bone loss, decreased bone strength, and increased risk of fracture. Deficiencies in vitamins C, E, and K are also associated with compromised bone health; this effect may be modified by smoking, estrogen use or hormonal therapy after menopause, calcium intake, and vitamin D. These findings highlight the importance of adequate nutrition in preserving bone mass and reducing the risk of osteoporosis and fractures.

Topics: Animals; Ascorbic Acid; Avitaminosis; Bone and Bones; Female; Fractures, Bone; Humans; Male; Nutritional Status; Osteoporosis; Osteoporosis, Postmenopausal; Vitamin A; Vitamin B Complex; Vitamin E; Vitamin K; Vitamins

For early prevention or inhibition of postmenopausal and age-related bone loss, nutritional interventions might be a first choice. For some vitamins and minerals an important role in bone metabolism is known or suggested. Calcium and vitamin D support bone mineral density and are basic components in most preventive strategies. Magnesium is involved in a number of activities supporting bone strength, preservation, and remodeling. Fluorine and strontium have bone-forming effects. However, high amounts of both elements may reduce bone strength. Boron is especially effective in case of vitamin D, magnesium, and potassium deficiency. Vitamin K is essential for the activation of osteocalcin. Vitamin C is an important stimulus for osteoblast-derived proteins. Increasing the recommended amounts (US RDA 1989), adequate intakes (US DRI 1997), or assumed normal intakes of mentioned food components may lead to a considerable reduction or even prevention of bone loss, especially in late postmenopausal women and the elderly.

Topics: Ascorbic Acid; Bone Density; Boron; Calcium; Female; Humans; Magnesium; Middle Aged; Minerals; Osteoporosis; Osteoporosis, Postmenopausal; Strontium; Vitamin D; Vitamin K; Vitamins

Oxidative stress is thought to play a central role in the pathophysiology of various conditions affecting women's health, including cancer, preeclampsia and osteoporosis. On the back of animal experimentation, we sought to establish whether the oral administration of vitamin C at high doses to postmenopausal women would achieve the plasma antioxidant activity that could prevent osteoporosis.. In our pilot study, we administered vitamin C at a dose of 10 grams daily to eight healthy postmenopausal women over a period of four weeks and measured their serum levels of vitamin C and crosslaps (markers of bone turnover) at baseline and then on a weekly basis.. We found an initial rise in the plasma levels of vitamin C, but these rapidly fell over four weeks and could not be sustained despite continued therapy, presumably due to limited absorption and possibly even augmented excretion. We found no discernable change in the serum levels of crosslaps in association with the consumption of high doses of vitamin C.. Although vitamin C has antioxidant properties, when given orally, even at a high dose, the serum levels required for it to exhibit antioxidant activity cannot be attained. This approach holds no potential for the use of vitamin C in the prevention of osteoporosis, although other routes of administration could overcome this.

Topics: Antioxidants; Ascorbic Acid; Biomarkers; Bone Density; Female; Humans; Middle Aged; Osteoporosis, Postmenopausal; Oxidative Stress; Pilot Projects; Postmenopause

Statins decrease the hepatic biosynthesis of cholesterol, and reduce the incidence of myocardial infarction in women who have already experienced a myocardial infarction. Statins also reduce the risk of atherosclerosis in diabetic patients, but it is unknown whether they influence the glucose tolerance. It has further been suggested that they may influence bone metabolism. Vitamin C is an antioxidant and it decreases serum cholesterol moderately. Antioxidants may also have other metabolic effects, but these are insufficiently studied. The aim of the present study was to investigate the metabolic effects of the cholesterol-lowering agent fluvastatin and the antioxidant vitamin C. Sixty-eight elderly, postmenopausal women with osteoporosis and mild hypercholesterolemia were randomly assigned to 12 weeks open treatment with either fluvastatin (40 mg daily) + 500 mg vitamin C (n = 45) or vitamin C only (n = 23). We measured biochemical markers of bone formation (serum osteocalcin and total alkaline phosphatase) and bone resorption (serum and urinary CTX), parameters related to diabetes and serum lipids and lipoproteins. Fluvastatin in combination with vitamin C had no effect on bone formation markers. We found a weak decrease in parameters of bone resorption, which was significant from baseline, but not different between the two groups. There were no significant effects on any of the other markers of either fluvastatin or vitamin C. The lipid-lowering effect of fluvastatin was confirmed with a decrease of 20% and 30% in serum total cholesterol and LDL-cholesterol, respectively. We conclude that fluvastatin given in clinically relevant doses has no influence on parameters of bone remodeling. Other statins remain to be investigated.

Topics: Aged; Anticholesteremic Agents; Antioxidants; Ascorbic Acid; Biomarkers; Bone Remodeling; Drug Therapy, Combination; Fatty Acids, Monounsaturated; Female; Fluvastatin; Humans; Hypercholesterolemia; Indoles; Lipoproteins; Osteoporosis, Postmenopausal

Five years ago we reported results from a cross-sectional study of the effect of nutritional factors on calcium-regulating hormones and bone loss in perimenopausal women. We found an inverse correlation between serum 25-hydroxyvitamin D (25OHD) and immunoreactive parathyroid hormone (PTH), and we postulated that over time, women with lower 25OHD would lose more bone because of increased bone remodeling induced by secondary hyperparathyroidism. We have followed 38 of these women for 5 years. Twenty-two have gone through menopause and we are reporting observations on these 22 subjects. Bone mineral analysis was performed twice a year at the distal and mid-radius using single-photon absorptiometry. The slope of the bone mineral content curve was calculated by least squares. Bone loss increased within 6 months of the rise in serum follicle stimulating hormone (FSH) to greater than 40 mIU/ml. We continued to see a negative correlation between 25OHD and PTH (r = -0.450, P = 0.03). Premenopause, PTH was negatively correlated with the proximal bone mineral content (PBMC) slope (-0.604, P = 0.002). The distal bone mineral content (DBMC) 5-year slope was correlated with dietary vitamin D (r = 0.509, P = 0.02), the higher the intake, the less negative the slope. The 5-year PBMC slope was negatively correlated with serum osteocalcin (OC) levels (r = -0.382, P = 0.08). Before menopause, the change in PBMC was positively correlated with OC (r = 0.450, P = 0.03). Postmenopause, the correlation with DBMC slope was negative (r = -0.506, P = 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: 25-Hydroxyvitamin D 2; Absorptiometry, Photon; Administration, Oral; Adult; Ascorbic Acid; Bone Density; Calcifediol; Calcium; Cross-Sectional Studies; Estrogens; Female; Follicle Stimulating Hormone; Food, Fortified; Humans; Middle Aged; Minerals; Osteocalcin; Osteoporosis, Postmenopausal; Parathyroid Hormone; Phosphorus; Radius; Time Factors; Vitamin D

Osteoporosis is a skeletal disease characterized by low bone mass, reduced bone strength, and increased fracture risk. We aimed to investigate the association between combined dietary antioxidant intake and the likelihood of osteoporosis in premenopausal and postmenopausal women, based on data from the National Health and Nutrition Examination Survey.. Nutrient intake data were obtained using two 24-hour recalls. Composite dietary antioxidant index (CDAI), which refers to the intake amounts of β-carotene, vitamin A, vitamin C, vitamin E, selenium, zinc, copper, and iron, was then constructed. Prevalent osteoporosis was defined according to bone mineral density T scores of ≤ -2.5 and self-reports. Multiple logistic and Poisson regression models were used for association analyses.. A total of 3,418 participants (1,157 premenopausal and 2,261 postmenopausal women) 40 years or older were included, 776 (22.70%) of whom had prevalent osteoporosis. In terms of individual nutrients, postmenopausal women in the highest CDAI quartiles for dietary β-carotene, vitamin A, vitamin C, and iron intakes had a low likelihood of osteoporosis. Regarding the CDAI-osteoporosis association, postmenopausal women in the highest quartile were less likely to have osteoporosis (OR Q3 vs Q1 , 0.64; 95% CI, 0.43-0.96; OR Q4 vs Q1 , 0.56; 95% CI, 0.35-0.89; P for trend = 0.013), after controlling for covariates.. CDAI was negatively associated with the likelihood of osteoporosis in postmenopausal women. Our findings suggest that the combined intake of antioxidant nutrients can help reduce the likelihood of osteoporosis in women.

Topics: Antioxidants; Ascorbic Acid; beta Carotene; Bone Density; Diet; Eating; Female; Humans; Iron; Nutrition Surveys; Osteoporosis; Osteoporosis, Postmenopausal; Postmenopause; United States; Vitamin A; Vitamins

Recent epidemiological studies show that antioxidant vitamins and carotenoids might be beneficial to the maintenance of bone health. Recently, we found that serum carotenoids were inversely associated with the risk of developing osteoporosis in post-menopausal Japanese female subjects. However, little is known about the vitamin alone and/or the combination of the vitamin and carotenoid with the risk of osteoporosis. The objective of this study was to investigate longitudinally whether antioxidant vitamins and their combination with carotenoids are associated with the risk of developing of osteoporosis. We conducted a follow-up study on 187 post-menopausal female subjects from the Mikkabi prospective cohort study. Those who participated in previous bone mineral density (BMD) surveys and completed four years of follow-up were examined longitudinally. During a four-year follow-up, fifteen of the post-menopausal female subjects developed new-onset osteoporosis. After adjustment for confounders, the odds ratios (OR) for osteoporosis in the highest tertiles of vitamins C and E and retinol intakes against the lowest tertiles were 0.15 (95% confidence interval (CI): 0.02-0.99), 0.50 (CI: 0.08-3.23), and 1.49 (CI: 0.36-6.22), respectively. Furthermore, a significantly lower odds ratio was observed in the higher vitamin C intake group (169-625 mg/d) with higher serum β-cryptoxanthin (1.88-10.53 μM) against the lower vitamin C intake group (47-168 mg/d) with lower serum β-cryptoxanthin (0.24-1.84 μM) used for the reference group (p<0.05). The combination of β-cryptoxanthin and vitamin C is inversely associated with the risk of developing osteoporosis in post-menopausal Japanese female subjects.

Topics: Aged; Ascorbic Acid; Beta-Cryptoxanthin; Bone Density; Cohort Studies; Diet; Female; Humans; Japan; Middle Aged; Odds Ratio; Osteoporosis, Postmenopausal; Prospective Studies; Risk Factors

Objective To examine the relationship between nutritional intake and bone mineral density (BMD) in postmenopausal Korean women. Methods Dietary intake was recorded in postmenopausal Korean women using a semiquantitative questionnaire. The frequency of consumption of various food groups and nutrient intake were calculated. BMD T-scores were measured at the lumbar spine, femoral neck and total hip using dual-energy X-ray absorptiometry. Associations between T-scores and dietary intake were analysed using partial correlation coefficients and multiple linear regression analysis. Results A total of 189 postmenopausal women were included in the study. β-Carotene intake was positively correlated with the lumbar spine T-score. Sodium and vitamin C intake were positively associated and folate intake negatively associated with the femoral neck T-score. Sodium, zinc and vitamin C intake were positively correlated and potassium intake was negatively correlated with the total hip T-score. Vegetable intake showed a positive association with the femoral neck and total hip T-scores. Conclusion In postmenopausal Korean women, β-carotene, vitamin C, zinc and sodium intakes were positively associated with bone mass. Furthermore, frequency of vegetable consumption was positively associated with femoral neck and total hip T-scores.

Topics: Aged; Ascorbic Acid; beta Carotene; Bone Density; Cross-Sectional Studies; Diet; Female; Femur Neck; Humans; Lumbar Vertebrae; Middle Aged; Osteoporosis, Postmenopausal; Pelvic Bones; Postmenopause; Republic of Korea; Surveys and Questionnaires; Vegetables; Zinc

Offrir aux fournisseurs de soins de santé des lignes directrices quant à la prévention, au diagnostic et à la prise en charge clinique de l'ostéoporose postménopausique.. Stratégies visant à identifier et à évaluer les femmes exposées à des risques élevés; utilisation de la densité minérale osseuse et des marqueurs du renouvellement des cellules osseuses pour l'évaluation du diagnostic et de la réaction à la prise en charge; et recommandations quant à la nutrition, à l'activité physique et au choix du traitement pharmacologique en vue de prévenir l'ostéoporose et d'en assurer la prise en charge. RéSULTATS: La littérature publiée a été récupérée par l'intermédiaire de recherches menées dans MEDLINE et The Cochrane Library le 30 août et le 18 septembre 2012, respectivement, au moyen d'un vocabulaire contrôlé (p. ex. « osteoporosis », « bone density », « menopause ») et de mots clés (p. ex. « bone health », « bone loss », « BMD ») appropriés. Les résultats ont été restreints aux analyses systématiques, aux essais comparatifs randomisés / essais cliniques comparatifs et aux études observationnelles publiés en anglais ou en français. Les résultats ont été restreints aux documents publiés à partir de 2009. Les recherches ont été mises à jour de façon régulière et intégrées à la directive clinique jusqu'en mars 2013. La littérature grise (non publiée) a été identifiée par l'intermédiaire de recherches menées dans les sites Web d'organismes s'intéressant à l'évaluation des technologies dans le domaine de la santé et d'organismes connexes, dans des collections de directives cliniques, dans des registres d'essais cliniques et auprès de sociétés de spécialité médicale nationales et internationales.. La qualité des résultats est évaluée au moyen des critères décrits dans le rapport du Groupe d'étude canadien sur les soins de santé préventifs (Tableau 1).. La Société des obstétriciens et gynécologues du Canada. RECOMMANDATIONS.

Topics: Ascorbic Acid; Bone Density; Bone Density Conservation Agents; Canada; Cross-Sectional Studies; Diphosphonates; Estrogen Replacement Therapy; Female; Humans; Menopause; Osteoporosis, Postmenopausal; Quebec; Surveys and Questionnaires; Vitamin D

Dietary vitamin C intake showed significant positive associations with BMD in postmenopausal women, especially with vitamin D deficiency.. Although there is a positive role of vitamin C in osteoblastogenesis, debate remains about the contribution of vitamin C to bone mineral density (BMD) in humans.. Data were derived from the Fourth Korean National Health and Nutrition Examination Survey. Dietary information was assessed using a 24-h dietary recall questionnaire. BMD was measured by dual-energy X-ray absorptiometry at the lumbar and hip.. A total of 1,196 postmenopausal women aged 50 years and older were stratified into tertiles by daily dietary vitamin C intake. After adjusting for traditional confounders, dietary vitamin C intake tertile was significantly positively associated with BMD at all sites (R = 0.513 for lumbar spine (LS) and R = 0.657 for femoral neck (FN), P < 0.05 for each). The subjects with osteoporosis had significantly lower dietary vitamin C intake than did subjects without osteoporosis (74.4 ± 66.2 vs 94.1 ± 78.6 mg/day for LS and 65.5 ± 56.6 vs 94.3 ± 79.2 mg/day for FN, respectively, P < 0.001). The multiple-adjusted odds ratio for osteoporosis for dietary vitamin C <100 mg/day was 1.790 (95 % CI 1.333-2.405, P < 0.001). However, the significant association between vitamin C intake and BMD was only observed in subjects with vitamin D deficiency and aged 50-59 years or >70 years.. Dietary vitamin C intake was positively associated with BMD in postmenopausal women, and inadequate vitamin C intake could increase the risk of osteoporosis.

Topics: Absorptiometry, Photon; Aged; Ascorbic Acid; Bone Density; Cross-Sectional Studies; Diet; Female; Hip Joint; Humans; Lumbar Vertebrae; Middle Aged; Nutrition Surveys; Osteoporosis, Postmenopausal; Postmenopause; Vitamin D; Vitamin D Deficiency

Osteoporosis, which has become a serious public health concern, is influenced by diet, especially calcium intake. Dairy products are a good source of calcium, but plant calcium may also be important in populations that do not consume a large amount of milk. The purpose of the present study was to examine the hypothesis that calcium from vegetable sources is associated with osteoporosis risk and bone mineral density in postmenopausal Korean women with osteoporosis and age-matched controls (N = 144). The results of multivariate-adjusted regression analyses indicated that the intake of calcium, plant calcium, potassium, vitamin A, carotene, vitamin B(1), niacin, vitamin E, vitamin C, and vegetables was associated with significantly reduced risk of osteoporosis after adjusting for age, body mass index, hormone replacement therapy, and energy intake. In addition, intake of vegetables alone, as well as calcium, plant calcium, potassium, and antioxidant vitamins (vitamin C, vitamin E, β-carotene), which are abundant in vegetables, was significantly and positively associated with bone mineral density. However, in this population of low-dairy consumers, intake of calcium from meat and dairy products was not related to risk of osteoporosis and bone mineral density. Our results suggest that high dietary intake of calcium, especially plant calcium, reduces the risk of osteoporosis and increased bone mineral density in postmenopausal Korean women. Vegetables may be an important source of calcium and may also provide vitamins and minerals that exert additional beneficial effects on the bone.

Topics: Ascorbic Acid; Asian People; beta Carotene; Body Mass Index; Bone Density; Calcium; Calcium, Dietary; Case-Control Studies; Diet; Energy Intake; Female; Humans; Middle Aged; Multivariate Analysis; Osteoporosis, Postmenopausal; Plant Extracts; Regression Analysis; Risk Factors; Vegetables; Vitamin A; Vitamin E

Whereas several epidemiological studies suggest that low dietary intake of vitamins C and E is linked to increased hip fracture in smokers and antioxidants (dietary and endogenous) are reduced in elderly osteoporotic women, none has demonstrated an effect of supplemental antioxidants on bone turnover.. In an observational study of 533 randomly selected women, we investigated the associations among the use of antioxidant supplements, vitamins C and E, serum levels of biochemical markers of bone turnover (C-telopeptide [CTx] and bone-specific alkaline phosphatase [BSAP]), and whole body bone mineral density (BMD).. Twenty-two women were identified as current users of supplemental vitamin C or E. Duration of antioxidant supplement use was negatively associated with age-adjusted and weight-adjusted serum CTx, such that mean CTx levels (natural log transformed) were 0.022 units lower for each year of exposure. No significant differences were detected for adjusted serum BSAP or whole body BMD.. Our results suggest that antioxidant vitamin E or C supplements may suppress bone resorption in nonsmoking postmenopausal women. Coupling of bone formation and resorption may explain the absence of an effect on bone formation markers, given evidence of enhanced effects of antioxidants on osteoblast differentiation; this warrants further investigation. This work adds to the growing body of evidence that antioxidants may play a role in preventing osteoporosis.

Topics: Aged; Aged, 80 and over; Aging; Antioxidants; Ascorbic Acid; Australia; Biomarkers; Bone Resorption; Cohort Studies; Cross-Sectional Studies; Female; Health Knowledge, Attitudes, Practice; Humans; Middle Aged; Osteoporosis, Postmenopausal; Regression Analysis; Surveys and Questionnaires; Vitamin E; Women's Health

Nutrition is an important factor in the prevention and treatment of osteoporosis. Our goal was to examine the relationship between various nutrients and bone mass of several skeletal sites in elderly women, taking into account possible confounding variables.. A cross-sectional study in 136 healthy Caucasian, postmenopausal women, free of medications known to affect bone was carried out. Bone mineral density (BMD) and body composition (lean and fat tissue) were measured by dual X-ray absorptiometry using specialized software for different skeletal sites. Parathyroid hormone (PTH) and vitamin D, 25(OH)D, as possible confounders, were determined in serum samples. Dietary intake, including all supplements, was assessed by 3-day dietary record and analyzed using Food Processor. Past physical activity and present walking were examined as well and accounted for as potential confounders. Simple and multiple regression models were created to assess the relationships between nutrients and BMD. To examine the co-linear variables and their possible independent association with bone, subgroup analyses were performed.. : Showed independent influence of calcium, energy, and protein, examined separately and in multiple regression models on BMD of several skeletal sites. Magnesium, zinc and vitamin C were significantly related to BMD of several skeletal sites in multiple regression models (controlled for age, fat and lean tissue, physical activity and energy intake), each contributing more than 1% of variance. Serum PTH and 25(OH)D did not show significant association with bone mass.. Despite the cross-sectional nature of our study we were able to show a significant relationship between BMD and several critical nutrients: energy, protein, calcium, magnesium, zinc and vitamin C. The exact involvement of these nutrients and their clinical significance in bone health need to be further elucidated in humans and conclusions about the effects of a single nutrient on bone mass must be given cautiously, taking into account its interaction and co-linearity with others. Understanding relationships among nutrients, not just limited to calcium and vitamin D, but others that have not been investigated to such extent, is an important step toward identifying preventive measures for bone loss and prevention of osteoporosis.

Topics: Aged; Aging; Ascorbic Acid; Bone Density; Calcium; Calcium, Dietary; Cross-Sectional Studies; Dietary Proteins; Energy Intake; Exercise; Female; Humans; Magnesium; Middle Aged; Nutritional Physiological Phenomena; Nutritional Status; Osteoporosis, Postmenopausal; Parathyroid Hormone; Postmenopause; Regression Analysis; Vitamin D; Zinc

Topics: Aged; Aged, 80 and over; Ascorbic Acid; Calcium; Female; Humans; Hypercalcemia; Osteoporosis; Osteoporosis, Postmenopausal; Vitamin D; Vitamins