Effects of dietary improvement on bone metabolism in elderly underweight women with osteoporosis: a randomised controlled trial
- 1 September 2003
- journal article
- clinical trial
- Published by Springer Science and Business Media LLC in Osteoporosis International
- Vol. 14 (9), 750-756
- https://doi.org/10.1007/s00198-003-1440-1
Abstract
Malnutrition in elderly people contributes to osteoporosis and fracture. The aim of the study was to investigate the effects of nutritional improvement on bone metabolism in elderly community-dwelling women. A 12-month randomized controlled trial of 71 ambulant women aged ≥70 years with BMI ≤21 kg/m2 and osteoporosis at the hip was undertaken. They received either calcium (1 g) and vitamin D (800 units of cholecalciferol) only (group 1: n=35) or calcium/vitamin D and one or two cartons of a nutritional supplement drink which provided 300 Kcal, 12 g protein, 11.6 g fat and 36.8 g carbohydrate per carton(group 2: n=36). Body composition and bone mineral density (BMD) were assessed at baseline and 12 months. Biochemical markers of bone turnover were measured at baseline and at 1, 3, 6, 9 and 12 months. Group 2 gained significantly more weight [mean (SD) group 1: 0.15 (2.45), group 2:2.66 (2.8) kg P P P=0.13]. In a subgroup analysis, irrespective of their treatment group, there was a significant difference in changes in BMD at the lumbar spine and total hip in those who lost body weight (A) compared to those who had maintained or increased their weight (B), [mean (SD) % change in BMD lumbar spine; A: −1.64 (3.75), B: 0.96 (2.75) P=0.013, total hip A: −2.09 (6.0), B: 1.04 (3.3), P=0.05)] A significant reduction in serum CTX, a marker of bone resorption, was seen in group 2 [% decrease at 3 months, group 1: 1 (8.7), Group 2: 32 (5.8), PPP P=0.05]. Serum osteocalcin increased at 12 months in group 2 (P=0.01). Dietary improvement in elderly women with low BMI is associated with a reduction in bone resorption with a small but "net" positive effect on bone formation.Keywords
This publication has 25 references indexed in Scilit:
- Relationships Between Bone Mineral Density and Incident Vertebral Fracture Risk with Raloxifene TherapyJournal of Bone and Mineral Research, 2002
- Serum type I collagen breakdown product (serum CTX) predicts hip fracture risk in elderly women:: The EPIDOS studyBone, 2000
- The Roles of Osteoprotegerin and Osteoprotegerin Ligand in the Paracrine Regulation of Bone ResorptionJournal of Bone and Mineral Research, 2000
- Reduction of Vertebral Fracture Risk in Postmenopausal Women With Osteoporosis Treated With RaloxifeneResults From a 3-Year Randomized Clinical TrialJAMA, 1999
- Do Markers of Bone Resorption Add to Bone Mineral Density and Ultrasonographic Heel Measurement for the Prediction of Hip Fracture in Elderly Women? The EPIDOS Prospective StudyOsteoporosis International, 1998
- Assessment of biochemical markers of bone metabolism in relation to the occurrence of fracture: A retrospective and prospective population-based study of womenJournal of Bone and Mineral Research, 1995
- Serum Osteocalcin Regulation in Protein-Energy Malnourished ChildrenPediatric Research, 1995
- Determinants of the rate of bone loss in normal postmenopausal women.Journal of Clinical Endocrinology & Metabolism, 1994
- Physical Activity and Muscle Training in the ElderlyActa Medica Scandinavica, 1986
- EVALUATION OF A MENTAL TEST SCORE FOR ASSESSMENT OF MENTAL IMPAIRMENT IN THE ELDERLYAge and Ageing, 1972