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The Mediterranean Diet in Osteoporosis Prevention: An Insight in a Peri- and Post-Menopausal Population.
Quattrini, S, Pampaloni, B, Gronchi, G, Giusti, F, Brandi, ML
Nutrients. 2021;13(2)
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Osteoporosis (OP) is a public health problem in western countries and steadily increasing worldwide. Management and prevention of osteoporosis starts with lifestyle, and diet is of critical interest because it is one of the few safely modifiable risk factors. Several different nutrients, especially calcium are essential for bone and mineral metabolism. It has been observed that the incidence of OP is lower in the Mediterranean area. This prospective observational study looks at the relationship between Mediterranean diet (MD), calcium intake and bone health. Two hundred peri- and post-menopausal women aged 30-80 years, took part. Their adherence to the MD and dietary calcium intake were evaluated by a first visit and a follow-up visit, through questionnaires. Although not statistically significant, in both visits a slight increase in calcium intake was observed for high adherence to MD diet. However, it did highlight the importance of preventive action such as a 15–20 min nutritional conversation to improve lifestyle habits. A cause-effect relationship between MD adherence and calcium intake could not be established by this study, a randomized controlled trial would be useful to gather more data.
Abstract
Osteoporosis represent a widespread public health problem. The management and prevention of osteoporosis and related low energy fractures start with a correct lifestyle and proper nutrition. Several different nutrients are essential for bone and mineral metabolism, especially calcium. Nevertheless, a well-balanced nutrition, such as Mediterranean diet (MD), proved to be beneficial for several chronic diseases and also fragility fractures resulted lower in the Mediterranean area. A prospective observational study in a population of two hundred peri- and post-menopausal women (aged 30-80 years) was developed at Careggi hospital, Florence. Both MD adherence and dietary calcium intake were evaluated in occasion of a "first visit" and a "follow-up" visit, through validated questionnaires. From a descriptive point of view, although not statistically significant, in both visits a slight increase in calcium intake was observed for high adherence to MD diet. Moreover, a short nutritional interview (20 min) was applied in our population and demonstrated to be sufficient to significantly improve MD adherence level (mean score at T0 = 6.98 ± 1.74 and T1 = 7.53 ± 1.68), opening promising paths in osteoporosis prevention.
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Tenth year reenrollment randomized trial investigating the effects of childhood probiotics and calcium supplementation on height and weight at adolescence.
Setiawan, EA, Rianda, D, Kadim, M, Meilianawati, Susanto, F, Kok, FJ, Shankar, AH, Agustina, R
Scientific reports. 2021;11(1):11860
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In combination, probiotics and calcium may help to support gut health and aid growth in early life. This 10 year follow up of 238 children from a previous randomised control trial aimed to determine the long-term effects of probiotic and calcium supplementation on growth during adolescence. The use of probiotics and calcium had no effect on changes in height, weight, or body mass for age. When more analyses were performed the use of Lactobacillus casei was shown to influence changes in body mass for age but only in females. Interestingly those in the probiotic group had poorer gut health than those who were not supplemented. It was concluded that in females, the use of probiotics and calcium during early life may decrease the risk of obesity later in life due to improved body mass. However, this warrants further research. This study could be used by health care professionals to understand that the use of probiotics and calcium in early life may have long-term benefits such as risk reduction of metabolic diseases.
Abstract
Microbiota and its modification with specific probiotics in early life could provide long term health benefits. Probiotics and calcium strengthen intestinal integrity and may support linear growth. This study investigated the long-term effects of childhood probiotics and calcium supplementation on growth in adolescence. We re-enrolled 238 adolescents aged 11-18 years from 494 children 10-years after 6-months of supplementation with either low-lactose milk fortified with low levels of calcium (LC, ∼50 mg/day, n = 53/124), with regular levels of calcium (RC, ∼440 mg/day, n = 70/126), or with regular calcium + 5 x 108 CFU/day Lactobacillus reuteri DSM 17938 (Reuteri, n = 55/124), or regular calcium + 5 x 108 CFU/day L. casei CRL 431 (Casei, n = 60/120). Changes in height-for-age z-score (HAZ) and body mass index-for-age z-score (BMIZ) were determined from the end of intervention to re-enrollment. General linear models were used to assess the effects on HAZ and BMIZ of group, gender, living area, maternal education, family income, physical activity, diet quality, nutritional status, and gut integrity as determined by urinary lactulose/mannitol ratio (L:M). Adolescent mean age was 15.3 years, mean HAZ was - 1.11, mean BMIZ was - 0.2 and median L:M (n = 155) was 0.23. Changes in HAZ and BMIZ were not significantly different between Casei, Reuteri, LC compared to RC. However, a significant decrease in BMIZ was observed among female adolescents in the Casei compared to RC group (- 0.5 SD, 95% CI - 0.8 to - 0.003, p = 0.048). Childhood probiotic and calcium supplementation may therefore selectively affect female adolescents.Clinical trial registration: This follow-up study has been registered at www.clinicaltrials.gov , Registry name: Rina Agustina, Registration number: NCT04046289, First Registration Date 06/08/19. web link: https://www.clinicaltrials.gov/ct2/show/NCT04046289 .