1.
Temporal Change in Biomarkers of Bone Turnover Following Late Evening Ingestion of a Calcium-Fortified, Milk-Based Protein Matrix in Postmenopausal Women with Osteopenia.
Hettiarachchi, M, Cooke, R, Norton, C, Jakeman, P
Nutrients. 2019;11(6)
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Low bone mineral density (bone mineral content) and a diminution in bone quality (bone microarchitecture) are attributes of risk of fracture in people with osteopenia. The aim of this study was to investigate the effect of feeding a milk protein-based matrix (MBPM) fortified with calcium and vitamin D prior to bedtime on the biomarkers of bone remodelling in postmenopausal women with osteopenia. The study is a block-randomised cross-over design which recruited a sample of 41 postmenopausal women aged 50 to 70 years. Out of the 24 participants classified as osteopenic, 16 volunteers progressed to the RCT and randomly assigned to receive either a milk-based protein supplement (MBPM) or an isoenergetic, control. Results indicate that a dairy-based protein supplement fortified with calcium (MBPM) fed at bedtime has a potent effect on nocturnal rates of bone resorption in healthy osteopenic postmenopausal women. Furthermore, the synergistic, pluripotent quality of a milk-based protein matrix and timing of ingestion to the nocturnal, peak rate of bone remodelling transiently depressed bone turnover. Authors conclude that a late-evening supplement of calcium-fortified milk protein affects a beneficial decrease in the homeostatic rate of bone remodelling in persons at risk of degenerative bone disease.
Abstract
The diurnal rhythm of bone remodeling suggests nocturnal dietary intervention to be most effective. This study investigated the effect of bedtime ingestion of a calcium-fortified, milk-derived protein matrix (MBPM) or maltodextrin (CON) on acute (0-4 h) blood and 24-h urinary change in biomarkers of bone remodeling in postmenopausal women with osteopenia. In CON, participants received 804 ± 52 mg calcium, 8.2 ± 3.2 µg vitamin D and 1.3 ± 0.2 g/kg BM protein per day. MBPM increased calcium intake to 1679 ± 196 mg, vitamin D to 9.2 ± 3.1 µg and protein to 1.6 ± 0.2 g/kg BM. Serum C-terminal cross-linked telopeptide of type I collagen (CTX) and procollagen type 1 amino-terminal propeptide (P1NP), and urinary N-telopeptide cross-links of type I collagen (NTX), pyridinoline (PYD) and deoxypyridinoline (DPD) was measured. Analyzed by AUC and compared to CON, a -32% lower CTX (p = 0.011, d = 0.83) and 24% (p = 0.52, d = 0.2) increase in P1NP was observed for MBPM. Mean total 24 h NTX excreted in MBPM was -10% (p = 0.035) lower than CON. Urinary PYD and DPD were unaffected by treatment. This study demonstrates the acute effects of bedtime ingestion of a calcium-fortified, milk-based protein matrix on bone remodeling.
2.
Changing the zinc:iron ratio in a cereal-based nutritional supplement has no effect on percent absorption of iron and zinc in Sri Lankan children.
Hettiarachchi, M, Liyanage, C, Hilmers, D, Griffin, I, Abrams, SA
The British journal of nutrition. 2010;(7):1015-22
Abstract
The Thriposha programme is a community-level nutrition intervention in Sri Lanka that provides a combination of energy, protein and micronutrients as a 'ready-to-eat' cereal-based food. We measured the bioavailability of Fe and Zn from Thriposha formula at two different molar ratios of Zn:Fe in order to determine the effect on Fe and Zn absorption. Children 4-7 years (n 53) were given a meal prepared with 50 g Thriposha containing 1.5 mg Zn as zinc sulphate and either 9 mg (high Fe concentration (HiFe)) or 4.5 mg (low Fe concentration (LoFe)) Fe as ferrous fumarate. Zn and Fe percent absorption were measured using stable isotopes by tracer:tracee ratio and by incorporation of erythrocytes, respectively. Percent Fe absorption from the two meals was similar (6.6 % (4.8) v. 4.8 % (2.6); P = 0.15), but total Fe absorption was significantly higher from the HiFe meal (0.59 (0.43) mg) than the LoFe meal (0.20 (0.12) mg; P = 0.01). There was no significant difference between the two groups in Zn absorption (10.7 % (0.9) v. 8.8 % (1.4), P = 0.13, respectively). Decreasing the amount of Fe in Thriposha did not cause a significant change in the percent absorption of Fe and Zn, but significantly lowered the total amount of absorbed Fe. These results demonstrate the utility of maintaining a higher Fe content in this supplement. Further studies to increase Zn content are warranted while maintaining a HiFe.
3.
Long-term cereal-based nutritional supplementation improved the total spine bone mineral density amongst Sri Lankan preschool children: a randomized controlled study.
Hettiarachchi, M, Lekamwasam, S, Liyanage, C
Journal of pediatric endocrinology & metabolism : JPEM. 2010;(6):555-63
Abstract
BACKGROUND The Thriposha programme in Sri Lanka provides a combination of energy, protein and micronutrients as a 'ready-to-eat' cereal-based food. OBJECTIVE To assess the effectiveness of calcium and vitamin D3 in the Thriposha on bone mineralization among preschool children aged 3-5 years. DESIGN Subjects (n = 30) were fed with conventional Thriposha while the control group (n = 30) children were fed without mineral and vitamin premix (Corn-Soya-Blend - CSB) for a period of nine months. Dual-energy X-ray absorptiometry (DXA) of total spine was measured at the baseline and after the intervention. RESULTS The mean baseline total spine BMD was 0.464 (0.050) g/cm2 in the interventional group and 0.453 (0.035) g/cm2 in the control group (p = 0.09). At the end of the study, the BMD levels were 0.487 (0.047) and 0.454 (0.031) g/cm2 (p < 0.001) respectively. CONCLUSION Daily supplementation of cereal based food supplement over a period of nine months improved the total spine BMD.
4.
The efficacy of micronutrient supplementation in reducing the prevalence of anaemia and deficiencies of zinc and iron among adolescents in Sri Lanka.
Hettiarachchi, M, Liyanage, C, Wickremasinghe, R, Hilmers, DC, Abrams, SA
European journal of clinical nutrition. 2008;(7):856-65
Abstract
OBJECTIVE To determine the effectiveness of combined iron and zinc over the iron or zinc-only supplementation in correcting deficiency and possible interactive effects in a group of adolescent school children. SUBJECTS AND METHODS Schoolchildren (n=821) of 12-16 years of age were randomized into four groups and supplemented with iron (50 mg/day), zinc (14 mg/day), iron+zinc or placebo capsules 5 days per week for 24 weeks. Anthropometry, and haemoglobin (Hb), serum zinc (SZn) and serum ferritin (SF) concentrations were determined before and after the intervention. RESULTS There were no significant effects between-groups in their weight, height and Hb concentrations with the intervention when compared with the placebo group. Iron-only and combination-supplemented groups had reached mean SF concentrations of 55.1 microg/l with no difference between them (P=0.99). The zinc-only group had a mean change of 4.3 micromol//l whereas the combine-supplemented group had a mean change of 4.0 micromol/l (P=0.82). The prevalence of anaemia was found to be 70.3% in the iron group at baseline; this was reduced to 14.5% after the supplementation. In the combine-supplemented group anaemia, prevalence was reduced from 64.8 to 19.3%. CONCLUSIONS Zinc alone or in combination with iron has not shown a significant improvement in growth in adolescence. Severe and moderate forms of anaemia were successfully treated in children who received iron supplementation. Initial high prevalence of low SZn and iron stores was significantly improved with micronutrient supplementation.