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Plant-based diets and bone health: sorting through the evidence.
Hsu, E
Current opinion in endocrinology, diabetes, and obesity. 2020;(4):248-252
Abstract
PURPOSE OF REVIEW An increase in awareness of vegetarian and vegan (plant-based) diets has brought forth numerous studies on their effects on health. The study of nutrition-based factors affecting bone health is difficult, given the length of time before clinical effects are evident. Furthermore, population-based studies must account for strong confounding influences as effects may be because of association, not causality. Yet, it is highly plausible that dietary factors affect bone remodeling in multiple ways. Plant-based diets may alter macronutrient and micronutrient balance, may cause differences in prebiotic and probiotic effects on gut microbiota, and may subtly change the inflammatory and immune response. RECENT FINDINGS Several recent studies have looked at plant-based nutrition and markers of bone health, using measures such as bone turnover markers, bone mineral density, or fracture rates. Although population based and cross-sectional studies can be prone to confounding effects, a majority did not show differences in bone health between vegetarians/vegans and omnivores as long as calcium and vitamin D intake were adequate. A few prospective cohort or longitudinal studies even demonstrate some benefit to a plant-based diet, but this claim remains unproven. SUMMARY There is no evidence that a plant-based diet, when carefully chosen to maintain adequate calcium and vitamin D levels, has any detrimental effects on bone health. Theoretical findings suggest a long-term plant-based diet may reduce the risk of osteoporosis, through mechanisms that are currently speculative.
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Nutritional influence on bone: role of gut microbiota.
Rizzoli, R
Aging clinical and experimental research. 2019;(6):743-751
Abstract
Gut microbiota (GM) located within the intestinal tract lumen comprises the largest number of cells (10E14) in the human body. The gut microbiome refers to the collection of genomes and genes present in gut microbiota. GM can vary according to age, sex, genetic background, immune status, geography, diet, prebiotics, which are non-digestible fibers metabolized in the distal part of the gastrointestinal tract, probiotics, which are micro-organisms conferring a health benefit on the host when administered in adequate amounts, living conditions, diseases and drugs. A source of probiotics is fortified fermented dairy products, which in addition provide calcium, protein, phosphorus and various micronutrients. Bone homeostasis is influenced by GM composition and/or products. GM appears to be a major player in the various determinants of bone health. However, it remains to be demonstrated in well conducted long-term randomized controlled trials, whether interventions changing GM composition and/or function are capable of reducing fracture risk.
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Microbial osteoporosis: The interplay between the gut microbiota and bones via host metabolism and immunity.
Li, L, Rao, S, Cheng, Y, Zhuo, X, Deng, C, Xu, N, Zhang, H, Yang, L
MicrobiologyOpen. 2019;(8):e00810
Abstract
The complex relationship between intestinal microbiota and host is a novel field in recent years. A large number of studies are being conducted on the relationship between intestinal microbiota and bone metabolism. Bone metabolism consisted of bone absorption and formation exists in the whole process of human growth and development. The nutrient components, inflammatory factors, and hormone environment play important roles in bone metabolism. Recently, intestinal microbiota has been found to influence bone metabolism via influencing the host metabolism, immune function, and hormone secretion. Here, we searched relevant literature on Pubmed and reviewed the effect of intestinal microbiota on bone metabolism through the three aspects, which may provide new ideas and targets for the clinical treatment of osteoporosis.
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Vitamin D in burn-injured patients.
Rech, MA, Colon Hidalgo, D, Larson, J, Zavala, S, Mosier, M
Burns : journal of the International Society for Burn Injuries. 2019;(1):32-41
Abstract
Recently, many studies have demonstrated pleotropic effects of vitamin D, including immune modulation and cardiovascular system activity. Sufficient vitamin D concentrations and supplementation of vitamin D may be of benefit in burn-injured patients. Low 25(OH)D has been observed in nearly all pediatric and most adult burn patients. Vitamin D has primarily been studied in pediatric burn patients, focusing on bone marker measurements and the incidence of fractures. The preferred vitamin D dose, formulation, and route of administration remain unknown, and there is limited data on the impact of vitamin D status on clinical outcomes. Further research should focus on determining optimal monitoring strategies, supplementation regimens and clinical outcomes like mortality, length of stay and incidence of sepsis.
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Biology of Bone: The Vasculature of the Skeletal System.
Watson, EC, Adams, RH
Cold Spring Harbor perspectives in medicine. 2018;(7)
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Abstract
Blood vessels are essential for the distribution of oxygen, nutrients, and immune cells, as well as the removal of waste products. In addition to this conventional role as a versatile conduit system, the endothelial cells forming the innermost layer of the vessel wall also possess important signaling capabilities and can control growth, patterning, homeostasis, and regeneration of the surrounding organ. In the skeletal system, blood vessels regulate developmental and regenerative bone formation as well as hematopoiesis by providing vascular niches for hematopoietic stem cells. Here we provide an overview of blood vessel architecture, growth and properties in the healthy, aging, and diseased skeletal system.
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The Biological Activities of Vitamin D and Its Receptor in Relation to Calcium and Bone Homeostasis, Cancer, Immune and Cardiovascular Systems, Skin Biology, and Oral Health.
Khammissa, RAG, Fourie, J, Motswaledi, MH, Ballyram, R, Lemmer, J, Feller, L
BioMed research international. 2018;:9276380
Abstract
Vitamin D plays an important role in calcium homeostasis and bone metabolism, with the capacity to modulate innate and adaptive immune function, cardiovascular function, and proliferation and differentiation of both normal and malignant keratinocytes. 1,25(OH)2D, the biologically active form of vitamin D, exerts most of its functions through the almost universally distributed nuclear vitamin D receptor (VDR). Upon stimulation by 1,25(OH)2D, VDR forms a heterodimer with the retinoid X receptor (RXR). In turn, VDR/RXR binds to DNA sequences termed vitamin D response elements in target genes, regulating gene transcription. In order to exert its biological effects, VDR signalling interacts with other intracellular signalling pathways. In some cases 1,25(OH)2D exerts its biological effects without regulating either gene expression or protein synthesis. Although the regulatory role of vitamin D in many biological processes is well documented, there is not enough evidence to support the therapeutic use of vitamin D supplementation in the prevention or treatment of infectious, immunoinflammatory, or hyperproliferative disorders. In this review we highlight the effects of 1,25(OH)2D on bone and calcium homeostasis, on cancer, and refer to its effects on the cardiovascular and immune systems.