Nutritional Regulation of bone

骨骼的营养调节

• 批准号: 7889883
• 负责人: Sue Amy Shapses
• 金额: $ 3.11万
• 依托单位: RUTGERS, THE STATE UNIV OF N.J.
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-08-05 至 2011-10-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7889883
• 关键词: Acids; Address; Adult; Affect; Age; Attenuated; Biological Markers; Body Weight decreased; Bone Density; Bone Resorption; Calcium; Caloric Restriction; Calories; Carbohydrates; Chronic; Data; Diet; Dietary Calcium; Dietary Proteins; Estrogens; Fat-Restricted Diet; Fatty acid glycerol esters; Fracture; Goals; High Prevalence; Hormones; Insulin-Like Growth Factor I; Insulin-Like Growth-Factor-Binding Proteins; Intake; Knowledge; Metabolic; Nutritional; Obesity; Older Population; Osteoporosis; Osteoporosis prevention; Parathyroid Hormones; Placebos; Population; Postmenopause; Prevention; Procedures; Proteins; Public Health; Recommendation; Regulation; Risk; Role; Serum; Stomach; Trochanters; Vitamin D; Weight; Woman; absorption; bariatric surgery; bone; bone health; bone loss; bone mass; bone quality; bone turnover; calcium absorption; calcium intake; calcium metabolism; high standard; human PTH protein; hypercalciuria; improved; interest; moderate obesity; mortality; prevent; primary outcome; weight maintenance

Osteoporosis and obesity are both important public health problems. Weight (wt) reduction is recommended to reduce obesity-related complications, but induces bone loss (even with adequate Ca intake) in post- menopausal women. Although several studies have begun to address the effects of diet composition during caloric restriction (CR) on metabolic parameters, virtually nothing is known its role on bone mass and quality. This proposal will address several major gaps in our knowledge concerning dietary composition during wt loss as it impacts bone health. In particular we will address dietary protein (pro) levels, and the role of vitamin D (vitD) in Ca absorption. Evidence in wt-stable adults showsthat higher dietary pro increases insulin-like growth factor-1 and Ca absorption and may contribute to a higher bone mass and reduced fracture risk. In contrast, a high pro intake has also been shown to increase the acid load, leading to hypercalciuria, and potential bone loss. It is currently not known how a high pro diet affects bone density or quality during CR. In addition, the level of pro intake may be especially important during severe wt loss after gastric bypass surgery (GB), because of the deficient pro intake (rather than Ca and vit D) that typically follows the procedure that may exacerbate bone loss. Furthermore, because serum parathyroid hormone (PTH) explains part of the reduction in Ca absorption observed during CR (400IU vit D /day), it is possible that increasing serum 25-hydroxy-vit D levels through diet will attenuate serum PTH and enhance true fractional Ca absorption (TFCA). The aims of this proposal are: 1)to examine how a high-pro diet compared to a standard high-carbohydrate (HC) wt loss diet affects bone turnover, mass and quality in post- menopausal women, while controlling for normal Ca and vit D intake; 2) to examine bone with usual and higher pro intake during severe wt loss in womenwith GB; and 3) to determine if a high vit D intake (1200 lU/d) can increase TFCA in postmenopausal women during a standard HC wt-loss diet. Overall, rationale recommendations for the prevention of bone loss are needed for nearly % of the US population that is regularly dieting. The older population is going to double in only a few decades, and wt loss is a major determinant of bone loss, fracture risk, and ultimately mortality. Thus, the importance of these studies for identifying how diet composition can prevent bone loss in the older population is both critical and timely.

骨质疏松症和肥胖症都是重要的公共卫生问题。建议减轻重量（wt） 减少与肥胖相关的并发症，但会在术后引起骨质流失（即使摄入足够的钙） 更年期妇女。尽管一些研究已经开始探讨饮食成分对 热量限制（CR）对代谢参数的影响，实际上对其对骨量和骨量的作用一无所知。 质量。该提案将解决我们在膳食成分方面的知识中的几个主要差距 在体重损失期间，因为它会影响骨骼健康。特别是，我们将解决膳食蛋白质（pro）水平，以及 维生素 D (vitD) 在钙吸收中的作用。体重稳定的成年人的证据表明，较高的饮食亲和力 增加胰岛素样生长因子 1 和 Ca 的吸收，可能有助于增加骨量和 降低骨折风险。相比之下，高摄入量也被证明会增加酸负荷，导致 高钙尿症和潜在的骨质流失。目前尚不清楚高营养饮食如何影响骨密度 或 CR 期间的质量。此外，在体重严重损失期间，维生素E的摄入水平可能尤其重要 胃绕道手术 (GB) 后，由于维生素 B 摄入量不足（而不是钙和维生素 D），通常 遵循可能加剧骨质流失的手术。此外，由于血清甲状旁腺激素 (PTH) 部分解释了 CR 期间观察到的 Ca 吸收减少（400IU 维生素 D /天），这是可能的 通过饮食增加血清 25-羟基维生素 D 水平将减弱血清 PTH 并增强真实 钙吸收分数 (TFCA)。该提案的目的是：1）研究高亲饮食与 标准的高碳水化合物 (HC) 减重饮食会影响术后骨转换、质量和质量 更年期女性，同时控制正常的钙和维生素 D 摄入量； 2）用通常的方法检查骨骼 患有 GB 的女性在体重严重下降期间摄入较高的维生素 B； 3) 确定维生素 D 摄入量是否较高（1200 lU/d）可以在标准 HC 减重饮食期间增加绝经后妇女的 TFCA。总体来说，理由 近 % 的美国人口需要预防骨质流失的建议 定期节食。老年人口将在短短几十年内翻一番，而体重下降是一个主要因素 骨质流失、骨折风险和最终死亡率的决定因素。因此，这些研究对于 确定饮食成分如何预防老年人骨质流失既重要又及时。