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Friday, 4 December 2015

Most Common Diseases of elder: The Clinical Trials and Studies of Musculo-Skeletal disorders: Osteoporosis - The Prevention and Management Diet

Kyle J. Norton (Scholar)

Health article writer and researcher; Over 10.000 articles and research papers have been written and published on line, including world wide health, ezine articles, article base, healthblogs, selfgrowth, best before it's news, the karate GB daily, etc.,.
Named TOP 50 MEDICAL ESSAYS FOR ARTISTS & AUTHORS TO READ by Disilgold.com Named 50 of the best health Tweeters Canada - Huffington Post
Nominated for shorty award over last 4 years
Some articles have been used as references in medical research, such as international journal Pharma and Bio science, ISSN 0975-6299.

Musculoskeletal disorders (MSDs) are  medical condition mostly caused by work related occupations and working environment, affecting patients’ muscles, joints, tendons, ligaments and nerves and developing over time. According to a community sample of 73 females and 32 males aged 85 and over underwent a standardised examination at home, musculoskeletal pain was reported by 57% of those interviewed(1).

      Types of Musculo-Skeletal disorders in elder(2)

1. Osteoarthritis
2. Gout
3. Rheumatoid Arthritis
4. Polymalagia Arthritis
5. Cervical myleopathy and spinal canal stenosis
6. Osteoporosis
7. Low back pain
8. Fibromyalgia

                                Osteoporosis

Osteoporosis is defined as a condition of thinning of bone and bone tissues as a result of the loss of bone density over a long period of time. It is a widespread degenerative disease of skeletal joints and often associated with senescence in vertebrates due to excessive or abnormal mechanical loading of weight-bearing joints, arising from heavy long-term use or specific injuries(6).



                               The Prevention and Management 
The prevention and management of osteoporosis are always important due to the prevalent of the diseases in  in all populations and all ages(221), especially to elder, causing a significant physical, psychosocial, and financial consequences(220).

                                   The Diet

Certain foods are found to associate to reduce risk of osteoporosis, according to the dietitian of Canada(222)
1. Dairy products
With high amount calcium, diary product, including milk, yogurt plays an important role in reduced risk of osteopororsis. In a review of 139 papers published since 1975 and describing studies, higher intake of dairy products is contributed to higher intake of calcium of that induce substantial augmentation of the protective effect of osteoporosis(223). The study of 170 women aged 32 to 59 in bone mineral density (BMD), daily consumption of dairy products and dietary calcium and some non-modifiable risk factors may contrite to good bone health(224). 
The Myongji University supported the intake of dairy product and higher calcium foods beans, fish, seaweeds, and fruits may contribute to the Ca absorption and prevention of osteoporosis in later life(226). In fact, dairy products also attenuate the risk of the disease due to its amount of vitamin D in induced the calcium absorption(227).
Unfortunately, according to the study by Purdue University, Purdue University higher dairy product consumption is only associated with greater hip BMD in men, but not in women. Calcium supplementation intake protected bone loss in both sex(225).

2. Sardines
Vitamin D found abundantly in sardines is associated to induce absorption of intestineal calcium of which contribute to reduced risk osteoporosis(227). According to Dr. Gennari C, intake of fish including sardine together with milk, yoghurts and cheese, the main source of calcium and few vegetables and fruits may provide the RDA is 700-800 mg/day for lower the risk of aosteoporosis(228)

3. Green tea
Epidemiological studies have shown an strong association between tea consumption in prevention of age-related bone loss in elderly women and men(233).In obese female rats fed with high-fat diet and caloric restricted diet, green tea polyphenols (GTP) supplementation increased all factors in reduced risk of osteoporosis, including increased femoral mass and strength, trabecular thickness and eroded surface at proximal tibia, and insulin-like growth factor-I and leptin,...(229).  Intake of Green tea polyphenols (GTP) in conjunction of Tai Chi (TC) is considered as a effective strategies of reducing the levels of oxidative stress, as well as induced the potential as alternative tools to improve bone health in this population(230).
Green tea, epigallocatechin-3-gallate (EGCG) are found to be a lead compounds for the treatment of bone resorption diseases, through inhibition of the formation and differentiation of osteoclasts(231)(232).

4. Organic Soybean and sesame seed
Intake of soy bean oil exhibited significant increase in BMD (bone mineral density), accompanied with improved level of Ca as it is considered as a functional foods in retarding risks of osteoporosis associated with estrogen deficiency(233), probably through restoring minerals, antioxidant enzymes, antioxidant biomarkers, oxidative stress markers, inflammatory indices(234) according to the in ovariectomy in rats(233a)(234). In fact, in post menopause women, phystestrogens, including isoflavones, have a great similarity with estradiol, principal endogenous estrogen may contribute to the reduced risk of osteoporosis and other menopause symptoms(235). Unfortunately, soy protein and isoflavones (either alone or together) did not affect BMD, they should not be considered as effective interventions for preserving skeletal health in older women

Ingestion soy isoflavone extracts (not soy protein or foods containing isoflavones) supplements increased lumbar spine BMD in menopausal women, but not femoral neck, hip total, and trochanter BMD(237), but other suggested that soy protein and isoflavones (either alone or together) did not affect BMD, they should not be considered as effective interventions for preserving skeletal health in older women(236) according to study.

5. Calcium-fortified foods 
Calcium-fortified foods such as orange juice, cereal, enriched breads, grains, and waffles, etc. may provide rich sources of calcium of that is necessary to reduce bone mineral loss, especially in elder.
Oyster shell rich in calcium may be included in many different diet formulas, especially lentil soup,has a significant effect on minimized risk factors associated with osteoporosis, such as tibial weight, total protein, total calcium and phosphorus with noticeable reduction in ALP activity(238).
According to the Texas Woman's University, consumption of calcium-fortified cereal bars exhibit significantly improve dietary calcium intake of healthy women(240).
Other calcium-fortified foods(242) also have a beneficiary effect in improvement the the sources of calcium and prevented risk of osteoporosis, include powdered lobster shell(239), vitamin D-and calcium-fortified soft white cheese lowers(241),.....

6. Green leafy vegetable (Coccinia grandix Voigt.)
Green leafy vegetable such as spinach, kale, turnips, collard greens has found to have a persistent effect in reduced risk of osteoporosis, through enhancing calcium absorption(243), with some of the difference accounted for by the phytate, oxalate(243), and dietary fiber content of the vegetables(242), according to the study of 19 healthy adult Thais women aged 20 to 45.
In 13 healthy adults in a randomized cross-over design study of spinach absorbability of calcium is very low in comparison to milk produce as a result of oxalative effect(244).

Finally, we would like to remind readers that selection of alkali-generating foods and less acid-generating foods and, can significantly improve bone health of postmenopausal Iranian women, together with adequate dietary calcium intake(297)..  


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References
(1) Prevalence of rheumatic symptoms, rheumatoid arthritis, ankylosing spondylitis, and gout in Shanghai, China: a COPCORD study by Dai SM1, Han XH, Zhao DB, Shi YQ, Liu Y, Meng JM.(PubMed)
(2) Musculoskeletal Disorders in the Elderly by Ramon Gheno, Juan M. Cepparo, Cristina E. Rosca,1 and Anne Cotten(PMC)
(3) Osteoporosis(Life extension)
(4) Hormone and bone by Francisco Bandeira1, Marise Lazaretti-Castro2, John P. Bilezikian3
(5) Growth hormone and bone by Ohlsson C1, Bengtsson BA, Isaksson OG, Andreassen TT, Slootweg MC.(PubMed)
(6) GH and bone--experimental and clinical studies by Isaksson OG1, Ohlsson C, Bengtsson BA, Johannsson G.(PubMed)
(221) Osteoporosis prevention, diagnosis, and therapy by [No authors listed](PubMed)
(222) Eating Guidelines to Prevent Osteoporosis - It's Never Too Late! by dietitian of Canada
(223) Calcium, dairy products and osteoporosis by Heaney RP1.(PubMed)
(224) Dairy products, dietary calcium and bone health: possibility of prevention of osteoporosis in women: the Polish experience by Wadolowska L1, Sobas K, Szczepanska JW, Slowinska MA, Czlapka-Matyasik M, Niedzwiedzka E.(PubMed)
(225) Dairy intakes affect bone density in the elderly by McCabe LD1, Martin BR, McCabe GP, Johnston CC, Weaver CM, Peacock M.(PubMed)
(226) Prevalence of osteoporosis according to nutrient and food group intake levels in Korean postmenopausalwomen: using the 2010 Korea National Health and Nutrition Examination Survey Data by Lim YS1, Lee SW1, Tserendejid Z1, Jeong SY1, Go G1, Park HR1.(PubMed)
(227) Vitamin D and intestinal calcium absorption by Christakos S1, Dhawan P, Porta A, Mady LJ, Seth T.(PubMed)
(228) Calcium and vitamin D nutrition and bone disease of the elderly by Gennari C1.(PubMed)
(229) Green tea supplementation benefits body composition and improves bone properties in obese female rats fed with high-fat diet and caloric restricted diet by Shen CL1, Han J2, Wang S3, Chung E4, Chyu MC5, Cao JJ6.(PubMed)
(230) Mitigation of oxidative damage by green tea polyphenols and Tai Chi exercise in postmenopausal women with osteopenia by Qian G1, Xue K, Tang L, Wang F, Song X, Chyu MC, Pence BC, Shen CL, Wang JS.(PubMed)
(231) Tea polyphenols inhibit rat osteoclast formation and differentiation by Oka Y1, Iwai S, Amano H, Irie Y, Yatomi K, Ryu K, Yamada S, Inagaki K, Oguchi K.(PubMed)
(232) Green tea polyphenol epigallocatechin 3-gallate in arthritis: progress and promis by Salahuddin Ahmed(PubMed)
(233) Green Tea and Bone metabolismby Chwan-Li Shen,1 James K. Yeh,2 Jay Cao,3 and Jia-Sheng Wang4(PMC)
(233a) Role of phytoestrogenic oils in alleviating osteoporosis associated with ovariectomy in rats by Hassan HA1, El Wakf AM, El Gharib NE.(PubMed)
(234) Osteoprotective effect of soybean and sesame oils in ovariectomized rats via estrogen-like mechanism by El Wakf AM1, Hassan HA, Gharib NS(PubMed)
(235) [Effects on health of soy in menopausic women].[Article in Spanish] by de Luis DA1, Aller R, Sagrado J.(PubMed)
(236) Soy proteins and isoflavones affect bone mineral density in older women: a randomized controlled trial1,2,3 by Anne M Kenny, Kelsey M Mangano, Robin H Abourizk, Richard S Bruno, Denise E Anamani, Alison Kleppinger,Stephen J Walsh, Karen M Prestwood, and Jane E Kerstetter(PMC)
(237) Effect of soy isoflavone extract supplements on bone mineral density in menopausal women: meta-analysis of randomized controlled trials by Taku K1, Melby MK, Takebayashi J, Mizuno S, Ishimi Y, Omori T, Watanabe S.(PubMed)
(238) Evaluation of food products fortified with oyster shell for the prevention and treatment of osteoporosis by Ahmed SA1, Gibriel AA2, Abdellatif AK1, Ebied HM3.(PubMed)
(239) The effect of spiny lobster shell powder on bone metabolism in ovariectomized osteoporotic model rats by Omi N1, Morikawa N, Ezawa I.(PubMed)
(240) Consumption of calcium-fortified cereal bars to improve dietary calcium intake of healthy women: randomized controlled feasibility study by Lee JT1, Moore CE2, Radcliffe JD2.(PubMed)
(241) The selection and prevalence of natural and fortified calcium food sources in the diets of adolescent girls by Rafferty K1, Watson P, Lappe JM.(PubMed)
(242) Calcium absorption from commonly consumed vegetables in healthy Thai women by Charoenkiatkul S1, Kriengsinyos W, Tuntipopipat S, Suthutvoravut U, Weaver CM.(PubMed)
(242) Calcium absorption from kale by Heaney RP1, Weaver CM.(PubMed)
(243) Oxalate: effect on calcium absorbability by Heaney RP1, Weaver CM.(PubMed)
(244) Calcium absorbability from spinach by Heaney RP1, Weaver CM, Recker RR.(PubMed)
(297) Higher Dietary Acidity is Associated with Lower Bone Mineral Density in Postmenopausal Iranian Women, Independent of Dietary Calcium Intake by Shariati-Bafghi SE1, Nosrat-Mirshekarlou E, Karamati M, Rashidkhani B.(PubMed)