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。建议减少重量（wt） 以减少肥胖相关的并发症，但诱导骨丢失（即使有足够的钙摄入量）后， 更年期女性。虽然有几项研究已经开始解决饮食组成的影响， 热量限制（CR）对代谢参数的影响，实际上还不知道它对骨量的作用， 质量.这一建议将解决我们对饮食组成的认识中的几个主要空白 因为它会影响骨骼健康。特别是，我们将讨论膳食蛋白质（pro）水平， 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， 增加胰岛素样生长因子-1和钙的吸收，并可能有助于更高的骨量， 降低骨折风险。相比之下，高pro摄入量也被证明会增加酸负荷， 高钙尿症和潜在的骨质流失目前尚不清楚高亲饮食如何影响骨密度 或CR期间的质量。此外，在体重严重下降期间， 胃旁路手术（GB）后，由于缺乏pro摄入（而不是Ca和维生素D）， 可能会加剧骨质流失此外，由于血清甲状旁腺激素 (PTH)解释了CR（400 IU vit D /天）期间观察到的钙吸收减少的部分原因， 通过饮食增加血清25-羟基-维生素D水平将减弱血清PTH， 钙吸收分数（TFCA）。这项建议的目的是：1）研究如何高亲饮食比较 标准的高碳水化合物（HC）减肥饮食会影响术后的骨转换，质量和质量， 绝经期妇女，同时控制正常的钙和维生素D摄入量; 2）用常规和 GB妇女体重严重下降时摄入较高的维生素D; 3）确定高维生素D摄入量（1200 IU/d）可以增加绝经后妇女在标准HC重量损失饮食期间的TFCA。总体而言，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，体重下降是一个主要问题。 骨丢失、骨折风险和最终死亡率的决定因素。因此，这些研究对于 确定饮食结构如何防止老年人骨质流失是至关重要和及时的。