Nutritional Regulation of bone

骨骼的营养调节

• 批准号: 7475754
• 负责人: Sue Amy Shapses
• 金额: $ 29.69万
• 依托单位: RUTGERS, THE STATE UNIV OF N.J.
• 依托单位国家: 美国
• 财政年份: 1994
• 资助国家: 美国
• 起止时间: 1994-09-30 至 2011-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7475754
• 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; Outcome; Parathyroid Hormones; Placebos; Population; Postmenopause; Prevention; Procedures; Proteins; Public Health; Recommendation; Regulation; Risk; Role; Serum; Somatomedins; Standards of Weights and Measures; Stomach; Trochanters; Vitamin D; Weight; Woman; YARS gene; absorption; bariatric surgery; bone; bone health; bone loss; bone quality; bone turnover; calcium metabolism; day; human PTH protein; hypercalciuria; improved; interest; moderate obesity; mortality; prevent; weight maintenance

DESCRIPTION (provided by applicant): 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 (vit D) in Ca absorption. Evidence in wt-stable adults shows that 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 women with 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.

描述（由申请人提供）：骨质疏松症和肥胖症都是重要的公共卫生问题。建议减轻体重（wt）以减少肥胖相关并发症，但会导致绝经后妇女的骨丢失（即使摄入足够的钙）。虽然一些研究已经开始解决热量限制（CR）期间饮食组成对代谢参数的影响，但实际上还不知道其对骨量和质量的作用。这项提案将解决我们在体重减轻期间对饮食组成的认识方面的几个主要空白，因为它会影响骨骼健康。特别是，我们将解决膳食蛋白质（亲）水平，以及维生素D（维生素D）在钙吸收中的作用。在体重稳定的成年人中的证据表明，较高的饮食pro增加胰岛素样生长因子-1和Ca的吸收，并可能有助于提高骨量和降低骨折风险。相反，高pro摄入量也被证明会增加酸负荷，导致高钙尿症和潜在的骨丢失。目前尚不清楚高蛋白饮食如何影响CR期间的骨密度或质量。此外，在胃旁路手术（GB）后的严重体重减轻期间，蛋白质摄入水平可能特别重要，因为通常在手术后蛋白质摄入不足（而不是Ca和维生素D）可能会加剧骨丢失。此外，由于血清甲状旁腺激素（PTH）解释了CR（400 IU维生素D /天）期间观察到的钙吸收减少的部分原因，因此通过饮食增加血清25-羟基-维生素D水平可能会减弱血清PTH并增强真正的钙吸收分数（TFCA）。该建议的目的是：1）检查高蛋白饮食与标准高碳水化合物（HC）重量损失饮食相比如何影响绝经后妇女的骨转换、质量和质量，同时控制正常的Ca和维生素D摄入; 2）检查患有GB的妇女在严重重量损失期间具有常规和较高蛋白摄入的骨;和3）确定高维生素D摄入量（1200 IU/d）是否可以在标准HC重量损失饮食期间增加绝经后妇女的TFCA。总的来说，近%的美国人口需要定期节食来预防骨质流失。老年人口将在短短几十年内翻一番，体重下降是骨质流失、骨折风险和最终死亡率的主要决定因素。因此，这些研究对于确定饮食组成如何防止老年人骨质流失的重要性是至关重要和及时的。