Osteoporosis and vitamin D

[Guest guest]

Hi All,

How nutrients may affect osteoporosis is reviewed in a new pdf-available

paper (1) in a journal, Current Opinion in Internal Medicine, that is not it

seems abstracted in Medline. Below are most of the abstract and comments

describing references (2-7) thought to be of outstanding merit that seemed

to be the important focus of (1): the importance of vitamin D.

Free to all full-text is (5), Also pdf-available, are: (2, 3, 4 and 6).

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1. Current Opinion in Internal Medicine Feb. 2006 5 (1) 57-61

Osteoporosis nutrition beyond calcium: update 2005.

Agrawal, Sabina; Krueger, Diane; Binkley, Neil

.... Vitamin D inadequacy is common and contributes to osteoporosis and

fractures. Assessment of vitamin D status requires measurement of

circulating 25-hydroxyvitamin D which has been problematic; recent advances

in assay methodology have improved this situation. Expert opinion suggests

that the optimal 25-hydroxyvitamin D concentration is above 30 ng/ml, which

may necessitate a daily intake of approximately 1000 IU D3. Vitamin D3

appears to be more potent than D2 in maintenance of circulating

25-hydroxyvitamin D. Recent studies do not support a major role of vitamin K

supplementation in preservation of bone mass, while the role of vitamin A

excess in contributing to osteoporosis remains controversial. Although

higher dietary protein intake does increase urinary calcium excretion, this

may result from enhanced calcium absorption. The prevailing assumption that

dietary phosphorus intake is always adequate is being challenged; though

data are limited, it may be prudent to consider calcium phosphate

supplementation in undernourished osteoporotic patients receiving anabolic

therapy. The role of magnesium in osteoporosis remains undefined.

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A cross-sectional evaluation of over 1500 women after menopause receiving

prescribed medication for osteoporosis. Vitamin D inadequacy is present in

approximately half, despite many having had the importance of vitamin D

discussed by their physicians. Additionally, the futility of attempting to

estimate 25OHD status from PTH on an individual basis is documented.

2. Holick MF, Siris ES, Binkley N, Beard MK, Khan A, Katzer JT, Petruschke

RA, Chen E, de Papp AE.

Prevalence of Vitamin D inadequacy among postmenopausal North American women

receiving osteoporosis therapy.

J Clin Endocrinol Metab. 2005 Jun;90(6):3215-24. Epub 2005 Mar 29.

PMID: 15797954

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=pubmed & dopt=Abstra\

ct & list_uids=15797954 & query_hl=30 & itool=pubmed_docsum

An excellent compilation of current thought regarding optimal vitamin D

status. Advances the concept of using highly sun-exposed individuals to

define normal vitamin D status.

3. Hollis BW.

Circulating 25-hydroxyvitamin D levels indicative of vitamin D sufficiency:

implications for establishing a new effective dietary intake recommendation

for vitamin D.

J Nutr. 2005 Feb;135(2):317-22. Review.

PMID: 15671234

Circulating 25-hydroxyvitamin D levels indicative of vitamin D sufficiency:

implications for establishing a new effective dietary intake recommendation

for vitamin D.

A summation of expert opinion regarding the desired 25OHD concentration (~30

ng/ml) and the oral intake necessary to achieve this.

A summation of expert opinion regarding the desired 25OHD concentration (~30

ng/ml) and the oral intake necessary to achieve this

4. Dawson- B, Heaney RP, Holick MF, Lips P, Meunier PJ, Vieth R.

Estimates of optimal vitamin D status.

Osteoporos Int. 2005 Jul;16(7):713-6. Epub 2005 Mar 18.

PMID: 15776217

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=pubmed & dopt=Abstra\

ct & list_uids=15776217 & query_hl=22 & itool=pubmed_docsum

A small study confirming the report by Tjellesen et al. [21] that vitamin D3

is more potent than D2.

5. Armas LA, Hollis BW, Heaney RP.

Vitamin D2 is much less effective than vitamin D3 in humans.

J Clin Endocrinol Metab. 2004 Nov;89(11):5387-91.

PMID: 15531486

http://jcem.endojournals.org/cgi/content/full/89/11/5387

An excellent review of the role of phosphorus in osteoporosis management.

Heaney advances the concept that phosphorus inadequacy could be a clinically

relevant problem and confound both calcium supplementation and anabolic

therapy in those with undernutrition.

6. Heaney RP.

Phosphorus nutrition and the treatment of osteoporosis.

Mayo Clin Proc. 2004 Jan;79(1):91-7. Review.

PMID: 14708952

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=pubmed & dopt=Abstra\

ct & list_uids=14708952 & query_hl=26 & itool=pubmed_docsum

An excellent review of an understudied area. Suggests potential mechanisms

by which magnesium inadequacy could affect bone and calls for additional

study.

7. Rude RK, Gruber HE.

Magnesium deficiency and osteoporosis: animal and human observations.

J Nutr Biochem. 2004 Dec;15(12):710-6. Review.

PMID: 15607643

-- Al Pater, alpater@...

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