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OSTEODIET
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| INTRODUCTION | |||||
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Age-related osteoporosis is a major, and
increasing, public health problem in Europe which has a considerable
impact in terms of increased mortality, morbidity and reduced quality of
life, as well as placing an increasing burden on health care systems.
It is defined as a reduction in bone mass and disruption of bone
architecture, resulting in reduced bone strength and increased fracture
risk. Fragility fractures
are the hallmark of osteoporosis and are particularly common in the
spine, hip and forearm. They
show a steep age-related increase.
It is estimated that 414,000 hip and 237,000 vertebral fractures
occur in Europe alone each year. Ageing
demographics of Europe will lead to a dramatic increase in the number of
people suffering from fractures over the next few decades (e.g., it is
estimated that by the year 2050, there may be 972,000 hip and 373,000
vertebral fractures alone in Europe) unless more effective action is
taken to prevent the disease. Many factors are involved in the development of osteoporosis, including age, gender, hormonal status, as well as genetic and diet and lifestyle factors. Predisposition to osteoporotic fracture is related first to peak bone mass in early adulthood and second to the subsequent rate of bone loss. Both the development of bone to peak bone mass at maturity and subsequent bone loss depend on the interaction of genetic, hormonal, environmental and nutritional factors. It has been suggested that genetic factors probably account for up to 80% of the bone mass variation in the population. While diet and lifestyle factors, such as physical activity, may have a smaller influence than genetics on bone mass, these factors are nonetheless important since they are modulators for the achievement of genetically programmed peak bone mass as well as the subsequent rate of bone loss and, unlike genotype, they can be modified. Research on nutrient-bone interactions to date has focused mainly on calcium and vitamin D even though, undoubtedly, other nutrients are involved in skeletal metabolism and bone health. A recent report of the European Commission ‘Report on osteoporosis in the European Community: Action for prevention’ recommended the development of coherent nutrition policies across the European Union for prevention of osteoporosis and identified the need for more research to reinforce the scientific base for such policies. Among the areas identified for further research were: · the influence of dietary factors other than calcium and vitamin D on bone metabolism (for example, salt, protein, vitamin K, vitamin C, magnesium) · how effects of diet on bone are modulated by individual genetic variation · improved methods for investigating the effects of diet on bone. Some of these issues are being investigated in the "OSTEODIET [Optimal Nutrition towards Osteoporosis Prevention: Impact of Diet and Gene-Nutrient Interactions on Calcium and Bone Metabolism]" project, funded through the EU 5th Framework Programme. This is a multidisciplinary research project, with seven European partners, which is investigating the influence of diet (sodium, calcium, protein, vitamin K) and individual genetic variation (genes which have been linked to osteoporosis), on the metabolism of calcium and bone in humans in order to reinforce the scientific base for dietary strategies for osteoporosis prevention in Europe. |
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