Research
Horm Res. 2006 Mar 28;65(5):223-230
Calcium Supplementation Increases Bone Mass in GH-Deficient Prepubertal Children during GH Replacement.
Zamboni G, Antoniazzi F, Lauriola S, Bertoldo F, Tato L.
Pediatric Clinic, University of Verona, Verona, Italy.
Background/aims: Since GH plays an important role in bone mineralization, and several studies demonstrated
the positive influence of a higher calcium intake on bone mass, we studied the effect of calcium supplementation in GHD children during GH therapy. Methods: 28 prepubertal GHD children, 5.0-9.9 years old, were assigned to two groups: group A (n = 14; 7 females) treated with GH, and group B (n = 14; 7 females) treated with GH + calcium gluconolactate and carbonate (1 g calcium/day per os). Auxological parameters, total bone mineral content (TBMC) and density (TBMD), leg BMC and BMD, lumbar BMD, fat mass (FM) and lean tissue mass (LTM), blood 25-hydroxyvitamin D (25-OHD), parathyroid hormone (PTH), osteocalcin (OC) and urinary N-terminal telopeptide of type I collagen (NTx) were determined at the start of therapy and after 1 and 2 years of treatment. Results: During the 2 years of the study, TBMC, TBMD, leg BMC and BMD (but not lumbar BMD) increased in both groups of patients, however after 2 years of treatment they were significantly higher in the calcium-supplemented group B than in group A (p < 0.05, for all parameters). At the start of therapy, in both groups of patients percentage FM was higher and total and leg
LTM lower than in controls (p < 0.05 for each parameter). Thereafter, FM decreased and LTM increased and after 2 years they were both different from baseline (p < 0.05). After 2 years of treatment, leg BMC and BMD were more positively correlated with regional leg LTM in patients of group B (r = 0.834 and r = 0.827, respectively; p < 0.001) than in patients of group A (r = 0.617 and r = 0.637, respectively; p < 0.05). 25-OHD and PTH levels were in the normal range in all patients at the start and during treatment. OC levels were lower and urinary NTx levels higher in patients than in controls (p < 0.05 for both parameters), either at the start and after 1 year of treatment. After 2 years of treatment, OC levels were significantly higher than at the start of the study (p < 0.05) in both groups of patients, but they were higher in group B than in group A (p < 0.05); on the contrary, urinary Ntx levels were lower in group B than in group A (p < 0.05). Conclusion: In GHD children, treated with GH, calcium supplementation improved bone mass; it may aid in reaching better peak bone mass and in protecting weight-bearing
bones, usually completed in childhood to maximum levels, from risk of osteoporosis and fractures later in life. Copyright (c) 2006 S. Karger AG, Basel.
PMID: 16569932 [PubMed - as supplied by publisher]
Clin Calcium. 2006 Jan;16(1):103-9.
Osteoporosis And Nutrition: Trends Of Calcium Intake And Bone Mineral Densities]
[Article in Japanese]
Yoshimura N, Oka H.
Department of Joint Disease Research, Graduate School of Medicine, the University of Tokyo.
To predict the future incidence and prevalence of osteoporosis in Japan, bone mineral densities (BMDs) in
the same age ranges, but attained by different birth cohorts in 1990 or in 2000, were compared. In men, the
mean value of BMD at the lumbar spine in the birth cohort of 1930-1939, when they reached the age stratum
60-69, was significantly higher than that of the older cohort born in 1920-1929 when in the same age stratum (p<0.05). The same tendency was observed in BMD of the femoral neck. In women ,the mean value of BMD of the lumbar spine L2-4 in the birth cohort of 1940-1949, when they reached the age stratum 50-59, was significantly higher than that of the cohort born in 1930-1939 when in the same age stratum (p<0.05). Again, the same tendency was observed in BMD at the femoral neck. The comparatively higher levels of BMD observed in women in the 1940-1949 birth cohort when they reached their fifties, may reflect nutritional improvements in Japan. The nationwide nutritional survey reports mean values of calcium intake as 253 mg/day in 1946 (1st survey), 338 mg/day in 1955, 465 mg/day in 1965 and 552 mg/day in 1975 , a dramatic increase. These nutritional improvements might be expected to increase BMD in all age groups;but nevertheless, for females born in 1940-1949 calcium intake per life year would be the highest among the birth cohorts of the present study. The improvement observed in men in their sixties, rather than
their fifties as in women, might be attributed to differences in the timing of growth spurts in younger
generations. It is encouraging that both men and women in later birth cohorts showed higher BMDs in
middle-age, for this may predict a decrease in the incidence and prevalence of osteoporosis in the near
future in Japan.
PMID: 16397359 [PubMed - indexed for MEDLINE]
J Bone Miner Res. 2006 Mar;21(3):397-405. Epub 2005 Dec 19.
Calcium- And Vitamin D3-Fortified Milk Reduces Bone Loss At Clinically Relevant Skeletal Sites In Older Men: A 2-Year Randomized Controlled Trial.
Daly RM, Brown M, Bass S, Kukuljan S, Nowson C.
Centre for Physical Activity and Nutrition Research, School of Exercise and Nutrition Sciences, Deakin
University, Melbourne, Australia. robin.daly@deakin.edu.au
In this 2-year randomized controlled study of 167 men >50 years of age, supplementation with calcium-vitamin
D3-fortified milk providing an additional 1000 mg of calcium and 800 IU of vitamin D3 per day was effective
for suppressing PTH and stopping or slowing bone loss at several clinically important skeletal sites at risk for fracture. INTRODUCTION: Low dietary calcium and inadequate vitamin D stores have long been implicated in age-related bone loss and osteoporosis. The aim of this study was to assess the effects of calcium and vitamin D3 fortified milk on BMD in community living men >50 years of age.
MATERIALS AND METHODS: This was a 2-year randomized controlled study in which 167 men (mean age +/- SD, 61.9 +/- 7.7 years) were assigned to receive either 400 ml/day of reduced fat ( approximately 1%) ultra-high temperature (UHT) milk containing 1000 mg of calcium plus 800 IU of vitamin D3 or to a control group receiving no additional milk. Primary endpoints were changes in BMD, serum 25(OH)D, and PTH.
RESULTS: One hundred forty-nine men completed the study. Baseline characteristics between the groups were not different; mean dietary calcium and serum 25(OH)D levels were 941 +/- 387 mg/day and 77 +/- 23 nM, respectively. After 2 years, the mean percent change in BMD was 0.9-1.6% less in the milk supplementation compared with control group at the femoral neck, total hip, and ultradistal radius (range, p < 0.08 to p < 0.001 after adjusting for covariates). There was a greater increase in lumbar spine BMD in the milk supplementation group after 12 and 18 months (0.8-1.0%, p < or = 0.05), but the between-group difference was not significant after 2 years (0.7%; 95% CI, -0.3, 1.7). Serum 25(OH)D increased and PTH decreased in the milk supplementation relative to control group after the first year (31% and -18%, respectively; both p < 0.001), and these differences remained after 2 years. Body weight remained unchanged in both groups at the completion of the study.
CONCLUSIONS: Supplementing the diet of men >50 years of age with reduced-fat calcium- and vitamin D3-enriched milk may represent a simple, nutritionally sound and cost-effective strategy to reduce age-related bone loss at several skeletal sites at risk for fracture in the elderly.
PMID: 16491287 [PubMed - in process]
Am J Clin Nutr. 2004 May;79(5):907S-912S.
Role Of Calcium And Dairy Products In Energy Partitioning And Weight Management.
Zemel MB.
University of Tennessee Nutrition Institute, 1215 West Cumberland Avenue, Room 229, Knoxville, TN 37996-1920, USA. mzemel@itk.edu
Dietary calcium plays a pivotal role in the regulation of energy metabolism because high-calcium diets
attenuate adipocyte lipid accretion and weight gain during the overconsumption of an energy-dense diet and
increase lipolysis and preserve thermogenesis during caloric restriction, which thereby markedly accelerates weight loss. Intracellular Ca(2+) plays a key regulatory role in adipocyte lipid metabolism and triacylglycerol storage; increased intracellular Ca(2+) results in the stimulation of lipogenic gene expression and lipogenesis and the suppression of lipolysis, which results in increased lipid filling and increased adiposity. Moreover, the increased calcitriol produced in response to low-calcium diets stimulates adipocyte Ca(2+) influx and, consequently, promotes adiposity, whereas higher-calcium diets inhibit lipogenesis, inhibit diet-induced obesity in mice, and promote lipolysis, lipid oxidation, and thermogenesis. Notably, dairy sources of calcium markedly attenuate weight and fat gain and accelerate fat loss to a greater degree than do supplemental sources of calcium. This augmented effect of dairy products relative to supplemental calcium is likely due to additional bioactive compounds, including the angiotensin-converting enzyme inhibitors and the rich concentration of branched-chain amino acids in whey,
which act synergistically with calcium to attenuate adiposity. These concepts are confirmed by epidemiologic data and recent clinical trials, which indicate that diets that include > or =3 daily servings of dairy products result in significant reductions in adipose tissue mass in obese humans in the absence of caloric restriction and markedly accelerate weight and body fat loss secondary to caloric restriction compared with diets low in dairy products. These data indicate an important role for dairy products in both the prevention and treatment of obesity.
J Nutr. 2004 Mar;134(3):568-73.
A High Dairy Protein, High-Calcium Diet Minimizes Bone Turnover In Overweight Adults During Weight Loss.
Bowen J, Noakes M, Clifton PM.
CSIRO Health Sciences and Nutrition, Adelaide, South Australia, Australia, 5000.
Weight loss induces bone resorption and this can be attenuated by calcium supplementation. Protein-rich
diets were recently associated with favorable effects on bone density, although this remains controversial.
We hypothesized that a diet high in calcium and protein would minimize bone resorption during weight loss compared with a lower calcium, protein-rich diet. The effects of dietary calcium in high protein diets on calcium excretion and bone metabolism were examined in overweight adults (n = 50, BMI 33.4 +/- 2.1 kg/m(2)) during 12 wk of energy restriction followed by 4 wk of energy balance. Subjects were randomly assigned to isoenergetic diets (5.5 MJ/d, 34% energy from protein, 41% carbohydrate, 24% fat) high in either dairy protein (DP, 2400 mg Ca/d) or mixed protein sources (MP, 500 mg Ca/d). During energy restriction, weight loss was 10% (-9.7 +/- 3.8 kg, P < 0.01), and 24-h urinary calcium excretion decreased independently of diet (-1.09 +/- 0.23 mmol/d, P < 0.01). By wk 16, the MP diet group had a 40% greater increase in deoxypyridinoline (bone resorption marker) than the DP diet group (P = 0.008). Osteocalcin (bone formation marker) increased from wk 0 to 16 in only the MP diet group [+2.16 +/- 0.63 micro g/L (+0.63 +/- 0.11nmol/L), P = 0.001]. In conclusion, weight loss was associated with increased bone
resorption, yet the DP diet had a modest advantage over the MP diet by minimizing overall turnover.
Combined with reduced urinary calcium excretion, this suggests that a high-protein, calcium-replete diet
may protect against bone loss during weight reduction.
PMID: 14988448 [PubMed - indexed for MEDLINE]
Magnesium :
1: Congest Heart Fail. 2006 Jan-Feb;12(1):9-13.
Acute And Chronic Oral Magnesium Supplementation: Effects On Endothelial Function, Exercise Capacity, And Quality Of Life In Patients With Symptomatic Heart Failure.
Fuentes JC, Salmon AA, Silver MA.
Department of Medicine and Heart Failure Institute, Advocate Christ Medical Center, Oak Lawn, IL 60453, USA. marc.silver@advocatehealth.com
Endothelial dysfunction is an important pathophysiologic mechanism in the progression of heart failure.
The objective of the present study was to determine the effects of acute and chronic oral magnesium supplementation on endothelial function in patients with symptomatic heart failure. Twenty-two symptomatic chronic heart failure patients were randomized to receive 800 mg oral magnesium oxide daily or placebo for 3 months. Data collected included large and small arterial elasticity/compliance, hemodynamic parameters, exercise capacity, and quality-of-life score at baseline, 1 week, and 3 months. Patients who received magnesium had improved small arterial compliance at 3 months from baseline compared with placebo. This study suggests that chronic supplementation with oral magnesium is well tolerated and could improve endothelial function in symptomatic heart failure patients.
PMID: 16470086 [PubMed - in process]
In: Dis Mon (1988 Apr) 34(4):161-218
Magnesium Metabolism In Health And Disease.
Magnesium is an important element for health and disease. Magnesium, the second most abundant intracellular
cation, has been identified as a cofactor in over 300 enzymatic reactions involving energy metabolism and
protein and nucleic acid synthesis. Approximately half of the total magnesium in the body is present in
soft tissue, and the other half in bone. Less than 1% of the total body magnesium is present in blood.
Nonetheless, the majority of our experimental information comes from determination of magnesium in serum
and red blood cells. At present, we have little information about equilibrium among and state of magnesium
within body pools. Magnesium is absorbed uniformly from the small intestine and the serum concentration
controlled by excretion from the kidney. The clinical laboratory evaluation of magnesium status is primarily
limited to the serum magnesium concentration, 24-hour urinary excretion, and percent retention following
parenteral magnesium. However, results for these tests do not necessarily correlate with intracellular
magnesium. Thus, there is no readily available test to determine intracellular/total body magnesium status.
Magnesium deficiency may cause weakness, tremors, seizures, cardiac arrhythmias, hypokalemia, and
hypocalcemia. The causes of hypomagnesemia are reduced intake (poor nutrition or IV fluids without magnesium)
,reduced absorption (chronic diarrhea, malabsorption, or bypass/resection of bowel), redistribution
(exchange transfusion or acute pancreatitis), and increased excretion (medication, alcoholism, diabetes
mellitus, renal tubular disorders, hypercalcemia, hyperthyroidism, aldosteronism, stress, or excessive
lactation). A large segment of the U.S. population may have an inadequate intake of magnesium and may
have a chronic latent magnesium deficiency that has been linked to atherosclerosis, myocardial infarction,
hypertension, cancer, kidney stones, premenstrual syndrome, and psychiatric disorders. Hypermagnesemia is
primarily seen in acute and chronic renal failure, and is treated effectively by dialysis.
In: Fortschr Med (1994 Aug 30) 112(24):328-30 (Published in German)
Taubert K.
Magnesium in migraine. Results of a multicenter pilot study
BACKGROUND: Numerous experiments and clinical observations have credited magnesium with a positive influence on the incidence of migraine attacks.
METHODS: With the aim of testing this hypothesis, a doubleblind, cross-over multicenter pilot study was initiated. The study contained 43 migraine patients who met the criteria of the international Headache Society.
INTERVENTIONS: Administration of 600 mg magnesium/day in the form of trimagnesium dicitrate for prophylaxis.
RESULTS: Under this medication, a significant reduction in the incidence of migraine attacks was observed. Although the level of effectiveness of the regimen does not appear to be as high as that of presently approved migraine prophylactic substances, a very low rate of side effects can be expected.
CONCLUSION: The working hypothesis to the effect that magnesium may be useful in the prevention of migraine attacks has been confirmed by the pilot study. Further studies aimed at determining dosage and enabling a further differentiation of patient material are in preparation.
Institutional address: Klinikum Neubrandenburg.
Zinc:
Ann Intern Med 1996 (Jul 15); 125 (2): 81–88
Zinc Gluconate Lozenges For Treating The Common Cold. A Randomized, Double-Blind, Placebo-Controlled Study.
Mossad SB, Macknin ML, Medendorp SV, Mason P
Cleveland Clinic Foundation, Ohio, USA
BACKGROUND: The common cold is one of the most frequent human illnesses and is responsible for substantial
morbidity and economic loss. No consistently effective therapy for the common cold has been well documented,
but evidence suggests that several possible mechanisms may make zinc an effective treatment.
OBJECTIVE: To test the efficacy of zinc gluconate lozenges in reducing the duration of symptoms caused by
the common cold.
DESIGN. Randomized, double-blind, placebo-controlled study.
SETTING. Outpatient department of a large tertiary care center.
PATIENTS: 100 employees of the Cleveland Clinic who developed symptoms of the common cold within 24 hours
before enrollment.
INTERVENTION: Patients in the zinc group (n = 50) received lozenges (one lozenge every 2 hours while awake)
containing 13.3 mg of zinc from zinc gluconate as long as they had cold symptoms. Patients in the placebo group (n = 50) received similarly administered lozenges that contained 5% calcium lactate pentahydrate instead of zinc gluconate.
MAIN OUTCOME MEASURES: Subjective daily symptom scores for cough, headache, hoarseness, muscle ache, nasal
drainage, nasal congestion, scratchy throat, sore throat, sneezing, and fever (assessed by oral temperature).
RESULTS: The time to complete resolution of symptoms was significantly shorter in the zinc group than in the
placebo group (median, 4.4 days compared with 7.6 days; P < 0.001). The zinc group had significantly fewer days with coughing (median, 2.0 days compared with 4.5 days; P = 0.04), headache (2.0 days and 3.0 days; P = 0.02), hoarseness (2.0 days and 3.0 days; P = 0.02), nasal congestion (4.0 days and 6.0 days; P = 0.002), nasal drainage (4.0 days and 7.0 days; P < 0.001), and sore throat (1.0 day and 3.0 days; P < 0.001). The groups did not differ significantly in the resolution of fever, muscle ache, scratchy throat, or sneezing. More patients in the zinc group than in the placebo group had side effects (90% compared with 62%; P < 0.001), nausea (20% compared with 4%; P = 0.02), and bad-taste reactions (80% compared with 30%; P < 0.001)
CONCLUSION: Zinc gluconate in the form and dosage studied significantly reduced the duration of symptoms of
the common cold. The mechanism of action of this substance in treating the common cold remains unknown. Individual patients must decide whether the possible beneficial effects of zinc gluconate on cold symptoms outweigh the possible adverse effects.
1: Ann Nutr Metab. 2006;50(2):85-94. Epub 2005 Dec 21
Immune-Enhancing Role Of Vitamin C And Zinc And Effect On Clinical Conditions.
Wintergerst ES, Maggini S, Hornig DH.
Bayer Consumer Care Ltd., Basel, Switzerland. eva.wintergerst.ew@bayer.ch
Vitamin C concentrations in the plasma and leukocytes rapidly decline during infections and stress.
Supplementation of vitamin C was found to improve components of the human immune system such as
antimicrobial and natural killer cell activities, lymphocyte proliferation, chemotaxis, and delayed-type hypersensitivity. Vitamin C contributes to maintaining the redox integrity of cells and thereby protects them against reactive oxygen species generated during the respiratory burst and in the inflammatory response. Likewise, zinc undernutrition or deficiency was shown to impair cellular mediators of innate immunity such as phagocytosis, natural killer cell activity, and the generation of oxidative burst. Therefore, both nutrients play important roles in immune function and the modulation of host resistance to infectious agents, reducing the risk, severity, and duration of infectious diseases. This is of special importance in populations in which insufficient intake of these nutrients is prevalent. In the developing world, this is the case in low- and middle-income countries, but also in subpopulations in industrialized countries, e.g. in the elderly. A large number of randomized controlled intervention trials with intakes of up to 1 g of vitamin C and up to 30 mg of zinc are available. These trials document that adequate intakes of vitamin C and zinc ameliorate symptoms and shorten the duration of respiratory tract infections including the common cold. Furthermore, vitamin C and zinc reduce the incidence and improve the outcome of pneumonia, malaria, and diarrhea infections, especially in children in developing countries.
