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Influences of Select Dietary Components on Bone Volumetric Density, Bone Geometry and Indices of Bone Strength in Young Girls
Osteoporosis, a major public health problem, likely has its origins in childhood. During periods of rapid skeletal growth, diet may influence accrual of bone mineral density (BMD) and adult bone health. This study used novel approaches in bone imaging to further characterize optimal skeletal development and enhance our understanding of key dietary components that influence attainment of peak bone mass (PBM) and contribute to determinants of peak bone strength in peri-pubertal females. The use of a validated food-frequency questionnaire (FFQ) enabled the influence of usual dietary intake on bone parameters to be examined.This study examined the relationship of dietary intake of micronutrients and bone macro-architectural structure in peri-pubertal girls. This study suggested that vitamin C and zinc intake are associated with objective measures of bone status in 4th, but not 6th grade girls. This indicates potential differences in micronutrient and bone associations at various age-associated stages of bone maturation.The impact of dietary fat on peri-pubertal skeletal growth is not well characterized. This study examined relationships of select dietary fatty acid (FA) intakes and measures of bone status in peri-pubertal girls. This study suggested that MUFA, total PUFA, n-6 and linoleic acid (LA) are inversely associated with bone status prior to menarche, but composition of dietary fat may be more important during the early-pubertal years. Decreased intakes of n-6 PUFA may benefit bone health in young girls.The impact of a dietary protein on volumetric bone mineral density (vBMD), bone mineral content (BMC) and bone strength throughout maturation remains controversial. Given evidence of both anabolic and catabolic affects of protein on bone health, this study examined relations of dietary protein from different sources with bone parameters in peri-pubertal girls. This study showed that dietary protein intake is related to higher trabecular but not cortical vBMD, BMC and BSI, and accounts for 2-4% of their variability in peri-pubertal girls. The relationship seems to vary by the source of dietary protein and calcium intake. However, a negative impact of animal protein on bone health is not supported. Large scale observational and intervention studies are needed to establish causality
The women in steady exercise research (WISER) survivor trial : The innovative transdisciplinary design of a randomized controlled trial of exercise and weight-loss interventions among breast cancer survivors with lymphedema
Introduction Breast cancer survivors face dual challenges: long term sequelae of treatment, and risk of recurrent disease. Obesity and a sedentary lifestyle complicate both challenges. The WISER Survivor trial assessed the effects of exercise and/or weight-loss on lymphedema, biomarkers of breast cancer recurrence, and quality of life. We report on the innovative transdisciplinary design of this trial and report attrition rates. Methods This one year trial randomized breast cancer survivors who had a BMI of ≥ 25 kg/m2, were sedentary and had breast-cancer-related-lymphedema to 1) exercise (weight training and aerobic exercise) 2) weight-loss 3) exercise and weight-loss 4) or control group. Innovative aspects included: adaptation of a community-based weight training program to a largely home-based program; use of a commercial meal replacement system as part of the lifestyle modification weight-loss program; inclusion of measures of cost-effectiveness to enable economic evaluations; and alignment with a parallel mouse model for breast cancer recurrence to enable transdisciplinary research. In this model, mice bearing dormant residual tumor cells, which spontaneously relapse, were placed on a high-fat diet. Overweight animals were randomly assigned to exercise, calorie restriction, both, or control group and followed for cancer recurrence. The animal model will guide mechanistic biomarkers to be tested in the human trial. Results & discussion 351 participants were randomized; 13 experienced breast cancer recurrence during the trial. Of the 338 participants without recurrence, 83% completed the trial. The WISER Survivor trial will show the effects of exercise and weight-loss on lymphedema outcomes, biomarkers of recurrence and quality of life. NCT ClinicalTrials.gov registration #: NCT01515124</p