The effect of behavioural risk factors on osteoporosis in Irish women

Background Osteoporosis constitutes a major public health concern and its underlying pathogenesis is complex and multifactorial. Although hereditary factors strongly contribute to bone health, behavioural factors can modulate the genetically determined pattern of skeletal modelling and remodelling. Aims The aim of this study was to investigate the effect(s) of behavioural risk factors on osteoporosis in Irish women. Methods Pre- and post-menopausal adult women (n = 189; 44 ± 15y) participated in this cross-sectional study. Demographic, anthropometric and lifestyle data were collected during a single clinic visit. Dietary calcium intake and lifetime physical activity (PA) was assessed for each subject. Lumbar and femoral bone mineral density (BMD) was measured by dual energy X-ray absorptiometry (DXA). Multivariate analysis was used to determine the independent predictors of low BMD. Results Low BMD was present in 59% of subjects (42% pre- and 77% postmenopausal). Smoking was the strongest behavioural predictor of lumbar and femoral BMD. Age, height, family history, smoking, metabolic (MET) and mechanical (MECH) PA (lifetime) and weight (body mass) accounted for 39% of the variance in lumbar BMD. Age, height, family history, alcohol consumption, MET and MECH PA (lifetime) and weight accounted for 41% of the variance in femoral BMD. Conclusions Prevalence of osteopenia and osteoporosis is high in Irish women and is associated with modifiable risk factors. A clearer focus should be paid to educating Irish women on preventative health behaviours for osteoporosis in order to curb the prevalence of this disease and the human and fiscal costs associated with it

Raman spectroscopy of fingernails: a novel tool for evaluation of bone quality?

Raman data from human fingernails has been analysed to determine if a relationship exists between spectral features and bone quality. Previous work demonstrated a relationship between the manually determined intensity of the disulphide peak (Bone Quality Test; BQT) and osteoporotic fracture. A computer program is now described that automates the BQT determination for large sample-sets. In this study the ability of the automated BQT to discriminate between fractures and controls was compared to that of bone mineral density (BMD) and biomarkers of bone remodelling. Females aged 18–67 years participated in the study (n = 159). Fingernails were analysed using Raman spectroscopy. Lumbar and Femoral BMD was measured by dual energy X-ray absorptiometry (DXA). Fasting venepuncture samples were analysed for osteocalcin and CTx (collagen C-telopeptides) by electrochemiluminescence. No correlation was found between the BQT and BMD or the biomarkers. The BQT and BMD were found to be equally accurate in identifying subjects with a history of fracture (p < 0.01) and both outperformed osteocalcin and CTx. It appears that keratin and collagen are related structural proteins that require disulphide bonding for stability. Therefore, these preliminary results suggest that Raman spectroscopy of keratin may have potential as a diagnostic tool for screening bone quality in large populati

Acute effects of anaerobic exercise on bone turnover in healthy post-menopausal women.

Skeletal tissue is in a constant state of flux, remodelling itself to changing physical demands via the bone multicellular unit (BMU). At any one time there are approximately 2m BMUs active on the mature skeleton that individually remodel over a time-course of about 3 months. Physical activity is a known prophylactic to many bone disorders and can perturb the remodelling process, either mechanically1 or metabolically2. Using specific biochemical markers for bone resorption and renewal, this study sought to investigate whether acute (9 days) changes in bone turnover could be observed following a discrete anaerobic exercise challenge

Biological day-to-day variability and critical differences in the serial measurement of two markers of bone turnover in the sera of healthy young males. National

The study outlined here is part of an overall project, which aims to identify the optimum marker of bone resorption for both healthy young males and post-menopausal, non-osteoporotic women, and is as yet ongoing1. The purpose of this investigation was to quantify the biological day-to-day variability in serum levels of N-Mid Osteocalcin (OC; ng/ml) and CrossLaps (ng/ml) in healthy males (n=14). From this biological variation (CVi: individual biological variability), the critical difference (CD) or least significant change was calculated as previously described2. This value represents the minimal difference between two measurements of a biochemical marker that indicates a medically significant alteration of homeostasis (and is not due to normal biological and/or analytical variability alone). Given the CD of these markers the viability of using them in the assessment and/or monitoring of bone metabolism will be considered

The components of variance and the critical difference in specific markers of bone turnover in healthy adult males and postmenopausal women.

The study outlined here is part of an overall project, which aims to identify the optimum marker of bone resorption for both healthy young males and post-menopausal, non-osteoporotic women, and is as yet ongoing1. The purpose of this investigation was to quantify the components of variance in specific biochemical markers of bone turnover in healthy males and post-menopausal women i.e. total (CVS), analytical (CVA), within-subject biological (CVI) and betweensubject (CVG) variances. Using CVA and CVI for each individual, the individual critical difference (CDI) or least significant change (P<0.05) was calculated as previously described2. This value represents the minimal difference between two measurements of a biochemical marker that indicates a medically significant alteration of homeostasis (and is not due to normal biological and/or analytical variability alone). Given the CD of these markers the viability of using them in the assessment and/or monitoring of bone metabolism will be considered

Barriers and facilitators to implementing community-based physical activity interventions: a qualitative systematic review

Background: Over the past decade several physical activity (PA) interventions have been shown to be efficacious in a controlled research setting, however there is a continued lack of evidence for how to successfully implement these PA interventions in real-world settings such as the community. This review aims to explore the barriers and facilitators that affect the implementation of community-based PA interventions and make recommendations to improve implementation from the included studies. Methods: A systematic literature search of EBSCOhost, Scopus, PUBMED and Web of Science was conducted to identify articles that reported qualitative data on the implementation factors of community-based interventions where PA was a primary outcome. Data were extracted using the Consolidated Framework for Implementation Research (CFIR) as a guide. Implementation factors and recommendations were then mapped onto the 5 domains of the CFIR and synthesised thematically. Results: From 495 articles, a total of 13 eligible studies were identified, with 6 studies using a mixed methods approach, and 7 reporting qualitative methods only. There were 82 implementation factors identified, including 37 barriers and 45 facilitators, and a further 26 recommendations from the papers across all 5 domains of the CFIR. More barriers than facilitators were identified within the CFIR domain inner setting, in contrast to all other domains where facilitator numbers outweighed barriers. Conclusions: This review identified many facilitators and barriers of implementing physical activity interventions in the community. A key finding of this review was the impact of implementation strategies on successful implementation of community PA interventions. From the evidence, it was clear that many barriers to implementation could have been negated or reduced by an implementation plan in which several strategies are embedded. The findings of this review also suggest more attention to individual’ skills and involvement is needed to improve self-efficacy and knowledge. The role of individuals across all organisational levels, from providers to leaders, can impact on the implementation of an intervention and its succes