Osteoporosis epidemiology

Based on limited epidemiologic evidence, fluoride supplements, with or without calcium, estrogen and vitamin D, are used by clinicians for the treatment of osteoporosis. However, knowledge of the effects of fluoride on calcium and phosphorus metabolism in normal animals is limited although Spencer et al. (32) reported that ingestion of fluoride by three osteoporotic men did not affect calcium absorption but caused a decrease in urinary excretion. Moreover, there is a need to determine the long-term effects of fluoride treatment on bone strength and on soft tissues ( ). 

Fluoride is well established as effective for the prophylaxis of dental caries and has been under investigation for the treatment of osteoporosis. Both therapeutic applications originated from epidemiologic observations that subjects living in areas with naturally fluoridated water (1-2 ppm) had less dental caries and fewer vertebral compression fractures than subjects living in nonfluoridated water areas. Fluoride is accumulated by bones and teeth, where it may stabilize the... 

Olszynski WP, Davison KS, Adachi JD, Brown JP, Cummings SR, Hanley DA, Harris ST, Hodsman AB, Kendler D, McClumg MR, Miller PD, Yuen CK. Osteoporosis in men epidemiology, diagnosis, prevention and treatment. ClinTher 2004 26 15-28. 

Considerable evidence exists from epidemiological and experimental studies for preventive effects of soy or isoflavones against chronic diseases including cancer (breast, prostate, colorectal, lung), osteoporosis, cardiovascular disorders, and menopausal symptoms, but this is not always consistent [Adlercreutz... 

Oxidative stress is now recognized as an important etiological factor in the causation of several chronic diseases including cancer, cardiovascular diseases, osteoporosis, and diabetes. Antioxidants play an important role in mitigating the damaging effects of oxidative stress on cells. Lycopene, a carotenoid antioxidant, has received considerable scientific interest in recent years. Epidemiological, tissue culture, and animal studies provide... 

Wasnich R. D. (1999) Epidemiology of osteoporosis. In Primer on the Metabolic Bone Diseases and Disorders of Mineral Metabolism, 4th edn. (ed. M. J. Favus). Lippincott, Williams and Wilkins, Philadelphia, pp. 257-259. 

Epidemiological studies (Aldercreutz et al., 1991 Aldercreutz, 1998) indicate that consumption of tofu and other soy foods may be associated with the low incidence of breast cancer in Japanese women. This discovery has led numerous researchers in recent years to search for the biochemical components in soybean that are responsible for the cancer risk-lowering effect. Aside from the potential cancer prevention effect (Wu et al., 1996 Cline and Hughes, 1998 Griffiths et al., 1998 Messina and Bennink, 1998 Stephens, 1999), isoflavones also have been found to have other potential health benefits, including heart disease prevention (Anthony et al., 1998), bone mass density increase to prevent osteoporosis (Anderson and Camer, 1997) and the reduction of postmenopausal syndromes in women (Knight et al., 1996). 

Riggs BL, Melton LJ III. 1995. The worldwide problem of osteoporosis insights afforded by epidemiology. Bone 17(5 Suppl) 505S-511S. 

An estimated 75 million people are affected by osteoporosis to some degree in the United States, Europe, and Japan. Osteoporosis is a systematic skeletal disease characterized by bone mass and microarchitectural deterioration with a consequent increase in bone fragility and susceptibility to fracture. Operationally, osteoporosis can be defined as a certain level of bone mineral density. The definition of osteoporosis is somewhat arbitrary and is based on epidemiological data relating fracture incidence to bone mass. Uncertainty also is introduced due to variability in bone densitometry measurements. Other clinical measures to assess the skeleton include collagen cross-links (measure of bone resorption) and levels of bone-specific alkaline phosphatase and osteocalcin (bone formation). A list of biochemical markers of bone remodeling is provided in Table 37-3. Measurement of total serum alkaline phosphatase level and urinary hydroxyproline or calcium levels is of limited value. 

Olszynski WP, Shawn Davison K, Adachi ID, et al. Osteoporosis in men Epidemiology, diagnosis, prevention, and treatment. Clin Ther 2004 26 15-28. 

Epidemiologic observations consistendy show lower rates of prostate and breast cancer, and osteoporosis in populations that consume soy (Anderson Garner, 1997 Moyad, 1999 Nagata et ah, 2001a Wu et al., 1998). Intervention studies were conducted to investigate whether these observations are reproducible. These studies will help clarify whether the results reported in epidemiologic studies are causal, and due specifically to soy products (Reinwald Weaver, 2006 Rice Whitehead, 2006). 

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