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5. Population nutrient intake goals for preventing diet-related chronic diseases: Previous page | 1,2,3,4,5,6,7,8,9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27

The following conclusions were reached:

  • There is no case for global, population-based approaches. A case can be made for targeted approaches with respect to calcium and vitamin D in high-risk subgroups of populations, i.e. those with a high fracture incidence.

  • In countries with high osteoporotic fracture incidence, a low calcium intake (i.e. below 400-500 mg per day) (15) among older men and women is associated with increased fracture risk.

  • In countries with high fracture incidence, increases in dietary vitamin D and calcium in the older populations can decrease fracture risk. Therefore, an adequate vitamin D status should be ensured. If vitamin D is obtained predominantly from dietary sources, for example, when sunshine exposure is limited, an intake of 5-10 mg per day is recommended.

  • Although firm evidence is lacking, prudent dietary and some lifestyle recommendations developed in respect of other chronic diseases may prove helpful in terms of reducing fracture risk. These include:

    • increase physical activity;
    • reduce sodium intake;
    • increase consumption of fruits and vegetables;
    • maintain a healthy body weight;
    • avoid smoking;
    • limit alcohol intake.

  • Convincing evidence indicates that physical activity, particularly activity that maintains or increases muscle strength, coordination and balance as important determinants of propensity for falling, is beneficial in prevention of osteoporotic fractures. In addition, regular lifetime weight-bearing activities, especially in modes that include impacts on bones and are done in vigorous fashion, increase peak bone mass in youth and help to maintain bone mass in later life.

References

1. Consensus Development Conference. Diagnosis, prophylaxis, and treatment of osteoporosis. American Journal of Medicine, 1993, 94:646-650.

2. Prentice A. Is nutrition important in osteoporosis? Proceedings of the Nutrition Society, 1997, 56:357-367.

3. Compston JE. Osteoporosis. In: Campbell GA, Compston JE, Crisp AJ, eds. The management of common metabolic bone disorders. Cambridge, Cambridge University Press, 1993:29-62.

4. Johnell O. The socioeconomic burden of fractures: today and in the 21st century. American Journal of Medicine, 1997, 103(Suppl. 2A):S20-S25.

5. Royal College of Physicians. Fractured neck of femur. Prevention and management. Summary and recommendations of a report of the Royal College of Physicians. Journal of the Royal College of Physicians, 1989, 23:8-12.

6. Cooper C, Campion G, Melton LJ. Hip fractures in the elderly: a world-wide projection. Osteoporosis International, 1992, 2:285-289.

7. Melton LJ III. Epidemiology of fractures. In: Riggs BL, Melton LJ III, eds. Osteoporosis: etiology, diagnosis, and management, 2nd ed. Philadelphia, Lippincott-Raven, 1995:225-247.

8. Eastell R et al. Management of male osteoporosis: report of the UK Consensus Group. Quarterly Journal of Medicine, 1998, 91:71-92.

9. Yan L et al. Epidemiological study of hip fracture in Shenyang, People’s Republic of China. Bone, 1999, 24:151-155.

10. Elffors L et al. The variable incidence of hip fracture in southern Europe: the MEDOS Study. Osteoporosis International, 1994, 4:253-263.

11. Maggi S et al. Incidence of hip fracture in the elderly: a cross-national analysis. Osteoporosis International, 1991, 1:232-241.

12. Osteoporosis: clinical guidelines for prevention and treatment. London, Royal College of Physicians, 1999.

13. Kannus P et al. Epidemiology of hip fractures. Bone, 1996, 18(Suppl.1): 57S-63S.

14. Lau EM, Cooper C. The epidemiology of osteoporosis: the oriental perspective in a world context. Clinical Orthopaedics and Related Research, 1996, 323:65-74.

15. Department of Health. Nutrition and bone health: with particular reference to calcium and vitamin D. Report of the Subgroup on Bone Health, Working Group on the Nutritional Status of the Population of the Committee on Medical Aspects of Food and Nutrition Policy. London, The Stationery Office, 1998 (Report on Health and Social Subjects, No. 49).

16. Standing Committee on the Scientific Evaluation of Dietary Reference Intakes, Food and Nutrition Board, Institute of Medicine. Dietary reference intakes for calcium, phosphorus, magnesium, vitamin D, and fluoride. Washington, DC, National Academy Press, 1997.

17. NIH Consensus Development Panel on Optimal Calcium Intake. Optimal calcium intake. NIH Consensus Conference. Journal of the American Medical Association, 1994, 272:1942-1948.

18. Vitamin and mineral requirements in human nutrition. Report of the Joint FAO/WHO Expert Consultation. Geneva, World Health Organization, (in press).

5. Population nutrient intake goals for preventing diet-related chronic diseases: 1,2,3,4,5,6,7,8,9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27

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