Association between low bone mass and calcium and caffeine intake among perimenopausal women in Southern Brazil
cross-sectional study
Keywords:
Osteoporosis, Calcium, dietary, Caffeine, Ultrasonography, Body mass indexAbstract
CONTEXT AND OBJECTIVE: Osteoporosis is a skeletal abnormality characterized by reduction and alteration of bone microarchitecture that results in increased fragility and greater predisposition to fractures. Age and low bone mass are the main non-modifiable risk factors for osteoporotic fractures. The modifiable factors include sedentary lifestyle, inadequate calcium intake, excessive alcohol and/or caffeine consumption, smoking and low body weight. The aim here was to evaluate the association between low bone mass and calcium and caffeine intake among perimenopausal women in Southern Brazil. DESIGN AND SETTING: Cross-sectional study conducted in Porto Alegre and Canoas, Rio Grande do Sul, Brazil. METHODS: Women (n = 155) of mean age 53.6 ± 9.5 years were evaluated through a cross-sectional study in Southern Brazil. Food frequency questionnaires, bone mass evaluation using calcaneal ultrasound and anthropometric assessment were used. RESULTS: The prevalence of overweight was 67.7%. In the bone mass screening, 30.3% had low bone mass and 4.5% had osteoporosis. The median calcium intake was 574.94 mg/day and the caffeine intake was 108.11 mg/day. No association was found between bone mass and anthropometric parameters, calcium intake or caffeine intake. It was found that 38.4% of the women had low bone mass. CONCLUSIONS: No association was found between calcium and caffeine intake and bone mass. High prevalence of low bone mass was observed.
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References
World Health Organization. Sexual and reproductive health. Assessment of fracture risk and its application to screening for postmenopausal osteoporosis. Available from: http://www.who. int/reproductivehealth/publications/ageing/9241208430/en/index. html. Accessed in 2012 (Oct 25).
NIH Consensus Development Panel on Osteoporosis Prevention, Diagnosis, and Therapy. JAMA. 2001;285(6):785-95.
Schwartz AV, Kelsey JL, Maggi S, et al. International variation in the incidence of hip fractures: cross-national project on osteoporosis for the World Health Organization Program for Research on Aging. Osteoporos Int. 1999;9(3):242-53.
Fuller GF. Falls in the elderly. Am Fam Physician. 2000;61(7):2159-68.
Cummings SR, Melton LJ. Epidemiology and outcomes of osteoporotic fractures. Lancet. 2002;359(9319):1761-7.
Kanis JA, Johnell O, Oden A, et al. Risk of hip fracture according to the World Health Organization criteria for osteopenia and osteoporosis. Bone. 2000;27(5):585-90.
National Academy of Sciences. Dietary reference intakes. In: National Academy of Sciences. Dietary reference intakes for calcium, phosphorus, magnesium, vitamin D, and fluoride. Washington: National Academy Press; 2006. p. 21-37. Available from: http://www. nap.edu/openbook.php?record_id=5776&page=21. Accessed in 2012 (Oct 25).
Heaney RP. Calcium, dairy products and osteoporosis. J Am Coll Nutr. 2000;19(2 Suppl):83S-99S.
Management of osteoporosis in postmenopausal women: 2010 position statement of The North American Menopause Society. Menopause. 2010;17(1):25-54; quiz 55-6.
Hannan MT, Felson DT, Dawson-Hughes B, et al. Risk factors for longitudinal bone loss in elderly men and women: the Framingham Osteoporosis Study. J Bone Miner Res. 2000;15(4):710-20.
Lloyd T, Johnson-Rollings N, Eggli DF, et al. Bone status among postmenopausal women with different habitual caffeine intakes: a longitudinal investigation. J Am Coll Nutr. 2000;19(2):256-61.
Heaney RP. Effects of caffeine on bone and the calcium economy. Food Chem Toxicol. 2002;40(9):1263-70.
Harris SS, Dawson-Hughes B. Caffeine and bone loss in healthy postmenopausal women. Am J Clin Nutr. 1994;60(4):573-8.
Rapuri PB, Gallagher JC, Kinyamu HK, Ryschon KL. Caffeine intake increases the rate of bone loss in elderly women and interacts with vitamin D receptor genotypes. Am J Clin Nutr. 2001;74(5):694-700.
Barger-Lux MJ, Heaney RP. Caffeine and the calcium economy revisited. Osteoporos Int. 1995;5(2):97-102.
Higdon JV, Frei B. Coffee and health: a review of recent human research. Crit Rev Food Sci Nutr. 2006;46(2):101-23.
Hulley SB, Cummings SR, Browner WS, Grady DG, Newman TB. Delineando a pesquisa clínica: uma abordagem epidemiológica. 3a ed. Porto Alegre: Artmed; 2008.
Brasil. Ministério da Saúde. Secretaria de Atenção à Saúde. Departamento de Ações Programáticas Estratégicas. Manual de atenção à mulher no climatério/menopausa. Brasília: Ministério da Saúde; 2008. Available from: http://portal.saude.gov.br/ portal/arquivos/pdf/manual_climaterio.pdf. Accessed in 2012 (Oct 25).
Fontanive R, Paula TP, Peres WAF. Avaliação da composição corporal de adultos. In: Duarte ACG. Avaliação nutricional: aspectos clínicos e laboratoriais. São Paulo: Atheneu, 2007. p. 41-63.
Physical status: the use and interpretation of anthropometry. Report of a WHO Expert Committee. World Health Organ Tech Rep Ser. 1995;854:1-452.
Obesity: preventing and managing the global epidemic. Report of a WHO consultation. World Health Organ Tech Rep Ser. 2000;894:i-xii, 1-253.
Lipschitz DA. Screening for nutritional status in the elderly. Prim Care. 1994;21(1):55-67.
Blackburn GL, Thornton PA. Nutritional assessment of the hospitalized patient. Med Clin North Am. 1979;63(5):11103-15.
Frisancho AR. New norms of upper limb fat and muscle areas for assessment of nutrition status. Am J Clin Nutr. 1981;34(11):2540-5.
McDowell MA, Fryar CD, Ogden CL. Anthropometric reference data for children and adults: United States, 1988-1994. Vital Health Stat 11. 2009;(249):1-68.
Heath AL, Skeaff CM, Gibson RS. The relative validity of a computerized food frequency questionnaire for estimating intake of dietary iron and its absorption modifiers. Eur J Clin Nutr. 2000;54(7):592-9.
Fisberg RM, Martini LA, Slater B. Métodos de inquéritos alimentares [Methods of food surveillance]. In: Fisberg RM, Slater B, Marchioni DML, Martini LA. Inquéritos alimentares: métodos e bases científicas [Nutritional surveys: methodology and scientific bases]. 2a ed. Barueri: Manole; 2005. p. 334-31.
Hands ES. Nutrients in food. Philadelphia: Lippincott Williams & Wilkins; 2000.
Software. USDA Food Search for Windows© 2002 version 1.0.0.9 [free software online]. Available from: http://www.ars.usda.gov/Services/ docs.htm?docid=5720. Accessed in 2009 (Jul 20).
Haytowiz DB, Gebhardt SE, Pehrsson PR, et al. USDA national nutrient database for standard reference, release No. 17 – CD-ROM. United States Department of Agriculture. Agricultural Research Service. Available from: http://www.ars.usda.gov/research/publications/ publications.htm?seq_no_115=172518. Accessed in 2012 (Oct 25).
Tabela brasileira de composição de alimentos/NEPA-UNICAMP. Versão II. 2a ed. Campinas: NEPA-UNICAMP; 2006. Available from: http://www.unicamp.br/nepa/taco/contar/taco_versao2.pdf. Accessed in 2012 (Oct 25).
Castro CHM, Pinheiro MM, Szejnfeld VL. Prós e contras da ultra-sonometria óssea de calcâneo [Pros and cons of the bone ultrasonometry of calcaneus]. Rev Ass Med Bras (1992). 2000;46(1):63-9.
Bauer DC, Glüer CC, Genant HK, Stone K. Quantitative ultrasound and vertebral fracture in postmenopausal women. Fracture Intervention Trial Research Group. J Bone Miner Res. 1995;10(3):353–8.
Glüer CC. Quantitative ultrasound techniques for the assessment of osteoporosis: expert agreement on current status. The International Quantitative Ultrasound Consensus Group. J Bone Miner Res. 1997;12(8):1280-8.
Frost ML, Blake GM, Fogelman I. Does quantitative ultrasound imaging enhance precision and discrimination? Osteoporos Int. 2000;11(5):425-33.
Stewart A, Kumar V, Reid DM. Long-term fracture prediction by DXA and QUS: a 10-year prospective study. J Bone Miner Res. 2006;21(3):413-8.
Cheng S, Tylavsky F, Carbone L. Utility of ultrasound to assess risk of fracture. J Am Geriatr Soc. 1997;45(11):1382-94.
Brasil. Ministério do Planejamento, Orçamento e Gestão. Instituto Brasileiro de Geografia e Estatística. Diretoria de Pesquisas. Coordenação de Trabalho e Rendimento. Pesquisa de Orçamentos Familiares 2008-2009. Antropometria e estado nutricional de crianças, adolescentes e adultos no Brasil. Rio de Janeiro: IBGE; 2010. Available from: http://www.ibge.gov.br/home/estatistica/ populacao/condicaodevida/pof/2008_2009_encaa/pof_20082009_ encaa.pdf. Accessed in 2012 (Oct 25).
Steiner ML, Fernandes CE, Strufaldi R, et al. Accuracy study on “Osteorisk”: a new osteoporosis screening clinical tool for women over 50 years old. Sao Paulo Med J. 2008;126(1):23-8.
Kidambi S, Partington S, Binkley N. Low bone mass prevalence and osteoporosis risk factor assessment in African American Wisconsin women. WMJ. 2005 Nov;104(8):59-65.
Parisi Júnior PD, Chahade WH. Fatores de risco associados à osteoporose em uma população de mulheres brasileiras residentes em São José do Rio Pardo, estado de São Paulo. Rev Bras Reumatol. 2007;47(1):16-24.
Palacios C, Bertrán JJ, Ríos RE, Soltero S. No effects of low and high consumption of dairy products and calcium supplements on body composition and serum lipids in Puerto Rican obese adults. Nutrition. 2011;27(5):520-5.
Boggs DA, Palmer JR, Stampfer MJ, et al. Tea and coffee intake in relation to risk of breast cancer in the Black Women’s Health Study. Cancer Causes Control. 2010;21(11):1941-8.
Jaime PC, Latorre M do R, Florindo AA, Tanaka T, Zerbini CA. Dietary intake of Brazilian black and white men and its relationship to the bone mineral density of the femoral neck. Sao Paulo Med J. 2006;124(5):267-70.
Hallström H, Wolk A, Glynn A, Michaëlsson K. Coffee, tea and caffeine consumption in relation to osteoporotic fracture risk in a cohort of Swedish women. Osteoporos Int. 2006;17:1055-64.
Prince RL, Devine A, Dhaliwal SS, Dick IM. Effects of calcium supplementation on clinical fracture and bone structure: results of a 5-year, double-blind, placebo-controlled trial in elderly women. Arch Intern Med. 2006;166(8):869-75.
