Entries in Bones (3)


Mediterranean Diet May Improve Bone Health, Study Suggests

iStockphoto/Thinkstock(NEW YORK) -- Could olive oil be the new milk?  A new study suggests that this might be the case -- though not all health experts are convinced yet.

The study, which looked at 127 elderly Spanish men, found that those who ate a Mediterranean diet enriched with olive oil had higher levels of a protein called osteocalcin that plays a role in bone formation.  The research was published in the Journal of Clinical Endocrinology and Metabolism.

This could be an important finding since osteoporosis is the most common bone disease in the United States, affecting more than 10 million people.  Osteoporosis mainly affects elderly women, but men can develop the disease too.  In 2005, there were an estimated two million osteoporosis-related fractures, 29 percent of them in men.

Earlier studies have found that there are lower rates of osteoporosis in the Mediterranean basin, compared to the rest of Europe, and that may have something to do with the Mediterranean diet.  This diet consists of minimally processed fruits, vegetables, breads, beans, nuts and seeds.  Olive oil is supposed to be the main source of fat, and there is usually limited dairy, egg and red meat.

Past studies have suggested that the Mediterranean diet has the potential to lower cardiovascular risk, increase weight loss, lower cancer risk, improve diabetes, and reduce pain and swollen joints in rheumatoid arthritis.  What if improved bone health could be added to this growing list?

“We have more evidence that what is good for health in one way, tends to be good for health overall,” says Dr. David Katz, director of Yale University Prevention Research Center.  “The very same Mediterranean diet known to be good for cardiovascular health may also confer benefits on your bones.”

However, Dr. Beth Kitchin, a patient educator at the University of Alabama at Birmingham Osteoporosis Clinic, cautions that osteocalcin is simply a marker of bone health -- in other words, the new study doesn’t actually look at whether the Mediterranean diet increased bone density or lowered fracture risk.

“This is very interesting data but much, much more work needs to be done before you can say if this has a true clinical impact on bone health,” says Kitchin.

On this point, Katz agrees. “This is not a study of bone density, or clinical effects; it is a short-term study of biomarkers.  Interesting, but [it is] more useful for hypothesis generation than anything else.”

Nutritionists were also quick to point out that this study shouldn’t undermine the importance of calcium and vitamin D in bone health.

“It doesn’t replace calcium and vitamin D in the diet, however,” says Keith-Thomas Ayoob, a dietician and professor at Albert Einstein College of Medicine.  “But including all three, and regular exercise, are showing promise as the best way to ensure good bone health."

Copyright 2012 ABC News Radio


FDA Still Cautious About Bone Drugs

Peter Dazeley/Getty Images(NEW YORK) -- The U.S. Food and Drug Administration says doctors need to reassess which women are likely to benefit from popular bone-building drugs, given the lack of evidence showing that taking them for the long term really helps and the possibility that they put some women at risk for rare but serious side effects.

In a report published in the New England Journal of Medicine on Wednesday, the U.S. Food and Drug Administration raised concerns about the potential for some serious side effects in women taking bone-building drugs called bisphosphonates, specifically Fosamax, Actonel and Reclast.

The published findings are not new. In 2011, the agency voiced concerns that taking the drugs long-term may actually make bones weaker and increase the risk of rare but serious side effects such as atypical fractures of the thigh bone, esophageal cancer and osteonecrosis of the jaw, a rare but painful condition in which the jaw bone crumbles. To investigate, the FDA reviewed data from women who had taken the drugs for six to 10 years.

In Wednesday's report, the agency repeated its 2011 conclusions: Women without osteoporosis seem to get few to no benefits to their bones from taking the drugs beyond five years. In light of the concerns about the potential side effects, the authors said some patients should be able to safely stop taking the drugs after that time, particularly if they are younger and at low risk of fractures.

They suggested that women who continue to have very low bone density, measured by a "T score" lower than minus 2.5, are the ones who may benefit the most from taking the drugs after five years.

A commentary accompanying the FDA's report said it is older women who have a history of fractures or are at an increased fracture risk, particularly of spine fractures, who stand to benefit from taking the drugs for longer than five years.

Dennis Black, a professor of epidemiology at the University of California, San Francisco and the lead author of the commentary, said the drugs appear to be safe and helpful for women taking them for just few years at a time.

"These drugs in general have very strong proven benefits for the first five years," Black said. "I would want a patient with osteoporosis to not let the worry about these very rare side effects overwhelm the very strong benefits they would get."

The reports reflect overall uncertainty about the optimal length of time a patient should take these drugs. Clinical trials of bisphosphonates have studied large numbers of women for up to five years and have shown that the drugs are effective for that length of time. But the trials looking at the effects after five years have included a much smaller number of patients, meaning their results are less certain.

According to the FDA, doctors wrote more than 150 million prescriptions for bisphosphonates between 2005 and 2009. The drugs work by targeting the body's process of breaking down and regenerating bone cells. After age 30 or so, a woman's bones start to break down faster than the body can rebuild them, which can lead to the brittle, vulnerable bones of osteoporosis. The drugs work to slow down the bone-dissolving process, letting the cells that work to build bone mass catch up.

The drugs are incorporated into the newly formed bone and can stay there for years, even after a woman stops taking them.

It's not clear how many women are affected by the FDA's recommendations, but the researchers estimated that as many as 70 percent of women currently taking bisphosphonates could be candidates for stopping the drugs after five years. A number of women stop taking the drugs after only one or two years anyway, because of several inconvenient aspects of the prescriptions, such as needing to remain upright for several hours after taking the drug.

Doctors emphasize that the risk of atypical fractures associated with bisphosphonates is very low and appears to account for less than 1 percent of leg and hip fractures overall. Dr. Beatrice Edwards, an associate professor of orthopedic surgery at the Northwestern University Feinberg School of Medicine, said she thinks the drugs are generally safe for as long as five years, but still keeps a close eye on her patients who take them.

The FDA's report said additional research is needed before doctors can determine if interruption of treatments is helpful.

For now, the FDA and other experts say women should be mindful of how long they have been taking the drugs and talk to their doctors about whether continuing to use the drugs is best for them. The FDA already placed a statement on the drugs' labels saying patients should be reevaluated periodically.

For patients at low risk of osteoporosis, experts recommend regular exercise and diets rich in calcium and vitamin D for staving off the disease.

Copyright 2012 ABC News Radio


Drug Delays Prostate Cancer Spread to Bones

Pixland/Thinkstock(CAMBRIDGE, Mass.) -- A new drug administered to prostate cancer patients has been found to delay the spread of cancer to the bones, according to a new study published in the Lancet.

The drug, known as denosumab, has been approved by the Food and Drug Administration for treatment of osteoporosis and prevention of fractures with bone metastases from solid tumors. Researchers believed it had potential to slow the progression of prostate cancer to the bones. Previous science has revealed that inhibiting of the cells that cause resorption of the bone can reduce the risk of the cancer's spread to the bone.

"Prostate cancer patients who develop bone metastases usually have poor outcomes, so preventing the development of metastasis has been a major unmet clinical need," Dr. Matthew Smith, lead author of the study and professor of medicine at Harvard Medical School, said in a statement. "This first demonstration of a treatment that can meet the goal is a significant accomplishment that should lead to better treatment strategies."

Smith serves as a consultant for Amgen, which marketed the drug and funded the study.

The research was based on more than 1,400 study participants from 30 different countries who were randomly assigned to receive injection treatments of the drug or a placebo each month over a two-year study period, when patients underwent bone scans and skeletal surveys to analyze the presence of metastases. The men who participated in the study did not have tumors that had metastatized, but their cancer had not responded to hormone therapy.

The drug appeared to increase bone-metastasis-free survival by an average of four months more than the men who took the placebo.  It did not increase survival overall, though.  But patients were taken off the treatment when the cancer metastasized, which could explain the incongruous findings, experts said.

Copyright 2011 ABC News Radio

ABC News Radio