Prevalence of low bone health using quantitative ultrasound in Indian women aged 41–60 years: Its association with nutrition and other related risk factors

The purpose of this study was to find the prevalence of low bone health conditions and assess associated nutritional and other risk factors in Indian women aged 41–60 years. A total of 1,911 women participated in this cross-sectional study. Bone health was assessed using an Omnisense multisite quantitative ultrasound bone densitometer on two sites (radius and tibia). Crude prevalence of osteopenia and osteoporosis was found to be 30.09% and 19.89%, respectively. The Indian women were deficient in a majority of nutrients. Postmenopause, hysterectomy, hyperthyroid, hypothyroid, hypertension, low physical activity, low sun exposure, high stress levels, and low calcium levels were found to be independent risk factors of low bone health.     

Ultrasonometric profiling of incidence and risk of osteoporosis in rural women

BACKGROUND: It is estimated that over 200 million people worldwide have osteoporosis. The prevalence of osteoporosis is continuing to escalate with the increasingly aging population. The major complication of osteoporosis is an increase in fragility fractures leading to morbidity, mortality, and decreased quality of life. This investigation profiled the incidence and risk of osteoporosis in adult women from a rural setting using ultrasonic bone scanning technology. METHODS: Between 2001 and 2005, adult female subjects (n = 323) in the age range of 40-87 were drawn from an independent, community dwelling, convenience sample. Bone mineral density T-scores were evaluated using heel ultrasonometry. Demographic and risk factor data, Merck Osteoporosis Evaluation SCORE questionnaire data, and the Osteoporosis Risk Assessment questionnaire data were analyzed. RESULTS: Results of these scans indicate that 25% of the total population had a T-score < or = -1.0, implying a 1.5- to 2.0-fold increase in risk ratio of hip or spinal fracture for each standard deviational decrease. Age at menopause and weight had a positive correlation with T-scores. While the overall scores on the Merck SCORE questionnaire were inversely correlated to T-scores, no significant correlation was found between the Osteoporosis Risk Assessment questionnaire and T-score data. Additionally, women who had taken estrogen had significantly higher T-scores (p = 0.038) than those who had not. CONCLUSION: That approximately 25% of this sample has low bone mass or osteoporosis underscores the importance of early screening in order to develop preventative awareness and provide education on bone health management. This finding has particularly important ramifications, since the sample was rural women, who typically have limited access to diagnostic bone density procedures.     

Focus groups identified women's perceptions of dairy foods

Focus groups were conducted with 39 Caucasian women (ages 30-55 years) to gain insight regarding their thoughts and feelings toward dairy foods. Women resided in Virginia; all had at least a high school education. Themes characterizing the group discussions were identified. Women knew that dairy foods were a good source of calcium and discussed it in relation to osteoporosis. Although many knew the risk factors related to osteoporosis, most were confused about measures to prevent it. Many used calcium supplements or vitamin/mineral supplements to help meet calcium requirements. Most thought dairy foods were high in fat. Women also discussed the sensory attributes of dairy foods as well as convenience and cost of dairy foods in relation to their dairy food choices.     

Focus Groups Identified Women's Perceptions of Dairy Foods

ABSTRACT

Focus groups were conducted with 39 Caucasian women (ages 30–55 years) to gain insight regarding their thoughts and feelings toward dairy foods. Women resided in Virginia; all had at least a high school education. Themes characterizing the group discussions were identified. Women knew that dairy foods were a good source of calcium and discussed it in relation to osteoporosis. Although many knew the risk factors related to osteoporosis, most were confused about measures to prevent it. Many used calcium supplements or vitamin/mineral supplements to help meet calcium requirements. Most thought dairy foods were high in fat. Women also discussed the sensory attributes of dairy foods as well as convenience and cost of dairy foods in relation to their dairy food choices.     

Knowledge and correlates of osteoporosis: a comparison of Israeli-Jewish and Israeli-Arab women

The present study examined levels and correlates of knowledge about osteoporosis among 176 Israeli-Jewish (mean age = 55) and 80 Israeli-Arab (mean age = 51) women. Levels of knowledge about the disease were low among all women, especially regarding some of the risk factors. Knowledge and awareness about the disease were especially deficient among Arab women. Younger age and lower education were the main vulnerability factors among Jewish women, and lower desire to seek information from the medical establishment, higher religiosity, and the lack of extended medical insurance among Arab women. Educational programs, geared to the needs and capabilities of the different ethnic populations, should be encouraged.     

Knowledge and Correlates of Osteoporosis: A Comparison of Israeli-Jewish and Israeli-Arab Women

ABSTRACT

The present study examined levels and correlates of knowledge about osteoporosis among 176 Israeli-Jewish (mean age = 55) and 80 Israeli-Arab (mean age = 51) women. Levels of knowledge about the disease were low among all women, especially regarding some of the risk factors. Knowledge and awareness about the disease were especially deficient among Arab women. Younger age and lower education were the main vulnerability factors among Jewish women, and lower desire to seek information from the medical establishment, higher religiosity, and the lack of extended medical insurance among Arab women. Educational programs, geared to the needs and capabilities of the different ethnic populations, should be encouraged.     

The effect of protein diets in postmenopausal women with osteoporosis: Systematic review of randomized controlled trials

The main objective of this systematic review was to examine the effectiveness of protein supplementation through diet or dietary supplements on osteoporosis in postmenopausal women as evidenced by randomized controlled trials (RCTs). Five RCTs were included using dietary protein (N = 2), protein supplements (N = 2), and proteins through diet and supplements (N = 1). A total of 677 postmenopausal woman were included, all diagnosed with osteoporosis (T score < –2.5) and aged between 50 and 80 years. Results have found that combined protein administration through diet, mainly from animal sources and supplemental proteins (whey proteins, 86 g/d PRO including 6 g WPI), for a short period of time (up to 12 months) may positively affect osteoporosis in postmenopausal women. In addition, a positive effect can also be achieved by the single administration of a 250 mg/d supplement in which 10 g was WPI for a six-month period. In this review, it is shown that both combined administration of proteins through diet and supplements and single administration through protein supplements may reduce the risk of fracture in postmenopausal osteoporotic women. In contrast, dietary proteins alone, in doses similar to and/or higher than the RDA values, may not have any positive effect on treating osteoporosis.     

Risk factors for severe perineal trauma during vaginal childbirth: A Western Australian retrospective cohort study

AimTo determine rates and risk factors for third and fourth degree perineal tears (severe perineal trauma) in a Western Australian context.Design and settingA retrospective hospital-based cohort study was performed using computerised data for 10,408 singleton vaginal deliveries from 28 weeks gestation.MethodsWomen with severe perineal trauma were compared to those without. Logistic regression analysis, stratified by parity, was used to assess demographic and obstetric factors associated with perineal trauma.ResultsSevere perineal trauma incidence was 3% (338/10408), 5.4% (239/4405) for primiparas and 1.7% (99/5990) for multiparas (p < 0.001). Adjusted risk factors associated with trauma and common across parity included Asian or Indian ethnicity, shoulder dystocia and assisted delivery. Epidural analgesia (OR 0.72, 95% CI 0.54–0.96), preterm birth (OR 0.40, 95% CI 0.23–0.72) and episiotomy (OR 0.54, 95% CI 0.39–0.74) were protective in primiparas, while episiotomy was associated with increased risk in multiparas (OR 2.01, 95% CI 1.18–3.45). Additional factors among primiparas were occipito posterior (OP) delivery (OR 3.35, 95% CI 1.75–6.41) and prolonged second stage (OR 1.98, 95% CI 1.46–2.68), and among multiparas included gestational diabetes (OR 1.78, 95% CI 1.04–3.03) and birth weight >4000 g (OR 1.86, 95% CI 1.10–3.15).ConclusionParity differences in risk factors such as episiotomy, infant weight, OP delivery, gestational diabetes and prolonged second stage warrant investigation into clinical management. Although rates differ internationally, and replication evidence has confirmed consistency for certain demographic and obstetric factors, the development of internationally endorsed clinical guidelines and further research around interventions to protect the perineum are recommended.     

Race/ethnic differences in respiratory problems among a nationally-representative cohort of young children in the United States

Using data from a nationally-representative cohort of young children in the United States, we ask the following: (1) Are there race/ethnic and birth weight differentials in the likelihood of developing respiratory problems by age three in a nationally representative birth cohort? (2) To what extent does birth weight, vis-á-vis other key sociodemographic risk factors, mediate race/ethnic differentials in reported respiratory problems? (3) Does the effect of birth weight on respiratory problems risk differ by race? We find that non-Hispanic black children are 1.7 times as likely as non-Hispanic white children to be reported to have respiratory problems by age three, while the risk for Hispanic children is similar to that of non-Hispanic white children. Birth weight is also very strongly related to respiratory problem risk. Specifically, children born at very low weights (500–1499 g) have four times the odds of having respiratory problems of heavier children. Statistical controls for birth weight decrease the black-white differential by about 20%, while additional controls for sociodemographic factors reduce the race differential by an additional 35%. Finally, the net effect of birth weight is different for black and white children: whereas birth weight affects the risk of respiratory problems for black children only at low weights (<1500 g), it remains an important predictor of excess risk for white children up to 3500 g.

     

Risk factors associated with osteoporosis in Hispanic women

This study examined risk factors for osteoporosis in Hispanic women. Factors examined included ethnicity, gender, age, height, weight, family and personal history of fractures, height loss, exercise, diet, time since menopause or hysterectomy, hormone replacement therapy (HRT), calcium supplementation, hypertension, thyroid disease, diabetes, arthritis, chemotherapy, family history of breast cancer, use of water pills, fosamax, steroids, alcohol, and smoking. Most results found parallel those found in the Caucasian population. Heavier patients had greater bone density, as well as patients who exercised and those using HRT. Older patients had lower bone density as did diabetic patients. Results not anticipated were higher bone density in patients not taking calcium supplements, and in patients who consumed alcohol.     

HIV Risk Among Men Who Have Sex with Men Only (MSMO) and Men Who Have Sex with Men and Women (MSMW) in Baltimore

Men who have sex with men and women (MSMW) are at high risk for HIV. However, the majority of research on populations of men who have sex with men (MSM) combines MSMW and men who have sex with men only (MSMO) samples, which limits our understanding of HIV risk behaviors and factors associated with HIV risk among MSMW populations. We used the BESURE-MSM2, a venue-based cross-sectional study of HIV risk behaviors among MSM in Baltimore, MD, to examine HIV risk among MSMW. MSMW were less likely to report unprotected receptive anal intercourse than MSMO (6.8% vs. 19.6%, p = .0024). Among MSMW, 43.0% reported unprotected sex with a woman in the past year, but only 19.4% reported unprotected sex with both men and women, representing only 5.0% of the total MSM sample. In multivariate analyses, we found that among MSMW having unprotected sex with women in the past year, disclosing same sex behavior and having a main female partner were associated with unprotected anal intercourse with male partners. HIV prevention programs for MSMW are needed that address the complex partnerships of MSMW and the social contextual factors within which relationships and behaviors are embedded.     

A Preliminary Investigation of Risks for Adverse Outcomes of Relationship Seeking on Social Network Sites (SNS): A Descriptive Study of Women Over 50 Seeking Relationships on MySpace in Hillsborough County,Florida

In contrast to younger populations, little attention has been paid to the increase in seniors using Internet-based venues to find relationships and the potential risk for adverse outcomes this poses. This study examined data collected via an online survey from 45 ethnically diverse women aged 50+ “seeking relationships” on MySpace. The majority of women reported a relationship with someone they met online (85%). They also reported experiencing adverse events including financial exploitation (40%), threats (55%), and physical harm (38%) by someone they met online at levels greater than traditional relationship seeking in the general population. Directions for future research are explored.     

Adaptation and Dissonance in Quality of Life: A Case Study in Mekelle,Ethiopia

This study aimed to determine predictability of life satisfaction by focusing on social support, substance abuse, socio-demographic factors as well as received health services from medical and traditional centers in the elderly with dementia. The subjects were 1,210 non-institutionalized Malaysian elderly with cognitive problems. In addition, age, ethnicity, sex differences, marital status, educational level, social support, substance abuse and receiving health services were evaluated to predict the risk of falls in samples. Social support was measured by Lubben score. Substance abuse was referred to smoking per day, addiction to alcohol consumption as well as dependency to medications. Health care supports, which were received by individuals included medical and traditional treatments. Life satisfaction was measured by asking in general ‘Are you satisfied with your current life’. The multiple logistic regression analysis was used to determine the effects of contributing variables on life satisfaction in respondents. Approximately 83 % of subjects reported that they were satisfied with their current life. The results of multiple regression analysis showed that marital status (OR = 1.98), traditional treatments (OR = 0.43), social support (OR = 2.28) and educational level (OR = 1.79) significantly affected life satisfaction in samples (p < 0.05). Furthermore, age, ethnicity, sex differences, substance abuse and medical treatments were not significant predictors of life satisfaction (p > 0.05). It was concluded that social support, being married and education increased life satisfaction in subjects but traditional treatments decreased life satisfaction.     

The Effect of a Multicomponent Dual-Modality Exercise Program Targeting Osteoporosis on Bone Health Status and Physical Function Capacity of Postmenopausal Women

Purpose: Exercise is important for the prevention of osteoporosis and the reduction of fracture risk because it improves muscle mass and strength, besides improving balance. We evaluated the effect of a specific exercise program on bone mass and quality and physical function capacity in postmenopausal women with low bone mineral density. Methods: Participants (N = 125) underwent a bone mass (Dual X-ray Absorptiometry), bone quality (osteosonography), and physical functional capacity assessment. Fifty-eight of them took part in an 11-month exercise program (E), that included a multicomponent (strength, aerobic capacity, balance, joint mobility) dual-modality (on ground and in the water; alternating group and home-based exercise periods) exercise regimen. The others represented a control group (C) that did not exercise. After the exercise program all participants were reevaluated. Results: After the training program: femoral neck T-score significantly improved in E; C significantly decreased all bone quality (osteosonography) parameters, whereas E showed no differences; E significantly improved all the physical function capacity parameters, while most of them decreased or did not change in C. Conclusions: A specific exercise program targeting osteoporosis improves physical function capacity, reduces physiological bone loss, and maintains bone quality in low bone mineral density postmenopausal women.     

The prevalence and incidence of HIV among injection drug users: A five year panel study

Six hundred and one injection drug users (IDUs) who attended drug treatment programs in Miami, Florida, were enrolled in a panel study to determine the prevalence and incidence of human immunodeficiency virus (HIV) and associated risk factors. A structured questionnaire which elicited injection and sexual behaviors was administered and blood was obtained by venipduncture. All participants were reassessed at six month intervals for 5 years. The baseline prevalence of HIV was 16.3%. African–Americans had a prevalence of HIV (37.1%) that was significantly higher than that of non-Hispanic whites (7.6%); the prevalence of HIV among Hispanics was 27.2%. Persons who were more than thirty years of age were more likely to test HIV positive (17.8%) than were younger participants (9.7%). The annual incidence per 1000 person-years of exposure for the 503 initially seronegative participants was consistently low for each year of the study. The 5 year incidence was 4.1 per 1000 person years; 7.5 for men and 1.7 for women, 7.5 for African–Americans and 3.8 for non-Hispanic whites. No Hispanic participants seroconverted. Multivariate logistic techniques were used to identify the independent risk factors for HIV prevalence. Earlier injection, ethnicity, and income were independently associated with HIV serostatus. A history of a sexually transmitted disease was marginally associated with HIV prevalence. Low incidence probably is a function of the reduction of risk behavior that occurred over the course of the study and the stage of the epidemic.     

Reproductive mortality in Georgia: A lifestyle and environmental analysis

Frequencies and rates of maternal mortality in the United States have declined sharply since the turn of the century. During this decline, researchers have closely examined maternal mortality relative to various risk factors. However, maternal death as currently defined and coded on death certificates may not reveal the true extent of the problem of reproductive mortality. In Georgia, an analysis of death certificates of females ages 10 to 49 indicates that deaths due to pregnancy related conditions are not being discovered by traditional underlying cause-of-death maternal mortality classification. Frequencies and rates were calculated showing the difference between the traditional International Classification of Disease codes for maternal deaths (ICD 630–676) and the reproductive mortality definition used in this paper (which emphasizes the Health Field Concept classification of Lifestyle, Environment, Biology and Health Care Delivery System) (Lalonde, M., 1974 and Laframboise, H. L., 1973). The analysis suggests that a revised definition of maternal mortality be employed to take into consideration all risk factors related to reproductive mortality.     

Relationship between sarcopenia and fracture risks in obese postmenopausal women

It is known that obesity is inversely correlated with fracture risk. It remains unclear if a low muscle mass (sarcopenia) modulates the relationship between obesity and bone mass density. Twenty-seven obese women were matched for total fat mass (+/- 0.5 kg) and age (+/- 4 yrs) and divided in 3 equal groups: class II sarcopenic, class I sarcopenic, and nonsarcopenic. Body composition (DXA) and dietary intake were measured. Our results suggest that obesity may offer some protection against osteoporosis, even in sarcopenic postmenopausal women. However, further studies are needed to examine the actual implication of these results on a clinical standpoint.     

Osteoporosis and Older Women:

Osteoporosis, a metabolic bone disorder, affects four times as many women as men. Each year 1.3 million fractures, primarily of the vertebra, hip, and wrist can be attributed to osteoporosis. Risk factors for the development of this disease include age, sex, body build, family history, race, loss of estrogen, calcium deficiency, sedentary lifestyle, smoking, and the excessive use of alcohol. Three common approaches used in the treatment and prevention of osteoporosis are hormone replacement therapies, nutrition interventions. and exercise programs. These strategies are aimed at maintaining or stabilizing bone mass and preventing further loss. Living with osteoporosis presents older women with a variety of physical, psychological, and social challenges. To maintain a productive and healthy lifestyle, older women must recognize their physical limitations and make adjustments in their daily lives to cope successfully with these changes.     

Relationship Between Sarcopenia and Fracture Risks in Obese Postmenopausal Women

ABSTRACT

It is known that obesity is inversely correlated with fracture risk. It remains unclear if a low muscle mass (sarcopenia) modulates the relationship between obesity and bone mass density. Twenty-seven obese women were matched for total fat mass (± 0.5 kg) and age (± 4 yrs) and divided in 3 equal groups: class II sarcopenic, class I sarcopenic, and nonsarcopenic. Body composition (DXA) and dietary intake were measured. Our results suggest that obesity may offer some protection against osteoporosis, even in sarcopenic postmenopausal women. However, further studies are needed to examine the actual implication of these results on a clinical standpoint.