The National Osteoporosis Foundation's position statement on peak bone mass development and lifestyle factors: a systematic review and implementation recommendations.

Lifestyle choices influence 20-40 % of adult peak bone mass. Therefore, optimization of lifestyle factors known to influence peak bone mass and strength is an important strategy aimed at reducing risk of osteoporosis or low bone mass later in life. The National Osteoporosis Foundation has issued this scientific statement to provide evidence-based guidance and a national implementation strategy for the purpose of helping individuals achieve maximal peak bone mass early in life. In this scientific statement, we (1) report the results of an evidence-based review of the literature since 2000 on factors that influence achieving the full genetic potential for skeletal mass; (2) recommend lifestyle choices that promote maximal bone health throughout the lifespan; (3) outline a research agenda to address current gaps; and (4) identify implementation strategies. We conducted a systematic review of the role of individual nutrients, food patterns, special issues, contraceptives, and physical activity on bone mass and strength development in youth. An evidence grading system was applied to describe the strength of available evidence on these individual modifiable lifestyle factors that may (or may not) influence the development of peak bone mass (Table 1). A summary of the grades for each of these factors is given below. We describe the underpinning biology of these relationships as well as other factors for which a systematic review approach was not possible. Articles published since 2000, all of which followed the report by Heaney et al. [1] published in that year, were considered for this scientific statement. This current review is a systematic update of the previous review conducted by the National Osteoporosis Foundation [1]. [Table: see text] Considering the evidence-based literature review, we recommend lifestyle choices that promote maximal bone health from childhood through young to late adolescence and outline a research agenda to address current gaps in knowledge. The best evidence (grade A) is available for positive effects of calcium intake and physical activity, especially during the late childhood and peripubertal years-a critical period for bone accretion. Good evidence is also available for a role of vitamin D and dairy consumption and a detriment of DMPA injections. However, more rigorous trial data on many other lifestyle choices are needed and this need is outlined in our research agenda. Implementation strategies for lifestyle modifications to promote development of peak bone mass and strength within one's genetic potential require a multisectored (i.e., family, schools, healthcare systems) approach.

Calcium plus vitamin D supplementation and risk of fractures: an updated meta-analysis from the National Osteoporosis Foundation.

UNLABELLED: The aim was to meta-analyze randomized controlled trials of calcium plus vitamin D supplementation and fracture prevention. Meta-analysis showed a significant 15 % reduced risk of total fractures (summary relative risk estimate [SRRE], 0.85; 95 % confidence interval [CI], 0.73-0.98) and a 30 % reduced risk of hip fractures (SRRE, 0.70; 95 % CI, 0.56-0.87). INTRODUCTION: Calcium plus vitamin D supplementation has been widely recommended to prevent osteoporosis and subsequent fractures; however, considerable controversy exists regarding the association of such supplementation and fracture risk. The aim was to conduct a meta-analysis of randomized controlled trials [RCTs] of calcium plus vitamin D supplementation and fracture prevention in adults. METHODS: A PubMed literature search was conducted for the period from July 1, 2011 through July 31, 2015. RCTs reporting the effect of calcium plus vitamin D supplementation on fracture incidence were selected from English-language studies. Qualitative and quantitative information was extracted; random-effects meta-analyses were conducted to generate summary relative risk estimates (SRREs) for total and hip fractures. Statistical heterogeneity was assessed using Cochran's Q test and the I (2) statistic, and potential for publication bias was assessed. RESULTS: Of the citations retrieved, eight studies including 30,970 participants met criteria for inclusion in the primary analysis, reporting 195 hip fractures and 2231 total fractures. Meta-analysis of all studies showed that calcium plus vitamin D supplementation produced a statistically significant 15 % reduced risk of total fractures (SRRE, 0.85; 95 % confidence interval [CI], 0.73-0.98) and a 30 % reduced risk of hip fractures (SRRE, 0.70; 95 % CI, 0.56-0.87). Numerous sensitivity and subgroup analyses produced similar summary associations. A limitation is that this study utilized data from subgroup analysis of the Women's Health Initiative. CONCLUSIONS: This meta-analysis of RCTs supports the use of calcium plus vitamin D supplements as an intervention for fracture risk reduction in both community-dwelling and institutionalized middle-aged to older adults.

Determination of color, pigment, and phenolic stability in yogurt systems colored with nonacylated anthocyanins from Berberis boliviana L. as compared to other natural/synthetic colorants.

Anthocyanins are of interest to the food industry because of their antioxidant power, attractive color, and stability in high acid foods. Powder from the Peruvian berry Berberis boliviana Lechler, rich in nonacylated anthocyanins (7% to 8% dry weight), was incorporated into yogurt samples containing 3 different fat levels. Color (CIE L, a, b, chroma, and hue angle), pigment (monomeric anthocyanin and polymeric color), and total phenolics were monitored over 8 wk of storage and compared to yogurt treatments containing purple carrot acylated anthocyanins, red beet betalaines, or FD&C Red nr 40. Anthocyanin profiles were analyzed by HPLC coupled to photodiode array and mass detectors. Color of yogurt containing B. boliviana anthocyanins at 20 mg cyanidin-3-glucoside (cy-3-glu) equivalents/100 g yogurt (L*= 65, chroma = 14, and hue angle = 335 degrees ) was similar to commercial blueberry yogurt (L*= 65, chroma = 10.5, and hue angle = 341 degrees ). High color, pigment, and phenolic stability were observed in yogurts colored with B. boliviana, independent of the fat matrix. Acylated anthocyanins from purple carrot extracts exhibited increased stability with higher fat content. Anthocyanin degradation followed 1st-order kinetics. Pigment half-lives were 125 and 104 d for nonacylated anthocyanins at 10 and 20 mg cy-3-glu equivalents/100 g yogurt and 550.2, 232.6, and 128.9 d for acylated anthocyanins at 20 mg of cy-3-glu equivalents/100 g of 4%, 2%, and 0% fat yogurt. Addition of B. boliviana whole berry powder to yogurt matrices produced an attractive, stable anthocyanin-rich product, eliminating the need for industrial colorant extraction.

Rupture characteristics of the deep bolivian earthquake of 9 june 1994 and the mechanism of deep-focus earthquakes.

The M(w) = 8.3 deep (636 kilometers) Bolivian earthquake of 9 June 1994 was the largest deep-focus earthquake ever recorded. Seismic data from permanent stations plus portable instruments in South America show that rupture occurred on a horizontal plane and extended at least 30 by 50 kilometers. Rupture proceeded at 1 to 3 kilometers per second along the down-dip azimuth of the slab and penetrated through more than a third of the slab thickness. This extent is more than three times that expected for a metastable wedge of olivine at the core of the slab, and thus appears to be incompatible with an origin by transformational faulting. These large events may instead represent slip on preserved zones of weakness established in oceanic lithosphere at the Earth's surface.

Amperometric assay of coenzyme-dependent oxidoreductase enzymes in a flow-through cell.

We have demonstrated that a simple electrochemical cell can serve as a detector of NADH concentration in a flow system thereby providing an assay technique for NADH dependent enzymes. When this is applied to NADH produced by enzymatic reaction, then a reproducible measure of enzyme activity is obtained. This method of enzyme activity assay is applicable to a number of oxidoreductase enzymes which employ NAD+ or NADP+ as coenzymes to achieve substrate modification. The presence of electroactive species in samples of human serum has proved a serious problem in the electrochemical analysis of serum activity. These species produce a large background anode current at the anode voltage appropriate for NADH oxidation. The presence of this high current limits the usefulness of amplification of the current output to detect small changes in NADH concentration.