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1.   Calcium and Vitamin D May Not Be the Only Protection Against Bone Loss

2.   Pediatric Obesity May Alter Thyroid Function and Structure

3.   New Hormone Foundation Bilingual Patient Fact Sheet on Type 2 Diabetes Screening

1. Calcium and Vitamin D May Not Be the Only Protection Against Bone Loss

New study finds diet rich in fruits and vegetables may strengthen bones in healthy older adults.

Diets that are high in protein and cereal grains produce an excess of acid in the body which may increase calcium excretion and weaken bones, according to a new study accepted for publication in The Endocrine Society's Journal of Clinical Endocrinology & Metabolism (JCEM). The study found that increasing the alkali content of the diet, with a pill or through a diet rich in fruits and vegetables has the opposite effect and strengthens skeletal health.

"Heredity, diet, and other lifestyle factors contribute to the problem of bone loss and fractures," said Bess Dawson-Hughes, M.D., of Tufts University in Boston, Mass. and lead author of the study. "When it comes to dietary concerns regarding bone health, calcium and vitamin D have received the most attention, but there is increasing evidence that the acid/base balance of the diet is also important."

Average older adults consume diets that, when metabolized, add acid to the body, said Dr. Dawson-Hughes. With aging, we become less able to excrete the acid. One way the body may counteract the acid from our diets is through bone resorption, a process by which bones are broken down to release minerals such as calcium, phosphates, and alkaline (basic) salts into the blood. Unfortunately, increased bone resorption leads to declines in bone mass and increases in fracture risk.

"When fruits and vegetables are metabolized they add bicarbonate, an alkaline compound, to the body," said Dr. Dawson Hughes. "Our study found that bicarbonate had a favorable effect on bone resorption and calcium excretion. This suggests that increasing the alkali content of the diet may attenuate bone loss in healthy older adults."

In this study, 171 men and women aged 50 and older were randomized to receive placebo or doses of either: potassium bicarbonate, sodium bicarbonate, or potassium chloride for three months. Researchers found that subjects taking bicarbonate had significant reductions in calcium excretion, signaling a decrease in bone resorption.

"In this study, we demonstrated that adding alkali in pill form reduced bone resorption and reduced the losses of calcium in the urine over a three month period," said Dr. Dawson-Hughes. "This intervention warrants further investigation as a safe and well tolerated supplement to reduce bone loss and fracture risk in older men and women."

Other researchers working on the study include Susan Harris, Nancy Palermo, Helen Rasmussen, and Gerard Dallal of Tufts University in Boston, Mass., and Carmen Castaneda-Sceppa of Northeastern University in Boston, Mass.

The article "Treatment with Potassium Bicarbonate Lowers Calcium Excretion and Bone Resorption in Older Men and Women," will appear in the January issue of JCEM.

2. Pediatric Obesity May Alter Thyroid Function and Structure

In addition to its strong associations with hypertension, cardiovascular disease, and diabetes, pediatric obesity may induce alterations in thyroid function and structure, according to a new study accepted for publication in The Endocrine Society's Journal of Clinical Endocrinology & Metabolism (JCEM).

Thyroid hormones drive metabolism, however demonstration of a direct or strong correlation of obesity with deficient thyroid function has been controversial, and previous studies provide conflicting conclusions. While some studies have found that thyroid disorders may lead to obesity, this recent study shows that in some cases, it is the obesity that may cause the disorder.

"Our study shows that alterations in thyroid function and structure are common in obese children and we may have uncovered the link," said Giorgio Radetti, M.D., of the Regional Hospital of Bolzano in Italy and lead author of the study. "We found an association between body mass index and thyroid hormone levels which suggests that fat excess may have a role in thyroid tissue modification."

This study evaluated 186 overweight and obese children over a period of nearly three years. Researchers measured subjects' thyroid hormone levels and thyroid antibodies and also performed a thyroid ultrasound.

The presence of thyroid antibodies would suggest a diagnosis of Hashimoto's thyroiditis, an autoimmune disease of the thyroid where T-cells attack the cells of the thyroid. In this study, 73 children did not show these antibodies, yet their ultrasound pattern was still suggestive of Hashimoto's thyroiditis.

"The ultrasound findings are a bit mysterious," said Dr. Radetti. "However, the findings do suggest the existence of a low-grade inflammation state, which has been known to characterize obesity."

Thyroid function has been shown to return to normal after weight loss, said Dr Radetti, raising the question of the potential reversibility of thyroid abnormalities shown on an ultrasound. However, researchers still do not know whether the persistence of thyroid abnormalities in obese children may also progress into chronic thyroid disease in early adulthood. Dr. Radetti says more studies are needed to answer these questions.

Other researchers working on the study include Wolfgang Kleon, Lucia Pappalardo, and Claudio Crivellaro of the Regional Hospital of Bolzano in Italy, Fabio Buzi of the University of Brescia in Italy, and Natascia di Iorgi and Mohamad Maghnie of the University of Genova in Italy.

The article "Thyroid Function and Structure are Affected in Childhood Obesity," will appear in the December issue of JCEM.

3. New Hormone Foundation Bilingual Patient Fact Sheet on Type 2 Diabetes Screening

The Hormone Foundation has published a bilingual (English/Spanish) fact sheet on Type 2 Diabetes Screening. This fact sheet explains what type 2 diabetes and prediabetes are, why screening for diabetes is important, who is at risk, and how to get screened.  It also provides information about what to do if your screening shows you do have type 2 diabetes or prediabetes.  To download free copies and other useful health resources for patients, visit the Foundation's Web site (www.hormone.org).

 

 

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Founded in 1916, The Endocrine Society is the world's oldest, largest, and most active organization devoted to research on hormones and the clinical practice of endocrinology. Today, The Endocrine Society's membership consists of over 14,000 scientists, physicians, educators, nurses and students in more than 80 countries. Together, these members represent all basic, applied, and clinical interests in endocrinology. The Endocrine Society is based in Chevy Chase, Md. To learn more about the Society, and the field of endocrinology, visit our web site at www.endo-society.org.