Sodium and Bone Health: Impact of Moderately High and Low Salt Intakes on Calcium Metabolism in Postmenopausal Women

Teucher, Birgit; Dainty, J.; Spinks, Caroline A; Majsak‐Newman, Gosia; Berry, David J.; Hoogewerff, Jurian; Foxall, Robert J.; Jakobsen, Jette; Cashman, Kevin D.; Flynn, Albert; Fairweather‐Tait, Susan J.

doi:10.1359/jbmr.080408

Cited by 126 publications

(95 citation statements)

References 32 publications

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“…Vitamin D is a direct regulator of the metabolism of calcium and, partly, phosphate with feedback relationships encompassing bone, intestine and kidney (36). On the other hand, excessive sodium intake represents a recognised risk factor for development of osteoporosis (often associated with vitamin D deficiency) due to interference with the renal excretion of calcium (37). Psychotropic medications by themselves could cause sodium disturbances, primarily hyponatremia (16,17,40).…”

Section: Discussionmentioning

confidence: 99%

Vitamin D Deficiency and Associated Factors in Patients with Mental Disorders Treated in Routine Practice

Ristic

Živanović

Milovanovic

et al. 2017

J Nutr Sci Vitaminol

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SummaryThis research aimed to investigate factors associated with vitamin D deficiency and to provide data about its prevalence in patients suffering from different psychiatric illnesses. The study had a cross-sectional design and it included 220 patients of both genders, aged from 19-81 y, with a wide range of mental disorders (F00-F89), and treated in routine ambulatory and hospital practice. The researchers collected data from three sources: medical records, a study questionnaire and biochemical analysis of patients' serum samples (concentration of vitamin D measured as 25(OH)D, calcium, phosphorus, magnesium, sodium and potassium). Data were analyzed using descriptive statistics, methods for hypothesis testing and binary logistic regression, at the p#0.05 level. A total of 140 patients (64%) had a deficiency of vitamin D (,12 ng/mL), and 45 (20%) had inadequate vitamin D serum levels (12-20 ng/mL), while 35 (16%) had sufficient vitamin D serum concentrations (.20 ng/mL). Among variables related to demographics, life style habits, mental illness, comorbid disorders and drugs, two of them, female gender (odds ratio (OR)52.5, 95% confidence interval (CI)51.3-4.9, p50.006) and using clozapine (OR515.6, 95% CI 1.7-144.7, p50.02), were significantly associated with vitamin D deficiency. Physical activity (OR5 0.4, p50.02), exercising (OR50.2, 95% CI , p50.02) and offal in the diet (OR50.5, 95% CI 0.3-0.9, p50.03) significantly aggregated in the patients who had a 25(OH)D serum concentration above the deficiency cut-off level. Patients with mental disorders are at high risk for vitamin D deficiency, particularly females and clozapine users as well as those having no adequate physical activity or dietary habits.

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Section: Discussionmentioning

confidence: 99%

Vitamin D Deficiency and Associated Factors in Patients with Mental Disorders Treated in Routine Practice

Ristic

Živanović

Milovanovic

et al. 2017

J Nutr Sci Vitaminol

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“…One of the noncontrolled Paleolithic diet-intervention studies also showed a decrease from baseline in calcium excretion after 10 d consumption of the Paleolithic diet (22). The low-salt, high-protein, and alkalizing properties of Paleo nutrition may substantially contribute to a healthy calcium balance (42)(43)(44).…”

Section: Safety Concernsmentioning

confidence: 98%

Paleolithic nutrition for metabolic syndrome: systematic review and meta-analysis

Manheimer

Zuuren²,

Fedorowicz

et al. 2015

The American Journal of Clinical Nutrition

158

103

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Background: Paleolithic nutrition, which has attracted substantial public attention lately because of its putative health benefits, differs radically from dietary patterns currently recommended in guidelines, particularly in terms of its recommendation to exclude grains, dairy, and nutritional products of industry. Objective: We evaluated whether a Paleolithic nutritional pattern improves risk factors for chronic disease more than do other dietary interventions. Design: We conducted a systematic review of randomized controlled trials (RCTs) that compared the Paleolithic nutritional pattern with any other dietary pattern in participants with one or more of the 5 components of metabolic syndrome. Two reviewers independently extracted study data and assessed risk of bias. Outcome data were extracted from the first measurement time point (#6 mo). A random-effects model was used to estimate the average intervention effect. The quality of the evidence was rated with the use of the Grading of Recommendations Assessment, Development and Evaluation approach. Results: Four RCTs that involved 159 participants were included. The 4 control diets were based on distinct national nutrition guidelines but were broadly similar. Paleolithic nutrition resulted in greater short-term improvements than did the control diets (random-effects model) for waist circumference (mean difference: 22.38 cm; 95% CI: 24.73, 20.04 cm), triglycerides (20.40 mmol/L; 95% CI: 20.76, 20.04 mmol/L), systolic blood pressure (23.64 mm Hg; 95% CI: 27.36, 0.08 mm Hg), diastolic blood pressure (22.48 mm Hg; 95% CI: 24.98, 0.02 mm Hg), HDL cholesterol (0.12 mmol/L; 95% CI: 20.03, 0.28 mmol/L), and fasting blood sugar (20.16 mmol/L; 95% CI: 20.44, 0.11 mmol/L). The quality of the evidence for each of the 5 metabolic components was moderate. The home-delivery (n = 1) and dietary recommendation (n = 3) RCTs showed similar effects with the exception of greater improvements in triglycerides relative to the control with the home delivery. None of the RCTs evaluated an improvement in quality of life. Conclusions: The Paleolithic diet resulted in greater short-term improvements in metabolic syndrome components than did guidelinebased control diets. The available data warrant additional evaluations of the health benefits of Paleolithic nutrition. This systematic review was registered at PROSPERO (www.crd.york.ac.uk/PROSPERO) as CRD42014015119.Am J Clin Nutr 2015;102:922-32.

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“…37 In both rats and man, marked Na + loading alone (for example, a 8% NaCl diet) is accompanied by hypercalciuria, SHPT with bone loss and a proinflammatory vascular phenotype. [42][43][44][45][46][47][48][49][50] The likely mechanism is thought to be related to an expansion of the extravascular space, resulting in decreased proximal tubular resorption and thereby increased distal delivery of Na + , Ca 2+ and Mg 2+ , with the mineralocorticoid promoting distal tubular Na + resorption without retarding Ca 2+ or Mg 2+ excretion. [32][33][34][35][36] This may be further accentuated by nitric oxide-mediated increments in medullary blood flow.…”

Section: Sodium: the Facilitator In Aldosteronismmentioning

confidence: 99%

From aldosteronism to oxidative stress: the role of excessive intracellular calcium accumulation

et al. 2010

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Inappropriately (relative to dietary Na + ) elevated plasma aldosterone concentrations (PAC), or aldosteronism, have been incriminated in both the appearance of the cardiometabolic syndrome (CMS) and its progressive nature. The deleterious dual consequences of elevated PAC and dietary Na + have been linked to several components of the CMS, including salt-sensitive hypertension. Moreover, their adverse consequences are considered to be synergistic, culminating in a pro-oxidant phenotype with oxidative injury involving the heart and systemic tissues, including peripheral blood mononuclear cells (PBMC). Our experimental studies in rats receiving aldosterone/salt treatment have identified a common pathogenic event that links aldosteronism to the induction of oxidative stress. Herein, we review these findings and the important role of excessive intracellular Ca 2+ accumulation (EICA), or intracellular Ca 2+ overloading, which occurs in the heart and PBMC, leading to, respectively, cardiomyocyte necrosis with a replacement fibrosis and an immunostimulatory state with consequent coronary vasculopathy. The origin of EICA is based on elevations in plasma parathyroid hormone, which are integral to the genesis of secondary hyperparathyroidism that accompanies aldosteronism and occurs in response to plasma-ionized hypocalcemia and hypomagnesemia whose appearance is the consequence of marked urinary and fecal excretory losses of Ca 2+ and Mg 2+ . In addition, we found intracellular Ca 2+ overloading to be intrinsically coupled to a dyshomeostasis of intracellular Zn 2+ , which together regulate the redox state of cardiac myocytes and mitochondria via the induction of oxidative stress and generation of antioxidant defenses, respectively. To validate our hypothesis, a series of site-directed, sequential pharmacological and/or nutriceutical interventions targeted along cellular-molecular cascades were carried out to either block downstream events leading to the pro-oxidant phenotype or to enhance antioxidant defenses. In each case, the interventions were found to be cardioprotective. These cumulative salutary responses raise the prospect that pharmacological agents and nutriceuticals capable of influencing extra-and intracellular Ca 2+ and Zn 2+ equilibrium could prevent adverse cardiac remodeling and thereby enhance the management of aldosteronism.

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Sodium and Bone Health: Impact of Moderately High and Low Salt Intakes on Calcium Metabolism in Postmenopausal Women

Cited by 126 publications

References 32 publications

Vitamin D Deficiency and Associated Factors in Patients with Mental Disorders Treated in Routine Practice

Vitamin D Deficiency and Associated Factors in Patients with Mental Disorders Treated in Routine Practice

Paleolithic nutrition for metabolic syndrome: systematic review and meta-analysis

From aldosteronism to oxidative stress: the role of excessive intracellular calcium accumulation

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