A few prunes a day may keep the doctor away.

Prunes for your bones

That is what the latest findings from Florida State University suggest when it comes to bone health and osteoporosis prevention.   Researchers discovered that postmenopausal women who consumed dried plums daily, as compared to a control group who ate dried apples daily showed an increase in bone density after one year.  These results may provide alternatives to drug therapy for the one in five American women over the age of fifty who are estimated to suffer from osteoporosis, which causes bone fractures.

One hundred postmenopausal women were randomly assigned to consume either 100g of prunes (dried plums) or 75g of dried apple daily since both portions offer about the same amount of calories, fat and fiber. Both groups of women were also given 500mg of calcium and 400IU of vitamin D daily.  The researchers then examined their diets, activity levels, height, weight, blood samples and bone mineral density (BMD) over a 12-month period. The BMD x-ray scan measured how much calcium and other types of minerals were present in their bones.  The lower density of a bone indicates a greater risk of fractures.

Results from the study showed that while both dried fruits had a protective effect on bone density, the prunes proved slightly better at increasing bone density, particularly in regions of the spine and forearm.  Researchers believe that the bone density increased among the prune-eaters because these women did not lose any bone mass as a result of re-absorption.  Reasons for this result are still unclear but vitamin C, vitamin K, phytochemicals and antioxidants, all of which are found in prunes, may aid in restoring bone tissue and slowing bone re-absorption.  Additionally, prunes contain high amounts of the mineral boron which has been showed to improve bone density by aiding in calcium absorption.

Osteoporosis is a bone disease in which the rate of bone re-absorption, or breakdown, is faster than the formation of new bone tissue. When we are young, the body uses calcium and phosphorous from our diet to form new bone.   If these minerals are lacking in the diet the body may access the mineral reserves found in the bone to meet it’s needs.  This causes the bones to become weak and porous which may result in bone fractures.   The rate of bone re-absorption increases significantly over the age of 50 due to the decline in estrogen in women and testosterone in men.

If you are now sold on the idea of adding prunes to your diet, increasing your bone density should not be the only reason to get started.  These dried fruits offer about 6 grams of fiber per serving, which helps to lower blood cholesterol, reduce the risk of diabetes and aid in weight loss.  Prunes are also a good source of energy yet do not create a rapid rise in blood sugars like processed sugars do according to research by Stacewicz-Sapuntzakis et al. (2001).  Prunes also contain large amounts of potassium and phenolic compounds, which may help prevent heart disease and cancer.

Larger studies are still needed to provide more information about how prunes offer such benefits to bone health and the researchers caution that the health benefits associated with prunes cannot be attributed to a single nutrient.  Instead, whole fruits and vegetables, when consumed regularly offer nutrition benefits which can not be quantified.  Therefore, increasing your consumption of fruits and vegetables in general may help in preventing osteoporosis and bone fractures.

Summary
Some postmenopausal women use alternative therapies to improve bone strength to eliminate unwanted consequences of drugs. Dried plum or prunes have proven to be the best solution to slow down bone loss. The present study is an effort to quantify this benefit by comparing the effects of dried plum versus dried apples in conjunction with calcium and vitamin D consumed for one year. Evaluation at the end of the study showed higher increase in bone mineral density with plums rather than apples, thus establishing that plums effectively retard bone loss in postmenopausal women.

No matter which osteoporosis drug your doctor chooses for you, it’s helpful to know as much as possible about how the disease has affected you. One way to tell is to ask about your “markers.”

When you’re being treated for osteoporosis, your doctor orders a blood or urine test. This reveals several markers — levels of different enzymes, proteins, and other substances circulating in the body — that provide clues about your disease and the progress of your treatment.

Some of these measures include:

* Bone-specific alkaline phosphatase (Bone ALP or BALP). This is an estimate of the rate of bone formation over your entire skeleton. Bone formation may sound like a good thing, but depending on the circumstances, too much can be bad. People with osteoporosis generally have BALP levels that are up to three times normal.
* Osteocalcin. This is another marker of bone formation.
* Urinary N-telopeptide of type I collagen, or uNTX. This is a marker of bone resorption, or loss of bone.
* Vitamin D levels. This measure assesses whether you have a deficiency of vitamin D, which is essential for your body’s absorption of calcium. You can be taking plenty of calcium, but if you don’t have enough vitamin D, it won’t be efficiently absorbed by your body.

Source: WebMD
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Prolia, generic Denosumab, is a new treatment for prevention of osteoporosis and bone related disease.  Prolia™ is the first and only FDA-approved RANK Ligand inhibitor. Prolia™ targets and binds to RANK Ligand, inhibiting osteoclast formation, function and survival.[1] Thus, Prolia™ can keep osteoclasts from resorbing bone. SOURCE: proliahcp.com

Studies have shown that Prolia works to improve bone mineral density and reduce different types of fractures.

This is an extremely important function in older women.  After menopause, low levels of estrogen result in bones becoming weaker.  30% of women after menopause will have osteoporosis, and 40% of those will have some sort of fragility fracture.

(more…)

How does the Osteoporosis Drug Forteo work?

Osteoporosis

Forteo contains the active portion of parathyroid hormone, a substance naturally produced by the body and involved in the maintenance of calcium and phosphorus levels. When given once a day, Forteo stimulates the growth of new bone by increasing the number and activity of bone-forming cells called osteoblasts. As a result, bone mass and bone strength increase.

How Well Does Forteo Work?

Clinical trials show that Forteo increases bone mineral density (BMD) and lowers the risk of fractures in postmenopausal women with osteoporosis. In a randomized trial of 1,637 postmenopausal women with prior vertebral fractures, published in The New England Journal of Medicine, women who took Forteo for a median of 19 months had a 65% lower risk of new vertebral fractures and a 53% lower risk of new nonvertebral fractures, compared with women who received a placebo. In addition, Forteo increased BMD by nine more percentage points in the spine and three more percentage points in the hip than did the placebo.

According to a study in the Journal of Bone and Mineral Research, Forteo is also effective in increasing BMD in men with osteoporosis. The effect of Forteo on fracture risk in men has not been studied.

SOURCE: johnshopkinshealthalerts.com

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There is a good slide show article about Osteoporosis

Osteoporosis and bone density

Click here to see the slide show article

New Osteoporosis Drug Coming?
2 Positive Studies Published on Experimental Drug Denosumab; FDA Panel Review
By Miranda Hitti
WebMD Health News
Reviewed by Louise Chang, MD

Aug. 11, 2009 — The experimental drug denosumab may be on its way to becoming the newest way to treat osteoporosis.

Denosumab, a biological drug given by injection every six months, looks safe and effective, researchers report in today’s advance online edition of the New England Journal of Medicine.

An FDA advisory panel will meet Aug. 13 to decide whether to recommend denosumab for FDA approval. The FDA often follows the advice of its advisory committees, but it doesn’t have to.
Denosumab Studies

Denosumab works differently than other osteoporosis drugs. It binds to a protein called RANKL, which cells called osteoclasts need to break down bone as part of the bone remodeling process.

The idea behind denosumab is to slow the bone-breakdown process in people whose bones are already dangerously thin.

WebMD first reported on denosumab in September 2008, when news about the drug’s potential to treat osteoporosis in postmenopausal women was presented at the annual meeting of the American Society for Bone and Mineral Research in Montreal.

Now, that trial’s results have been published, along with a separate study in men with prostate cancer taking bone-weakening hormone therapy to treat their cancer.

In both studies, patients got a shot of either denosumab or a placebo every six months for three years. And in both studies, fractures were rarer in patients taking denosumab.

In the postmenopausal osteoporosis study, which included 7,800 women 60-90 years old with osteoporosis, new vertebral fractures occurred in 2.3% of patients taking denosumab, compared with 7.2% of patients taking the placebo.

That’s a difference of 68%, notes researcher Steven Cummings, MD, director of the San Francisco Coordinating Center at the California Pacific Medical Center and a professor of medicine and epidemiology at the University of California at San Francisco.

“It’s more effective for reducing vertebral fractures than I expected … 68% is a very powerful reduction,” Cummings tells WebMD.

In the prostate cancer study, which included more than 1,400 men with prostate cancer on bone-weakening hormone therapy, new vertebral fractures occurred in 1.5% of patients taking denosumab, compared with 3.9% of patients who got the placebo.

“To see this very dramatic 62% decrease in vertebral fractures in three years in this relatively high-risk population of men is very impressive,” researcher Matthew Smith, MD, PhD, tells WebMD. Smith is the director of genitourinary medical oncology at Massachusetts General Hospital Cancer Center.

Denosumab’s Side Effects

Denosumab didn’t show an increased risk of infection or cancer — risks seen with other types of biologic drugs — in either trial.

Denosumab also wasn’t linked to osteonecrosis of the jaw (sometimes called “jawbone death”), which has been reported with other osteoporosis drugs called bisphosphonates.

But eczema and severe cases of a skin infection called cellulitis were more common in women taking denosumab in Cummings’ study. The reason for that isn’t clear.

Denosumab’s safety profile “appeared excellent” in the prostate cancer study, Smith says, adding that the study was the first large study of fracture prevention in men.

“Previously, there had been no large studies to address that problem in men with prostate cancer, and frankly, not in men in any setting,” Smith says.

Both denosumab studies were sponsored by the drug’s maker, Amgen. Smith and Cummings disclose working as consultants for Amgen, and several researchers on both studies are Amgen employees.
Other Opinions

Denosumab “seems at least as efficacious as the currently approved alternatives,” states an editorial published with the studies.

But editorialist Sundeep Khosla, MD, of the Mayo Clinic’s medical school in Rochester, Minn., notes that there haven’t been any head-to-head trials comparing denosumab to other osteoporosis drugs for fracture prevention, that the drug’s longer-term safety isn’t known yet, and that cost could be an issue if denosumab is pricey. Khosla notes no conflicts of interest.

Cummings says there are plans to follow the patients in his study for at least 10 years. He also hopes that patients will be more compliant about taking denosumab than other osteoporosis drugs.

“It’s as effective as any other treatment and can be given twice a year as a simple injection, like a flu shot” and can be given by a nurse or primary care doctor, Cummings says.

Susan Bukata, MD, an osteoporosis specialist and associate professor of orthopaedics at New York’s University of Rochester Medical Center, says denosumab would be “another option” for people who can’t or won’t take other osteoporosis drugs, such as people with kidney failure or gastrointestinal issues.

“There’s definitely a place for this drug,” Bukata says. “I think still, the gold standard is we start on the pills, we start on the generics. But this is certainly a good second-line choice and for some patients … this may be my first-line choice.”

Bukata wasn’t involved in the denosumab trials. She discloses that she expects to soon work on a clinical trial of another Amgen drug.

Source: webmd.com

Click here to read the Web MD Article

Osteoporosis means “porous bone.” If you looked at healthy bone under a microscope, you would see that parts of it look like a honeycomb. If you have osteoporosis, the holes and spaces in the honeycomb are much bigger than they are in healthy bone. This means your bones have lost density, or mass. It also means that the structure of your bone tissues has become abnormal. As your bones become less dense, they become weaker.
From the National Osteoporosis Foundation
For some people affected by the disease, simple activities such as lifting a child, bending down to pick up a newspaper or even sneezing can cause a bone to break. Because osteoporosis is a disease of the bones, it is important to know some basics about your bones. Your bones are made up of three major components that make them both
flexible and strong:

1. Collagen, a protein that gives bones a flexible framework
2. Calcium-phosphate mineral complexes that make bones hard and strong
3. Living bone cells that remove and replace weakened sections of bone

See pictures on what normal bone looks like and what osteoporotic bone looks like

See Pictures and more info