Page 19 - Today's Dietitian (February 2020)

Plant Compounds plant compounds in EVOO exert a stim- facilitates calcium absorption and thus
Frequent onion consumption appears ulatory effect on markers involved in bone mass and strength. In addition,
to be associated with increased bone osteoblast proliferation, differentiation, vitamin D affects muscle performance,
density. Three compounds isolated and maturation. balance, and risk of falling. However, it
from onions may be responsible: sulf- can be difficult, if not impossible, to get
oxide is believed to work by inhibiting Practice Pearls an adequate amount of vitamin D from
the production of osteoclasts. The other Traditionally, nutrition research has food. The RDA for older adults (both
two compounds, the flavonoids querce- focused on single nutrients in relation men and women) aged 51 to 70 is 600
tin and kaempferol, have been shown to health. This approach is limited IU, and it increases to 800 IU beyond
to cause apoptosis (programmed cell because it doesn’t account for diet age 70. According to Beth Dawson-
death) in mature osteoclasts. Other quality or nutrient synergy, or that Hughes, MD, a professor of medicine
research has demonstrated that these a single nutrient may be too small and director of the Bone Metabolism
three compounds stimulate osteoblasts to detect. Perhaps most important Laboratory at Tufts University, vitamin
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to increase bone deposition. is that isolating nutrients makes D is limited to “foods that people don’t
Bone resorption (when osteoclasts it difficult to translate results into tend to eat daily like fatty fish.” She
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break down bone tissue and release dietary recommendations. Recently, emphasizes that “a serving of most
minerals, resulting in a transfer of cal- researchers confirmed that adequate fortified cereals provides only 40 IU,
cium from bone to the blood) appears intake of nutrients from food—but not and a cup of milk has just 100 IU.”
to be affected by certain plant com- dietary supplements—is linked to a Mushrooms, especially if exposed to
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pounds. Common fruits, such as oranges reduction in poor health outcomes. sunlight, along with other fortified
and prunes; vegetables including toma- According to Fang Fang Zhang, MD, foods, such as dairy, are good sources
toes, green beans, cucumbers, broccoli, PhD, an associate professor of nutrition of vitamin D, but for some people, a
and lettuce; the herbs dill, sage, garlic, at Tufts University and corresponding dietary supplement may be needed.
parsley, thyme, and rosemary previ- author of the study, “While supplement Dawson-Hughes also recommends
ously have been classified to possess use contributes to an increased level protein, as it composes about one-half
bone resorption–inhibiting properties of nutrient intake, there are beneficial of bone. She says, “Consuming protein
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(BRIPs). In a 2015 study, healthy post- associations with nutrients from foods stimulates insulinlike growth factor-1, a
menopausal women were randomized that aren’t seen with supplements.” growth factor that builds both bone and
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to receive either a diet of at least nine Thus, RDs should continue to practice muscle.” The RDA for protein for adults
daily servings of vegetables, herbs, and food first. Diets rich in fruits and vegeta- older than 50 is 46 g for women and 56 g
fruit classified as containing BRIPs; nine bles contain both a plethora and expan- for men, but this is a minimum. Some
daily servings of ad lib vegetables; or sive variety of phytochemicals that have older adults may need more protein (1
their usual diet. The group consuming been shown to suppress the proinflam- to 1.2 g protein per kilogram of body
plant foods with the highest content of matory milieu and bone loss associated weight). With increased rates of over-
BRIPs showed a significant decrease in with aging. Data from the Framingham weight and obesity, many older adults
bone turnover markers compared with research suggest that subjects who con- also are dieting. Care should be taken to
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the other dietary groups. sumed the most fruits, vegetables, and avoid very low-calorie diets, as low BMD
cereal grains had the greatest BMD at all has been reported in obese women who
Dietary Patterns bone sites. consume fewer than 1,000 kcal per day.
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The incidence of osteoporosis and asso- It’s important to reinforce the USDA’s When working with older adults, RDs
ciated fractures is found to be lower in dietary guidelines aimed at five to 13 need to emphasize a plant-based diet
countries that predominantly follow the servings of fruits and vegetables daily. 3 with nutrient-dense foods high in bio-
Mediterranean diet. A key constituent Demonstrating to seniors what consti- available vitamins, minerals, phyto-
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of the Mediterranean diet, extra-virgin tutes a portion size of these plant foods chemicals, and antioxidants that help
olive oil (EVOO), contains more than 30 would be useful, especially since the to support bone health. RDs can seek
phenolic compounds with antioxidant Centers for Disease Control and Preven- opportunities to integrate these rec-
activities. Polyphenols in EVOO have tion reports that only 1 in 10 adults con- ommendations as part of a multidisci-
been shown to stimulate the prolifera- sumes enough. plinary team, serving seniors in both
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tion of osteoblasts. Recent research has Adequate calcium and vitamin primary care and geriatric settings.
explored the mechanisms of EVOO’s D intake remain a nutrition focus
phenolic compounds that underlie the for bone health. The Recommended KC Wright, MS, RDN, is a research dietitian
protective effects on bone by study- Dietary Allowance (RDA) for calcium at Dartmouth Hitchcock Medical Center in
ing the gene expression of osteoblast- is 1,000 mg for men and 1,200 mg for New Hampshire and focuses on sustainable
related markers. The findings indicate women aged 51 to 70; beyond the age nutrition at wildberrycommunications.com.
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that bone physiology may be modulated of 70, the RDA is 1,200 for both. For
by phenolic compounds in EVOO, sup- best absorption, calcium should be
porting previous observations on their consumed from food in amounts of For references, view this article on our
action on osteoblasts at different levels, 300 to 500 mg, as the body can’t absorb website at www.TodaysDietitian.com.
favoring bone tissue regeneration. The more than that at one time. Vitamin D
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