Should women take calcium and
vitamin D supplements after menopause for bone health?
Recommendations conflict, and
opinions are strong.
But now, an analysis from the major
Women's Health Initiative (WHI) trial throws weight on the supplement side --
at least for women taking hormones after menopause.
Among the nearly 30,000
postmenopausal women in the hormone trial, some 8,000 took supplemental calcium
(1,000 mg/day) and vitamin D (400 mg/day), and some 8,000 took look-alike
placebos. These women came from all the hormone groups in the study -- those
who took estrogen plus a progestogen (required for women with a uterus), those
who took estrogen alone, and those who took the hormone look-alike placebos.
The researchers looked at how the
rates of hip fracture differed among women who took hormones and supplements,
those who took hormones alone, and those who took neither.
The supplements and hormones had a synergistic effect.
Women using both therapies had much
greater protection against hip fractures than with either therapy alone. Taking
supplements alone wasn't significantly better than taking no supplements and no
hormones. The benefit of hormone therapy was strong in women who had a total
calcium intake (supplements plus diet) greater than 1,200 mg/day.
Similarly, the benefit was strong
in women who had higher intakes of vitamin D, but the individual effect of each
one could not be determined because the two supplements were given together.
The effects translated into 11 hip
fractures per 10,000 women per year among the women who took both hormones and
supplements compared with 18 per 10,000 women per year among those who took
hormones only, 25 per 10,000 women per year among those who took supplements
alone, and 22 among those who got neither therapy.
These results suggest, said the authors, that women taking
postmenopausal hormone therapy should also take supplemental calcium and
Although they couldn't specify how
much, they noted that the benefits seem to increase with increasing total
intake of calcium and vitamin D. The dose will depend on keeping side effects,
such as constipation from too much calcium, to a minimum, they said.
That differs from the
recommendation of the US Preventive Services Task Force (USPSTF), made earlier
this year. USPSTF stated there was no basis for recommending calcium and
vitamin D supplements to prevent fractures. But now, with a study this large,
there may well be.
The analysis was published ahead of print edition of Menopause:
Robbins JA, Aragaki A, Crandall CJ, Manson JE, Carbone L, Jackson
R, Lewis CE, Johnson KC, Sarto G, Stefanick ML, Wactawski-Wende J. Women's
Health Initiative clinical trials: interaction of calcium and vitamin D with
hormone therapy. Menopause, 2013; DOI: 10.1097/GME.0b013e3182963901
can prevent and delay Alzheimer’s Disease. But it has been unclear how this
a team of researchers from The University of Nottingham has identified a stress
hormone, corticotrophin-releasing factor
or CRF, produced during moderate exercise that may slow down the
progression of memory loss in people with Alzheimer's disease.
work, funded by Research into Ageing (Age UK) and the University and published
in the Journal of Alzheimer's Disease, may also explain why people who are
susceptible to stress are at more risk of developing the disease.
effect of CRF
The Nottingham team, led by Dr
Marie-Christine Pardon in the School of Biomedical Sciences, has discovered
that the stress hormone CRF -- may have a protective effect on the brain from
the memory changes brought on by Alzheimer's disease.
CRF is most associated with producing
stress and is found in high levels in people experiencing some forms of anxiety
and depressive diseases. Normal levels of CRF, however, are beneficial to the
brain, keeping the mental faculties sharp and aiding the survival of nerve
cells. Unsurprisingly then, studies have shown that people with Alzheimer's
disease have a reduced level of CRF.
The researchers used an experimental
drug to prevent the hormone from binding to a brain receptor called CRFR1 in
mice with Alzheimer's disease that were free from memory impairments, therefore
blocking the effects of the hormone. They discovered that the mice had an
abnormal stress response with reduced anxiety but increased behavioural
inhibition when confronted by a stressful situation -- in this case being
placed in a new environment -- and this is was due to the abnormal functioning
of the CRFR1. This abnormal stress response before the onset of symptoms may
explain why people susceptible to stress are more at risk of developing
enhancing effect of CRF
Dr Pardon and her team also found that
interrupting the hormone from binding on to the CRFR1 receptor blocked the
improvement of memory normally promoted by exercise. However, in mice with
Alzheimer's a repeated regime of moderate exercise restored the normal function
of the CRF system allowing its memory enhancing effects. The results are in
line with the idea that regular exercise is a means of improving one's ability
to deal with everyday stress in addition to keeping mental abilities keen.
Finally, their study showed that the
switching on of this particular brain receptor during exercise increased the
density of synapses, which makes the connection between nerve cells, the loss
of which is thought to be responsible for the early memory loss seen in
Dr Pardon said: "This is the first
time that researchers have been able to identify a brain process directly
responsible for the beneficial effects of exercise in slowing down the
progression of the early memory decline characteristics of Alzheimer's disease.
"Overall, this research provides further
evidence that a healthy lifestyle involving exercise slows down the risk of
Alzheimer's disease and opens avenues for the new interventions targeting
the altered CRFR1 function associated with the early stages of the
incontinence affects approximately 35% of the female population. The main cause
in women is pregnancy, with the number of children they have increasing their
chances of becoming incontinent.
research from the University of Adelaide shows middle-aged women are more
likely to suffer depression from this common medical problem that they find too
embarrassing to talk about.
a study of the experiences of women with urinary incontinence, researcher Jodie
Avery found that middle-aged women with incontinence (aged 43-65) were more
likely to be depressed than older women (aged 65-89).
in the lead up to World Continence Week (24-30 June), Ms Avery says the younger
women's self-esteem is often hit hard by urinary incontinence, while older
women tend to be more resilient and accepting of their condition.
issues for younger women affected by incontinence are family, sexual
relationships and sport and leisure activities.
most common difficulties women express about their incontinence are things
like: 'I can't play netball', 'I can't go to the gym', 'I can't go for walks',
or 'I can't go dancing', and these are real issues for women who are still in
the prime of their lives."
studies show that 20% of the incontinent population has depression, and this is
something that we need both sufferers and GPs to better understand," Ms
we hope that our research helps to raise awareness in the community about both
the mental and physical issues associated with incontinence. We know it's
embarrassing, but if you discuss it with your GP, your life really can
is banned in products such as baby bottles and sippy cups, but the chemical
continues to be used in many other consumer products. The most prominent
continuing use of BPA is in the lining of aluminum and tin cans, where it
new study links foetal exposure to a common chemical pollutant, bisphenol A(BPA), to defects of a testicular hormone in new-borns with undescended testicles.
the medical name for undescended testicles, occurs in 2 to 5 percent of
full-term male newborns, according to the authors.
the testicles descend on their own within six months after birth otherwise surgery
is required to bring the testes out of the abdominal cavity. Untreated, it
carries an increased risk in adulthood of decreased fertility and testicular
findings do not draw a direct link between BPA and cryptorchidism, as the
newborns with undescended testicles did not have greatly increased levels of
BPA compared with newborns without the birth defect.
found, however, that the BPA level in newborns' cord blood inversely correlated
with the level of INSL3. That is, the higher the BPA level, the lower the level
of the important testicular hormone.
our study cannot be considered as definitive evidence for an environmental
cause of undescended testis," said lead author Patrick Fenichel, MD, PhD,
professor and head of reproductive endocrinology at the University Hospital of
Nice in France. "But it suggests, for the first time in humans, a link
that could contribute to one co-factor of idiopathic [unexplained] undescended
testis, the most frequent congenital malformation in male newborns."
is needed to study exposure to BPA during pregnancy.
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