[Bone and Nutrition. Nutritional management of osteoporosis].

Calcium intake was negatively associated with bone resorption marker such as DPD, NTX, and P1NP in Japanese postmenopausal osteoporotic patients. Not only to suppress bone resorption but also to keep higher hip bone mineral density were observed in the patients with higher intake of calcium than 800mg/day and higher vitamin D condition (more than 50nmol/L of serum 25 (OH) D). Higher calcium intake than 800mg/day from dairy and Tofu products, higher intake of vitamin D than 10μg/day from fish, and higher intake of vitamin K from vegetables should be recommended in Japanese postmenopausal osteoporotic patients.

[Nutrition in bone growth and development].

The greatest increase in bone density was observed around ages 10-14 years in girls and thereafter peak bone mass was attained. Maximizing peak bone mass during adolescence is one of the most important strategies to decrease osteoporotic fractures later in life. Initial bone mass adjusted by height and weight in 10-year-old girl was associated positively with intakes of dairy products and small fish.

[Diet for lifestyle-related diseases to maintain bone health].

Dieting methods for preventing age-related diseases such as cardiovascular disease, hypertension and diabetes, as well as osteoporosis are proposed here. Losing weight to prevent and ameliorate metabolic syndrome can lead to loss of bone and muscle mass. However, when subjects had milk before dinner while dieting, their fat mass was efficiently decreased and their muscle mass increased without any change of bone mass.

Laparoscopic resection of an epidermal inclusion cyst at the vaginal cuff.

An epidermal inclusion cyst rarely occurs at the vaginal cuff, whereas it sometimes develops at the vulva and the site of episiotomy due to entrapment of the squamous epithelium. We present the case of a 58-year-old woman who developed an epidermal cyst at the vaginal cuff 6 years after laparoscopic hysterectomy. Although we could not make a precise diagnosis at imaging before the operation, the cyst was completely removed at laparoscopic surgery without any complications.

[Present knowledge in nutritional aspects of fracture].

Bone fractures are affected by bone mineral density, bone turnover, and risk of falls. Nutritional status could influence all these factors. The preventive effect of higher intake of calcium (1200 - 1500 mg/day) and vitamin D (10 - 20 microg/day) on osteoporotic fractures is well established and these are strongly recommended for the prevention of fractures in European and North American countries.

[Nutrition-related bone disease].

Bone disorders clearly related to nutrition are osteomalacia and osteoporosis. Osteomalacia is caused by a deficiency of vitamin D or a disturbance of its metabolism. Dietary deficiency of phosphate or excess of aluminum or cadmium will also cause osteomalacia.

[Nutritional condition affect the potency of pharmacological therapy].

Recent development of pharmacological treatments with proven efficacy will increase demand for the more effective management of patients with osteoporosis. Osteoporosis is a chronic disease concerned many risk factors such as diet and nutrition, and pharmacological efficacy could much depend on such nutritional conditions in patients as calcium, vitamin D, and protein, etc. Especially Japanese elderly usually took extremely low calcium and protein intake as well as low vitamin D, however, physicians usually give just pharmacological prescription.

[Dietary guidelines for osteoporosis-comparison among different countries].

Physician's guidelines for osteoporosis based on evidence from randomized, controlled clinical trials were available in many countries. Most of these guidelines include not only pharmacological therapies but also non-pharmacological treatments. Non-pharmacological treatments include nutrition as high intake of calcium and vitamin D.

[Osteoporosis and intake of vitamins].

Subclinical vitamins deficiency is common in the elderly, especially in osteoporotic patients. However, most physicians in this area are just focused on drugs for the treatment of osteoporosis. It is already established that several vitamins influence bone turnover, bone mineral density, or even the risk of hip fractures.

[Exercise and other lifestyle factors for prevention of osteoporosis during growth and young adulthood].

Increased mechanical loading of the skeleton results in bone gain, whereas unloading the skeleton leads to bone loss. Regular exercise, especially resistance and high-impact activities, contributes to development of high peak bone mass and the greatest effects on bone mass appear to occur in early adolescence. Therefore, it seems reasonable to turn our attention to intervening in the younger population to establish lifelong exercise habit that maximize peak bone mass.

[Nutrients and osteoporosis in children and adolescents].

It is widely accepted that development of a higher peak bone mass during adolescent years protects against postmenopausal osteoporosis. It is wise to instill in children good eating habits before adolescence. However, low intake of calcium, frequent intake of fast food, convenience food and oily snack as well as cyclical dieting often observed in recent Japanese children.

[Calcium and vitamin D metabolism during pregnancy and lactation].

During pregnancy, considerable amounts of calcium are transported from mother to fetus through the placenta. Calcium needs for milk production during lactation. The maternal bone density during reproducton if there is enough calcium supplimentation.

Improvement of nutrition stimulates bone mineral gain in Japanese school children and adolescents.

Calcium supplementation could accelerate bone mineral accrual, but the effect of other dietary factors in children is unclear. The aim of this study was to determine associations of changes in diet with bone accrual in Japanese children. All female (n=262) and male (n=286) school children aged 10-15 years living in a small town were recruited.

[Strategies for the prevention of osteoporosis in young and middle aged adults].

Strategies for the prevention of osteoporosis in young and middle aged adults include: a balanced diet which provides a calcium intake of at least 800 mg/day; encouragement of a physically active lifestyle; avoidance of smoking and of high alcohol and caffeine intakes; minimization of glucocorticoid use; promotion of intake of vitamin D, protein, vitamin K, vitamin C and potassium.