Advertisement

Archives of Osteoporosis

, 13:105 | Cite as

Prevention of low bone mass to achieve high bone density in Mexico: position of the Mexican Association for Bone and Mineral Metabolism

  • Rolando Espinosa
  • Patricia Clark
  • Edgar Denova-Gutiérrez
  • María de los Ángeles Aguilera-Barreiro
  • Mario Flores
  • Pilar Diez
  • Salomón Jasqui
  • María del Pilar De la Peña
  • Federico Cisneros-Dreinhofer
  • Pilar Lavielle
  • Víctor Mercado
Position Paper

Abstract

Summary

In Mexico, osteoporosis is a public health problem. In this document, the Mexican Association for Bone and Mineral Metabolism defines its position on calcium, vitamin D supplement use, and physical activity as an effective, safe, and cost-effective initiatives to prevent low bone mass.

Introduction

In Mexico, osteoporosis is a public health problem that is expected to increase in the decades ahead. Generally, modifiable risk factors for bone health are related with lifestyles, especially nutrition and physical activity.

Methods

In this position paper, the Mexican Association for Bone and Mineral Metabolism (AMMOM, by its acronym in Spanish), which is a multidisciplinary group of researchers, dietitians, epidemiologists, nurses, and physicians who study bone and related tissues and communicate the best strategies for diagnosis, treatment, and prevention of bone problems, aims to analyze the association between nutrition and bone health, risk behaviors for low bone mass, and the economic impact that prevention of low bone mass represents for the health care system.

Results

Addressing therapeutic management with pharmacological and non-pharmacological approaches, we emphasize the important role the patient plays in the doctor–patient relationship, both in the consulting room and in daily life. Furthermore, the AMMOM defines its position on calcium and vitamin D supplement use as an effective, safe, and cost-effective initiative to prevent low bone mass.

Conclusions

In summary, most research and clinical practice related to osteoporosis have focused on diagnosis and treatment, but general measures for primary prevention based on addressing modifiable risk factors as a public health priority to delay the onset of loss of bone mass have not been considered by Mexican authorities. Consequently, the AMMOM task force also seeks to provide information on concrete actions to prevent low bone mass.

Keywords

Bone density Osteoporosis Prevention Calcium Vitamin D Dietary supplements 

Notes

Contributors

All the authors were involved in the conceptual design of the manuscript. RE, PC, EDG, MAAB, MF, PD, SJ, MPPR, FS, PL, and VM prepared a section of the first version of the manuscript. EDG reviewed and edited the first version of the manuscript. All the authors reviewed and approved the final version of the manuscript.

Funding

This paper was supported by Pfizer Mexico, SA de CV, which allowed the experts’ meetings. All the authors received an honorarium from Pfizer in connection with the development of this manuscript.

Medical writing support was provided by Dr. Karim Majluf Cruz at ByronMuller and was funded by Pfizer.

Editorial support was provided by Dr. Edgar Denova and was funded by Pfizer.

Compliance with ethical standards

Conflicts of interest

None.

Statement of human and animal rights

This article does not contain any studies with human participants or animals performed by any of the authors.

Informed consent

For this type of study, informed consent is not required.

Supplementary material

11657_2018_520_MOESM1_ESM.docx (37 kb)
ESM 1 (DOCX 36 kb)

References

  1. 1.
    Kanis JA, McCloskey EV, Johansson H et al (2013) European guidance for the diagnosis and management of osteoporosis in postmenopausal women. Osteoporos Int 24:23–57CrossRefPubMedCentralGoogle Scholar
  2. 2.
    Clark P, Lavielle P, Franco-Marina F, Ramírez E, Salmerón J, Kanis JA, Cummings SR (2005) Incidence rates and life-time risk of hip fractures in Mexicans over 50 years of age: a population-based study. Osteoporos Int 16:2025–2030CrossRefPubMedCentralGoogle Scholar
  3. 3.
    Clark P, Cons-Molina F, Deleze M, Ragi S, Haddock L, Zanchetta JR, Jaller JJ, Palermo L, Talavera JO, Messina DO, Morales-Torres J, Salmeron J, Navarrete A, Suarez E, Pérez CM, Cummings SR (2009) The prevalence of radiographic vertebral fractures in Latin American countries: the Latin American Vertebral Osteoporosis Study (LAVOS). Osteoporos Int 20:275–282CrossRefPubMedCentralGoogle Scholar
  4. 4.
    Carlos F, Clark P, Galindo-Suárez RM, Chico-Barba LG (2013) Health care costs of osteopenia, osteoporosis, and fragility. Arch Osteoporos 8:125.  https://doi.org/10.1007/s11657-013-0125-4 CrossRefPubMedPubMedCentralGoogle Scholar
  5. 5.
    Gennari C (2001) Calcium and vitamin D nutrition and bone disease of the elderly. Public Health Nutr 4:547–559Google Scholar
  6. 6.
    North American Menopause Society (2006) The role of calcium in peri- and postmenopausal women: 2006 position statement of the North American Menopause Society. Menopause 13:862–877CrossRefGoogle Scholar
  7. 7.
    Food and Agriculture Organization (2013) Dairy production and products. Milk and milk products. www.fao.org/dairy-production-products/products/en/. Accessed 20 Jan 2018)
  8. 8.
    Rivera-Dommarco J, López-Olmedo N, Aburto-Soto T et al (2014) Consumo de productos lácteos en población Mexicana. Resultados de la Encuesta Nacional de Salud y Nutrición 2012. Instituto Nacional de Salud Pública, MéxicoGoogle Scholar
  9. 9.
    Heaney RP (2008) Vitamin D and calcium interactions: functional outcomes. Am J Clin Nutr 88:541S–544SCrossRefPubMedCentralGoogle Scholar
  10. 10.
    Contreras-Manzano A, Villalpando S, Robledo-Pérez R (2017) Vitamin D status by sociodemographic factors and body mass index in Mexican women at reproductive age. Salud Publica Mex 59:518–525CrossRefPubMedCentralGoogle Scholar
  11. 11.
    Denova-Gutiérrez E, Clark P, Muñoz-Aguirre P et al (2016) Dietary patterns are associated with calcium and vitamin D intake in an adult Mexican population. Nutr Hosp 33:276.  https://doi.org/10.20960/nh.276 CrossRefPubMedPubMedCentralGoogle Scholar
  12. 12.
    Institute of Medicine (2011) Dietary reference intakes for calcium and vitamin D. The National Academies Press (US), Washington, DCGoogle Scholar
  13. 13.
    Sánchez-Pimienta TG, López-Olmedo N, Rodríguez-Ramírez S et al (2016) High prevalence of inadequate calcium and iron intakes by Mexican population groups as assessed by 24-hour recalls. J Nutr 146:1874S–1880SCrossRefPubMedCentralGoogle Scholar
  14. 14.
    Pedroza-Tobías A, Hernández-Barrera L, López-Olmedo N, et al (2016) Usual vitamin intakes by Mexican populations. J Nutr 146:1866S–1873SCrossRefPubMedCentralGoogle Scholar
  15. 15.
    Rizzoli R, Bianchi ML, Garabedian M et al (2010) Maximizing bone mineral mass gain during growth for the prevention of fractures in the adolescents and the elderly. Bone 46:294–305CrossRefPubMedCentralGoogle Scholar
  16. 16.
    Cheng S, Lyytikainen A, Kroger H et al (2005) Effects of calcium, dairy product, and vitamin D supplementation on bone mass accrual and body composition in 10-12-y-old girls: a 2-y randomized trial. Am J Clin Nutr 82:1115–1126CrossRefPubMedCentralGoogle Scholar
  17. 17.
    Esterle L, Sabatier JP, Guillon-Metz F, Walrant-Debray O, Guaydier-Souquières G, Jehan F, Garabédian M (2009) Milk, rather than other foods, is associated with vertebral bone mass and circulating IGF-1 in female adolescents. Osteoporos Int 20:567–575CrossRefPubMedCentralGoogle Scholar
  18. 18.
    Manios Y, Moschonis G, Trovas G, et al (2007) Changes in biochemical indexes of bone metabolism and bone mineral density after a 12-mo dietary intervention program: the Postmenopausal Health Study. Am J Clin Nutr 86:781–789CrossRefPubMedCentralGoogle Scholar
  19. 19.
    Bonjour JP, Benoit V, Pourchaire O, et al (2009) Inhibition of markers of bone resorption by consumption of vitamin D and calcium-fortified soft plain cheese by institutionalised elderly women. Br J Nutr 102:962–966CrossRefPubMedCentralGoogle Scholar
  20. 20.
    Denova-Gutierrez E, Clark P, Tucker KL, et al (2016) Dietary patterns are associated with bone mineral density in an urban Mexican adult population. Osteoporos Int 27:3033–3040CrossRefPubMedCentralGoogle Scholar
  21. 21.
    Winzenberg TM, Shaw K, Fryer J, et al (2006) Calcium supplementation for improving bone mineral density in children. Cochrane Database Syst Rev 2:CD005119Google Scholar
  22. 22.
    Avenell A, Mak JC, O'Connell D (2014) Vitamin D and vitamin D analogues for preventing fractures in post-menopausal women and older men. Cochrane Database Syst Rev 4:CD000227Google Scholar
  23. 23.
    Shea B, Wells G, Cranney A, et al (2004) Calcium supplementation on bone loss in postmenopausal women. Cochrane Database Syst Rev 1:CD004526Google Scholar
  24. 24.
    Osteoporosis. Clinical guideline for prevention and treatment. Executive Summary. National Osteoporosis Guideline Group (NOGG) on behalf of the Bone Research Society, British Geriatrics Society, British Orthopaedic Association, British Society of Rheumatology, National Osteoporosis Society, Osteoporosis 2000, Osteoporosis Dorset, Primary Care Rheumatology Society, Royal College of Physicians and Society for Endocrinology. 2010Google Scholar
  25. 25.
    Wadsworth TG (1990) Colles’ fracture: failure in management may cause permanent disability. BMJ 301:192–194CrossRefPubMedCentralGoogle Scholar
  26. 26.
    Ross PD, He YF, Yates AJ, et al (1994) Body size accounts for most differences in bone density between Asian and Afro-Caribbean women. Clin Sci 87:339–343Google Scholar
  27. 27.
    Tobias JH, Cook DG, Chambers TJ, et al. A comparison of bone mineral density between Caucasian, Asian and Afro-Caribbean women. Clin Sci 1994;87(5):587–591CrossRefPubMedCentralGoogle Scholar
  28. 28.
    The DIPART (vitamin D Individual Patient Analysis of Randomized Trials) Group (2010) Patient level pooled analysis of 68500 patients from seven major vitamin D fracture trials in US and Europe. BMJ 340:b5463.  https://doi.org/10.1136/bmj.b5463
  29. 29.
    Wang L, Manson JE, Sesso HD (2012) Calcium Intake and Risk of Cardiovascular Disease: A Review of Prospective Studies and Randomized Clinical Trials. American Journal of Cardiovascular Drugs12:105–116.  https://doi.org/10.2165/11595400-000000000-00000 CrossRefGoogle Scholar
  30. 30.
    Chung M, Tang AM, Fu Z, et al (2016) Calcium intake and cardiovascular disease risk. An updated systematic review and meta-analysis. Ann Intern Med 165:856–866CrossRefPubMedCentralGoogle Scholar
  31. 31.
    Margolis KL, Manson JE (2016) Calcium supplements and cardiovascular disease risk: What do clinicians and patients need to know? Ann Intern Med 165:884-885CrossRefPubMedCentralGoogle Scholar
  32. 32.
    Russell-Aulet, Wang J (1993) Bone mineral density and mass in a crossectional study of white and asian women, J Bone Miner Res 8:575–582CrossRefGoogle Scholar
  33. 33.
    Hodgson SF, Watts NB, Bilezikian JP (2003) American Association of Clinical Endocrinologists medical guidelines for clinical practice for the prevention and treatment of postmenopausal osteoporosis: 2001 edition, with selected updates for 2003.Endoc Pract 9:544–564Google Scholar
  34. 34.
    Mykkanen HM, Wasserman RH (1983) Enhanced absorption of calcium by casein phosphopeptides in rachitic a normal chick. J Nutr 110:2141–2148CrossRefPubMedCentralGoogle Scholar
  35. 35.
    Recker RR, Bammi A, Barger-Lux MJ, et al (1988) Calcium absorbability from milk products, and imitation milk, and calcium carbonate. Am J Clin Nutr 47:93–95CrossRefPubMedCentralGoogle Scholar
  36. 36.
    Rosado JL (2016) Lactose Intolerance. Gac Med Mex 152(Suppl 1):67-73Google Scholar
  37. 37.
    Heine RG, AlRefaee F, Bachina P, et al (2017) Lactose intolerance and gastrointestinal cow's milk allergy in infants and children - common misconceptions revisited.World Allergy Organ J10:41.  https://doi.org/10.1186/s40413-017-0173-0
  38. 38.
    Shea B, Wells G, Cranney A, et al (2002) Meta-analyses of therapies for postmenopausal osteoporosis. VII. Meta-analysis of calcium supplementation for the prevention of postmenopausal osteoporosis. Endocr Rev 23:552–559CrossRefPubMedCentralGoogle Scholar
  39. 39.
    Aguilera-Barreiro MA, Guerrero-Mercado AS, Méndez-Jiménez TE, et al (2005) Efecto del calcio dietético vs el citrato de calcio sobre marcadores bioquímicos convencionales, en mujeres perimenopáusicas. Salud Publica Mex 47:259–267CrossRefGoogle Scholar
  40. 40.
    Mavroeidi A, Stewart AD, Reid DM, et al (2009) Physical activity and dietary calcium interactions in bone mass in Scottish postmenopausal women. Osteoporos Int 20:409–416CrossRefPubMedCentralGoogle Scholar
  41. 41.
    Yoon SJ, Lee MJ, Lee HM, et al (2016) Effect of low-intensity resistance training with heat stress on the HSP72, anabolic hormones, muscle size, and strength in elderly women.Aging Clin Exp Res 29:977–984CrossRefPubMedCentralGoogle Scholar
  42. 42.
    Pham HM, Nguyen ND, Center JR, et al (2016)Contribution of Quadriceps Weakness to Fragility Fracture: A Prospective Study. J Bone Miner Res 31:208–214CrossRefPubMedCentralGoogle Scholar
  43. 43.
    Lombardi G, Sanchis-Gomar F, Perego S (2016)Implications of exercise-induced adipo-myokines in bone metabolism. Endocrine 54:284–305CrossRefPubMedCentralGoogle Scholar
  44. 44.
    Martyn-St James M, Carroll S(2010)Effects of different impact exercise modalities on bone mineral density in premenopausal women: a meta-analysis.  J Bone Miner Metab28:251–267CrossRefPubMedCentralGoogle Scholar
  45. 45.
    Smith EN, Boser A (2013) Yoga, vertebral fractures, and osteoporosis: research and recommendations. Int J Yoga Therap 23:17–23Google Scholar
  46. 46.
    Tüzün S, Aktas I, Akarirmak U, et al (2010)Yoga might be an alternative training for the quality of life and balance in postmenopausal osteoporosis.Eur J Phys Rehabil Med 46:69–72Google Scholar
  47. 47.
    Fielding RA, Vellas B, Evans WJ, et al (2011) Sarcopenia: an undiagnosed condition in older adults. Current consensus definition: prevalence, etiology, and conse- quences. International working group on sarcopenia. J Am Med Dir Assoc 12:249–256CrossRefPubMedCentralGoogle Scholar
  48. 48.
    Espinel-Bermúdez MC, Sánchez-García S, García-Peña C, et al (2018) Associated factors with sarcopenia among Mexican elderly: 2012 National Health and Nutrition Survey. Rev Med Inst Mex Seguro Soc56(Suppl 1):S46–S53Google Scholar
  49. 49.
    Olsen CF, Bergland A (2014) The effect of exercise and education on fear of falling in elderly women with osteoporosis and a history of vertebral fracture: results of a randomized controlled trial.Osteoporos Int 25:2017–2025CrossRefPubMedCentralGoogle Scholar
  50. 50.
    Stalmeier PF (2011) Adherence and decision AIDS: a model and a narrative review. Med Decis Making 31:121–129CrossRefPubMedCentralGoogle Scholar
  51. 51.
    Hill L, Mueller M, Roussos S, et al (2009) Opportunities for the use decision aids in primary care. Fam Med 41:350–355Google Scholar

Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2018

Authors and Affiliations

  • Rolando Espinosa
    • 1
  • Patricia Clark
    • 2
    • 3
  • Edgar Denova-Gutiérrez
    • 4
  • María de los Ángeles Aguilera-Barreiro
    • 5
  • Mario Flores
    • 4
  • Pilar Diez
    • 6
    • 7
  • Salomón Jasqui
    • 8
    • 9
  • María del Pilar De la Peña
    • 10
  • Federico Cisneros-Dreinhofer
    • 11
  • Pilar Lavielle
    • 12
  • Víctor Mercado
    • 13
  1. 1.Departamento de ReumatologíaInstituto Nacional de RehabilitaciónCiudad de MéxicoMexico
  2. 2.Unidad de Investigación en Epidemiología ClínicaHospital Infantil de México Federico GómezCiudad de MéxicoMexico
  3. 3.Facultad de MedicinaUniversidad Nacional Autónoma de MéxicoCiudad de MéxicoMexico
  4. 4.Centro de Investigación en Nutrición y SaludInstituto Nacional de Salud PúblicaCuernavacaMexico
  5. 5.Facultad de Ciencias NaturalesUniversidad Autónoma de QuerétaroQuerétaroMexico
  6. 6.Instituto Nacional de RehabilitaciónCiudad de MéxicoMexico
  7. 7.Sanatorio San José SatéliteNaucalpanMexico
  8. 8.Servicio de Ortopedia y TraumatologíaHospital Angeles de las LomasCiudad de MéxicoMexico
  9. 9.Facultad de MedicinaUniversidad AnáhuacCiudad de MéxicoMexico
  10. 10.Servicios Médicos de la PeñaGuadalajaraMexico
  11. 11.Servicio de OrtopediaHospital Angeles MetropolitanoCiudad de MéxicoMexico
  12. 12.Unidad de Investigación en Epidemiologia ClínicaInstituto Mexicano del Seguro SocialCiudad de MéxicoMexico
  13. 13.Clínica Integral de MenopausiaCentro Medico DalindeCiudad de MéxicoMexico

Personalised recommendations