Osteoporosis in Asia

  • E. M. C. Lau
  • J. Woo
Part of the Advances in Nutritional Research book series (ANUR, volume 9)


During the last two decades, osteoporosis has evolved from a relatively rare condition to an epidemic one in urbanized parts of Asia. In the past, there was a definite geographical pattern to osteoporosis and osteoporotic fractures. The age-adjusted incidence of hip fracture among Caucasians from Europe and North America was two- to threefold higher than the rates observed in Chinese, Bantu and Maori in the late 1960s (Table 1) (Maggi et al.,1991).


Bone Mineral Density Postmenopausal Woman Bone Mineral Content Calcium Intake Protein Intake 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. Albanese, A.A., Edelson, A.H., Lorenze, A.H., Woodhull, M.C., and Wein, E.H., 1975, Problems of bone health in elderly, NY State J. Med. 75: 326.Google Scholar
  2. Angus, R.M., Sambrook, P.N., Pocock, N.A., and Eisman, J.A., 1988, Dietary intake and bone mineral density, Bone and Mineral 4: 265.Google Scholar
  3. Baker, M.R., McDonnell, H., Peacock, M., Nordin, B.E.C., 1979, Plasma 25-hydroxyvitamin D concentrations in patients with fractures of the femoral neck, Br. Med. J. 1: 589.CrossRefGoogle Scholar
  4. Chow, R., Harrison, J.E., and Notarius, C., 1987, Effect of two randomised exercise programmes on bone mass of healthy postmenopausal women, Br. Med. J. 295: 1441.CrossRefGoogle Scholar
  5. Cooper, C., McLaren, M., Wood, P.J., Coulton, L., and Kanis, J.A.,1989, Indices of calcium metabolism in women with hip fractures, Bone and Mineral 5: 193.Google Scholar
  6. Cumming, R.G., 1990, Calcium intake and bone mass: a quantitative review of the evidence, Calcif. Tissue Int. 47: 194.CrossRefGoogle Scholar
  7. Cummings, J.H., Hill, M.J., Jivrai, T., Houston, J., Branch, W.J., and Jenkins, D.J.A., 1979, The effect of meat protein and dietary fiber on colonic function and metabolism: 1. Changes in bowel habit, bile acid excretion and calcium absorption. Am. J. Clin. Nutr. 32: 2086.Google Scholar
  8. Da!sky, G.P., Stocke, K.S., Ehsani, A.A., Slatopolsky, E., Lee, W.C., and Birge, S.J. Jr., 1988, Weight-bearing exercise training and lumbar bone mineral content in postmenopausal women, Ann. Intern. Med. 108: 824.CrossRefGoogle Scholar
  9. Dawson-Hughes, B., 1991, Calcium supplementation and bone loss: a review of controlled clinical trials, Am. J. Clin. Nutr. 54: 274S.Google Scholar
  10. Dawson-Hughes, B., Dallai, G.E., Krall, E.A., Harris, S., Sokoll, L.J., and Falconer, G., 1991, Effect of vitamin D supplementation on wintertime and overall bone loss in healthy postmenopausal women, Ann. Intern. Med. 115: 505.CrossRefGoogle Scholar
  11. Dawson-Hughes, B., Dallai, G.E., Krall, E.A., Sadowski, L., Nadine Sahyoun, R.D., and Tannenbaum, S., 1990, A controlled trial of the effect of calcium supplementation on bone density in postmenopausal women, N. Engl. J. Med. 323: 878.CrossRefGoogle Scholar
  12. Ettinger, B., Genant, H.K., and Cann, C.E., 1987, Postmenopausal bone loss is prevented by treatment with low-dosage estrogen with calcium, Ann. Intern. Med. 106: 40.CrossRefGoogle Scholar
  13. Freudenheim, L.L., Johnson, N.E., Smith, E.L., 1986, Relationships between usual nutrient intake and bone-mineral content of women 35–65 years of age: Longitudinal and cross-sectional analysis. Am. J Clin. Nutr. 44: 863.Google Scholar
  14. Fujita, T., 1990, Studies of osteoporosis in Japan, Metabolism 39: 38.CrossRefGoogle Scholar
  15. Garn, S.M., and Kangas, J., 1981, “Protein intake, bone mass, and bone loss,” in: Osteoporosis: Recent Advances in Pathogenesis and Treatment ( H.F. DeLuca, H.M. Frost, W.S.S. Jee, C.C. Johnston, and A.M. Parfitt, eds.), pp. 257–267, University Park Press, Baltimore MD.Google Scholar
  16. Goulding, A., 1981, Fasting urinary sodium/creatinine in relation to calcium/creatinine and hydroxyproiine/creatinine in a general population of women, N.Z. Med. J 93: 294.Google Scholar
  17. Goulding, A., and Campbell, D.R., 1984, Effects of oral loads of sodium chloride on bone composition in growing rats consuming ample dietary calcium. Min. Electrolyte Metab. 10: 58.Google Scholar
  18. Goulding, A., Everitt, H.E., Cooney, J.M., and Spears, G.F.S., 1986, “Sodium and osteoporosis,” in: Recent Advances in Clinical Nutrition ( M.L. Wahlquist and A.S. Truswell, eds.), pp. 99–108, John Libby, London.Google Scholar
  19. Hansson, T., and Roos, B., 1987, The effect of fluoride and calcium on spinal bone content: a controlled, prospective (3 years) study, Calcif. Tissue Int. 40: 315.CrossRefGoogle Scholar
  20. Heaney, R.P., and Recker, R.R., 1982, Effects of nitrogen, phosphorus, and caffeine on calcium balance in women, J. Lab. Clin. Med. 99: 46.Google Scholar
  21. Hegsted, M., and Linkswiler, H.M., 1981, Long-term effects of level of protein intake on calcium metabolism in young adult women,. 1. Nutr. 111: 244.Google Scholar
  22. Ho, S.C., Donnan, S., and Sham, A., 1988, Dietary intake among elderly Chinese in Hong Kong, J. Hum. Nutr. and Dietetics 1: 205.CrossRefGoogle Scholar
  23. Horsman, A., Gallagher, J.C., Simpson, M., and Nordin B.E.C., 1977, Prospective trial of estrogen and calcium in postmenopausal women. Br. Med. J 2: 789.CrossRefGoogle Scholar
  24. Intersalt Cooperative Research Group, 1988, Intersalt: an international study of electrolyte excretion and blood pressure. Results for 24 hour urinary sodium and potassium excretion. Br. Med. J. 297: 319.CrossRefGoogle Scholar
  25. Kelly, P.J., Eisman, J.A., and Sambrook, P.N., 1990, Interaction of genetic and environmental influences on peak bone density, Osteoporosis Int. 1: 56.CrossRefGoogle Scholar
  26. Kesteloot, H., Huang D.X., Li, Y.L., Gebsers, J., and Joosens, J.V., 1987, The relationship between cations and blood pressure in the People’s Republic of China, Hypertension 9: 654.CrossRefGoogle Scholar
  27. Lacey, J.M., and Anderson, J.J.B., 1988, “Older women in Japan and the United States: physical and nutritional comparisons,” in: Proceedings of the Fifth International Congress on Bone Morphometry ( H.E. Takahashi, ed.), pp. 562–565, Nishimura, Japan.Google Scholar
  28. Lacey, J., Anderson, J.J.B., Fujita, T., Yoshimoto, Y., Fukase, M., Tsuchie, S., and Koch, G.G., 1991, Correlates of cortical bone mass among premenopausal and postmenopausal Japanese women, J. Bone Min. Res. 6: 651.CrossRefGoogle Scholar
  29. Lamke, B., Sjoberg, H-E., and Sylvan, M., 1978, Bone mineral content in women with Colles’ fracture: effect of calcium supplement, Acta Orthop. Scand. 49: 143.CrossRefGoogle Scholar
  30. Lau, E., Dorman, D., Barker D., and Cooper, C., 1988, Physical activity and calcium intake in fracture of the proximal femur in Hong Kong, Br. Med. J. 296: 1441.CrossRefGoogle Scholar
  31. Lau, E.M.C., Woo, J., Swaminathan, R., MacDonald, D., and Donnan, S.P.B., 1989, Plasma 25-hydroxyvitamin D concentration in patients with hip fracture in Hong Kong, Gerontology 35: 198.CrossRefGoogle Scholar
  32. Lau, E., Cooper, C., Dorman, S., and Barker, D.J.P., 1990, “Incidence and risk factors for hip fractures in Hong Kong Chinese,” in: Proceedings of the Third International Symposium on Osteoporosis ( G. Christiansen and K. Overgaard, eds.), pp. 66–70, Osteopress, Copenhagen.Google Scholar
  33. Lau, E.M.C., Woo, J., Leung, P.C., Swaminathan, R., and Leung, D., 1992, The effects of calcium supplementation and exercise on bone density in elderly Chinese women, Osteoporosis Int. 2: 168.CrossRefGoogle Scholar
  34. Law, L.K., Swaminathan, R., and Donnan, S.P.B., 1988, Relationship between sodium excretion and calcium excretion in healthy subjects, Med. Sci. Res. 16: 643.Google Scholar
  35. Lee, S.T., Lee, K.O., and Bose, K., 1988, Osteoporosis in elderly Chinese, Br. Med. J. 296: 1402.CrossRefGoogle Scholar
  36. Licata, A.A., Bou, E., Bartter, F.C., and West, F., 1981, Acute effects of dietary protein in calcium metabolism in patients with osteoporosis, J. Gerontol. 36: 14.CrossRefGoogle Scholar
  37. MacDonald, D., Lau, E., Chan, E.L.P., Mak, T., Woo, J., Leung, P.C., and Swaminathan, R., Serum intact parathyroid hormone levels in hip fracture, Calcif. Tissue Int. (in press). Maggi, S., Kelsey, J.L., Litvak, J., and Heyse, S.P., 1991, Incidence of hip fractures in the elderly: A cross-national analysis, Osteoporosis Int. 1:232.Google Scholar
  38. Matkovic, V., Kostial, K., Simonovic, I., Buzina, R., Brodare, A., and Nordin, B.E.C., 1979, Bone status and fracture rates in two regions of Yugoslavia, Am. J. Clin. Nutr. 32: 540.Google Scholar
  39. Mazess, R.B., and Barden, H.S., 1991, Bone density in premenopausal women: Effects of age, dietary intake, physical activity, smoking, and birth-control pills, Am. J. Clin. Nutr. 53: 132.Google Scholar
  40. Orimo, H., 1990, “Epidemiology of fractures in Asia,” in: Proceedings of the Third International Symposium on Osteoporosis ( C. Christiansen and K. Overgaard, eds.), pp. 66–70, Osteopress, Copenhagen.Google Scholar
  41. Orwell, E.S., 1992, The effects of dietary protein insufficiency and excess on skeletal health, Bone 13: 343.CrossRefGoogle Scholar
  42. Pocock, N.A., Eisman, J.A., Yeates, M.G., Sambrook, P.N., and Eberl, S., 1986, Physical fitness is a major determinant of femoral neck and lumbar spine bone mineral density, J. Clin. Invest. 78: 618.CrossRefGoogle Scholar
  43. Polley, K.J., Nordin, B.E.C., Baghurst, P.A., Walker, C.J., and Chatterton, B.E., 1987, Effect of calcium supplementation on forearm bone mineral content in postmenopausal women: a prospective, sequential controlled trial, J. Nutr. 117: 1929.Google Scholar
  44. Prince, R.L., Smith, M., Dick, I.M., Roger, I.P., Webb, P.G., Henderson, N.K., and Harris, M.M., 1991, Prevention of postmenopausal osteoporosis, N. Engl. J. Med. 325: 1192.CrossRefGoogle Scholar
  45. Pun, K.K., Chan, L.W.L., and Chung, V., 1989, The problem of calcium deficiency in Hong Kong, The Hong Kong Practitioner 11: 287.Google Scholar
  46. Recker, R.R., and Heaney, R.P., 1985, The effect of milk supplements on calcium metabolism, bone metabolism and calcium balance, Am. J. Clin. Nutr. 41: 254.Google Scholar
  47. Recker, R.R., Saville, P.D., and Heaney, R.P., 1977, Effect of estrogens and calcium carbonate on bone loss in postmenopausal women, Ann. Intern. Med. 87: 649.CrossRefGoogle Scholar
  48. Riffs, B., Thomsen, K., and Christiansen, C., 1987, Does calcium supplementation prevent postmenopausal bone loss? N. Engl. J. Med. 316: 173.CrossRefGoogle Scholar
  49. Schuette, S.A., and Linkswiler, H.M., 1982, Effects on Ca and P metabolism in humans by adding meat, meat plus milk, or purified proteins plus Ca and P to a low protein diet, J. Nutr. 112: 338.Google Scholar
  50. Simkin, A., Ayalon, J., and Leichter, I., 1987, Increased trabecular bone density due to bone- loading exercises in postmenopausal osteoporotic women, Calcif Tissue Int. 40: 59.CrossRefGoogle Scholar
  51. Smith, E.L., Reddan, W., and Smith, P.E., 1981, Physical activity and calcium modalities for bone mineral content in aged women, Med. Sci. Sports. Exer. 13: 60.Google Scholar
  52. Smith, E.L., Gilligan, C., Smith, P.E., and Sempos, C.T., 1989, Calcium supplementation and bone loss in middle-aged women, Am. J. Clin. Nutr. 50: 833.Google Scholar
  53. Spencer, H., Kramer, L., and Osis, D., 1988, Do protein and phosphorus cause calcium loss? J. Nutr. 118: 657.Google Scholar
  54. Swaminathan, R., 1989, Nutritional factors in osteoporosis, Journal of AFES. 10: 3.Google Scholar
  55. Tylaysky, F.A., and Anderson, J.J.B., 1988, Dietary factors in bone health of elderly lactoovovegetarian and omnivorous women, Am. J. Clin. Nutr. 48: 842.Google Scholar
  56. Weaver, C.M., 1992, Calcium bioavailability and its relation to osteoporosis, PSEBM 200: 157.Google Scholar
  57. Wong, P.C.N., 1966, Fracture epidemiology in a mixed Southeastern Asian Community (Singapore), Clinical Orthopaedics 45: 55.CrossRefGoogle Scholar
  58. Woo, J., Cheung, C.K., Ho, S.C., Mak, Y.T., and Swaminathan, R., 1988, Protein nutritional status in elderly Chinese in Hong Kong, Eur. J. Clin. Nutr. 42: 903.Google Scholar
  59. Woo, J., Ho, S.C., Cheung, C.K., Mak, Y.T., and Swaminathan, R., 1989a, Protein calorie malnutrition in elderly chronic care institutions in Hong Kong, Nutr. Rep. Int. 40: 1011.Google Scholar
  60. Woo, J., Ho, S.C., Mak, Y.T., MacDonald, P., and Swaminathan, R., 1989b, Vitamin nutritional status in elderly Chinese subjects living in chronic care institutions, Nutr. Res. 9: 1071.CrossRefGoogle Scholar
  61. Woo, J., Lau, E., Chan, A., Cockram, C., and Swaminathan, R., 1991, Blood pressure and urinary cations in a Chinese population, J. Hum. Hypertension 6: 299.Google Scholar
  62. Yano, K., and Heilbrun, L.K., 1985, The relationship between diet and bone mineral content of multiple skeletal sites in elderly Japanese-American men and women living in Hawaii, Am. J. Clin. Nutr. 42: 877.Google Scholar

Copyright information

© Springer Science+Business Media New York 1994

Authors and Affiliations

  • E. M. C. Lau
    • 1
  • J. Woo
    • 2
  1. 1.Department of Community and Family MedicineChinese University of Hong Kong, Lek Yuen Health CentreShatin, N. T.Hong Kong
  2. 2.Department of MedicineChinese UniversityHong Kong

Personalised recommendations