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Tag: fractures

Published on Leave a comment on Vegan Diets and Increased Risk of Bone Fractures

Vegan diets may be popular, but there is concern whether someone following a vegan diet can get all necessary nutrients from the diet and whether this impacts health in a negative way. This is because a person following a vegan diet avoids all animal foods - which means no dairy, no meat, no eggs, no honey, no fish, no shellfish, and no insects. This can mean difficulties in getting enough protein and some nutrients, for example choline (necessary for the brain), vitamin B-12, and calcium.

A recent study by University of Oxford researchers examined this issue by following about 55,000 people for 18 years: meat eaters, vegans, vegetarians (avoid meat, but eat dairy and /or eggs), and pescatarians (a vegetarian diet, but also eats fish). They found that when compared to meat eaters, vegans had a higher risk of fractures in their bodies (number of total fractures), and especially hip, leg, and vertebral fractures. Vegetarians and pescatarians also had a higher risk of hip fractures when compared to meat eaters, but a lower risk than vegans.

Other studies have shown that vegetarians have lower bone mineral density (BMD) than non-vegetarians, and that both calcium and protein intakes are linked to bone health. In this study and other studies, vegans had substantially lower intakes of calcium than the other dietary groups (since they do not consume dairy), and both vegetarians and vegans had lower protein intakes than meat and fish-eating groups.

Bottom line: Research finds diets rich in whole grains, legumes, fruits, vegetables, seeds, nuts, some fish, meat, eggs, and dairy (similar to the Mediterranean diet) as healthy and providing all nutrients. Pregnancy and childhood are times when one should be especially careful about getting all needed nutrients.

From Science Daily - Vegans, vegetarians and pescetarians may be at higher risk of bone fractures

Compared with people who ate meat, vegans with lower calcium and protein intakes on average, had a 43% higher risk of fractures anywhere in the body (total fractures), as well as higher risks of site-specific fractures of the hips, legs and vertebrae, according to a study published in the open access journal BMC Medicine.  ...continue reading "Vegan Diets and Increased Risk of Bone Fractures"

Published on Leave a comment on Even Six Days of Corticosteroid Use Is Linked to Higher Rate of Problems

Image result for pills wikipedia Huh?...A recent study found that short-term use (less than 30 days) of commonly prescribed corticosteroid medications are linked to some nasty side-effects: an increase in rates of sepsis,  venous thromboembolism, and fractures. The most common reasons for the prescriptions were for upper respiratory tract infections, spinal conditions, bronchitis, and allergies. The study looked at 1.5 milliion patients, and found that the most common prescriptions written for oral corticosteroids was a six day methylprednisolone “dosepak” (about 47% of prescriptions). Note that while this was an "observational" study (so doesn't prove corticosteroid medication caused the effects), it still is concerning. One should always keep in mind that all medications have side effects, some bigger and some smaller.

Corticosteroids are powerful anti-inflammatory drugs that have been used to treat a variety of diseases for over seven decades. Long term use of corticosteroids is generally avoided because of the risks of serious complications (such as infection, venous thromboembolism, fractures, as well as chronic diseases). However, side-effects of short-term use have been unclear- which is why they are so frequently prescribed (about 1 in 5 Americans or 21% of the people in this study). This is why this study was needed. From Medical Xpress:

Common drugs, uncommon risks? Higher rate of serious problems after short-term steroid use

Millions of times a year, Americans get prescriptions for a week's worth of steroid pills, hoping to ease a backache or quell a nagging cough or allergy symptoms. But a new study suggests that they and their doctors might want to pay a bit more attention to the potential side effects of this medication. People taking the pills were more likely to break a bone, have a potentially dangerous blood clot or suffer a life-threatening bout of sepsis in the months after their treatment, compared with similar adults who didn't use corticosteroids, researchers from the University of Michigan report in a new paper in the British Medical Journal (BMJ).

Though only a small percentage of both groups went to the hospital for these serious health threats, the higher rates seen among people who took steroids for even a few days are cause for caution and even concern, the researchers say. The study used data from 1.5 million non-elderly American adults with private insurance. One in 5 of them filled a short-term prescription for oral corticosteroids such as prednisone sometime in the three-year study period. While the rates of the serious events were highest in the first 30 days after a prescription, they stayed elevated even three months later.

Using anonymous insurance claims data that IHPI purchased for use by U-M health care researchers, they found that half of the people who received oral steroids had gotten them for just six diagnoses, related to back pain, allergies or respiratory tract infections including bronchitis. Nearly half received a six-day prepackaged methylprednisolone "dosepak," which tapers the dose of steroids from highest to lowest. 

Dr. Waljee and his colleagues found higher rates of sepsis, venous thromboembolism (VTE) and fractures among short-term steroid users using multiple different statistical approaches to ensure their findings were as robust as possible....The consistent findings across the three approaches are important given the frequent use of these drugs and potential implications for patients. Waljee notes that the reason for this broad effect of steroids on complications may have its roots in how the drugs work: they mimic hormones produced by the body, to reduce inflammation but this can also induce changes that put patients at additional risk of serious events.

In the meantime, based on the new results, he advises patients and prescribers to use the smallest amount of corticosteroids possible based on the condition being treated. "If there are alternatives to steroids, we should be use those when possible," he says. "Steroids may work faster, but they aren't as risk-free as you might think." [Original study.]