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Nutrition and Bone Health
The Nutrition and Bone Health Programme is led by Dr Ann Prentice. The aim is to identify the role of nutrition and lifestyle in bone health and the prevention of osteoporosis and rickets within the wider context of nutrition policy for calcium and vitamin D in developed and developing countries. The goal is to promote public health by investigating the role of nutrition and other factors in the optimisation of bone health and the prevention of fragility fractures and rickets. Research into the prevention of osteoporosis and the optimisation of bone health is of strategic relevance to the general population, government and industry. This programme helps to provide the scientific evidence on which future nutritional policy and practice in relation to optimal bone health and to calcium and vitamin D requirements can be based.
Osteoporosis is a major health concern world-wide. In the UK, fractures caused by osteoporosis affect 1 in 2 women and 1 in 5 men aged over 50 years. Internationally, more than 1.5 million hip fractures occur annually and it is predicted that this will increase four-fold by the year 2050. Poor bone health can affect people in several other ways. Stunting, for example, affects millions of children around the world, with implications for the health of individuals and for national economies. Rickets, a debilitating disease of children, is a problem in many countries and is re-emerging in the UK.
Our research is focused on calcium nutrition and vitamin D requirements with consideration of other potentially important influences such as other dietary factors, sunshine exposure, physical activity, muscle strength, body size and composition, underlying conditions, and metabolic processes. We integrate human physiological studies at different stages of life, conducted across population groups from different ethnic and cultural backgrounds, with metabolic studies of the calcium-phosphate-vitamin D system.
Our work is organised into three interlinking theme areas:
- Calcium, vitamin D and population health which characterises the calcium and vitamin D requirements of different populations and population groups, and to address issues of relevance to nutrition policy and practice worldwide;
- Bone health through the life course which takes a life course approach to define a ‘healthy bone phenotype’ and to characterise the influence of diet and lifestyle on musculoskeletal health; and
- Metabolic aspects of bone health which investigates the metabolic processes that underpin the development and the maintenance of a healthy bone phenotype, how these change during the life-course, and are modulated by nutrition, life-style and disease.
Our work is conducted mainly in the UK (especially Cambridge, Southampton, Newcastle); Keneba, The Gambia; Shenyang, People’s Republic of China; Chakaria, Bangladesh; Johannesburg, South Africa, Blantyre, Malawi, and Kampala, Uganda. These populations vary widely in fragility fracture incidence, calcium intake, vitamin D status, physical activity, and prevalence of infectious and chronic disease.
We conduct studies in infants, children, adolescents, young adults, women during pregnancy and lactation, and older men and women. Measurements of bone mineral content, shape and size, using techniques such as dual-energy X-ray absorptiometry (DXA), peripheral quantitative computed tomography (pQCT) and high resolution pQCT, are combined with assessments of dietary intake, physical activity, UVB sunshine exposure, body composition, muscle function, bone turnover, and calcium, phosphate and vitamin D metabolism. Some of our studies are observational and cross-sectional, others are interventions with follow-up (for example with calcium or vitamin D supplementation), and others are prospective longitudinal investigations. These studies allow us to test the influence of diet and lifestyle on bone health and the mechanisms of adaptation to a low calcium intake, a low vitamin D supply, or both.
We actively contribute to evidence synthesis, knowledge transfer and translation of our research by writing synthetic reviews and position papers, by presentations at international conferences, by serving on international expert advisory committees and engaging with policymakers, practitioners, the media and the public, most particularly in the UK and The Gambia, but also when appropriate in the other countries in which we conduct our research.