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PERIODICAL
FASTING AND CALORIC RESTRICTION FOR LIFE EXTENSION,
DISEASE TREATMENT AND CREATIVITY.
(clinical and experimental data)
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FASTING AND CALORIC RESTRICTION PREVENT AND CURE DISEASES
(Evidence) |
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BONES,
OSTEOPOROSIS AND FASTING |
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2005
Molecular and Nutritional Physiology
Unit, Gerontology Research Center, National Institute
on Aging, Baltimore, Maryland 21224, USA.
Little is known regarding the
effects of prolonged calorie restriction (CR) on skeletal
health. We investigated long-term (11 years) and short-term
(12 months) effects of moderate CR on bone mass and
biochemical indices of bone metabolism in male rhesus
monkeys across a range of ages. A lower bone mass
in long-term CR monkeys was accounted for by adjusting
for age and body weight differences. A further analysis
indicated that lean mass, but not fat mass, was a
strong predictor of bone mass in both CR and control
monkeys. No effect of short-term CR on bone mass was
observed in older monkeys (mean age, 19 years), although
young monkeys (4 years) subjected to short-term CR
exhibited slower gains in total body bone density
and content than age-matched controls. Neither biochemical
markers of bone turnover nor hormonal regulators of
bone metabolism were affected by long-term CR. Although
osteocalcin concentrations were significantly lower
in young restricted males after 1 month on 30% CR
in the short-term study, they were no longer different
from control values by 6 months on 30% CR.
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2001
Laboratory of Neurosciences,
National Institute on Aging, Gerontology Research
Center, 5600 Nathan Shock Drive, Baltimore, MD 21224,
USA.
Energy restriction (ER) extends
the life span and slows aging and age-related diseases
in short-lived mammalian species. Although a wide
variety of physiological systems have been studied
using this paradigm, little is known regarding the
effects of ER on skeletal health and reproductive
aging. Studies in rhesus monkeys have reported that
ER delays sexual and skeletal maturation in young
male monkeys and reduces bone mass in adult males.
No studies have examined the chronic effects on bone
health and reproductive aging in female rhesus monkeys.
The present cross-sectional study examined the effects
of chronic (6 y) ER on skeletal and reproductive indices
in 40 premenopausal and perimenopausal (7-27 y old)
female rhesus macaques (Macaca mulatta). Although
ER monkeys weighed less and had lower fat mass, ER
did not alter bone mineral density, bone mineral content,
osteocalcin, 25-hydroxyvitamin D, 1,25-hydroxyvitamin
D or parathyroid hormone concentrations, menstrual
cycling or reproductive hormone concentrations. Body
weight and lean mass were significantly related to
bone mineral density and bone mineral content at all
skeletal sites (total body, lumbar spine, mid and
distal radius; P: < or = 0.04). The number of total
menstrual cycles over 2 y, as well as the percentage
of normal-length cycles (24-31 d), was lower in older
than in younger monkeys (P: < or = 0.05). Older monkeys
also had lower estradiol (P: = 0.02) and higher follicle-stimulating
hormone (P: = 0.02) concentrations than did younger
monkeys. We conclude that ER does not negatively affect
these indices of skeletal or reproductive health and
does not alter age-associated changes in the same
variables.
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1995
AUTHOR AFFILIATION: Neuroendocrine
Unit, Massachusetts General Hospital, Boston 02114,
USA.
ABSTRACT: Severe chronic undernutrition
is associated with decreased bone turnover and significant
bone loss. However, little is known about the short-term
effects of nutritional deprivation on bone turnover.
To investigate the effects of short-term fasting on
bone metabolism and the contribution of acidosis to
these changes, 14 healthy women ages 18-26 (mean,
21 +/- 2 (SD years) were randomized to potassium bicarbonate
(KHCO3, 2 meq/kg/day in divided doses) to prevent
acidosis or control (potassium chloride, 25 meq/day)
during a complete 4-day fast. Bone turnover was assessed
using specific markers of formation [osteocalcin (OC)
and Type I procollagen carboxyl-terminal propeptide
(PICP)] and resorption [pyridinoline (PYRX) and deoxypyridinoline
(DPYRX)]. Serum bicarbonate levels fell significantly
from 27.0 +/- 3.2 to 17.3 +/- 2.6 mmol/L (P < 0.01)
in the control group and were decreased compared to
patients receiving KHCO3 [17.3 +/- 2.6 vs. 23.4 +/-
2.4 mmol/L, (P < 0.001)]. Serum total and ionized
calcium increased significantly in the control group
[9.1 +/- 0.1 to 9.4 +/- 0.2 mg/dL (P < 0.01) and 1.20
+/- 0.03 to 1.23 +/- 0.03 mmol/L (P < 0.05), respectively],
but not in patients receiving KHCO3. In addition,
serum parathyroid hormone (PTH) levels decreased from
32 +/- 17 to 16 +/- 10 pg/mL (P < 0.05) and urinary
calcium excretion increased [86 +/- 51 to 182 +/-
103 mg/day (P = 0.01)] in the control group, but not
in patients receiving KHCO3. Serum osteocalcin (OC)
and procollagen carboxyl-terminal propeptide (PICP)
levels decreased significantly after 4 days of fasting
from 9.1 +/- 3.4 to 5.5 +/- 4.2 ng/mL (P < 0.01) and
121 +/- 21 to 46 +/- 13 ng/mL (P = 0.0001) respectively
in the patients receiving bicarbonate, and from 10.1
+/- 3.3 to 4.0 +/- 2.9 ng/mL (P < 0.01) and from 133
+/- 22 to 47 +/- 19 ng/mL (P < 0.001) respectively
in the control group. The decrease in osteocalcin
and PICP during fasting was comparable in both treatment
groups. By contrast, urinary excretion of PYRX and
DPYRX did not change significantly in either group
with 4 days of fasting. These data are the first to
demonstrate that markers of bone formation decline
significantly with short-term fasting, independent
of changes in acid-base status. By contrast, these
data demonstrate a direct effect of acidosis in stimulating
calcium release from bone during short-term fasting
and suggest that acidosis may increase mineral dissolution
independent of osteoclast activation and PTH in this
experimental model of acute starvation. AAC comments:
This paper give us a sound message that we have to
implement alkaline, carbonate water intake during
fasting days.
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Neuroendocrine Unit, Massachusetts
General Hospital, Boston 02114, USA.
Insulin-like growth factor-I (IGF-I)
is a nutritionally dependent bone trophic hormone which
stimulates osteoblast function and collagen synthesis
in vivo and in vitro. We hypothesized that in the fasting
state, IGF-I levels would decline significantly and
would establish a model in which we could investigate
the effects of IGF-I administration on bone turnover.
We therefore studied 14 normal women ages 19-33 (mean,
24 +/- 4 [SD] years) during a complete 10-d fast. After
4 d of fasting, subjects were randomized to receive
rhIGF-I or placebo subcutaneously twice a day for 6
d. Bone turnover was assessed using specific markers
of formation (osteocalcin and type I procollagen carboxyl-terminal
propeptide [PICP]) and resorption (pyridinoline, deoxypyridinoline,
type I collagen crosslinked N-telopeptide [N-telopeptide]
and hydroxyproline). Serum levels of PICP and osteocalcin
decreased from 143 +/- 52 to 60 +/- 28 ng/ml (P = 0.001)
and from 7.6 +/- 5.4 to 4.2 +/- 3.1 ng/ml (P = 0.001)
respectively with 4 d of fasting. Urinary excretion
of pyridinoline and deoxypyridinoline decreased from
96 +/- 63 to 47 +/- 38 nmol/mmol creatinine (P < 0.05)
and from 28 +/- 17 to 14 +/- 11 nmol/mmol creatinine
(P < 0.05) respectively. Mean IGF-I levels decreased
from 310 +/- 81 to 186 +/- 78 ng/ml (P = 0.001). In
the second part of the experimental protocol, serum
osteocalcin and PICP levels increased 5- and 3-fold,
respectively with rhIGF-I administration and were significantly
elevated compared with the placebo group at the end
of treatment (20.9 +/- 17.3 vs. 5.9 +/- 6.4 ng/ml for
osteocalcin [P < 0.05] and 188 +/- 45 vs. 110 +/- 37
ng/ml for PICP [P < 0.05]). In contrast, all four markers
of bone resorption, including urinary pyridinoline,
deoxypyridinoline, N-telopeptide and hydroxyproline
were unchanged with rhIGF-I administration. This report
is the first to demonstrate that bone turnover falls
rapidly with acute caloric deprivation in normal women.
RhIGF-I administration uncouples bone formation in this
setting by significantly increasing bone formation,
but not resorption. These data suggest a novel use of
rhIGF-I to selectively stimulate bone formation in states
of undernutrition and low bone turnover.
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