The Easy Way to Build Bone?

Those of a certain age, and I count myself among them, may remember an 'I Love Lucy' episode where Lucy was attempting to lose weight. Rather than utilize the tried but true, eating less and exercising more, Lucy employed a machine where the user stood on a platform and passed a wide belt around around her waist.  The machine vibrated and jiggled, supposedly melting fat off without any effort by the user outside of simply staying upright and trying to prevent her teeth from chattering.  Needless to say, it didn't work for weight loss, and in this issue of Annals of Internal Medicine, we now know it doesn't work to improve bone density.  Surprise! as Rick and I agree in this week's podcast, and in our new weekly YouTube, no effort usually gets you no results, especially when it comes to our bodies.

The study recruited 202 healthy, postmenopausal women with established low bone mineral density who were not already taking medications to improve bone health.  The women were randomized to three groups:  all received calcium and vitamin D supplements, one group stood on a vibrating platform at the frequency of 30 cycles per minute for 20 minutes per day, another with a frequency of 90 cycles per minute for 20 minutes per day, and the third did not stand on the platform.  At the end of 12 months, there was no difference in the bone mineral density between the three groups, with robust measurement techniques, including the gold standard DEXA scan.  Sounds like it's back to the drawing board for those manufacturers of vibrating platform machines, where I hope they're joined by tanning bed designers.

What would have made anyone think simply standing on a vibrating platform would improve bone mineral density anyway?  Enter that favorite of medical and scientific research, the animal model.  Turns out that previous research in laboratory animals demonstrated that their bones were strengthened by such exposure, and the leap was made to people.  But as a prominent researcher I know is fond of intoning, "between mice and men is in the middle of the sea."  Meaning of course that that's quite a leap.  And as Rick opines in the podcast, it's great when these things are finally subjected to rigorous study and disproven.  Hopefully any women out there who are being told such a treatment will help will now chose instead to engage in walking, which is known, as a result of intensive study, to drive calcium into bones and improve their strength.

What about calcium supplements as a mainstay of osteoporosis prevention and treatment?  Concerns are emerging that in this very group, postmenopausal women, such supplementation may increase the risk of cardiovascular disease and adverse events.  It's challenging to know where to draw the line here between bone health and heart health, so stay tuned and advise your primary care doc if you are taking a calcium supplement.  It's possible that coronary calcium scanning may soon be widely employed to easily and inexpensively assess the likelihood of a cardiovascular event.

Other topics this week include whether kids at risk for developing asthma need medication every day in NEJM, bloodstream infections and atrial fibrillation and sodium and potassium excretion and risk of cardiovascular events, both in JAMA.  Until next week, y'all live well.

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Osteoporosis: a research review
November 28, 2011 at 2:04 pm

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