Tag Archives: comment

Nitroglycerin Needs More Study

Is nitroglycerin a novel and inexpensive treatment for osteoporosis?

Khosla S
JAMA Feb 2011
PMID: 21343584 | Free Full Text

Despite the differences in the results of the study by Jamal et al2 compared with the largely negative study by Wimalawansa et al,11 the findings reported by Jamal et al2 should set the stage for an adequately powered, larger study using nitroglycerin ointment with fracture as an outcome. If such a study demonstrates efficacy for reducing fractures, clinicians would have a novel and inexpensive therapy for osteoporosis. The findings of the current study also should prompt development of additional nitric oxide donors with greater skeletal efficacy and a better adverse effect profile, particularly with regard to headaches.

Animal Protein Increases Bone Loss and Fracture in Postmenopausal Women – 2001


A high ratio of dietary animal to vegetable protein increases the rate of bone loss and the risk of fracture in postmenopausal women. Study of Osteoporotic Fractures Research Group.

Different sources of dietary protein may have different effects on bone metabolism. Animal foods provide predominantly acid precursors, whereas protein in vegetable foods is accompanied by base precursors not found in animal foods. Imbalance between dietary acid and base precursors leads to a chronic net dietary acid load that may have adverse consequences on bone. We wanted to test the hypothesis that a high dietary ratio of animal to vegetable foods, quantified by protein content, increases bone loss and the risk of fracture. This was a prospective cohort study with a mean (+/-SD) of 7.0+/-1.5 y of follow-up of 1035 community-dwelling white women aged >65 y. Protein intake was measured by using a food-frequency questionnaire and bone mineral density was measured by dual-energy X-ray absorptiometry. Bone mineral density was not significantly associated with the ratio of animal to vegetable protein intake. Women with a high ratio had a higher rate of bone loss at the femoral neck than did those with a low ratio (P = 0.02) and a greater risk of hip fracture (relative risk = 3.7, P = 0.04). These associations were unaffected by adjustment for age, weight, estrogen use, tobacco use, exercise, total calcium intake, and total protein intake. Elderly women with a high dietary ratio of animal to vegetable protein intake have more rapid femoral neck bone loss and a greater risk of hip fracture than do those with a low ratio. This suggests that an increase in vegetable protein intake and a decrease in animal protein intake may decrease bone loss and the risk of hip fracture. This possibility should be confirmed in other prospective studies and tested in a randomized trial.

Sellmeyer DE, Stone KL, Sebastian A, Cummings SR
Am. J. Clin. Nutr. Jan 2001
PMID: 11124760 | Free Full Text

More recent studies and randomized trials have discredited the conclusions of this study.

There are two published comments on this study. The full text is available for both.

Protein intake and bone health: the influence of belief systems on the conduct of nutritional science.
Heaney RP
PMID: 11124741 | Free Full Text

Dietary ratio of animal to vegetable protein and rate of bone loss and risk of fracture in postmenopausal women.
Sebastian A, Sellmeyer DE, Stone KL, Cummings SR
Am. J. Clin. Nutr. Sep 2001
PMID: 11522569 | Free Full Text