Title: Nutrition and Bone Health Research: Diet, bone health and osteoporosis and rickets (NBH)
Funder: Medical Research Council

Abstract: We aim to identify the role of nutrition & lifestyle in bone health & the prevention of osteoporosis & rickets within the wider context of nutrition policy for calcium & vitamin D in developed & developing countries. Our goal is to promote global public health by investigating the role of nutrition & other factors in the optimisation of bone health & the prevention of fragility fractures & rickets. Poor bone health can affect people in several ways. Stunting, for example, affects millions of children around the world, with implications for the health of individuals & for national economies. Rickets, a debilitating disease of children, is a problem in many countries & is re-emerging in the UK. Osteoporosis is a major health concern world-wide. In the UK, fractures caused by osteoporosis affect 1 in 2 women & 1 in 5 men aged over 50 years. Internationally, more than 1.5 million hip fractures occur annually & it is predicted that this will increase four-fold by the year 2050. Our research is focussed on calcium nutrition & vitamin D requirements but with consideration of other potentially important influences such as muscle strength, body size & composition & metabolic processes. Health outcomes of particular relevance are fracture risk, osteoporosis, rickets, growth & stunting. The programme has a strong emphasis on translational engagement with policy informers. The main study sites are UK (especially Cambridge and Southampton); Keneba, The Gambia (Calcium, Vitamin D & Bone Health sub-programme U.1232.00.002.00001.01); Shenyang, People's Republic of China; Chakaria, Bangladesh; Johannesburg, South Africa; Blantyre, Malawi; Kampala, Uganda, & Nairobi Kenya. These populations vary widely in fragility fracture incidence, calcium intake, vitamin D status & physical activity patterns. Our research integrates 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. Studies are being conducted in infants, children, adolescents, women during pregnancy and lactation, young adults, and in older people. Measurements of bone mineral content, shape and size, using techniques such as dual-energy X-ray absorptiometry (DXA), peripheral quantitative computed tomography (pQCT) & high resolution pQCT, are combined with assessments of dietary intake, physical activity, sunshine exposure, body composition, muscle function, bone turnover, & calcium, phosphate and vitamin D metabolism. Intervention studies, with follow-up & prospective longitudinal investigations permit hypotheses to be tested concerning the influence of diet & lifestyle on musculoskeletal health & the mechanisms of adaptation to a low calcium intake, a low vitamin D supply, or both. Research into the optimisation of bone health & prevention of osteoporosis is of strategic relevance to global health policy. This programme aims to provide the scientific evidence on which future nutritional policy & practice world-wide can be based, with a pathway to impact through our translational involvements with governmental scientific advisory committees, other bodies & academic dissemination.


Research activity codes: 2.2 FACTORS RELATING TO PHYSICAL ENVIRONMENT;3.3 NUTRITION AND CHEMOPREVENTION;6.7 PHYSICAL
Health categories: MUSCULOSKELETAL;ORAL AND GASTROINTESTINAL;REPRODUCTIVE HEALTH AND CHILDBIRTH