There is a need for an improved bone mineral density measurement procedure for neonates. Currently, measurements are made using single photon absorptiometry (SPA). The poor reproducibility of this method means that it has little direct clinical diagnostic application and is therefore not suitable for diagnosing disease in individual patients. A technique using digital radiography has been developed to measure bone mineral density. Digital images of phantoms and chicken bones were acquired at two kvp settings of a digital angiographic unit. Digital information from water, aluminum and lucite phantoms were used to calculate effective mass attenuation coefficients of the phantom materials. These values were subsequently used in bone mineral density calculations of sections of the chicken bones. The bone mineral densities of the chicken bones obtained from the digital radiography method were compared to SPA measurements. The digital radiography method gave consistently higher bone mineral densities for the bones than SPA. This could be due to the differences in measurement technique as SPA scans a single slice whereas digital radiography images a large area of the bone. / Thesis / Master of Science (MSc)

Introduktion: Benskörhet är vanligt förekommande och är ett tillstånd där skelettets funktion försämras. Minskad bentäthet påverkas av faktorer såsom kost, fysisk aktivitet, ålder och hormoner. Av alla som får en höftledsfraktur över 75 års ålder avlider 30% av patienterna inom ett år. Benskörhet bidrar till minskad styrka, muskelmassa och större risk för fler framtida frakturer. Syfte: Syftet med studien är att sammanställa och jämföra studier kring fysisk träning hos äldre (60+) och träningens effektivitet vid osteoporos eller osteopeni. Metod: Metoden genomfördes enligt avancerad sökning i Pubmed, CINAHL och Scopus där endast RCT studier inkluderades. Kvalitetsgranskningen skedde enligt PEDro-skalan. Resultat: Artikelsökningen gav 288 träffar, efter artikelsökningen återstod 12 st artiklar. Resultatet av BMD analyserades  i femur, ländrygg, underarm, underben och total body. Styrketräning, multikomponent träning och vibrationsträning har visat ökning av BMD i femur och ländrygg. Submaximal träning kombinerat med läkemedel ger effekt på BMD. Vibrationsträning ser en ökning av BMD i distala radius och tibia. Konklusion: Högintensiv träning, multikomponent träning och vibratorisk träning gav effekt på BMD. Vandring och aerobisk träning gav inte lika stor effekt på BMD. Däremot sågs att varierad träning minskar fallrisk och att komponenter såsom styrka, balans, aerobisk kapacitet och koordination är viktiga för ökad och bibehållen fysisk funktion samt för att förhindra fallrisk hos äldre. Fysioterapeuter och sjukvårdens samarbete är viktigt för att minska risken för frakturer hos äldre.

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Disertacija skirta nustatyti sergančiųjų spondiloartropatijomis (SpA) (AS, ReA, PsA, EnA) KMT pokyčių dėsningumus stuburo juosmeninėje ir šlaunikaulių proksimalinėse dalyse bei įvertinti ryšį tarp kaulų masės pokyčių ir ligos specifinių veiksnių (ligos trukmės, fizinės negalios ir judėjimo funkcijos sumažėjimo, vartojamų medikamentų, ligos aktyvumo). Darbe nustatyta, kad sergančiųjų SpA KMT nesiskiria nuo sergančiųjų reumatoidiniu artritu, ir yra reikšmingai mažesnis lyginant su sveikų asmenų KMT ir stuburo juosmeninėje, ir šlaunikaulių proksimalinėse dalyse. Panašūs KMT pokyčiai stuburo juosmeninėje ir šlaunikaulių proksimalinėse dalyse būdingi SpA pacientams, sergantiems įvairiomis SpA grupės ligomis, bei nepriklauso nuo vyraujančio sąnarių pažeidimo tipo. KMT pokyčius geriau atspindi ligos trukmė, skaičiuojant ją ne nuo klinikinės diagnozės nustatymo momento, o nuo pirmųjų ligos simptomų pasireiškimo. Ligos trukmei ilgėjant – šlaunikaulių KMT mažėja, o stubure – didėja. Vidutinis ir didelis ligos aktyvumas, kurį nustatė gydytojas reumatologas, turi įtakos stuburo juosmeninės ir šlaunikaulių proksimalinių dalių KMT sumažėjimui. KMT mažėjimas ir stuburo juosmeninėje, ir šlaunikaulių proksimalinėse dalyse susijęs su SpA sergančiojo judėjimo funkcijos sumažėjimu. Šį ryšį tiksliausiai atspindi tarpkulkšnelinio atstumo matmuo – šlaunikaulių proksimalinių dalių KMT rodmenys mažiausi, kai stuburo paslankumas įvertintas sunkiu sumažėjimo lygiu. Gliukokortikoidų kumuliacinė dozė... [toliau žr. visą tekstą] / The aim of this work was to determine consistent patterns of BMD changes at the lumbar spine and the upper part of the left and right femur in patients with SpA (AS, ReA, PsA, EnA) and to assess relation between changes of bone mass and specific factors of the disease (duration of the disease, physical disability and immobility, activity of the disease, medications in use). It was established that in patients with SpA BMD is the same as in patients with rheumatoid arthritis and is significantly lower in comparison with BMD of healthy subjects measured at the lumbar spine and upper part of the left and right femur. Similar BMD changes at the lumbar spine and upper part of the left and right femur are characteristic of SpA patients with various diseases belonging to SpA group and do not depend on the predominant type of joint lesion. The duration of the disease reflects changes in BMD better when it is calculated not from the time of the establishment of clinical diagnosis, but from the time of onset of first clinical symptoms. BMD decrease at the upper part of the left and right femur and increase at the spine with the increase of the duration of disease. Moderate and high activity of the disease established by rheumatologist contribute to BMD loss at the lumbar spine and upper parts of the both femurs. BMD reduction at the lumbar spine and the upper part of the left and right femur is associated with the decrease of mmobility of SpA patients. Intermalleolar distance is the... [to full text]

Disertacija skirta nustatyti sergančiųjų spondiloartropatijomis (SpA) (AS, ReA, PsA, EnA) KMT pokyčių dėsningumus stuburo juosmeninėje ir šlaunikaulių proksimalinėse dalyse bei įvertinti ryšį tarp kaulų masės pokyčių ir ligos specifinių veiksnių (ligos trukmės, fizinės negalios ir judėjimo funkcijos sumažėjimo, vartojamų medikamentų, ligos aktyvumo). Darbe nustatyta, kad sergančiųjų SpA KMT nesiskiria nuo sergančiųjų reumatoidiniu artritu, ir yra reikšmingai mažesnis lyginant su sveikų asmenų KMT ir stuburo juosmeninėje, ir šlaunikaulių proksimalinėse dalyse. Panašūs KMT pokyčiai stuburo juosmeninėje ir šlaunikaulių proksimalinėse dalyse būdingi SpA pacientams, sergantiems įvairiomis SpA grupės ligomis, bei nepriklauso nuo vyraujančio sąnarių pažeidimo tipo. KMT pokyčius geriau atspindi ligos trukmė, skaičiuojant ją ne nuo klinikinės diagnozės nustatymo momento, o nuo pirmųjų ligos simptomų pasireiškimo. Ligos trukmei ilgėjant – šlaunikaulių KMT mažėja, o stubure – didėja. Vidutinis ir didelis ligos aktyvumas, kurį nustatė gydytojas reumatologas, turi įtakos stuburo juosmeninės ir šlaunikaulių proksimalinių dalių KMT sumažėjimui. KMT mažėjimas ir stuburo juosmeninėje, ir šlaunikaulių proksimalinėse dalyse susijęs su SpA sergančiojo judėjimo funkcijos sumažėjimu. Šį ryšį tiksliausiai atspindi tarpkulkšnelinio atstumo matmuo – šlaunikaulių proksimalinių dalių KMT rodmenys mažiausi, kai stuburo paslankumas įvertintas sunkiu sumažėjimo lygiu. Gliukokortikoidų kumuliacinė dozė... [toliau žr. visą tekstą] / The aim of this work was to determine consistent patterns of BMD changes at the lumbar spine and the upper part of the left and right femur in patients with SpA (AS, ReA, PsA, EnA) and to assess relation between changes of bone mass and specific factors of the disease (duration of the disease, physical disability and immobility, activity of the disease, medications in use). It was established that in patients with SpA BMD is the same as in patients with rheumatoid arthritis and is significantly lower in comparison with BMD of healthy subjects measured at the lumbar spine and upper part of the left and right femur. Similar BMD changes at the lumbar spine and upper part of the left and right femur are characteristic of SpA patients with various diseases belonging to SpA group and do not depend on the predominant type of joint lesion. The duration of the disease reflects changes in BMD better when it is calculated not from the time of the establishment of clinical diagnosis, but from the time of onset of first clinical symptoms. BMD decrease at the upper part of the left and right femur and increase at the spine with the increase of the duration of disease. Moderate and high activity of the disease established by rheumatologist contribute to BMD loss at the lumbar spine and upper parts of the both femurs. BMD reduction at the lumbar spine and the upper part of the left and right femur is associated with the decrease of mmobility of SpA patients. Intermalleolar distance is the... [to full text]

Conversely, AA lost femoral neck BMD over the winter and this was not recovered over the summer, although the increase in width of the femoral neck may have partly compensated BMD loss to maintain strength in bending. The final prospective analysis was conducted in a separate sample of female athletes who were diagnosed with a stress fracture injury. The aim of this analysis was to determine the magnitude and time scale of bone loss following a stress fracture injury and subsequent regain following retaining. A group of 4 stress fracture cases and 3 controls were followed for a period of 6-8 months following a stress fracture injury. BMD and BMC (lumbar spine, femoral neck, and trochanter) and estimations of geometric properties CSA, Z and buckling ratio) were assessed using DXA. The mean difference of bone loss and bone regain was determined by BMD, BMC and geometric parameters from baseline to 6-8 weeks and 6-8 weeks to 6-8 months respectively. No significant bone loss was found in either cases or controls from baseline to 6-8 weeks at any of the bone parameters. A significant difference at the femoral neck was found in the injured leg of the stress fracture cases from 6-8weeks to 6-8months (mean (SE) 1.042(0.102) to 1.070(0.102) g/cm2, p=0.004) with no significant change in the contra-lateral case leg 1.036 (0.102) to 1.054(0.109) g/cm2). No significant bone regain was found in the control subjects (health or injured legs ). Thus athletes do not seem to lose significant BMD during the recovery phase of training when partial weight bearing is required. Subsequent bone regain above the initial baseline value does seem to occur in the injured leg within 8 months following the stress fracture once training is resumed. In conclusion the work within this thesis has not only reinforced previous stress fracture findings, showing that a history of stress fracture is increased in athletes with a history of amenorrhoea, but has identified novel results indicating a lower incidence of stress fracture in female endurance athletes than previously reported. Exercise cognitions have been identified as risk factors for stress fracture history independent of menstrual dysfunction. Furthermore and potentially the most novel finding of this research is the importance for the examination of bone geometric properties in amenorrhoeic athletes. Findings suggest that possible structural adaptations counteract the effects of low BMD and annual losses of BMD during seasonal training in amenorrhoeic endurance athletes. In light of these findings this thesis highlights scope for further longitudinal research in the area of structural adaptation to bone in amenorrhoeic athletes. Keywords: Stress fracture, bone mineral density, bone geometry, endurance athletes, menstrual dysfunction, eating and exercise cognitions.

A cirurgia bariátrica é o tratamento de primeira escolha para a obesidade mórbida, uma vez que o tratamento clínico convencional apresenta baixa eficácia em produzir uma perda de peso significativa e, consequentemente, melhorar as comorbidades associadas à essa condição clínica. Contudo, estudos demonstram uma perda óssea relevante induzida pela cirurgia bariátrica, a qual pode aumentar o risco de fraturas em longo prazo. Diante disso, este estudo clínico randomizado teve como objetivo investigar os efeitos do treinamento físico sobre a saúde óssea em mulheres submetidas à cirurgia bariátrica pela técnica de derivação gástrica em Y de Roux. Antes da intervenção cirúrgica, as pacientes realizaram avaliações de diversos parâmetros ósseos e capacidade física, e foram alocadas aleatoriamente nos grupos treinamento físico (RYGB+TF) ou tratamento convencional (RYGB). Três meses após a cirurgia, ambos os grupos foram reavaliados e iniciaram os tratamentos com duração de 6 meses. Nove meses após o início do estudo, as pacientes efetuaram novamente todas as avaliações. Os resultados demonstram que a cirurgia bariátrica reduziu significantemente o peso corporal, IMC, porcentagem de gordura, tecido adiposo visceral e massa magra (P<0,001 para todas as variáveis) em ambos os grupos. O procedimento cirúrgico induziu uma perda significante na densidade mineral óssea areal (aDMO) do fêmur total, colo de fêmur, rádio distal e corpo total nos dois grupos (P<0,001 para todos os parâmetros). Constatou-se aumentos significantes dos marcadores de remodelação óssea CTX e P1NP, bem como das proteínas esclerostina e osteopontina (P<0,05 para todos os marcadores) após a intervenção cirúrgica nos grupos RYGB e RYGB+TF. A cirurgia acarretou efeitos deletérios sobre alguns parâmetros da microarquitetura do rádio distal das pacientes, tais como a redução na espessura cortical (Ct.Th) (P=0,001) e o aumento da porosidade cortical (Ct.Po) (P=0,009). A capacidade física e funcionalidade de ambos os grupos foram negativamente afetadas pela cirurgia (P<0,001 para todas as variáveis). De modo importante, o treinamento físico mitigou a redução percentual da aDMO do fêmur total (P=0,009), colo de fêmur (P=0,007), rádio distal (P=0,038) e massa magra (P=0,048) em comparação ao tratamento convencional. Atenuações significantes ocasionadas pelo treinamento físico foram observadas para o CTX (P=0,002), P1NP (P=0,024) e esclerostina (P=0,046). O grupo RYGB+TF experimentou uma menor redução percentual da densidade mineral óssea volumétrica cortical (Ct.vDMO) do rádio distal em comparação ao grupo RYGB (P=0,024). As pacientes expostas ao treinamento físico melhoraram significantemente a força muscular de membros superiores (P=0,002) e inferiores (P<0,001), bem como desempenharam melhor os testes funcionais de Sentar e Levantar (P<0,001) e Timed Up and Go (P=0,007) em relação às pacientes que receberam o tratamento convencional. Diante desses achados, concluímos que o treinamento físico supervisionado com duração de 6 meses foi eficaz em atenuar a redução induzida pela cirurgia bariátrica dos parâmetros relacionados à saúde óssea de mulheres, bem como melhorar a capacidade física e funcionalidade desta população / Bariatric surgery is the treatment of choice for morbid obesity, since conventional treatment yields low efficacy in producing a significant weight loss and, consequently, improves obesity-related comorbidities. Nevertheless, some studies demonstrate a bariatric surgeryinduced bone loss, which may increase the long-term risk of fractures. In light of this, the aim of this randomized controlled trial was to investigate the effects of exercise training on bone health in women underwent Roux-en-Y gastric bypass. Before surgical intervention, bone parameters and physical capacity were assessed, and patients were randomly assigned into bariatric surgery plus exercise training group (RYGB+TF) or bariatric surgery (RYGB). Three months after surgery, both groups were re-assessed and underwent a 6-month exercise training program or standard of care. Nine months after surgery, patients were re-evaluated. As a result of surgery, body weight, BMI, fat percentage, visceral adipose tissue, and lean mass significantly decreased in both groups (P<0.001 for all variables). Bariatric surgery induced a significant areal bone mineral density (aBMD) loss at the total hip, femoral neck, distal radius, and whole body in both groups (P<0.001 for all sites). Bone turnover markers (i.e. CTX and P1NP), as well as sclerostin and osteopontin significantly increased after surgery in RYGB and RYGB+TF (P<0.05 for all markers). After the surgery, cortical thickness was significantly reduced in both groups (P=0.001). At the same site, cortical porosity was significantly increased after surgical procedure (P=0.009). Physical and functional capacity were negatively affected by surgery in both groups (P<0.001 for all variables). Importantly, exercise training significantly mitigated percent loss of aBMD at the total hip (P=0.009), femoral neck (P=0.007), distal radius (P=0.038), and lean mass (P=0.048) compared to standard of care. Exercise also attenuated CTX (P=0.002), P1NP (P=0.024), and sclerostin (P=0.046). A significantly reduced percent loss in cortical volumetric bone mineral density (Ct.vBMD) at the distal radius was observed in RYGB+TF group compared to RYGB (P=0.024). Patients underwent exercise training significantly improved upper-limb muscular strength (P=0.002), lower-limb muscular strength (P<0.001), as well as Sit-to-Stand test (P<0.001) and Timed Up and Go test (P=0.007) compared to individuals who received standard of care. Thus, we conclude that a 6-month, supervised exercise training program was capable of attenuating bariatric surgery-induced bone loss, as well as improves physical and functional capacity in women

A ocorrência de fraturas em animais e, especialmente nas espécies de grande porte, geram preocupação quanto ao custo do tratamento e a ocorrência de sequelas, pois há a possibilidade de complicações pela carga excessiva que esses animais exercem sobre os membros. Dessa forma é importante a imobilização imediata do membro e de maneira adequada, e avaliar se há necessidade de se realizar cirurgia para estabilização da fratura. Em algumas fraturas pode haver falhas ósseas, principalmente em fraturas cominutivas com extensa lesão de tecidos adjacentes, o que dificulta e prolonga o tempo de consolidação. Por essas razões vem sendo estudado, há alguns anos, o uso de substitutos ósseos na forma de cimentos ou mantas ósseas para reparar esses defeitos. O estudo com biomateriais como substitutos ósseos tem tido grande evolução nos últimos anos, e aqueles à base de quitosana, hidroxiapatita e colágeno apresentam grande vantagem, pois a quitosana estimula a regeneração óssea, a hidroxiapatita confere a dureza que o material exige, e o colágeno fornece maleabilidade. O presente projeto teve por objetivo avaliar o reparo ósseo após implante de compósito à base de quitosana, hidroxiapatita e colágeno, em falhas ósseas de tíbias de ovinos induzidas experimentalmente. Foram utilizados os métodos de imagem por densitometria ótica radiográfica e microtomografia computadorizada 3D para avaliar o grau e o tempo de reparo ósseo, assim como a densidade mineral óssea durante a cicatrização. As falhas ósseas foram confeccionadas nas tíbias de ovelhas, em ambos os membros, onde foi implantado o biomaterial em um deles, e o membro contralateral mantido como controle. Posteriormente, os animais foram submetidos a exames radiográficos, quinzenalmente, até 90 dias de pós operatório. Após este período, os animais foram submetidos à eutanásia e fragmentos das tíbias foram colhidos para avaliação por microtomografia computadorizada 3D. Observou-se, pelos resultados qualitativos das imagens radiográficas e dos dados estatísticos, que houve absorção gradativa do biomaterial, e que não houve diferença estatística em relação à densidade mineral óssea entre os dois grupos estudados, embora a DMO tenha sido maior nos membros com o biomaterial. Este método mostrou-se prático e eficaz, além de ser uma técnica não invasiva. A microtomografia computadorizada 3D revelou importantes informações quanto à porosidade óssea e volume ósseo entre os dois grupos. As imagens em 3D mostraram detalhes do osso que não eram possíveis de visualizar por meio das radiografias. Dessa forma é uma técnica bastante eficaz e detalhada, mas é necessária padronização de todas as amostras para poder quantificar os valores adequadamente. O estudo estatístico não mostrou diferenças entre os grupos com biomaterial e controle para os parâmetros de volume ósseo, grau de porosidade e porcentagem de volume ósseo. Porém, pelas imagens em 3D observa-se nitidamente maior quantidade de poros nas amostras controle em relação às amostras com biomaterial. Conclui-se com este estudo que as técnicas de densitometria óssea por raios-X e &micro;CT 3D são bastante eficazes para avaliar a cicatrização óssea em ovinos / The occurrence of fractures in animals and, especially, in large animals are conditions that generate concern about the cost of treatment and the occurrence of future complications because there is the possibility of complications due to excessive load that these animals receive in their limbs. Thus, it is important the limb immobilization immediately and appropriately and assess whether it is necessary to perform surgery to stabilize the fracture. In some kinds of fractures, it might have large bone defects, mainly in comminuted fractures with extensive damage to surrounding tissue, which makes it more difficult and prolongs the consolidation time. For these reasons, scientists have been studied the use of bone substitutes in the form of bone cements to repair these defects. The study of biomaterials as bone substitutes has had great progress in last years, and those based on chitosan, hydroxyapatite and collagen had great advantage because chitosan stimulates bone regeneration, hydroxyapatite confers the hardness that the material requires, and collagen provides flexibility to the material. This project aims to assess bone repair after deploying a composite of chitosan, collagen and hydroxyapatite in bone defects experimentally induced in sheep tibiae. For assessing the degree and the time of bone healing, it was used imaging techniques like radiographic bone densitometry and 3D micro-computed tomography. Bone defects were made in the sheep tibiae in both limbs where the biomaterial was deployed in one of them, and the control was the contralateral limb. After the surgeries, the animals were submitted to radiographic exams every two weeks until 90 days postoperatively. After this period, the animals were euthanized and harvested tibiae fragments for evaluation by 3D micro-computed tomography. Through the qualitative results of images and statistical data, it was observed, radiographically, that there was a gradual absorption of the biomaterial, and also that there was no statistical difference in relation to bone mineral density between the two groups. The method of determining the X-ray BMD proved to be practical and effective, and it is a noninvasive technique. 3D micro-computed tomography revealed important information about bone porosity and bone volume between the two groups. The 3D images showed bone details that were not possible to visualize through radiographs. Thus it is a highly effective and detailed technique, but it requires patterning of all the samples in order to quantify the amounts properly. Statistical analysis showed no differences between the groups for bone volume parameters, degree of porosity and percentage of bone volume. However in the 3D images, it can be observed clearly larger amount of pores in the control samples in comparison to those with biomaterial. It is concluded from this study that the techniques of bone densitometry X-ray and 3D &micro;CT are very effective to evaluate bone healing in sheep. Bone mineral density was higher in limbs with biomaterial and there was a higher bone volume and lower degree of porosity in the samples with biomaterial compared to the control group

Introdução: A osteoporose requer estratégias para prevenir sua progressão, garantindo melhores condições de vida aos pacientes. Padrões alimentares fornecem informações sobre a influência da dieta global, contribuindo para o cuidado desses indivíduos. Objetivo: Investigar a associação entre o padrão alimentar e a densidade mineral óssea de mulheres menopausadas com osteoporose. Métodos: Trata-se de estudo transversal com 156 mulheres (> 45 anos), atendidas em ambulatório da cidade de São Paulo, Brasil. Densidade Mineral Óssea (DMO; g/cm2) da coluna (CL), fêmur total (FT), colo do fêmur (CF) e corpo total (CT) foram obtidas por absorciometria de feixe duplo. Peso (kg), estatura (m), Índice de Massa Corporal (IMC; kg/m2), gordura corporal (g), massa magra (g) e informações sobre os hábitos de vida também foram obtidos. A dieta foi avaliada por registro alimentar de 3 dias. Os padrões alimentares (PA) foram derivados via análise fatorial por componentes principais a partir de 13 grupos de alimentos. Utilizou-se regressão linear múltipla ajustada para ingestão energética e de cálcio, idade, tempo de menopausa e massa magra. Também foi conduzida ANOVA Two-way para avaliar a associação integrada dos PA com o IMC sobre a DMO, seguida de regressão linear estratificada pelas categorias de IMC. Adotou-se significância de 5 por cento . Resultados: Obteve-se 5 PA: 1) Saudável (frutas, hortaliças, tubérculos e raízes); 2) Carne vermelha e cereais refinados; 3) Laticínios magros; 4) Doces, café e chás; e 5) Ocidental (sucos artificiais, refrigerantes, snacks, pizzas, tortas e gorduras). O padrão Doces, café e chás foi inversamente associado à DMO do FT ( = -0.178; CI 95 por cento : -0.039 - -0.000) e à DMO do CT ( = -0,320; CI 95 por cento : -0,059 - -0,017). O padrão Saudável apresentou associação positiva com a DMO do FT entre as mulheres com IMC normal ( = 0,251; CI 95 por cento : 0,002 0,056). Conclusão: Uma dieta com elevada ingestão de doces, café e chás teve associação negativa com a DMO do fêmur e corpo total, enquanto o PA Saudável foi positivamente associado à DMO do fêmur entre aquelas com IMC normal. / Introduction: Osteoporosis claims for strategies to preventing disease progression, ensuring a better quality of life to patients. Dietary patterns could provide information about the influence of overall diet on osteoporosis treatment, contributing to osteoporotic care. Objective: To investigate the association between dietary patterns and bone mineral density in postmenopausal women with osteoporosis. Methods: This cross-sectional study included 156 postmenopausal osteoporotic women, over 45 y, attended in an outpatient clinic in Sao Paulo, Brazil. Bone Mineral Density (BMD; g/cm2) of Lumbar Spine (LS), Total Femur (TF), Femoral Neck (FN), and Total Body (TB) were obtained by dual-energy X-ray absorptiometry. Weight (kg), height (m), Body Mass Index (BMI; kg/m2), body fat (g), lean mass (g) and lifestyle information were also assessed. Dietary intake was evaluated using a 3-day food diary. Dietary patterns were obtained by principal component factor in the 13 previously formed food groups. Adjusted linear regression analysis was applied in order to evaluate the predict effect of dietary patterns on BMD. Two-way ANOVA was used to investigate the association between dietary patterns and BMI with BMD, followed by a linear regression model stratified by BMI categories. Significance level was set as 5 per cent . Results: Five patterns were retained: 1) Healthy (vegetables, fruits, tubers, and tuberous roots); 2) Red meat and refined cereals; 3) Low-fat dairy; 4) Sweets, coffee and tea; and 5) Western (fats, snacks, pizzas, pies, soft drinks, and fruit drinks). The Sweets, coffee, and tea pattern was inversely associated with TF BMD ( = -0.178; CI 95 per cent : -0.039 - -0.000) and with TB BMD ( = -0.320; CI 95 per cent : -0.059 - -0.017), whereas the Healthy pattern was positively associated with TF BMD only among those who were in the normal BMI category ( = 0.251; CI 95 per cent : 0.002 0.056). Conclusions: A diet with higher intake of Sweets, coffee, and tea was a negatively associated with TF and TB BMD, whereas a Healthy pattern showed a positive association with TF BMD among the women with normal BMI.

A baixa densidade mineral óssea é um indicador de risco de fratura por osteoporose, importante e crescente problema de saúde pública. O consumo deficiente de cálcio acarreta menor mineralização óssea. O presente estudo teve por objetivo identificar as relações entre consumo de cálcio dietético e densidade mineral óssea na coluna lombar, colo do fêmur e conteúdo de cálcio corporal total. É um estudo transversal, abrangendo 296 homens com idade média de 62,5 anos (DP=7,9). O consumo de cálcio dietético foi avaliado no momento atual, correspondente ao período de coleta de dados, e ao longo da vida, pelo método de registro alimentar (três dias) e questionário retrospectivo de freqüência de consumo de leite e derivados fontes de cálcio. Para análise da densidade mineral óssea foi realizado o exame de densitometria por emissão dupla de raios X. A análise da densidade mineral óssea foi feita de forma comparativa com os grupos conforme consumo de cálcio dietético, sendo calculado o coeficiente de correlação de Pearson e feitos os testes de diferença de médias, teste t-Student e Kruskai-Wallís. O consumo de cálcio dietético atual apresentou-se inadequado (72%) e o pregresso foi considerado adequado (65%) para maioria da população estudada. A principal fonte de cálcio dietético consumida no presente foi o leite, seguido dos derivados lácteos. Foram observadas relações entre o conteúdo de cálcio corporal total e o consumo de cálcio dietético tanto no passado como no presente. Contudo, não foi possível observar relações entre o consumo de cálcio dietético atual e pregresso e a densidade mineral óssea na coluna lombar e colo do fêmur, na população estudada de homens com mais de 50 anos. / The low bone mineral density is an indicator of osteoporotis fracture risk, an important and increasing health public concern. An insufficient calcium intake results in a lower bone mineralization. The objective of this study was to establish relationship between dietetic calcium intake and bone mineral density at the lumbar portion of the spinal column, femur neck and the total body calcium content. lt is a transversa study, including 296 men with age average of 62.5 years (standard deviation = 7.9). The dietetic calcium intake was evaluated both at the current time and throughout their lives. The data was collected using the methods of food intake record (three day) and retrospectiva questionnaire, regarding the frequency of consumption of milk and dairy products as calcium sources. Measurement of bone mineral density by dual energy x-ray absorptiometry. The bone mineral density was analysed by comparing the groups according to their dietetic calcium intake. Pearson\'s coefficient of correlation was calculated and the average differences were tested using t-Student and Kruskai-Wallis methods. The current dietetic calcium intake was inadequate (72%), whereas the past intake was considered appropriate (65%) for the major part of the studied population. The main calcium source at the current time was milk, followed by dairy products. lt was possible to establish relationship between the total body calcium content and dietetic calcium intake in the past and in the current time. However, for the bone mineral density at the lumbar portion of the spinal column and at the fêmur neck, it was not possible to stablish relationship with current and past dietetic calcium intake in the studied population of men over 50 years old.