mod5 incidence osteoporosis (1)
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o rig in l om m un i tions
The Am erican Journa l o f C lin ic a l N u trition 25 : J uNE1972 , pp . 555 558 P rin ted in U .S .A .
55 5
In c idence o f os teopo ros is in vege ta rians
and om n ivo res
Frey R . E llis ,3 M .D ., F .R .C . Pa th o l., Schura H ole sh ,4 M .B .C hB ., F .F .R ., D .M .R .D .,
a nd Joh n W . E llis ,5 B .Sc .
Th is in ve s tiga tio n w as in itia ted b y the hy -
po the s is p ro posed by W achm an and B ern -
s te in 1 th at bo ne d isso lu tio n is co ns id ered
a s a p oss ib le m echan ism to b uffe r th e fix ed
ac id lo ad im posed b y th e ing es tion o f an
acid ash d ie t in m an . If th is hy po the s is is
fe a sib le , on e w ou ld ex pec t to o bserv e a
g rea ter d eg ree o f bo ne d isso lu tion in a d iet
tha t
co n ta ins m ea t a
p rim a ry sou rce o f acid
ash than in a veg eta r ian d ie t.
Var ious stud ies 2 , 3 have show n tha t
the re is an inc rea sed bon e loss w ith ag e; th is
lo ss b eg ins at ap prox im ate ly age 35 to 45 in
w om en and app ro x im a te ly 45 to 65 in m en .
The ra te o f lo ss
is
also g rea te r in fem a le s
than in m a le s.
The d iag nos is o f os teop o ro sis by su b je c tive
stud y of X -rays is in accu ra te u n le ss th e
ch an ge s a re g ro ss. A s a re su lt, va rio us q uan -
titiv e m eth od s h av e been dev ised fo r the
m easu rem en t o f bo ne d ens ity , e .g ., X -ray
and g am m a-ray densitom etry . Th e h an ds a re
u sua lly exam in ed , a s th is is m o re co nven ien t
fo r the sub jec t and th e re is le ss so ft tissue to
a ffect d ensity read in gs. W est and R eed 4 ,
how ev er, h av e fo und th e be s t re su lts by ex -
am ina tion of the fem ur. A no the r m eth od o f
a sse ssing bone den sity is by m easu ring th e
co rtica l th ickn es s an d the to ta l d iam e te r o f
the 2 nd m etaca rp al. T he resu lt is expressed
as co rtica l th ick ness to to ta l th ick ness ratio
becau se th is va lue is a fun ctio n of bo ne den-
sity ra the r than bone m ass and has a m uch
sm a ller s tan da rd dev ia tio n 5 , 6 .
Mater ia ls an d method s
A g roup of tw en ty -five B ritish v eg eta rians ov o-
lac to veg eta rian s , con sis ting of eigh t m a les and
seven teen fem ales w ith an age ran ge o f 53 to 79
yea rs, w a s stu d ied .
A blood sam ple w as taken fo r
la bo rato ry in ve stig atio n.
In th is sho rt p re lim ina ry in ve stig atio n , it
w as
decid ed to
use a s im p le m etho d o f testing bone
dens ity , pa rticu lar ly as th e m ore com plica ted ap-
para tus w as no t av ailab le an d pa tien ts cam e in te r-
m itten tly from various p arts o f the co un try .
T he r ig h t hand w as exam ined in a ll in s tan ces
excep t in tw o p atien ts w ho w ere le ft-h an ded . K odak
casse tte s w ith h igh reso lu tio n sc reens an d rap id
p roc ess film s w ere used . T he X -ray fa cto rs w ere
45 kv , 5 0 to 70 m a, at
58 inch es tube-focus d istance
to avo id as m uch m agn ific atio n as possib le . A
gradu ated a lum inum step-w edge 1 to 8 m m w as
pla ced on each film to ensu re un iform ity of d ens ity .
The processing of all X -rays w as by a 9 0-sec au to -
m atic a pparatu s
A s th e 3rd fin ge r w a s in the cen ter of th e X -ray
film , it w as d ec ided to de te rm ine th e d ensity o f
the cen te r o f the th ird m etacarpa l m edu lla an d the
prox im al pha lanx us in g a B aldw in R ad io lo g ical
D ens itom ete r. T he cen te rs o f these bon es w ere
accura te ly m easured and grea t care w as tak en to
p lace th is area in the cen te r o f th e d en sitom eter
ap er tu re . B ecause o f th e ag e of som e of the pa-
tien ts , the re w as no t a su ffic ien tly c lea r d istinc tio n
b etw een the m edu lla and cortex an d it w as felt
tha t co r tica l m easurem en ts w ould be inaccura te .
A ll the d ensitom ete r read ing s w ere de te rm ined on
the sam e day to ensure un ifo rm ity and accuracy .
T he hem oglob in and w hite ce ll coun t w ere de-
te rm ined on a C oulte r M ode l
5
t he s ed im en ta tio n
ra te b y the m eth od o f W este rgren , a nd the se rum
concen tratio ns of u rea , c ho lestero l, ca lc ium , p hos -
ph ate , an d pro te ins w ere d ete rm ined by sta nda rd
au tom ated labo rato ry te chn iqu es. Th e se rum B 12
w as de te rm ined by the Lac tob ac il u s le ichrnan n ii
F rom the K ings to n H osp ita l, K ing ston-u pon-
T ham es , S urrey , Eng lan d .
S upported by a gran t from th e S ou th W est
M etropo litan R eg iona l H o sp ita l B oard .
C onsu ltan t H aem ato log is t. C onsu ltan t R a-
d io log is t. R esearch A ssistan t.
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6 E L L I S E T L
method 7 and the serum folate by the method of
Chanari n 8 .
A control group of 25 omniv ores, matched for
age 3 years and sex , w ere also studied T able 1 .
Results
I n Table 2, the resul ts of the radiological
and laboratory investigati ons are given as the
mean
sD
of the tw o separate groups. T he
mean of the serum folate and proteins in the
control group w ere determ ined on groups of
21 and 24, respecti vely ; in al l other cases,
the means are for groups of
25 .
The signi f i cance w as determ ined by apply-
i ng a
t
test on the pai red observations and
the level of significance w as taken as
P