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This first-ever Surgeon General's Report on bone health and osteoporosis illustrates the large burden that bone disease places on our Nation and its citizens. Like other chronic diseases that disproportionately affect the elderly, the prevalence of bone disease and fractures is projected to increase markedly as the population ages. If these predictions come true, bone disease and fractures will have a tremendous negative impact on the future well-being of Americans. But as this report makes clear, they need not come true: by working together we can change the picture of aging in America. Osteoporosis, fractures, and other chronic diseases no longer should be thought of as an inevitable part of growing old. By focusing on prevention and lifestyle changes, including physical activity and nutrition, as well as early diagnosis and appropriate treatment, Americans can avoid much of the damaging impact of bone disease and other chronic diseases. This Surgeon General's Report brings together for the first time the scientific evidence related to the prevention, assessment, diagnosis, and treatment of bone disease. More importantly, it provides a framework for moving forward. The report will be another effective tool in educating Americans about how they can promote bone health throughout their lives. This first-ever Surgeon General's Report on bone health and osteoporosis provides much needed information on bone health, an often overlooked aspect of physical health. This report follows in the tradition of previous Surgeon Generals' reports by identifying the relevant scientific data, rigorously evaluating and summarizing the evidence, and determining conclusions.
The aim of this treatise is to summarize the current understanding of the mechanisms for blood flow control to skeletal muscle under resting conditions, how perfusion is elevated (exercise hyperemia) to meet the increased demand for oxygen and other substrates during exercise, mechanisms underlying the beneficial effects of regular physical activity on cardiovascular health, the regulation of transcapillary fluid filtration and protein flux across the microvascular exchange vessels, and the role of changes in the skeletal muscle circulation in pathologic states. Skeletal muscle is unique among organs in that its blood flow can change over a remarkably large range. Compared to blood flow at rest, muscle blood flow can increase by more than 20-fold on average during intense exercise, while perfusion of certain individual white muscles or portions of those muscles can increase by as much as 80-fold. This is compared to maximal increases of 4- to 6-fold in the coronary circulation during exercise. These increases in muscle perfusion are required to meet the enormous demands for oxygen and nutrients by the active muscles. Because of its large mass and the fact that skeletal muscles receive 25% of the cardiac output at rest, sympathetically mediated vasoconstriction in vessels supplying this tissue allows central hemodynamic variables (e.g., blood pressure) to be spared during stresses such as hypovolemic shock. Sympathetic vasoconstriction in skeletal muscle in such pathologic conditions also effectively shunts blood flow away from muscles to tissues that are more sensitive to reductions in their blood supply that might otherwise occur. Again, because of its large mass and percentage of cardiac output directed to skeletal muscle, alterations in blood vessel structure and function with chronic disease (e.g., hypertension) contribute significantly to the pathology of such disorders. Alterations in skeletal muscle vascular resistance and/or in the exchange properties of this vascular bed also modify transcapillary fluid filtration and solute movement across the microvascular barrier to influence muscle function and contribute to disease pathology. Finally, it is clear that exercise training induces an adaptive transformation to a protected phenotype in the vasculature supplying skeletal muscle and other tissues to promote overall cardiovascular health. Table of Contents: Introduction / Anatomy of Skeletal Muscle and Its Vascular Supply / Regulation of Vascular Tone in Skeletal Muscle / Exercise Hyperemia and Regulation of Tissue Oxygenation During Muscular Activity / Microvascular Fluid and Solute Exchange in Skeletal Muscle / Skeletal Muscle Circulation in Aging and Disease States: Protective Effects of Exercise / References
Pediatric osteology, a medical specialty that has come of age, has contributed to the understanding of adult bone diseases as well. This second edition reference updates the 2003 edition with more emphasis on management as well as new and revised contributions. Thirty chapters present basic information regarding bone development, tools and techniques for evaluation (including a new chapter on radiographic imaging), and the specifics of various diseases. The three editors are affiliated as follows: Francis H. Glorieux (McGill U., Canada), John M. Pettifor (Chir Hani Baragwanath Hospital, South Africa), and Harald Juppner (Harvard Medical School, US). Academic Press is an imprint of Elsevier. Annotation ©2012 Book News, Inc., Portland, OR (booknews.com).
Nutritional Aspects of Bone Health provides an in-depth review of the role of diet in the development and maintenance of bone health throughout the lifecycle, and prevention of osteoporosis in later life. The book is multi-authored by the world's leading researchers in this area, who have come together to formulate the first ever textbook on nutritional aspects of bone health, and includes the current and cutting edge science underpinning the prevention of bone disease. The book is structured such that, in the first section, an overview is provided on what is meant by the terms bone health and osteoporosis and includes key areas such as epidemiology, genetics and the impact of non-nutritional exogenous factors influencing the skeleton. The second section details the established nutritional factors affecting bone health, namely calcium and vitamin D. Section three focuses on the role of macronutrients and macrominerals in bone health, namely protein, phosphorus, sodium and potassium, including the criticality of acid-base homeostasis to skeletal integrity. Section four addresses the effects of microminerals, trace elements, vitamin K, vitamin A and isoflavones on bone. Section five focuses attention on key issues connected with the influence of diet and anorexia and bulimia on bone health including nutrition and bone growth; nutrient: gene interactions; nutrient: drug interactions; and the final section discusses the effect of diet on reduction of fracture risk; the cost-effectiveness of nutritional supplements; and nutritional strategies for prevention and treatment of osteoporosis. The book is targeted at a number of key audiences. Whilst there is a focus on the academic research world and those principally involved in education, at both undergraduate and postgraduate levels, the book will also be of considerable interest to those participating in the treatment and prevention of osteoporosis, namely those working in the medical and health promotion fields. Furthermore, Nutritional Aspects of Bone Health will be of particular interest to the food industry as the popularity of foods designed to target specific health issues increases, and nutritional therapy has a critical role to play in this major public health problem.
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It is a commonly held belief that athletes, particularly body builders, have greater requirements for dietary protein than sedentary individuals. However, the evidence in support of this contention is controversial. This book is the latest in a series of publications designed to inform both civilian and military scientists and personnel about issues related to nutrition and military service. Among the many other stressors they experience, soldiers face unique nutritional demands during combat. Of particular concern is the role that dietary protein might play in controlling muscle mass and strength, response to injury and infection, and cognitive performance. The first part of the book contains the committee's summary of the workshop, responses to the Army's questions, conclusions, and recommendations. The remainder of the book contains papers contributed by speakers at the workshop on such topics as, the effects of aging and hormones on regulation of muscle mass and function, alterations in protein metabolism due to the stress of injury or infection, the role of individual amino acids, the components of proteins, as neurotransmitters, hormones, and modulators of various physiological processes, and the efficacy and safety considerations associated with dietary supplements aimed at enhancing performance.
This contributed volume presents the current state of research on regenerative rehabilitation across a broad range of neuro- and musculoskeletal tissues. At its core, the primary goal of regenerative rehabilitation is to restore function after damage to bones, skeletal muscles, cartilage, ligaments/tendons, or tissues of the central and peripheral nervous systems. The authors describe the physiology of these neuro- and musculoskeletal tissue types and their inherent plasticity. The latter quality is what enables these tissues to adapt to mechanical and/or chemical cues to improve functional capacity. As a result, readers will learn how regenerative rehabilitation exploits that quality, to trigger positive changes in tissue function. Combining basic, translational, and clinical aspects of the topic, the book offers a valuable resource for both scientists and clinicians in the regenerative rehabilitation field.
Attempts to cover a wide range of both basic research and applied clinical topics related to skeletal muscle damage and repair mechanisms and their application. This book examines muscle damage and repair mechanisms and issues in specific populations including older adults and special populations.
Translated from the German by Maquet, P.; Furlong, R.