Thursday, June 08, 2006

 

American Journal of Clinical Nutrition



American Journal of Clinical Nutrition, Vol. 83, No. 6, 1429-1437, June 2006© 2006 American Society for Nutrition
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Fluoride exposure and bone status in patients with chronic intestinal failure who are receiving home parenteral nutrition1,2,3
Paul H Boulétreau, Muriel Bost, Elisabeth Fontanges, Madeleine Lauverjat, Christel Gutknecht, René Ecochard, Pierre D Delmas and Cécile Chambrier
1 From the Artificial Nutrition Unit (PHB, ML, and CC) and the Departments of Biochemistry (MB) and Rheumatology (EF and PDD), E Herriot Hospital, Lyon, France; the Trace Element Institute for UNESCO, Lyon, France (MB); and the Department of Biostatistics, Hospices Civils, UMR CNRS 5558, Lyon, France (CG and RE)
Background and Objective: Metabolic bone disease is frequent in chronic intestinal failure. Because fluoride has a major effect on bones, the status of both fluoride and bone was studied in long-term home parenteral nutrition (HPN) patients.
Design: We studied 31 adults aged ((image placeholder) ± SD) 56.3 ± 15.1 y, mainly patients with short-bowel syndrome, who had been receiving HPN for >1 y. Bone mineral density (BMD) was measured by absorptiometry, and serum fluoride was measured by using a fluoride-sensitive electrode. All patients ate and drank ad libitum. HPN (3.4 ± 1.2 times/wk) complemented oral nutrition. Potential explicative factors were estimated by using a linear regression model (mixed-effects model).
Results: Of 120 fluoride dosages (2–6/patient), 102 were above the upper normal limit (1.58 µmol/L) at the laboratory. Mean (± SD) daily fluoride supply was 8.03 ± 7.71 mg (US adequate intake: 3.1 mg/d for women and 3.8 for men; tolerable upper normal limit: 10 mg/d); intravenous fluoride varied from 0.06 to 1.45 mg, and oral fluoride varied from 0.09 to 27.8 mg. Serum fluoride concentrations were correlated with creatinine clearance and fluoride supply. BMD was significantly lower in the femoral neck than in the spinal area. After adjustment for sex and the duration of HPN, only the effect of serum fluoride on spinal BMD was significant. Two patients had symptoms of fluorosis, eg, calcaneum fissures, interosseous calcifications, or femoral neck osteoporosis.
Conclusions: In chronic intestinal failure, high intakes of fluoride are frequent because of the beverages ingested to compensate for stool losses. Hyperfluoremia has an effect on bone metabolism and may increase skeletal fragility. The consumption of fluoride-rich beverages for extended periods is therefore not advisable.
Key Words: Fluoride • bone mineral density • fluorosis • home parenteral nutrition • chronic intestinal failure
http://www.ajcn.org/cgi/content/abstract/83/6/1429
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Copyright © 2006 by The American Society for Nutrition

Comments:
They tried to introduce fluoride into our drinking water (mass medication) a few years ago here in Scotland but we the public wouldn't let them.

I think they have it in England but it was all so long ago I can't remember so I'm not 100% on that... but it still crops up from time to time here. I think I'll need to look into that wee subject again!

It should be against our human rights to mass medicate in such a way without our consent if you ask me!!
 
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