Inflammation, Osteoporosis and Atherosclerosis: The Tsimtsoum Concept

There is evidence that the high intake of 6 and low intake of 3 fatty acids from the diet contribute to the development of CVD as well as of osteoporotic hip fractures. Increased intake of fruits, vegetables, legumes and nuts that are rich in 3 fatty acids (alpha-linolenic acid) has recently been found to be protective against CVD and osteoporosis, which raises the possibility that these foods and their nutrients may protect against CVD and hip fracture, and may provide better quality of life. Increased risks in co-twins without an index diagnosis suggest that genetic factors and genes/diet interactions may explain the association of CVD with osteoporotic fractures. There is evidence that Western diet rich in refined carbohydrates (coke drinks, biscuits, cakes, ice creams), trans fat, high 6 / low 3 fats, deficiencies in soluble fibers and antioxidants can enhance the expression of about 125 genes, the majority of which are pro-inflammatory; there is increase in AP-1, Egr-1 and NFkB, that are transcription factors for inflammation. It is possible that these pro-inflammatory factors increase risk of osteoporosis as well as of atherothrombosis, resulting into hip fractures and CVD, respectively. Calcification of vascular walls shares similarities with bone formation and resorption processes; in particular, bisphosphonates are known to not only decrease the progression of osteoporosis, but also to prevent the development of atherosclerosis, thereby reducing total mortality rates. On the other hand, cholesterol-lowering statins are anti-inflammatory and reduce risk of CVD and osteoporotic fractures.