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Post-publication Peer Reviews to:
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![[Read P3R]](/icons/misc/sectionDOWN.gif){kind=icon}
Missing Population
Response to Ahron Ebert
Unrecognized Genetic Basis?
Response to Unrecognized Genetic BAsis
Insitutional barriers to increasing calcium comsumption during the yeshiva school day
Re: Insitutional barriers to increasing calcium comsumption during the yeshiva school day
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Ahron Ebert, Computer Consultant none
Send letter to journal:
bigkhuna{at}aol.com Ahron Ebert
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The article has lumped together all so called Ultra-Orthodox together it doesn't distiguish between hasidim and non-chasidic (yeshivish). Nor does it say if chasidim were in the study what sect they belong to. Are Satmers more likely to have BMD than Lubavitchers? As far as environment do "Ultra-Orthodox in Monsey provide different results than in Brooklyn? Are Satmers in Monroe less likely to BMMD than Satmers in Willamsburg? |
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Henry Anhalt, Director Division of Pediatric Endocrinology Maimonides Medical Center
Send letter to journal:
hanhalt{at}maimonidesmed.org Henry Anhalt
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The study population was recruited through advertising in Der Yid and Hamodia. Although we made no attempt to document what chasidic sect each patient belonged to, we recruited mostly chasidic boys with approximately one third being yeshivish. Because of the limitations already mentioned, I have no way of knowing whether Satmar boys BMD was any lower than Lubavitch boys BMD. Suffice it to say that in this convenience sample of boys their bone mineral status was for the most part abnormal. Geographic determinants of BMD in this population have not been studied, but we plan on looking more closely at specific populations and the role of genetic influences on bone mineral health in the comunities that we serve. |
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Jody Gorran, Corporate Officer
Send letter to journal:
jgorran{at}primeline.com Jody Gorran
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Corrected response #2 I beleive that there might be an unrecognized genetic basis to the low bone density that was discovered in this population who are descended from eastern european Jews. I am a 50 year old non-orthodox Jewish male of eastern european extraction. I was diagnosed in 1992 as having idiopathic osteoporosis. I have NONE of the primary characteristics or secondary characteristics for this disease. I simply have extremely low bone density of L1-L4 Total BMD of 0.722 g/cm2 with a curent T score of -3.4 and a Z score of -3.0. For the hip, my current total BMD is 0.644 g/cm2 with a T score of -2.6 and a Z score of -2.3. My femorial neck is 0.557. I was on Fosomax for 3 years and am now in my 4th year of Miacalcin with no change in BMD over 9 years. For those who are interested, my serum testosterone is something like 890, more than normal. I had a bone biopsy of the hip with results that indicated I have no disease process. In 1992, my children were also had their bone densitometry performed and the results at the time were 2-4 standard deviations below the norm. My mother had Paget's. My older siblings also showed somewhat low bone density. The striking fact is that I have never fractured. My own belief is that this is genetic and that I have not "lost" bone density as much as I never reached "peak". I have searched the literature for years and have not read any discussion about this potential genetic predisposition except for low bone density in rare cases of problems with epipheseal maturation. I also had a skin biopsy done to look for any unusual collagen disorder. My estradiol level is high and my progesterone level is low. Any possibility on a problem with estrogen receptors? My low bone density was first discovered by a chiroprator upon viewing a standard radiograph. As my bone density was several standard deviations below the norm, it could actually be seen on an X-ray. Perhaps a retrospective study could be done of chiropractors full body radiographs to determine if in fact there is a subset of younger persons with low bone density. Again, I believe that you have found the results of a genetic defect as opposed to the results of nutrition or environment. I would be pleased to work with anyone wishing to further this line of inquiry. |
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Henry Anhalt, Physician Maimonides Medical Center
Send letter to journal:
hanhalt{at}maimonidesmed.org Henry Anhalt
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Dear Mr. Goran, Your case is fascinating and there is much more information that I would need to know prior to passing any judgement about your particular case. However, I don't beleive that the condition you have is widespread at all. In fact very few of the boys had such severe osteoporosis despite their lifestyle, which is known to put them at risk. I also beleive that if we intervened with weight bearing physical activity and even bisphosphonates (like Fosomax) the patients qwould respond quite nicely. Henry Anhalt, D.O. |
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Michelle Kraiman Gross, computational linguist San Diego Hebrew Day School Kindergarten room parent
Send letter to journal:
mkg8454{at}sbcglobal.net Michelle Kraiman Gross
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Private schools may not be aware of government programs to provide milk to students during the long school day or have the financial resources to provide milk. The school may be hesitant to provide milk because of the difficulty in accomodating kosher restrictions for students who observe extra strictures (chalav yisroel instead of chalav stam). Since many Ashkenazim consider themselves to be lactose intolerant, there may not be participation in any milk program that a school would offer. At my children's school bottled water is available for purchase at lunch-time if the payment is received at the beginning of the month. The school day extends from 8AM to 3:30PM for all ages, except that pre-schoolers (ages 2 to 4) may attend for the morning portion, ie until noon. Nutrition requirements may not motivate food choice selection. Food sales are used as a fund-raising device, so that the children may be provided with non-funded items, such as music instruction, playground sunshades, and field trip buses. It may be challenging to introduce the notion that a nutritional food can be sold without profit. At my children's school, refrigeration is not provided for milk brought from home, but students are encouraged to bring in yogurt or cheese for calcium consumption. I hope that the recent availability of long-life shelf milk will allow greater opportunity for milk to be brought in from home.
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Michelle K. Gross, mom school, Carrie, et al.
Send letter to journal:
mkg8454{at}sbcglobal.net Michelle K. Gross, et al.
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Other mothers have suggested to me that I freeze the pint-size milks and put in the kids' lunches for use during their lunchtime. This also sounds like a reasinable approach to ensuring adequate calcium intake during the school day on the days on which the lunch menu is not meat. On days when meat is available at the lunch table reserved for meat, I can provide soy milk that is pareve for the kids. Please let me know what works are your children's school or yeshiva. --Michelle |
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