Bone Health: An Integrated Approach to Monitoring the Dynamic Net Bone Mineral Balance During 2-, 6- and 12-Month Missions Aboard the ISS
Spaceflight-induced bone loss is a significant health concern for astronauts which is only partially mitigated by established countermeasures such as resistive exercise, vitamin D supplementation, and nutritional support. These countermeasures have proven adequate for nominal 6-month missions aboard the ISS, but individual crewmembers may experience a degree of net bone loss which varies significantly. Estimates of whole-body bone mineral content (BMC) made using DXA show the mean change in BMC averages only -1 % during a nominal 6-month ISS mission. However, the observed range of interpersonal variation extends from + 1 % to -5 % per mission for crewmembers using ARED as a primary bone loss countermeasure [1]. This highlights two significant outstanding issues: (1) we currently cannot predict which crewmembers will experience greater or lesser extents of net bone loss during space flight; and (2) because of limited information regarding the dynamics of net bone loss during space flight, we cannot currently extrapolate the net bone loss rates observed during 6-month ISS missions to even longer duration missions envisioned for the Moon and Mars. The overall goal of the Bone Health project is to improve our understanding of how net bone mineral balance dynamically evolves during 2-12 months of spaceflight using integrated biochemical and calcium isotopic measurements. This will provide a foundation for estimating the possible range of changes in BMC that might be expected during even longer duration missions. As part of the Integrated 1-Year Mission Project, we aim to address these issues by (1) determining the time course of net whole-body bone mineral balance during 2-month, 6-month, and 12-month missions aboard the ISS, (2) examining the interpersonal variation in net bone loss/gain to determine whether this distribution is skewed with rare individuals experiencing above average rates of net bone loss, and (3) exploring possible predictors for individuals who will experience above or below average rates of net bone loss.