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Med. J. Cairo Univ., Vol. 78, No. 1, March: 1-9, 2010
www.medicaljournalofcairouniversity.com
Effect of
Salvia Officinalis L.
(Sage) Herbs on Osteoporotic
Changes in Aged Non-Cycling Female Rats
INAS Z.A. ABDALLAH, Ph.D.*; HALA A.H. KHATTAB, Ph.D.*; FRANÇOIS A.R. SAWIRESS, Ph.D.** and
ROKIA A.S. EL-BANNA, Ph.D.***
The Department of Nutrition & Food Science, Faculty of Home Economics, Helwan University*;
the Department of Physiology, Faculty of Veterinary Medicine, Cairo University** and
the Department of Biological Anthropology, National Research Center***.
Abstract
The most common type of osteoporosis is bone loss
associated with ovarian hormone deficiency at menopause.
Sage
(Salvia officinalis L.)
plant, which contains flavonoid
phytoestrogens, has been used to reduce menopausal symp-
toms. Evidence suggests that flavonoid rich foods and bever-
ages may benefit bone health. The objective of this study was
to evaluate the protective effect of sage herbs water extract
prepared as a tea on the progression of bone loss occurred in
aged non-cycling female rats. Three groups were studied:
adult normal cycling rats (control group), aged non-cycling
rats (aged group) and aged non-cycling rats treated with sage
tea (aged treated group). Treatment with sage tea commenced
i
mmediately after baseline bone minerals density (BMD)
measurements of all rats at the left femur, left tibia and lumber
vertebrae using dual energy
x
-ray absorptiometry (DEXA).
At the end of the treatment period (2 months), BMD of the
left tibia, left femur and lumber vertebrae as well as serum
calcium (Ca), phosphorus (P), parathyroid hormone (PTH),
estradiol, osteocalcin (OCN) and alkaline phosphatase (ALP)
were examined and compared between groups. The results
from this study showed that aged non-cycling female rats
developed bone changes similar to those seen in osteoporotic
women as indicated by a decrease in bone minerals density
(BMD) of the left femur, left tibia and lumber vertebrae and
by a decrease of serum Ca, P and estradiol levels and an
increase of serum ALP, OCN and PTH levels. Treatment with
sage tea significantly decreased the decline in BMD of the
left femur and left tibia, increased serum Ca, P and estradiol
levels and prevented the rise of serum ALP, OCN and PTH
levels. These findings suggest that sage tea is effective in
reducing bone loss occurred in aged non-cycling female rats,
probably by reducing of the bone turnover via inhibition of
bone resorption.
Key Words:
Salvia officinalis L. – Flavonoid- phytoestrogens
– Osteoporosis – Rats – Bone minerals density –
Dual energy x-ray absorptiometry.
Introduction
SALVIA
officinalis L. (sage, common sage, garden
sage or Dalmatian sage) is a medicinal and aromatic
plant of the Lamiaceae (Labiatae) family, native
to Mediterranean countries which today is cultivat-
ed all over the world
[1]
. It is a popular herb com-
monly used as a culinary spice for flavouring and
seasoning that has also been used for centuries in
folk medicine for the treatment of a variety of
ailments. The botanical name of sage in a clear
reference to the important curative properties of
the plant: the genus name
salvia
comes from the
Latin salvare meaning "to save" or "to heal" and
officinalis
means medicinal
[2,3]
.
Sage enjoys the reputation of being a panacea
because of its wide range of medicinal effects: it
has been used as anti-inflammatory, antihydrotic,
spasmolytic, antiseptic, anti-mutagenic, hypogly-
cemic, estrogenic and also for treatment of meno-
pausal symptoms and mental and nervous condi-
tions
[4-7]
. Recently, several authors reported the
antioxidant properties of sage and some of its
constituents, mainly phenolic compounds such as
carnosic, rosmarinic, caffeic and salvianolic acids
as well as the flavonoid luteolin-7 glucoside and
other phenolic glycosides, which are thought to be
the key for several therapeutic properties attributed
to sage
[8-11]
.
Moreover, sage antioxidants can be used as an
alternative to the well-known rosemary antioxidants
for the protection and preservation of certain food
and nutraceutical products to extend their shelf
life
[12,13]
. Sage is an herb rich in essential oil,
which contains a mixture of ten volatile compounds
including monoterpenes, sesquiterpenes and diter-
penes
[14]
.
As the menoterpenes from the essential
oil of sage inhibit sweat production
[15]
. The con-
sumption of an herbal tea made from sage is rec-
ommended to women suffering from hot flushes
[16]
.
1
2
Effect of Salvia Officinalis L. (Sage) Herbs on Osteoporosis
Osteoporosis is one of the most common and
widespread metabolic bone disorders
[17]
. It is a
group of syndromes characterized by a net loss of
bone mass and micro-architectural deterioration
of bone tissue, leading to enhanced bone fragility
and an increase in fracture risk
[18]
. The decline
in estrogens in postmenopausal women is at least
in part responsible for the increase in bone fragility
and thereby in the incidence of skeletal fractures
[19]
.
Evidence suggests that flavonoid rich foods
and beverages may benefit bone health
[20,21]
.
Since the side effects of estrogen replacement
therapy include the possible incidence of breast
and endometrial cancers with long term use
[22]
,
women are increasingly using herbal remedies as
an alternative therapy
[23]
. Sage contains flavonoid
phytoestrogens that make it very useful for women,
phytoestrogens are plant compounds with estrogen-
like biological activity, the main classes of phy-
toestrogens are isoflavones, flavonoids, coumestans
and lignans
[24,25]
. Phytoestrogens are reported to
prevent bone resorption, and maintain or increase
bone density
[26,27]
.
Although
salvia officinalis
has been traditionally
known to improve postmenopausal symptoms, little
has been known about whether or not it prevents
the decreases of bone mass, which is one of the
deleterious symptoms for postmenopausal women.
The present study was therefore designed to evaluate
the protective effect of sage herbs water extract
prepared as a tea, the most common form of human
consumption of this plant, on the bone mass loss
occurring in aged non-cycling female rats.
Materials and Methods
Plant material:
leaves and branches of sage plant
(Salvia Offi-
cinalis L.)
, family Labiatae (Lamiaceae) were
obtained from Prof. Dr. E.A. El- Ghadban, Profes-
sor of Medicinal and Aromatic Plants, Medicinal
and Aromatic Plants Research department, Horti-
cultural Research Institute, Agricultural Research
Center. The plant was identified by Dr. Mohamed
A. El-Gibali, Senior Botanist, Department of Phar-
macognosy, Faculty of Pharmacy, Cairo University
Giza, Egypt. The plant was dried by the hybrid
solar convective drying system, belonging to the
Solar Energy Dept., National Research Center,
Dokki, Egypt, at 30-40ºC.
Drugs and chemicals:
Thiopental sodium 500 mg was obtained from
Eipico Pharm. Ind. Co. Cairo, Egypt, in powder
form packaged in a sterile vial and was dissolved
in 5 ml sodium chloride 0.9%. Diethyl ether was
obtained from Sigma-Aldrich (USA). Casein was
obtained from Misr Scientific Company, Dokki,
Giza, Egypt. Cellulose and D-L methionine were
purchased from Morgan Company, Cairo, Egypt.
Starch and corn oil were obtained from local mar-
ket. Vitamins and minerals mixture and sucrose
were obtained from El-Gomhoriya Pharm. and
Chem. Ind. Co. Cairo, Egypt.
Animals:
Adult (6 -7 month old, n= 10) and aged (16 -18
month old, n=20) female Sprague Dawley rats,
weighing about 140-150 g and 224-250g respec-
tively, were purchased from the animal house of
the National Research Center, Dokki, Egypt. Ani-
mals were housed in plastic cages, fed on standard
casein diet according to Reeves et al.
[28]
and given
tap water ad libitum. They were kept on 12 h light/
12 h dark regular cycle in partially humid and well-
aerated room. The experiment was done in Faculty
of Veterinary Medicine, Cairo University. Vaginal
smears were taken for 12 consecutive days to
ensure adult female rats displaying regular estrous
cycles, and aged female rats exhibiting ovarian
cyclicity ceases, they were left to accommodate
before experimental use.
Preparation of sage tea:
Considering the sage is traditionally used as a
tea, an infusion of sage tea was freshly prepared
by pouring 150 ml of boiling water onto 2g dried
plant material, covering and allowing it to steep
for 5 min according to Lima et al.
[29]
.
Experimental design:
After the period of adaptation (2 weeks), All
animals were measured for baseline bone minerals
density (BMD) of the left femur, left tibia and
spine (lumber vertebrae), by dual energy
x
-ray
absorptiometry (DEXA). They were then classified
into three groups (10 rats each): (1) Control group;
in which adult normal (regularly) cycling female
rats were given standard diet and tap water ad
libitum. (2) Aged group; in which aged non-cycling
female rats were given the same diet and water as
in group (1). (3) Aged treated group; in which aged
non-cycling female rats were given standard diet
and sage tea ad libitum as a replacement for their
water (beverage was renewed daily). The drinking
volumes consumed were not different between tape
water and sage tea in both control and aged treated
or non-treated groups.
Inas Z.A. Abdallah, et al.
3
Blood collection and serum separation:
At the end of the experimental period, the rats
were anaesthesized with diethyl ether. Blood sam-
ples were collected by puncture of retro-orbital
plexus with a fine capillary glass tube. Collected
blood was stored for 30 min at room temperature
and centrifuged with 3000 rpm for 15 min. The
supernatant kept in -20ºC before use.
Bone minerals density:
Bone minerals density (BMD) of the left tibia,
left femur and lumber vertebrae, was measured at
the beginning and after the 8 week experimental
period by dual energy
x
-ray absorptiometry
(DEXA), using a Norland XR-46 version 3.9.6
with small animal software in Bone Minerals Den-
sity Unit, Medical Service Unit, National Research
Center, Dokki, Egypt. During the measurements,
the animals were anaesthetized by an intraperitoneal
injection of thiopental sodium (50mg/kg b.w.) and
were lying on their backs with the posterior legs
maintained in external rotation by adhesive tape,
and the hip and knee articulations at the 90 flexure
position. The BMD of the left tibia was scanned
from the knee joint to the ankle joint, left femur
from the hip joint to the knee joint, and lumber
vertebrae from (L3-L5).
Biochemical analysis:
The concentrations of serum calcium (Ca) and
inorganic phosphorus (P) were determined spec-
trophotometrically using an automatic analyzer
(Hitachi 7070; Japan) according to method de-
scribed by Gitelman
[30]
and Goodwin
[31]
. The
activity of serum alkaline phosphatase (ALP) was
determined spectrophotometrically according to
method described by Malymy and Horecker
[32]
using an automatic analyzer (Hitachi 7070; Japan).
Hormone assays:
Osteocalcin level (OCN) were determined using
Sandwich Kit according to the method of Miles et
al.
[33]
. The minimum detection limint was 0.5ng/ml
and the intra- and inter- assay coefficient of varia-
tion were 4.5 and 10.3% respectively. The level of
serum parathyroid hormone (parathormone) (PTH)
was determined by enzyme immunoassay according
to the method of Rizzoli et al.
[34]
. The minimum
detection limit was 1ng/ml and the intra- and inter-
assay coefficient of variation were 5.8 and 7.2
respectively. Serum estradiol level was determined
by chemiluminescent micro particle immunoassay
kit purchased from Abott laboratories, USA. The
minimum detectable limit was 2pg/ml and the intra-
and inter-assay coefficient of variation were 6.5
and 11.3% respectively.
Statistical analysis:
Results were expressed as a (mean
±
SE). Data
were analyzed statistically by analysis of variance,
for statistical significance (
p
≤
0.05) using L.S.D.
test, one way ANOVA, post hoc multiple compar-
isons according to Snedecor and Cochron
[35]
.
An
IBM computer with a software system SPSS ver-
sion 16 was used for these calculations.
Results
Results of BMD of the left tibia, left femur and
spine in (Table 1) and Fig. (1) as an example of
DEXA showed that, compared to control, BMD
was significantly lower (
p
<0.05) in both aged
treated and non-treated groups at baseline. After
two months, results showed a significant decrease
in BMD of aged group when compared with control
group. Treatment of the aged rats with sage tea
exerted bone protecting effect by significantly
decreasing the decline in BMD compared to aged
non-treated group. The mean values of BMD of
the left tibia and femur of aged treated and non-
treated groups recorded significant differences at
baseline and after 2 months. Treatment with sage
tea induced significant difference after two months
in BMD of the left tibia when comparing with
baseline of the same group (
p
<0.05), as well as
there was significant reduction in BMD of the left
tibia and femur in aged group at baseline and after
the experimental period.
National research centre
Name
4 control
Ethnic
z
ID
20010813
Height
25
Age
0
Sex
Female
Weight
.1410
L
H
Sm
Bone image not for diagnosis
Subject on 19/01/09
14:20
19/01/09
0:131
SS Scan
BMD
BMC
AREA
LENGTH
WIDTH
g/cm
2
g
cm
2
cm cm
4 - Tibia
0.1312
0.3221
2.455
1.40
2.80
4 - Femur
0.1141
0.4079
3.576 3.40
1.50
4 - Spine
0.0882
0.1542
1.748
3.00
1.00
See Operator’s Guide for information on CVs.
1.0 x 1.0 mm, 60 mm/s, 10.40 cm Rev. 3.9.6/2.3.1 Calib. 19/01/09
Fig. (1): Showed example of BMD results from DEXA for
control rat (n=4) at baseline.
4
Effect of Salvia Officinalis L. (Sage) Herbs on Osteoporosis
Table (1): Effect of sage tea treatment on bone minerals density (BMD) of the left tibia, left femur and spine (g/cm
2
) at baseline
and after 2 months.
BMD
Time
Experimental groups
Control
Aged
Aged treated
Tibia
Baseline
0.12959
±
0.00149
0.117887
±
0.00076
a
0.11796
±
0.00143
a
2 months
0.12997
±
0.00249
0.0991
±
0.00398
ac
0.11117
±
0.00058
abc
Femur
Baseline
0.12159
±
0.0016
0.09855
±
0.0002
a
0.09796
±0.001
a
2 months
0.12163
±
0.0021
0.09277
±
0.0016
ac
0.1045
±
0.0007
ab
Spine
Baseline
0.09826
±
0.0032
0.08522
±
0.0035
a
0.08529
±
0.0055
a
2 months
0.0993
±
0.0026
0.081437
±
0.0052
a
0.084137
±
0.0010
a
Values are mean
±
SE of 10 rats in each group. Significance at
p
<0.05.
a
: Significant difference compared with control group,
b
: Significant difference between aged treated and non-treated groups,
c
: Significant
difference between baseline and after two months for the same group.
The effect of sage tea treatment on serum cal-
cium and phosphorus is presented in Table (2).
The results indicate a significant reduction (
p
<0.05)
in the serum Ca and p in aged rats when compared
with control, and aged treated rats. Replacing water
with sage tea induced significant increase in the
serum Ca and P levels in the aged treated group
when compared with aged untreated group, there
was improvement in the serum Ca and P levels
after treatment with sage, their levels tend to be
matched with control group.
Effect of sage tea treatment on serum parathy-
roid hormone (PTH) and estradiol levels is illus-
trated in Table (3). The levels of serum PTH were
significantly higher for the aged group than those
of the control group. Sage tea treatment signifi-
cantly reduced the serum PTH levels in the aged
treated group compared to aged group. Results of
estradiol assay indicated that, compared to control,
serum estradiol levels in aged rats were significantly
low (
p
<0.05). Meanwhile, sage tea treatment in-
duced significant increase (
p
<0.05) in serum estra-
diol level comparing with untreated aged group.
Serum osteocalcin (OCN) and alkaline phos-
phatase (ALP) levels are frequently used as the
bone turnover markers. The effect of sage tea
drinking on OCN and ALP levels is presented in
Table (4). Aged group revealed a significant in-
crease in serum OCN and ALP when compared
with control and aged treated groups. Treatment
with sage tea significantly suppressed the increase
in serum OCN and serum ALP levels in the aged
rats.
Table (2): Effect of sage tea treatment on serum calcium and phosphorus in different aged rats.
Parameters
Experimental groups
Control
Aged Aged treated
Total calcium (Ca) (mg/dl)
9.588
±
0.045 8.537
±
0.042
a
9.563
±
0.060
b
Phosphorus (P) (mg/dl)
6.794
±
0.049 5.670
±
0.062
a
6.8
±
0.084
b
Values are mean
±
SE of 10 rats in each group. Significance at
p
<0.05.
a
: Significant difference compared with control group,
b
: Significant difference between aged treated and
non-treated groups.
Table (3): Effect of sage tea treatment on serum parathyroid hormone and estradiol in aged rats.
Experimental groups
Parameters
Control
Aged
Aged treated
Parathyroid hormone (PTH) (pg/ml)
7.27
±
0.528
11.97±
0.305
a
7.02
±
0.087
b
Estradiol (pg/ml)
64.0
±
0.658
21.70
±
0.504
a
38.8
±
0.830
ab
Values are mean
±
SE of 10 rats in each group. Significance at
p
<0.05.
a
: Significant difference compared with control group,
b
: Significant difference between aged treated and
non-treated groups.
Inas Z.A. Abdallah, et al.
5
Table (4): Effect of sage tea treatment on serum osteocalcin and alkaline phosphatae in aged rats.
Parameters
Experimental groups
Control
Aged
Aged treated
Osteocalcin (OCN) (ng/ml)
9.92
±
0.304
39.45
±
0.676
a
28.05
±
0.607
ab
Alkaline phosphatase (ALP) (U/L)
192.2±
3.77
284
±
2.89
a
229.4
±
2.8 1
ab
Values are mean
±
SE of 10 rats in each group. Significance at
p
<0.05.
a
: Significant difference compared with control group,
b
: Significant difference between aged treated and
non-treated groups.
Discussion
Menopause involves a dramatic decrease in the
production of estrogens and progesterone and tends
to accelerate bone aging, just as it accelerates skin
and vascular aging, postmenopausal osteoporosis
is attributed to ovarian hormone deficiency and
has resulted in a significant morbidity and mortality
[36]
. Estrogen deficiency in postmenopausal women
is at least in part responsible for the decrease in
bone mass and the increase in the incidence of
fractures
[37]
.
In the present study, aged non-cycling female
rats developed bone changes similar to those seen
in osteoporotic women as indicated by a decrease
in BMD of the left femur, left tibia and lumber
vertebrae, a finding that matches with that of Riggs
and Melton
[38]
who found that menopause results
in elevated bone turnover, an imbalance between
bone formation and bone resorption and net bone
loss, and this is attributable to the cessation of
ovarian function and tapering-off estrogen secretion
[39]
.
The obtained results was in agreement with the
finding of Mühlbauer et al.
[40]
who tested the
effects of some common herbs (sage, rosemary
and thyme), and their constituent of essential oils
and monoterpenes on bone resorption in ovariec-
tomized rats and found that bone resorption was
inhibited by either addition of 1g of powdered
leaves of each herb, or the essential oils extracted
from sage and rosemary. These monoterpenes and
essential oil extracts act directly on bone cells via
inhibition of the mevalonate pathway and the
prenylation of small G-proteins such as Ras, Rho
and Rac to inhibit bone resorption
[40]
.
Data are also accumulating on the positive
effects of flavonoids on BMD and bone formation
[41,42]
. Flavonoids are a class of phytoestrogenes,
plant-derived chemicals, that when absorbed via
the gut mimic the actions of estrogen
[43]
and that
have been found to increase bone morphogenetic
protein 2 (BMP2) gene transcription
[44]
. Sage
(Salvia officinalis)
contains phenolic constituents,
which have the potential to bind to the estrogen
receptor
[45]
. These findings confirm the observa-
tions of other investigators that bone loss in ova-
riectomized rats is prevented by estrogen adminis-
tration, and that estrogen can also suppress the
ovariectomized induced increase in biochemical
markers of bone turnover such as serum ALP.
In fact, the bone conserving effects of estrogen
are well established in ovariectomized rat model
of osteoporosis. Several studies have shown that
17-
ß
estradiol (used as a positive control) is able
to prevent the decrease of bone density, bone ash
and calcium content, bone and uterine weights
induced by ovariectomy in rats
[46]
. In addition,
ovarian hormone deficiency in women and animals,
including rats, results in a drastic increase in the
rate of bone loss. These rapid rates of bone loss
partly are due to a rise in oxygen derived free
radical formation
[47,48]
. Therefore, the phenolic
compounds in sage may function as free radical
scavengers, which are likely to suppress the rate
of bone loss.
The present work demonstrated that the con-
centrations of serum Ca and P in aged non-treated
group were significantly lower than control group.
Similar to these results, Boulbaroud et al.
[49]
have
shown that the levels of serum Ca were decreased
in the ovariectomized rats. Contrary to this finding
Ohta et al.
[50]
reported that both concentrations
of Ca and P were on the increase in ovariectomized
groups. The obtained results suggested that ovarian
hormone deficiency following ovariectomy is
marked by reduced intestinal calcium absorption
and may contribute to the accompanying bone loss
[51]
.
Treatment with sage tea restored the decreased
levels of serum Ca and P to normal values. Phy-
toestrogenic compounds in sage have structural
similarities to estrogen conformation and binding
capabilities to estrogen receptors, which may there-
fore promote calcium absorption through an estro-
gen receptor pathway within intestinal cells
[52,42]
.
6
Effect of Salvia Officinalis L. (Sage) Herbs on Osteoporosis
It has been known that the out put of PTH is
closely regulated by serum calcium concentrations.
Low levels of serum calcium increase PTH output
[53]
. In the present study PTH, which is one of the
most important stimulators of osteoclastic bone
resorption
[54,55]
was significantly elevated in the
aged group, suggesting that the resulting high
hormone levels restore serum calcium by two
means. Firstly, PTH acts on bone to liberate bone
calcium. Secondly, PTH stimulates calcitriol pro-
duction by the kidney, thereby increasing the ab-
sorption of calcium from the intestine. This finding
was in accordance with Zhang et al.
[56]
who
reported an increase in serum PTH in the ovariec-
tomy control group when compared to ovariectomy
group treated with flavonoids derived from herbal
Epimedium Brevicornum Maxim . Sage tea treatment
significantly reduced serum PTH and protected
the bone compared to aged non-treated group. The
inhibitory effect of sage tea on bone resorption
was mainly mediated through its estrogenic effect.
Concerning serum estradiol levels, it was found
that aged group revealed significant reduction in
estradiol level compared to control group. This
was in accordance with the observation of Das et
al.
[57]
who reported a decrease in serum estradiol
level in ovariectomized group compared to control
group. Treatment of aged group with sage tea
significantly increased the level of estradiol in
serum. The results of sage tea which contains
phenolic compounds gave additional support to
the earlier suggestions that phytoestrogens can
bind with nuclear estrogen receptors and are strik-
ingly similar also in chemical structure to the
mammalian estrogen, estradiol
[58]
. The results
obtained by sage treatment in the present study,
may be attributed to the similar actions of its
phytoestrogens. The estrogen enhancing property
of flavonoids
[59,60]
and efficacy of osteoblast to
synthesize estradiol
[61]
also may contribute in
such an increase in serum estradiol level.
Serum osteocalcin (OCN) and alkaline phos-
phatase (ALP) levels are frequently used as the
bone formation markers to monitor drug actions
[62-64]
. Ostrocalcin, an extra cellular calcium bind-
ing protein expressed by mature osteoblast in
association with organic matrix mineralization
[65]
.
Serum osteocalcin levels most likely to either
reflect newly synthesized protein, as well as that
released from bone matrix during resorption
[66,67]
.
The present investigation showed that aged rats
exhibited a high levels of osteocalcin compared to
the control levels, moreover, treatment by sage
tend to lower serum osteocalcin levels reflecting
a decrease in bone turnover. The obtained result
coincided with that of Wang et al.
[68]
,
who showed
that ovariectomy induced a rise in serum osteocalcin
level as a result of compensation of increased bone
turnover and Nian et al.
[67]
who reported a decline
in serum levels of osteocalcin in ovariectomized
rats after treatment with steroidal saponins of some
herbs.
The present study revealed that the activity of
ALP in aged group was significantly higher than
the aged treated group. Serum ALP is an important
biochemical marker of bone formation. The levels
of this enzyme is increased in osteoporosis and
other metabolic disorders
[69]
. In a good line with
this, Zhang et al.
[70]
and Wang et al.
[68]
reported
that ovariectomized resulted in a significant in-
crease in serum ALP. The increase of concentration
of serum ALP is due to increasing the exchange
ratio of bone by ovariectomy
[50]
. The serum ALP,
a biochemical marker of bone formation, is pro-
duced in the osteoblast and the liver, which is
various among age, species and menstrual cycle.
The levels of serum ALP in fetal stage is higher
than those in adults, which is the case in woman
after menopause
[50,71]
. Treatment which sage tea
suppressed the increased levels of serum ALP
indicating its usefulness in osteoporosis.
In conclusion, sage treatment in an aged rat
model of postmenopausal bone loss, had shown
promising and beneficial effects on the progress
of bone loss and thus, indicating its usefulness as
a potential therapeutic agent in humans. Further
analytical studies of the substances in sage tea
extract are needed, as well as its study in prospec-
tive clinical trials of postmenopausal women with
bone loss, before any recommendations can be
made.
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col., 71: 513, 2000.
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DWECK A.C.: The folklore and cosmetic use of various
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