Top of page

Student/Staff Portal
Global Site Navigation

School of Medical and Health Sciences

Local Section Navigation
You are here: Main Content
  • Determining bone health through imaging

    Determining bone health through imaging

Related Contents

Disorders of Mineralisation

From before you are born, following birth and as you grow and develop towards maturity into early adulthood, your bones continue to change in size and shape to develop into a strong and durable skeleton. However, your bones do not always develop normally or optimally due to many influential factors, including hormones, genes, iatrogenesis, chronic disease, movement disorders, in-born errors of metabolism, and lifestyle (diet, physical activity and exercise). Furthermore, from adulthood, as you age, you start to have less bone in your bones leading to osteoporosis, and more “bone” in your blood vessels leading to vascular calcification which is an indicator of cardiovascular disease. These disorders of mineralisation in older individuals lead to increased risk of fractures, heart attacks and strokes. Our research is focused in two key areas: (1) vascular calcification, and (2) bone and mineral metabolism, and how these two systems are linked across the lifespan.

Associate Professor Josh Lewis leads the disorders of mineralisation research group within the Nutrition & Health Innovation Research Institute, in the School of Medical and Health Sciences. His research aims to develop better ways to identify and prevent disease before the onset of clinical symptoms. Josh supervises postgraduate students in a range of research areas including developing medical imaging tests for chronic diseases such as osteoporosis and cardiovascular diseases, clinical nutrition and lifestyle research as well as clinical trials to develop better evidence for healthy ageing. Josh is the PI for the 15-year Perth Longitudinal Study of Ageing Women (PLSAW) investigating the role of environmental, anatomical, physiological, metabolic and genetic factors on bone, cardiovascular and neurocognitive health outcomes in older women. He also leads the international Digital Lateral Spine Imaging to Better Predict Health and Prognosis consortium. Currently, he is conducting research on developing convenient, reliable and safe tests for vascular calcification as well as the identification of mechanism(s) and modifiable factors related to vascular calcification.

For more information, contact Associate Professor Joshua Lewis 

Current projects

  • Modification of Diet, Exercise and Lifestyle: The MODEL randomised controlled trial.
  • QuantiK project that aims to quantify levels of vitamin K1 and K2 in Australian foods using HPLC.
  • Lipocalin 2 project evaluates the association between a novel marker of satiety and physical activity and its relationship with cardiometabolic health during ageing.
  • Modifiable dietary and lifestyle factors related to arterial calcification.
  • Digital Lateral Spine Imaging to Better Predict Health and Prognosis (DECIPHER) Consortium.
  • The Global Screening Array Consortium.
  • Perth longitudinal Study of Ageing Women cardiovascular & biomarkers programs.
  • Influence of diet, especially vitamin K on bone structure and strength

Research Team

Leader

Lead - Associate Professor Josh Lewis

Deputy Leader

Deputy Lead - Dr Marc Sim

Research and Clinical staff
  • Dr Alex Liu
  • Ms Claire Palmer
  • Mrs Shelby Mullins
  • Ms Leticia Samuelsson
  • Dr Alexander Rodriguez

Adjunct researchers

PhD students
  • Mr Abadi Gebre
  • Ms Anjana Rajendra
  • Ms Afsah Saleem
  • Ms Bassant Abueilgheit
  • Ms Carlie Bauer
  • Ms Caroline Hill
  • Ms Cassandra Cuffe
  • Ms Emma Connolly
  • Ms Montana Dupuy
  • Mr Reindolf Anokye
  • Mr Zaid Ilyas

Postgraduate student project opportunities

  • The role of vitamin K on the bone-vascular axis.
  • Flavonoids and vascular calcification.
  • A novel approach to primary prevention of clinical cardiovascular disease.
  • Novel dietary factors and vascular calcification.
  • Understanding how and why abdominal aortic calcification develops and progresses

For more information visit the SMHS Higher Degree by Research or HDR students project opportunities webpages.

Recent Research Grants

Predicting falls in the elderly: A novel machine learning approach. , Edith Cowan University, Australia-Germany JRC Scheme (UA-DAAD), 2021 ‑ 2023, $24,250.

Developing a novel approach to improve diet and lifestyle, National Health and Medical Research Council, MRFF Preventive and Public Health, 2020 ‑ 2023, $309,660.

Developing & evaluating a novel tool for primary prevention of clinical cardiovascular disease, National Heart Foundation, NHF - Future Leader Fellowships, 2020 - 2023,  $1,166,638.

Automated methods for evaluating structural vascular disease, National Health and Medical Research Council, Ideas grants, 2020 - 2022, $652,128.

Bone tired: Better understanding of vascular-bone ageing, Rebecca L Cooper Medical Research Foundation Ltd, Grant, 2019 - 2021, $100,000.

Development of low-cost, very low radiation community-based screening method for primary prevention of cardiovascular disease, National Health and Medical Research Council, Career Development Fellowship, 2017 - 2020,  $242,438.

Can the short-term consumption of vitamin K rich vegetables improve markers of musculoskeletal health? Edith Cowan University Early Career Researcher Grant 2019, $19,474

Developing a national database for vitamin K1 and K2 content in food. Royal Perth Hospital Medical Research Foundation Research Grant, $19,064

Key publications

Select publications from the last 5 years

Selected Journal Articles:

Gebre AK, Sim M, Rodríguez AJ, Hodgson JM, Blekkenhorst LC, Szulc P, Bondonno, NP, Zhu K, Bondonno CP, Kiel DP, Schousbe JT, Prince RL, Lewis JR. Abdominal aortic calcification is associated with increased risk of injurious fall-related hospitalizations in older Australian women. Atherosclerosis (2021) In-press.

Lewis J, Voortman T, Ioannidis JPA. Perspective: Evaluating and Strengthening the Evidence for Nutritional Bone Research: Ready to Break New Ground? The Journal of Bone and Mineral Research. 2021; 36 (2), 219-226.

Leow K, Szulc P, Schousboe JT, Kiel DP, Teixeira‐Pinto A, Shaikh H, Sawang M, Sim M, Bondonno N, Hodgson JM, Sharma A, Thompson PL, Prince RL, Craig JC, Lim WH, Wong G, and Lewis JR. Prognostic Value of Abdominal Aortic Calcification: A Systematic Review and Meta‐Analysis of Observational Studies. Journal of the American Heart Association. 2021 Jan 19;10(2):e017205.

Smith C, Lewis JR, Sim M, Wai HL, Lim EM, Blekkenhorst LB, Brennan-Speranza, Adams L, Brynes E, Duque G, Levinger I, Prince. Higher undercarboxylated to total osteocalcin ratio is associated with reduced physical function and increased 15-year falls-related hospitalizations: The Perth Longitudinal Study of Ageing Women. Journal of Bone and Mineral Research 2020 36(3):523-530.

Sim M, Lewis JR, Prince RL, Levinger I, Brennan-Speranza TC, Palmer C, et al. (2020) The effects of vitamin K-rich green leafy vegetables on bone metabolism: A 4-week randomised controlled trial in middle-aged and older individuals. Bone Reports. 2020:100274.

Sim M, Blekkenhorst LC, Bondonno NP, Radavelli-Bagatini S, Peeling P, Bondonno CP, Magliano DJ, Shaw JE, Woodman R, Murray K, Lewis JR, Daly RM, Hodgson JM. (2020) Dietary nitrate intake is positively associated with muscle function in men and women independent of physical activity levels. Journal of Nutrition. 2021; 151(5):1222-1230.

Chong JJH, Prince RL, Thompson PL, Thavapalachandran S, Ooi E, Devine A, Lim EEM, Byrnes E, Wong G, Lim WH, Lewis J. Association Between Plasma Neutrophil Gelatinase-Associated Lipocalin and Cardiac Disease Hospitalizations and Deaths in Older Women. Journal of the American Heart association (2019); Jan 8;8(1):e011028.

Sim M, Prince RL, Scott D, Daly RM, Duque G, Inderjeeth CA, Zhu K, Woodman RJ, Hodgson JM, Lewis JR. (2019). Utility of four sarcopenia criteria for the prediction of falls-related hospitalization in older Australian women. Osteoporosis International: 30(1)167

Lewis, J., Eggermont, C., Schousboe, J., Lim, W., Wong, G., Khoo, B., Sim, M., Yu, M., Ueland, T., Bollerslev , J., Hodgson, J., Zhu, K., Wilson, K., Kiel, D., Prince, R., (2019), Association between abdominal aortic calcification, bone mineral density and fracture in older women. Journal of Bone and Mineral Research, 34(11), 2052-2060, DOI: 10.1002/jbmr.3830.

Zhu K, Lewis JR, Sim M, Richard RL (2019) Low vitamin D status is associated with impaired bone quality and increased risk of fracture-related hospitalization in older Australian women. Journal of Bone and Mineral Research 34(11):2019-2027.

Sim M, Lewis JR, Blekkenhorst LC, Bondonno CP, Devine A, Zhu K, Peeling P, Prince RL, Hodgson JM (2019) Higher dietary nitrate intake is associated with better muscle function in older women. Journal of Cachexia Sarcopenia and Muscle 10(3):601-610.

Rodríguez AJ, Leow K, Szulc P, Scott D, Ebeling P, Sim M, Wong G, Lim WH, Schousboe JT, Kiel DP, Prince RL, R Lewis J. Abdominal aortic calcification, bone mineral density and fractures: a systematic review and meta-analysis protocol. BMJ Open. 2019;9(4):e026232.

Blekkenhorst LC, Lewis J, Prince RL, Devine A, Bondonno NP, Bondonno CP, Wood LG, Puddey IB, Ward NC, Croft KD, Woodman RJ, Beilin LJ, Hodgson JM. Nitrate-rich vegetables do not lower blood pressure in individuals with mildly elevated blood pressure: a 4-week randomised controlled crossover trial. The American Journal of Clinical Nutrition (2018) Jun 1;107(6):894-908.

Sim M, Blekkenhorst LC, Lewis JR, Bondonno CP, Devine A, Zhu K, Woodman RJ, Prince RL, Hodgson JM. (2018) Vegetable diversity, injurious falls and fracture risk in older women: a prospective cohort study. Nutrients: 10(8), 1081

Alonso N, Estrada K, Albagha OME, Herrera L, Reppe S, Olsta OK, Gautvik KM , Ryan N, Evans K, C Nielson C, Hsu HY, Kiel D, Masi L, Brandi ML, Riches P, Daroszewska1 A, Olmos JM, Sañudo C, Riancho JA, Husted LB, Langdahl BL, Brown MA, Duncan EL, Sims M, Kaptoge S, Reeve J, Usategui R, del Pino J, Gonzalez-Sarmiento R, Lewis J, Prince RL, D’Amelio P, Garcia-Giralt N, Nogues X, Mencej-Bedrac S, Marc J, Wolstein O, Eisman J, Oei L, Medina-Gomez MC, Feenstra B, Melbye M, Schraut K, Navarro P, Wilson J, Davies G, Starr J, Deary I, Tanaka T, Ferrucci L, Gianfrancesco F, Gennari L, Lucas G, Elosua R, Uitterlinden AG, Rivadeneira F, Ralston SH. Identification of a novel locus on chromosome 2q13 which predisposes to clinical vertebral fractures independently of bone density. Annals of Rheumatic disease (2018) Mar;77(3):378-385

Lewis, J., Schousboe, J., Lim, W., Wong, G., Wilson, K., Zhu, K., Thompson, P., Kiel, D., Prince, R., (2018), Long-Term Atherosclerotic Vascular Disease Risk and Prognosis in Elderly Women With Abdominal Aortic Calcification on Lateral Spine Images Captured During Bone Density Testing: A Prospective Study. Journal of Bone and Mineral Research, 33(6), 1001–1010, United States, Wiley-Blackwell Publishing, Inc., DOI: 10.1002/jbmr.3405.

Lewis, J., Schousboe, JT., Lim, W., Wong, G., Zhu, K., Lim, E., Wilson, K., Thompson, P., Kiel, D., Prince, R., (2016), Abdominal Aortic Calcification Identified on Lateral Spine Images from Bone Densitometers Are a Marker of Generalized Atherosclerosis in Elderly Women. Arteriosclerosis, Thrombosis and Vascular Biology, 36(1), 166-173, USA, Lippincott Williams & Wilkins, DOI: 10.1161/ATVBAHA.115.306383.

Lim, W., Wong, G., Lim, E., Byrnes, E., Zhu, K., Devine, A., Pavlos, N., Prince, R., Lewis, J., (2015), Circulating Lipocalin 2 Levels Predict Fracture-Related Hospitalizations in Elderly Women: A Prospective Cohort Study. Journal of Bone and Mineral Research, 30(11), 2078-2085, Hoboken, USA, John Wiley and Sons Inc., DOI: 10.1002/jbmr.2546.

Zheng, H., Forgetta, V., Hsu, YH., Estrada, K., Rosello-Diez, A., Leo, PJ., Dahia, CL., Park-Min, KH., Tobias, JH., Kooperberg, C., Kleinman, A., Styrkarsdottir, U., Liu, C., Uggla, C., Evans, D., Nielson, CM., Walter, K., Pettersson-Kymmer, U., McCarthy, SE., Eriksson, JA., Kwan, T., Jhamai, M., Trajanoska, K., Memari, Y., Min, J., Huang, J., Danecek, P., Wilmot, B., Li, R., Chou, W., Mokry, LE., Moayyeri, A., Claussnitzer, M., Cheng, C., Cheung, W., Medina-Gomez, C., Ge, B., Chen, S., Choi, K., Oei, L., Fraser, J., Kraaij, R., Hibbs, MA., Gregson, CL., Paquette, D., Hofman, A., Wibom, C., Tranah, GJ., Marshall, M., Gardiner, BB., Cremin, K., Auer, P., Hsu, L., Ring, S., Tung, JY., Thorleifsson, G., Enneman, AW., Van Schoor, NM., De Groot, LC., Van Der Velde, N., Melin, B., Kemp, JP., Christiansen, C., Sayers, A., Zhou, Y., Calderari, S., Van Rooij, J., Carlson, C., Peters, U., Berlivet, S., Dostie, J., Uitterlinden, AG., Williams, SR., Farber, C., Grinberg, D., Lacroix, AZ., Haessler, J., Chasman, DI., Giulianini, F., Rose, LM., Ridker, PM., Eisman, JA., Nguyen, TV., Center, JR., Nogues, X., Garcia-Giralt, N., Launer, LL., Gudnason, V., Mellstrom, D., Vandenput, L., Amin, N., Van Duijn, CM., Karlsson, MK., Ljunggren, O., Svensson, O., Hallmans, G., Rousseau, F., Giroux, S., Bussiere, J., Arp, PP., Koromani, F., Prince, RL., Lewis, J., Langdahl, BL., Hermann, AP., Jensen, J., Kaptoge, S., Khaw, K., Reeve, J., Formosa, M., Xuereb-Anastasi, A., Akesson, K., McGuigan, FE., Garg, G., Olmos, JM., Zarrabeitia, MT., Riancho, JA., Ralston, SH., Alonso, N., Jiang, X., Goltzman, D., Pastinen, T., Grundberg, E., Gauguier, D., Orwoll, ES., Karasik, D., Davey-Smith, G., Aogc Consortium, AC., Smith, AV., Siggeirsdottir, K., Harris, TB., Zillikens, MC., Van Meurs, JB., Thorsteinsdottir, U., Maurano, MT., Timpson, NJ., Soranzo, N., Durbin, R., Wilson, SG., Ntzani, EE., Brown, MA., Stefansson, K., Hinds, DA., Spector, T., Cupples, LA., Ohlsson, C., Greenwood, CM., Uk 10k. Consortium, UK., Jackson, RD., Rowe, DW., Loomis, CA., Evans, DM., Ackert-Bicknell, CL., Joyner, AL., Duncan, EL., Kiel, DP., Rivadeneira, F., Richards, JB., (2015), Whole-genome sequencing identifies EN1 as a determinant of bone density and fracture. Nature, 526(7571), 112-117, UK, Nature Publishing Group, DOI: 10.1038/nature14878.

Blekkenhorst LC, Prince RL, Hodgson JM, Lim WH, Zhu K, Devine A, Thompson PL, Lewis J. Dietary saturated fat intake and the risk of atherosclerotic vascular disease mortality in elderly women: a prospective cohort study. The American Journal of Clinical Nutrition (2015) 101 6 1263 - 1268. PMID: 25948671.

Skip to top of page