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Cheng N, Josse AR. Dairy and Exercise for Bone Health: Evidence from Randomized Controlled Trials and Recommendations for Future Research. Curr Osteoporos Rep 2024; 22:502-514. [PMID: 39269594 DOI: 10.1007/s11914-024-00882-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/19/2024] [Indexed: 09/15/2024]
Abstract
PURPOSE OF REVIEW To examine evidence from randomized controlled trials (RCTs) on how modifiable factors such as exercise and nutrition, with a focus on dairy products, play a role in improving bone health across the lifespan. RECENT FINDINGS Meta-analyses of RCTs demonstrate the advantages of consuming dairy products to improve bone mineral density/content (BMD/BMC) and markers of bone metabolism and turnover (BTMs). Eighteen RCTs were conducted investigating the combined effects of dairy and exercise, with most indicating a benefit in youth and adult populations. Results were less conclusive in older adults, perhaps due to altered requirements for dairy/nutrients and exercise with increased age. RCTs demonstrate that dairy product consumption alone benefits bone health and can enhance the effects of exercise on bone. This may help improve skeletal growth and development in adolescence and prevent osteoporosis with increased age. Future RCTs should account for habitual nutrient intakes, and dairy dosage, timing, and matrix effects.
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Affiliation(s)
- Nicholas Cheng
- School of Kinesiology and Health Science, Muscle Health Research Centre, Faculty of Health, York University, 4700 Keele Street, ON, M3J 1P3, Toronto, Canada
| | - Andrea R Josse
- School of Kinesiology and Health Science, Muscle Health Research Centre, Faculty of Health, York University, 4700 Keele Street, ON, M3J 1P3, Toronto, Canada.
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Gong H, Jiang J, Choi S, Huang S. Sex differences in the association between dietary choline intake and total bone mineral density among adolescents aged 12-19 in the United States. Front Nutr 2024; 11:1459117. [PMID: 39634554 PMCID: PMC11614608 DOI: 10.3389/fnut.2024.1459117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2024] [Accepted: 11/08/2024] [Indexed: 12/07/2024] Open
Abstract
Background While prior research has established a correlation between dietary choline intake and bone density in the elderly, the relationship in adolescents remains ambiguous. This study seeks to examine the association between dietary choline intake and bone density in American adolescents. Methods Data from the National Health and Nutrition Examination Survey (NHANES) for 2005 to 2018 were used in this study, encompassing participants aged 12-19 years. The relationship between dietary choline intake and bone density was assessed using multivariate linear regression models and restricted cubic spline (RCS) models. Subgroup analyses were also performed to investigate differences across various subgroups. Results 3,800 participants with an average age of 15 years were included in this study. After adjusting for relevant confounding factors, a positive correlation was observed between dietary choline intake and total bone density in adolescents (95% CI: 0.03-0.17, p = 0.010). Gender-specific analysis indicated a significant positive correlation between dietary choline intake and total bone density in males (95% CI: 0.07-0.23, p < 0.001), while no significant correlation was found in females (95% CI: -0.19 to 0.09, p = 0.500). The stratified analysis revealed that the positive association was more pronounced in males and non-Hispanic whites (interaction p < 0.05). The restricted cubic spline model demonstrated a linear positive correlation between dietary choline intake and total bone density. Conclusion This study demonstrates that dietary choline intake levels are positively correlated with bone density in adolescents, with this association being specific to males.
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Affiliation(s)
- Hongyang Gong
- Department of Oncology Surgery, Fuzhou Hospital of Traditional Chinese Medicine Affiliated to Fujian University of Traditional Chinese Medicine, Fuzhou, China
- Department of Physiology, College of Medicine, Chosun University, Gwangju, Republic of Korea
| | - Jiecheng Jiang
- College of Acupuncture and Orthopedics, Hubei University of Chinese Medicine, Wuhan, China
| | - Seok Choi
- Department of Physiology, College of Medicine, Chosun University, Gwangju, Republic of Korea
| | - Shaoqun Huang
- Department of Oncology Surgery, Fuzhou Hospital of Traditional Chinese Medicine Affiliated to Fujian University of Traditional Chinese Medicine, Fuzhou, China
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Iannotti L, Rueda García AM, Palma G, Fontaine F, Scherf B, Neufeld LM, Zimmerman R, Fracassi P. Terrestrial Animal Source Foods and Health Outcomes for Those with Special Nutrient Needs in the Life Course. Nutrients 2024; 16:3231. [PMID: 39408199 PMCID: PMC11478082 DOI: 10.3390/nu16193231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2024] [Revised: 09/12/2024] [Accepted: 09/13/2024] [Indexed: 10/20/2024] Open
Abstract
Background. Animal source foods are under scrutiny for their role in human health, yet some nutritionally vulnerable populations are largely absent from consideration. Methods. Applying a Population Intervention/Exposure Comparator Outcome (PICO/PECO) framework and prioritizing systematic review and meta-analyses, we reviewed the literature on terrestrial animal source foods (TASFs) and human health, by life course phase. Results. There were consistent findings for milk and dairy products on positive health outcomes during pregnancy and lactation, childhood, and among older adults. Eggs were found to promote early childhood growth, depending on context. Unprocessed meat consumption was associated with a reduced risk for anemia during pregnancy, improved cognition among school-age children, and muscle health in older adults. Milk and eggs represent a risk for food sensitivities/allergies, though prevalence is low, and individuals tend to outgrow the allergies. TASFs affect the human microbiome and associated metabolites with both positive and negative health repercussions, varying by type and quantity. Conclusions. There were substantial gaps in the evidence base for studies limiting our review, specifically for studies in populations outside high-income countries and for several TASF types (pig, poultry, less common livestock species, wild animals, and insects). Nonetheless, sufficient evidence supports an important role for TASFs in health during certain periods of the life course.
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Affiliation(s)
- Lora Iannotti
- E3 Nutrition Lab, Brown School, Washington University, St. Louis, MO 63130, USA;
| | - Ana María Rueda García
- Food and Agriculture Organization of the United Nations, 00153 Rome, Italy; (A.M.R.G.); (G.P.); (F.F.); (B.S.); (L.M.N.); (P.F.)
| | - Giulia Palma
- Food and Agriculture Organization of the United Nations, 00153 Rome, Italy; (A.M.R.G.); (G.P.); (F.F.); (B.S.); (L.M.N.); (P.F.)
| | - Fanette Fontaine
- Food and Agriculture Organization of the United Nations, 00153 Rome, Italy; (A.M.R.G.); (G.P.); (F.F.); (B.S.); (L.M.N.); (P.F.)
| | - Beate Scherf
- Food and Agriculture Organization of the United Nations, 00153 Rome, Italy; (A.M.R.G.); (G.P.); (F.F.); (B.S.); (L.M.N.); (P.F.)
| | - Lynnette M. Neufeld
- Food and Agriculture Organization of the United Nations, 00153 Rome, Italy; (A.M.R.G.); (G.P.); (F.F.); (B.S.); (L.M.N.); (P.F.)
| | - Rachel Zimmerman
- E3 Nutrition Lab, Brown School, Washington University, St. Louis, MO 63130, USA;
| | - Patrizia Fracassi
- Food and Agriculture Organization of the United Nations, 00153 Rome, Italy; (A.M.R.G.); (G.P.); (F.F.); (B.S.); (L.M.N.); (P.F.)
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Zhao ZF, Li BY, He Q, Hao JY, Zhang KS, Zhang B, Hu W, Feng HT, Szeto IMY, Chen YM, Zhang GX, Tang XY. Impact of dairy supplementation on bone acquisition in children's limbs: a 12-month cluster-randomized controlled trial and meta-analysis. Arch Osteoporos 2024; 19:65. [PMID: 39043915 DOI: 10.1007/s11657-024-01422-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Accepted: 07/13/2024] [Indexed: 07/25/2024]
Abstract
The impact of milk on bone health in rural preschoolers is under-researched. This study, through a clinical trial and a meta-analysis, finds that milk supplementation enhances forearm and calcaneus bone acquisition in children, supporting the benefits of daily milk consumption. PURPOSE This study evaluated the impact of dairy supplementation on bone acquisition in children's limbs through a cluster-randomized controlled trial and a meta-analysis. METHODS The trial involved 315 children (4-6 year) from Northwest China, randomized to receive either 390 ml of milk daily (n = 215) or 20-30 g of bread (n = 100) over 12 months. We primarily assessed bone mineral density (BMD) and content (BMC) changes at the limbs, alongside bone-related biomarkers, measured at baseline, the 6th and 12th months. The meta-analysis aggregated BMD or BMC changes in the forearm/legs/calcaneus from published randomized trials involving children aged 3-18 years supplemented with dairy foods (vs. control group). RESULTS Of 278 completed the trial, intention-to-treat analysis revealed significant increases in BMD (4.05% and 7.31%) and BMC (4.69% and 7.34%) in the left forearm at the 6th and 12th months in the milk group compared to controls (P < 0.001). The calcaneus showed notable improvements in BMD (2.01%) and BMC (1.87%) at 6 months but not at 12 months. Additionally, milk supplementation was associated with beneficial changes in bone resorption markers, parathyroid hormone (- 12.70%), insulin-like growth factor 1 (6.69%), and the calcium-to-phosphorus ratio (2.22%) (all P < 0.05). The meta-analysis, encompassing 894 children, indicated that dairy supplementation significantly increased BMD (SMD, 0.629; 95%CI: 0.275, 0.983) and BMC (SMD, 0.616; 95%CI: 0.380, 0.851) (P < 0.05) in the arms, but not in the legs (P > 0.05). CONCLUSION Milk supplementation significantly improves bone health in children's forearms, underscoring its potential as a strategic dietary intervention for bone development. Trial registration NCT05074836.
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Affiliation(s)
- Zi-Fu Zhao
- Inner Mongolia Yili Industrial Group Co., Ltd., Hohhot, China
- Inner Mongolia Dairy Technology Research Institute Co. Ltd., Hohhot, China
| | - Bang-Yan Li
- Department of Epidemiology, School of Public Health, Sun Yat-Sen University, Guangzhou, China
| | - Qin He
- Institute of Nutrition and Food Hygiene, School of Public Health, Lanzhou University, Lanzhou, Gansu Province, China
| | - Jing-Yu Hao
- Inner Mongolia Yili Industrial Group Co., Ltd., Hohhot, China
- Inner Mongolia Dairy Technology Research Institute Co. Ltd., Hohhot, China
| | - Kai-Shuai Zhang
- Inner Mongolia Yili Industrial Group Co., Ltd., Hohhot, China
| | - Bo Zhang
- Inner Mongolia Yili Industrial Group Co., Ltd., Hohhot, China
| | - Wei Hu
- Department of Epidemiology, School of Public Health, Sun Yat-Sen University, Guangzhou, China
| | - Hao-Tian Feng
- Inner Mongolia Yili Industrial Group Co., Ltd., Hohhot, China
- Inner Mongolia Dairy Technology Research Institute Co. Ltd., Hohhot, China
| | - Ignatius Man-Yau Szeto
- Inner Mongolia Yili Industrial Group Co., Ltd., Hohhot, China
- Inner Mongolia Dairy Technology Research Institute Co. Ltd., Hohhot, China
| | - Yu-Ming Chen
- Department of Epidemiology, School of Public Health, Sun Yat-Sen University, Guangzhou, China.
| | - Ge-Xiang Zhang
- Institute of Nutrition and Food Hygiene, School of Public Health, Lanzhou University, Lanzhou, Gansu Province, China.
| | - Xin-Yi Tang
- Department of Pediatrics, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China.
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Ikegawa K, Koga E, Itonaga T, Sakakibara H, Kawai M, Hasegawa Y. Factors associated with low bone mineral density in Turner syndrome: a multicenter prospective observational study. Endocr J 2024; 71:561-569. [PMID: 38522940 DOI: 10.1507/endocrj.ej23-0628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/26/2024] Open
Abstract
Turner syndrome (TS) is associated with a high risk of fracture due to low bone mineral density (BMD). While hypogonadism is known to play a role in decreasing BMD, other factors have not been studied well. Focusing on diet, exercise, and bone metabolism markers, the present, multicentric, prospective, observational study aimed to identify factors contributing to decreased BMD in TS. In total, 48 patients with TS aged between 5 and 49 years comprising a pre-pubertal group (n = 9), a cyclical menstruation group (n = 6), and a hormone replacement therapy (HRT) group (n = 33) were enrolled. The cyclical menstruation group and the HRT group were referred to collectively as the post-pubertal group. The bone mineral apparent density (BMAD) Z-score was higher in the pre-pubertal group than in the post-pubertal group (-0.3 SD vs. -1.8 SD; p = 0.014). Within the post-pubertal group, the median BMAD Z-score was -0.2 SD in the cyclical menstruation group and -2.3 SD in the HRT group (p = 0.016). Spearman's rank correlation revealed no correlation between the BMAD Z-score and bone metabolism markers. No significant relationship was observed between the BMAD Z-score and either the vitamin D sufficiency rate or the step sufficiency rate. A negative correlation was found between BMAD Z-score and serum sclerostin in the pre-pubertal group and serum FSH in the post-pubertal group. In conclusion, the present study found no relationship between the vertebral BMAD Z-score and diet or exercise habits in TS, indicating that estrogen deficiency is the chief reason for low BMD in TS.
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Affiliation(s)
- Kento Ikegawa
- Division of Endocrinology and Metabolism, Tokyo Metropolitan Children's Medical Center, Fuchu 183-8561, Japan
- Clinical Research Support Center, Tokyo Metropolitan Children's Medical Center, Fuchu 183-8561, Japan
| | - Eri Koga
- Department of Gynecology, Yokohama City University Medical Center, Yokohama 232-0024, Japan
| | - Tomoyo Itonaga
- Department of Pediatrics, Oita University Faculty of Medicine, Oita 879-5593, Japan
| | - Hideya Sakakibara
- Department of Gynecology, Yokohama City University Medical Center, Yokohama 232-0024, Japan
| | - Masanobu Kawai
- Department of Bone and Mineral Research, Research Institute, Osaka Women's and Children's Hospital, Izumi 594-1101, Japan
| | - Yukihiro Hasegawa
- Division of Endocrinology and Metabolism, Tokyo Metropolitan Children's Medical Center, Fuchu 183-8561, Japan
- Department of Pediatrics, Tama-Hokubu Medical Center, Tokyo 189-8511, Japan
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Rodrick E, Kindler JM. Bone mass accrual in children. Curr Opin Endocrinol Diabetes Obes 2024; 31:53-59. [PMID: 38010050 PMCID: PMC11015822 DOI: 10.1097/med.0000000000000849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2023]
Abstract
PURPOSE OF REVIEW Bone accrual during childhood and adolescence is critical for the attainment of peak bone mass and is a major contributing factor towards osteoporosis in later life. Bone mass accrual is influenced by nonmodifiable factors, such as genetics, sex, race, ethnicity, and puberty, as well as modifiable factors, such as physical activity and diet. Recent progress in bone imaging has allowed clinicians and researchers to better measure the morphology, density, and strength of the growing skeleton, thereby encompassing key characteristics of peak bone strength. In this review, the patterning of bone accrual and contributors to these changes will be described, as well as new techniques assessing bone mass and strength in pediatric research and clinical settings. RECENT FINDINGS This review discusses factors influencing peak bone mass attainment and techniques used to assess the human skeleton. SUMMARY The rate of bone accrual and the magnitude of peak bone mass attainment occurs in specific patterns varying by sex, race, ethnicity, longitudinal growth, and body composition. Physical activity, diet, and nutritional status impact these processes. There is a need for longitudinal studies utilizing novel imaging modalities to unveil factors involved in the attainment and maintenance of peak bone strength.
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Affiliation(s)
- Eugene Rodrick
- University of Georgia, Department of Nutritional Sciences, Athens, Georgia, USA
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Malczewska-Lenczowska J, Surała O, Granda D, Szczepańska B, Czaplicki A, Kubacki R. The Relationship between Bone Health Parameters, Vitamin D and Iron Status, and Dietary Calcium Intake in Young Males. Nutrients 2024; 16:215. [PMID: 38257108 PMCID: PMC10818825 DOI: 10.3390/nu16020215] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 12/29/2023] [Accepted: 01/02/2024] [Indexed: 01/24/2024] Open
Abstract
Vitamin D, calcium, and iron are micronutrients crucial for bone health. However, their effect has been studied primarily in the cortical bone, with vitamin D status being assessed mainly from the total 25(OH)D serum fraction. The study aimed to investigate the impact of vitamin D (total and free fraction) and iron status (i.e., serum ferritin or soluble transferrin receptor) and calcium intake (ADOS-Ca questionnaire) on lumbar cortical and trabecular bone. In a cohort of 113 male subjects (76 athletes, 37 non-athletes) aged 15-19, the lumbar spine status (Z-score, bone mineral apparent density (BMAD), and trabecular bone score (TBS)) was determined using dual-energy X-ray absorptiometry (DXA). Relationships between the examined micronutrients and bone health parameters were observed only in athletes. Free 25(OH)D was significantly (p < 0.001) correlated with Z-score and BMAD, while total 25(OH)D (p < 0.001) and iron status (ferritin, Fe stores; p < 0.01) correlated solely with BMAD. Free 25(OH)D and ferritin concentrations were the best determinants of bone status (R2 = 0.330; p < 0.001) and explained 25% and 7% of the BMAD variance, respectively. No relationships were found between the micronutrients and TBS. The results confirmed the positive influence of vitamin D and iron on cortical, but not trabecular, bone status solely in physically active subjects. In athletes, free 25(OH)D seems to be a superior indicator of bone health to a total 25(OH)D fraction.
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Affiliation(s)
- Jadwiga Malczewska-Lenczowska
- Department of Nutrition Physiology, Institute of Sport, National Research Institute, 01-982 Warsaw, Poland; (J.M.-L.); (D.G.); (B.S.)
| | - Olga Surała
- Department of Nutrition Physiology, Institute of Sport, National Research Institute, 01-982 Warsaw, Poland; (J.M.-L.); (D.G.); (B.S.)
| | - Dominika Granda
- Department of Nutrition Physiology, Institute of Sport, National Research Institute, 01-982 Warsaw, Poland; (J.M.-L.); (D.G.); (B.S.)
| | - Beata Szczepańska
- Department of Nutrition Physiology, Institute of Sport, National Research Institute, 01-982 Warsaw, Poland; (J.M.-L.); (D.G.); (B.S.)
| | - Adam Czaplicki
- Faculty of Physical Education and Health in Biała Podlaska, Józef Piłsudski University of Physical Education, 00-968 Warsaw, Poland;
| | - Rafał Kubacki
- Faculty of Physical Education & Sport, University School of Physical Education, 51-612 Wroclaw, Poland;
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Zhou C, Zeng W, Chen X, Liu X, Zheng D, Yang X, Li Q. Association between lung function and bone mineral density in children and adolescents: Insights from the NHANES. Medicine (Baltimore) 2024; 103:e36752. [PMID: 38181285 PMCID: PMC10766276 DOI: 10.1097/md.0000000000036752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 12/01/2023] [Indexed: 01/07/2024] Open
Abstract
Bone development and lung function are integral to child and adolescent health. Both influence an individual's overall well-being and potentially affect long-term health. Utilizing a comprehensive dataset from the National Health and Nutrition Examination Survey, this study aims to elucidate the relationship between lung function and bone mineral density (BMD) in a representative sample of children and adolescents. The analysis covered 3410 participants aged 8 to 19 years. We employed weighted multivariate linear regression and restricted cubic spline curve visualizations to explore the intricate association between lung function metrics, particularly first-second expiratory volume 1 second/forced vital capacity ratio, and lumbar BMD. Our data indicated a positive association between lung function and lumbar BMD in children and adolescents. Specifically, higher lung function metrics were linked with increased lumbar BMD. This association was more pronounced in younger participants or those with a lower body mass index. A significant positive relationship exists between lung function and BMD in the pediatric population. Recognizing this association is crucial for holistic health strategies for children and adolescents. This study underscores the need for integrated health monitoring during formative years, which can influence health trajectories as these individuals transition to adulthood.
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Affiliation(s)
- Chunxiang Zhou
- Department of Thoracic Surgery, The Second Affiliated Hospital, Hengyang Medical School, University of South China. Hengyang, China
| | - Wei Zeng
- Department of Thoracic Surgery, The Second Affiliated Hospital, Hengyang Medical School, University of South China. Hengyang, China
| | - Xiaoyan Chen
- Department of Thoracic Surgery, The Second Affiliated Hospital, Hengyang Medical School, University of South China. Hengyang, China
| | - Xiang Liu
- Department of Thoracic Surgery, The Second Affiliated Hospital, Hengyang Medical School, University of South China. Hengyang, China
| | - Dayang Zheng
- Department of Thoracic Surgery, The Second Affiliated Hospital, Hengyang Medical School, University of South China. Hengyang, China
| | - Xu Yang
- Department of Thoracic Surgery, The Second Affiliated Hospital, Hengyang Medical School, University of South China. Hengyang, China
| | - Qian Li
- Department of Thoracic Surgery, The Second Affiliated Hospital, Hengyang Medical School, University of South China. Hengyang, China
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Rizzoli R, Chevalley T. Bone health: biology and nutrition. Curr Opin Clin Nutr Metab Care 2024; 27:24-30. [PMID: 37922025 PMCID: PMC10720787 DOI: 10.1097/mco.0000000000000988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2023]
Abstract
PURPOSE OF REVIEW Recent findings in the influence of dietary patterns, dairy products, beverages and microbiota composition and function on bone health are reviewed and discussed. RECENT FINDINGS Evidence is accumulating on the increased risk of fracture in individuals following a vegan diet. Meta-analysis of randomized controlled trials indicates a favourable, though of low amplitude, effect of dairy products on bone mass accrual during childhood and adolescence. Though mostly based on results from observational studies, it seems that dairy product consumption, particularly fermented dairy products, is associated with a lower risk of hip fracture. Regular green tea drinkers may have a lower fracture risk than tea abstainers. Magnesium intake is beneficial for bone health. Prune supplements prevents bone loss in untreated postmenopausal women. This seems to be associated with modification of gut microbiota. SUMMARY This information should help the medical practitioners facing questions from their patients on how to protect bone health through nutrition.
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Affiliation(s)
- René Rizzoli
- Service of Bone Diseases, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
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