Diet, nutrition and the prevention of osteoporosis
Diet, nutrition and the prevention of osteoporosis
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DOI：
10.1079/phn2003590
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发表时间：
2004-02-01
影响因子：
3.2
通讯作者：
Prentice, A
中科院分区：
文献类型：
--
作者：
Prentice, A
目的：回顾饮食和营养与骨质疏松症的关系，为预防骨质疏松症，特别是骨质疏松性骨折提供建议。方法：首先，回顾骨质疏松症的定义、诊断和流行病学，讨论在世界范围内使用骨密度来定义骨质疏松症风险的困难，并提出脆性骨折应被视为疾病终点。其次，概述科学数据，证据的优缺点以及解释饮食，营养和骨质疏松症研究的概念性困难。考虑了以下因素：钙、维生素D、磷、镁、蛋白质和氟。还讨论了其他可能对骨骼健康产生影响的饮食，包括维生素、微量元素、电解质、酸碱平衡、植物雌激素、素食主义和乳糖不耐症。结论：儿童和青少年的骨矿物质状况、生长速率或骨转换与老年时的长期获益之间的关系尚不充分，因此这些指标不能作为骨质疏松症风险的标志。对于成年人来说，除了钙和维生素D外，任何膳食成分的摄入量与骨折风险之间存在联系的证据都不够可靠，无法提出坚定的建议。对于饮食的其他方面，越来越多的证据表明，目前的D健康饮食建议是减少钠摄入量，增加钾摄入量，多吃新鲜水果和蔬菜，这些建议不太可能对骨骼健康有害，反而可能有益。
Objective: To review the evidence on diet and nutrition relating to osteoporosis and provide recommendations for preventing osteoporosis, in particular, osteopototic fracture.Approach: Firstly, to review the definition, diagnosis and epidemiology of osteoporosis, to discuss the difficulties in using bone mineral density to define osteoporosis risk in a world-wide context and to propose that fragility fracture should be considered as the disease endpoint. Secondly, to provide an overview of the scientific data, the strengths and weaknesses of the evidence and the conceptual difficulties in interpreting studies linking diet, nutrition and osteoporosis. The following were considered: calcium, vitamin D, phosphorus, magnesium, protein and fluorine. Other potential dietary influences on bone health were also discussed, including vitamins, trace elements, electrolytes, acid-base balance, phyto-oestrogens, vegetarianism and lactose intolerance.Conclusions: There is insufficient knowledge linking bone mineral status, growth rates or bone turnover in children and adolescents to long-term benefits in old age for these indices to be used as markers of osteoporotic disease risk. For adults, the evidence of a link between intakes of any dietary component and fracture risk is not sufficiently secure to make firm recommendations, with the exception of calcium and vitamin D. For other aspects of the diet, accumulating evidence suggests that current D healthy-eating advice to decrease sodium intake, to increase potassium intake, and to consume more fresh fruits and vegetables is unlikely to be detrimental to bone health and may be beneficial.