Abstract
Bone is a nutritionally modulated tissue. Given this background, aim of this review is to evaluate the latest data regarding ideal dietary approach in order to reduce bone mineral density loss and to construct a food pyramid that allows osteopenia/osteoporosis patients to easily figure out what to eat. The pyramid shows that carbohydrates should be consumed every day (3 portions of whole grains), together with fruits and vegetables (5 portions; orange-colored fruits and vegetables and green leafy vegetables are to be preferred), light yogurt (125 mL), skim milk (200 mL,) extra virgin olive oil (almost 20 mg/day), and calcium water (almost 1 l/day); weekly portions should include fish (4 portions), white meat (3 portions), legumes (2 portions), eggs (2 portions), cheeses (2 portions), and red or processed meats (once/week). At the top of the pyramid, there are two pennants: one green means that osteopenia/osteoporosis subjects need some personalized supplementation (if daily requirements cannot be satisfied through diet, calcium, vitamin D, boron, omega 3, and isoflavones supplementation could be an effective strategy with a great benefit/cost ratio), and one red means that there are some foods that are banned (salt, sugar, inorganic phosphate additives). Finally, three to four times per week of 30–40 min of aerobic and resistance exercises must be performed.
Highlights
Bones are characterized by a dynamic structure [1] continuously resorbed and rebuilt by osteoclasts and osteoblasts, respectively
Osteoporosis has been defined by The World Health Organization (WHO) as: “the osteoporotic state of the bone is defined by the T-score variable, which is the number of standard deviations (SDs) by which a patient’s test differs from the mean of the young adult reference group” [2]
The results showed a protection in the loss of bone mass at the level of the femoral neck in men belonging to the upper three quartiles of fiber intake compared to the lowest quartile; no significant associations emerged in women [42]
Summary
Bones are characterized by a dynamic structure [1] continuously resorbed and rebuilt by osteoclasts and osteoblasts, respectively. The balance between bone resorption and bone formation and its regulation are critical factors for maintaining adequate mineral homeostasis and bone density. Osteoporosis is caused by an impaired balance of these two remodeling processes, resulting in more bone resorption than bone deposition. There are several clinical conditions that can lead to an imbalance in this remodeling process: old age and postmenopausal period are the major causes of osteoporosis, but other risk factors, including medications, endocrine disorders, immobilization, inflammatory arthropathy, hematopoietic disorders, and nutrition disorders, can be involved. Osteopenia is considered as a state of lower-than-average bone density resulting in an intermediate risk similar to other clinical entities, such as prehypertension, impaired fasting glucose, and borderline high cholesterol [3] Osteoporosis has been defined by The World Health Organization (WHO) as: “the osteoporotic state of the bone is defined by the T-score variable, which is the number of standard deviations (SDs) by which a patient’s test differs from the mean of the young adult reference group (positive t-score values are associated with greater bone mass density than the reference group, negative ones with less bone density values)” [2].
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