Putative Effects of Nutritive Polyphenols on Bone Metabolism In Vivo-Evidence from Human Studies.

Katharina Austermann,Natalie Baecker,Martina Heer,Peter Stehle

doi:10.3390/nu11040871

Katharina Austermann, Natalie Baecker + Show 2 more

Open Access

https://doi.org/10.3390/nu11040871

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Abstract

For the prevention and treatment of bone loss related diseases, focus has been put on naturally derived substances such as polyphenols. Based on human intervention studies, this review gives an overview of the effects of dietary significant polyphenols (flavonoids, hydroxycinnamic acids, and stilbenes) on bone turnover. Literature research was conducted using PubMed database and articles published between 01/01/2008 and 31/12/2018 were included (last entry: 19/02/2019). Randomized controlled trials using oral polyphenol supplementation, either of isolated polyphenols or polyphenols-rich foods with healthy subjects or study populations with bone disorders were enclosed. Twenty articles fulfilled the inclusion criteria and the average study quality (mean Jadad score: 4.5) was above the pre-defined cut-off of 3.0. Evidence from these studies does not allow an explicit conclusion regarding the effects of dietary important polyphenols on bone mineral density and bone turnover markers. Differences in study population, habitual diet, lifestyle factors, applied polyphenols, used doses, and polyphenol bioavailability complicate the comparison of study outcomes.

Highlights

The human skeleton is continuously remodeled throughout life by osteoclast- and osteoblast activities [1]
The following search terms were used and at least one of the terms in each of the following four lists had to be present in the title and/or abstract of the article: (1) clinical, experimental, human, in vivo, intervention; (2) bone, bone turnover, bone markers, bone loss; (3) nutrition, nutritional, supplementation, oral; (4) polyphenols, flavonoids, flavanols, flavonols, flavanones, flavones, isoflavonoids, isoflavones, anthocyanins, stilbenes, hydroxycinnamic acids
Studies meeting the following inclusion criteria were included in the evaluation: (a) randomized controlled trials; (b) oral polyphenol supplementation; (c) supplementation of isolated polyphenols or polyphenol-rich foods; (d) healthy subjects or study populations with bone loss related diseases (e) outcomes: bone mineral density (BMD) or bone turnover markers; (f) publication date: 2008—2018

Summary

Introduction

The human skeleton is continuously remodeled throughout life by osteoclast- (bone resorbing cells) and osteoblast (bone forming cells) activities [1]. Bone remodeling ensures mineral homeostasis, maintains the integrity of the skeleton, and is responsible for removal and repair of damaged tissue [2]. The underlying close communication and interaction between osteoclasts and osteoblasts consist of four consecutive phases: activation, resorption, formation, and termination/resting [2,3]. During the activation phase, an initiating remodeling signal is detected by bone cell receptors supporting the migration of partially differentiated mononuclear preosteoclasts to the bone surface. Multinucleated osteoclasts are formed promoting resorption of bone mass. In the third phase mononuclear cells prepare the bone surface for the osteoblast-mediated formation and initiate osteoblast differentiation and

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