Bone is a metabolically active tissue throughout life, and bone remodelling maintains bone strength and controls mineral homeostasis. It is carried out by two specialised cell types, the osteoclast, which resorbs and recycles components of old bone matrix, and the osteoblast, which synthesises new bone matrix. After the age of 30, skeletal mass deteriorates as resorption exceeds formation, at a rate of ˜ 3% for males and 8% for females, resulting in increased fragility and susceptibility to fracture. This is osteoporosis, which affects an estimated 75 million people in Europe, USA and Japan. Worldwide, 1 in 3 women and 1 in 5 men over 50 will experience osteoporotic fractures [1]. Current treatment focuses mainly on preventing bone resorption using bisphosphonates, hormone replacement therapy, selective oestrogen receptor modulators (SERMs) and vitamin D analogues, but these simply halt further deterioration of skeletal microarchitecture [2]. Treatments which can increase bone mass and accelerate fracture healing are urgently needed and recent research indicates a role for natural products in the prevention and treatment of osteoporosis, by enhancing osteoblast activity as well as reducing osteoclast activity [2, 3]. Epidemiological evidence suggests a positive association between the accrual and maintenance of bone mass and fruit and vegetable intake, and experimental studies show that this is likely to be due to flavonoids and related polyphenols, which have the advantages of low toxicity whilst providing other health benefits at the same time [2]. Furthermore, natural phytoestrogens are now being compared to SERMs in terms of their binding to oestrogen receptors [4]. This presentation will give an overview of phytochemicals which modulate bone metabolism, including flavonoids, polyphenols, beta-glucans, allyl sulphides and even cannabinoids, from the numerous published experimental studies to the few clinical trials reported.
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