The effect of dietary interventions and nutritional supplementation on bone mineral density in otherwise healthy adults with osteopenia: A systematic review

Abstract

There are many health and economic consequences for patients with osteopenia, the precursor to osteoporosis. A range of treatments may provide positive outcomes for otherwise healthy adults, including dietary and exercise approaches, either alone or in combination. The primary aim of this systematic review was to evaluate the effect of dietary approaches (including diet alone, diet with dietary supplements, both with or without physical activity intervention) on bone mineral density (BMD) to treat adults aged ≥18 years who were classified as having osteopenia. Six databases (Ovid MEDLINE including Ovid Medline in process, Cochrane Library, EMBASE, CINAHL Plus, Web of Science and Scopus) were searched systematically to identify randomised controlled trials of dietary approaches to treat osteopenic adults published from 1994 to November 2014. Study eligibility was determined, and included studies were assessed for risk of bias. Outcome data, particularly the primary outcomes of BMD T-and Z-scores or other measures of bone density, were combined narratively. The searches yielded 3511 papers, with three studies fulfilling the inclusion criteria. These studies included 254 participants, all free-living post-menopausal females with confirmed osteopenia. Vitamin D interventions were tested in all included studies, with none showing significant differences between intervention and placebo groups on BMD. This review has identified a lack of evidence to guide clinical practice in this area. Opportunities exist for future research to determine the effect of nonpharmacological approaches to osteopenia treatment in healthy populations, especially research that considers younger-aged and male populations, physical activity, habitual dietary intake and key bone health nutrients.

Systematic review: exercise‐induced gastrointestinal syndrome—implications for health and intestinal disease

“…A systematic literature search was undertaken by three researchers (RC, RS and CK), in accordance with methods used by Porter et al., to determine the impact of acute exercise (ie, intensity, duration, and mode) on markers of exercise‐induced gastrointestinal syndrome, using five online scientific databases, which included PubMed, EBSCO, Web of Science (all databases), SPORTSdiscus and Ovid Medline (Table S1). Original field observational studies and/or laboratory controlled trials, presenting quantified data on markers of gastrointestinal integrity or function in a healthy (ie, absence of illness and disease) human population that required participants to perform an acute exercise bout were considered for the review.…”

Prevention and management of osteoporotic fractures by non-physician health professionals: a systematic literature review to inform EULAR points to consider

“…One systematic review,53 three meta-analyses24 30 31 and three primary studies54–56 contributed evidence about exercise interventions. Two RCTs explored falls prevention programmes36 57 and two systematic reviews58 59 and one RCT60 investigated nutrient supplementation. One systematic review explored patient education strategies61 (table 4).…”

“…Publications described nutritional supplementation with vitamin D analogues,58 protein59 and vitamin K 60. Change in BMD was the primary outcome in all studies and was assessed between 9 weeks and 48 months.…”

2019 EULAR points to consider for non-physician health professionals to prevent and manage fragility fractures in adults 50 years or older

“…The evidence identified in our SLR was insufficient to determine the effect of vitamin D analogues, non-soy protein or daily vitamin K on BMD or fractures in older women with T scores between −1 and ≥−2.5. [44][45][46] Nonetheless, maintenance of a healthy weight, increased consumption of fresh fruit and vegetables, lowering sodium intake and ensuring country-specific recommended intake levels of dietary calcium, may favourably impact bone health. 47 Adequate serum levels of vitamin D are important for good musculoskeletal health, although the effect of supplementation on bone health-related outcomes remains contested.…”