The Impact Of Supplements On Bone Health

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The Impact Of Supplements On Bone Health

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Mail received: 1 July 2020 / Revised: 26 July 2020 / Accepted: 1 July 2020 / Published: 3 July 2020

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Osteoporosis is a disease characterized by reduced bone mineral density, weak bones, and increased risk of bone fractures. Fragility fractures are associated with significant morbidity, mortality and disability and are a major public health problem worldwide. The influence of nutrition on the growth and development of this disease may be important and has not been well established. Calcium intake and vitamin D status are considered important for the homeostasis of bone metabolism. However, some recent studies have questioned the importance of calcium and vitamin D supplements in reducing the risk of osteoporosis. Adequate nutrition of protein, vegetables and other foods is also desirable, and the recommendations are based on expert opinion and clinical guidelines. It is important to understand the influence of nutrients not only in isolation but also in the context of food composition, which is a complex of nutrients. In this review, we evaluate the available scientific evidence for the effects of large dietary patterns on bone health. Although some dietary patterns seem to be beneficial, more research is needed to confirm the true effect of diet on bone fragility.

Osteoporosis is a debilitating disease that causes fragility fractures, increases morbidity and mortality, and increases medical costs [1]. Maintaining good health is very important to reduce the risk of osteoporosis. Getting enough calcium, vitamin D and protein – along with maintaining a healthy weight and cutting bad habits, such as drinking and smoking – helps improve bone health. Some supplements seem to have additional effects. European guidelines for the diagnosis and management of osteoporosis in postmenopausal women recommend a daily intake of at least 1000 mg/day of calcium, 800 IU/day of vitamin D to maintain blood 25-hydroxyvitamin D levels > 50 nmol/L and 1 g/kg body weight of protein for all women over the age of 50 to prevent age-related musculoskeletal health [2]. Although drug treatment seems to be the first option for reducing the risk of osteoporosis in the elderly, it is not always possible, and dietary changes – in particular, increasing consumption calcium, vitamin D and protein – may be the best choice. ]. For this article, we conducted an evidence-based review of the most important information available today related to bone health and nutrition.

Calcium and vitamin D are part of the mineral matrix of bones as calcium phosphate (hydroxyapatite crystals) and are needed for strong bones. The best way to get enough calcium is to follow a healthy diet. However, sometimes the nutrients are insufficient or insufficient, and, in such cases, taking calcium supplements may be necessary. This is the consensus of many clinical practices [4, 5, 6, 7]. However, some authors criticize this recommendation because of its low effectiveness and negative impact [7]. The most important sources of calcium in food are dairy products (milk, yogurt and cheese), fish (especially sardines and bones), legumes and vegetables and a few fruits (especially nuts and seeds).

Calcium homeostasis is, to a large extent, controlled by vitamin D. A total of 80-90% of vitamin D is obtained from the skin after exposure to sunlight, and 10-20%, from small foods small, such as fish with oil, mushrooms and. some fortified dairy products. However, no food can provide enough vitamin D to meet the needs. It can be responsible for different foods to increase vitamin D levels.

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Adequate sunlight is important for prevention and treatment of vitamin D deficiency Vitamin D is not beneficial for health, and this vitamin is important for bone health. In older or postmenopausal women, vitamin D deficiency can lead to osteoporosis. In addition, adequate levels of 25-hydroxyvitamin D (25 (OH)D) are important for the effectiveness of anti-osteoporotic drugs [8]. In addition, vitamin D is involved in the maintenance of muscles and strength as well as bones. Effectiveness has been shown for some vitamin D-fortified foods, such as reduced-fat cheese and vitamin D-fortified eggs [9, 10].

A recent meta-analysis of the effects of vitamin D-fortified foods on serum 25(OH)D levels, bone mineral density (BMD) and bone turnover (BTM) found beneficial, with increased serum 25 (OH)D. and BMD and decreased parathormone (PTH). No benefit was found for BTM [11].

Dairy products are important foods that provide nutrients that are beneficial to bones, such as calcium, phosphorus and magnesium, and these substances play a morphological role in the structure of healthy bones. drink clean. Dairy products also contain protein, vitamin B-12, zinc, potassium and riboflavin. Dairy products are also considered the best sources of vitamin D if they are fortified with them. Vitamin D levels by weight are higher in yogurt and cheese than in milk, but the amounts of these products are generally smaller than in milk. Figure 1 shows the essential nutrients per 100 g of commonly consumed foods.

Therefore, regular consumption of milk or those containing calcium and/or vitamin D can increase bone mineral density (BMC). However, this organization differs by race. In Caucasian and Chinese women, calcium from fortified dairy products increased BMD by 0.7-1.8% over 2 years, depending on the measurement site (lumbar spine, total hip, femoral neck or whole body). In elderly Caucasian women, consuming 200-250 mL of milk daily was associated with a 5% or greater risk of osteoporosis [12]. Another recent large-scale study showed an 8% reduction in the risk of osteoporosis for every day of daily breastfeeding, in both men and women, which is evaluated every 4 years, in addition, milk consumption has been shown to reduce the risk of osteoporotic fractures by 5-15% in a group of patient data, especially especially in elderly patients (80 years or more) [13]. In a group of healthy postmenopausal women, daily consumption of fortified milk with calcium and vitamin D improved vitamin D and BMD of the femoral neck, and also had a positive effect on glucose and lipids [14]. Information on this effect in men is less.

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Fermented milk products, such as yogurt or cheese, are also an important source of calcium, phosphorus, and protein. Fermented milks are attractive because they can contain prebiotics and provide probiotics. For example, inulin (a prebiotic) can be added to yogurt. In addition, probiotics can improve intestinal calcium absorption and bone metabolism. The balance of bone mass and the reduction of sex hormone deficiency caused by bone loss (especially important after menopause) have been shown to improve after taking the calcium, protein, prebiotics and probiotics. These drugs can change the intestinal microbiota composition and metabolism. Consumption of fermented milk products can be considered as a sign of a healthy lifestyle that supports bone [15].

In animal models, probiotics have been shown to prevent bone loss associated with estrogen deficiency, diabetes, or glucocorticoid therapy, by regulating bone resorption and formation [16]. In humans, probiotics alter 25(OH)D levels and calcium absorption, and reduce bone loss in older postpartum women to the same extent as vitamin D supplements with or without calcium supplementation [ 17 ]. Fermented milk products are an important food source of probiotics, which can improve calcium homeostasis, prevent secondary hyperparathyroidism, and prevent the aging of bones and bones. More research is needed to determine whether probiotics are effective or not