Nutrition and bone health: turning knowledge and beliefs into healthy behaviour

Abstract

Primary osteoporosis prevention requires healthy behaviours, such as regular physical exercise and adequate dietary intakes of calcium, vitamin D and protein. Calcium and vitamin D can decrease postmenopausal bone loss and prevent fracture risk. However, there is still a high prevalence of calcium and vitamin D insufficiency in women aged 50+ years. Dietary sources of these nutrients are the preferred choice, and dairy products represent a valuable dietary source of calcium due to the high content, high absorptive rate and relatively low cost. Furthermore, dairy products also contain other key nutrients including vitamin D, phosphorus and protein that contribute to bone health. Studies of women’s beliefs and behaviours with respect to osteoporosis highlight poor knowledge of the importance of dietary nutrient intakes and low concern regarding bone health. Osteoporosis educational programmes exist to help women change behaviours relevant to bone health. Such programmes can have positive influences on women’s knowledge, attitudes, perceived norms, motivation and behaviours. Increased awareness of the consequences of low calcium and vitamin D intakes may promote women’s attitudes towards dietary sources, in particular dairy products, and lead to better adherence to health recommendations. Increasing dietary nutrient intakes through educational initiatives should be further developed to aid the prevention of osteoporosis and the efficacy of osteoporosis management.

Keywords::

• Bone health
• Calcium
• Diet behaviours
• Health beliefs
• Nutrition
• Osteoporosis
• Protein
• Vitamin D

Transparency

Declaration of funding

This paper was developed from presentations made at a satellite symposium held at the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO) and International Osteoporosis Foundation (IOF) European Congress on Osteoporosis and Osteoarthritis, 19 April, 2013, which was made possible by an unrestricted grant from Danone SA.

The work of C.A. was partially funded by the UK National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care of the South West Peninsula (PenCLAHRC), but the views expressed in this paper are those of the author and not necessarily those of NIHR or the UK Department of Health.

Declaration of financial/other relationships

R.R. has disclosed receiving consulting and lecture fees from Merck Sharp and Dohme (MSD), Eli Lilly, Amgen, Servier, Takeda, Nestlé and Danone. C.A. has disclosed receiving consulting and lecture fees from Leverhulme, Johnston, and Danone; and receiving research funding from Shell UK. M.-L.B. has disclosed receiving consulting fees and grants from Amgen, Eli Lilly, MSD, Novartis, Roche and Servier.

CMRO peer reviewers on this manuscript have received an honorarium for their review work, but have no other relevant financial relationships to disclose.

Acknowledgements

Writing and editorial assistance were provided by Lisa Buttle PhD of Chill Pill Media LLP, which was contracted and funded by Danone SA.