Nutrition-Based Support for Osteoporosis in Postmenopausal Women: A Review of Recent Evidence

Figures & data

Table 1 Involvement of Different Macronutrients and Dietary Recommendations in Bone Health

Macronutrient	Role in Bone Health	Dietary Recommendation
Saturated Fatty Acids	Promote the formation of complexes with calcium, leading to its elimination through faeces, and apoptosis of osteoblasts^Citation1,Citation26	Limit the consumption of ultra-processed foods
Polyunsaturated Fatty Acids	Modulate the activity of osteoclasts and osteoblasts; control inflammatory processes^Citation27,Citation28	Ensure proper consumption of foods rich in omega-3 fatty acids, such as walnuts or fatty fish
Carbohydrates	Hyperglycemia increases inflammation, oxidative stress, bone resorption due to acidosis, and urinary calcium excretion^Citation29	Recommend foods with a high glycemic index and rich in fiber, such as fruits, vegetables, and whole grains
Proteins	Provide necessary amino acids for bone remodelling and enhance calcium absorption in the intestine^Citation1,Citation30	Increase protein intake above 0.8 g/kg of body weight per day if there are no contraindications

Table 2 Involvement of Different Micronutrients and Dietary Recommendations in Bone Health

Micronutrient	Role in Bone Health	Dietary Recommendation
Phosphorus	Important component of the bone matrix Excessive consumption, especially in populations with low calcium intake, increases PTH and bone resorption^Citation48,Citation49	Limit the consumption of ultra-processed foods
Magnesium	Enzymatic cofactor in bone matrix synthesis Its deficiency alters PTH secretion, reduces vitamin D levels, and increases bone resorption^Citation50,Citation51	Recommend adequate consumption of nuts and legumes
Vitamins B	Involvement in homocysteine metabolism Deficiency of B6, B9, and B12 leads to increased blood homocysteine levels, which is a risk factor for osteoporosis^Citation52–54	More scientific evidence needed
Vitamin C	Participation in the formation of osteoblasts, as well as in collagen synthesis^Citation55	Ensure proper intake of fruits and vegetables
Vitamin E	Potent antioxidant that helps control oxidative stress levels and, therefore, bone resorption^Citation56	Recommend the consumption of vegetable oils and seeds
Vitamin K	Essential cofactor for the gamma-carboxylation of osteocalcin and, therefore, for its activation Its deficiency increases serum levels of undercarboxylated osteocalcin, a risk factor for osteoporotic fractures^Citation57,Citation58	Promote the consumption of fermented foods like cheese and ensure proper intake of fish and eggs

Figure 1 Implication of different foods and nutrients on bone health.

Abbreviations: BMD, bone mineral density; DII, Dietary Inflammatory Index; DXA, dual-energy X-ray absorptiometry; IGF-1, insulin-like growth factor 1; MD, Mediterranean diet; PTH, parathyroid hormone; PUFA, polyunsaturated fatty acids; ROS, reactive oxygen species; SFA, saturated fatty acids.

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