Best Practice & Research Clinical Endocrinology & Metabolism
8Nutrition: its role in bone health
Section snippets
Bone mass accrual
Body mineral stores almost double during puberty, through an increase in the size of the skeleton with minor changes in volumetric bone density, i.e., the amount of bone in bone.6, 7 By the end of the second decade of life, most of the body mineral capital has been accumulated, though a very small proportion of bone consolidation may occur during the third decade, particularly in males.8 Puberty is the period during which the sex difference in bone mass observed in adult subjects becomes fully
Calcium and bone growth
Observational studies have shown that increasing calcium intake is associated with a greater gain in bone mass and hence a higher peak bone mass.8 This observation is of interest since it is estimated that a 10% increase in peak bone mass could reduce the risk of osteoporotic fractures during adult life by 50%. Furthermore, several prospective randomized, double-blind, placebo-controlled intervention trials have concluded that calcium supplementation increases bone mass gain, although the
Protein and bone growth
Protein intake in children and adolescents influences bone growth and bone mass accumulation.25 In ‘well’ nourished children and adolescents, it appears that variations in the protein intake within the ‘normal’ range can be associated with modifications in skeletal growth, thereby modulating the genetic potential in peak bone mass attainment.
Prospective observational studies suggest that both calcium and protein intakes are independent variables of bone mineral mass acquisition, particularly
Dairy products and bone growth
In addition to calcium, phosphorus, calories, and vitamins, one litre of milk provides 32–35 g of protein, mostly casein, but also whey protein which contains numerous growth-promoting elements.29, 30 In growing children, long-term milk avoidance is associated with smaller stature and lower bone mineral mass, either at specific sites or at whole-body levels.31, 32, 33, 34, 35, 36, 37, 38, 39 Low milk intake during childhood and/or adolescence increases the risk of fracture before puberty (a
Calcium and bone remodelling
After menopause, changes in sex hormone levels and nutrition are associated with an increase in bone remodelling, leading thereby to an increase in bone fragility. In adults, obligatory calcium losses have to be offset by sufficient calcium intakes and efficacious intestinal absorption. Otherwise, bone is used as a source of calcium to maintain homeostasis in extracellular calcium concentration (Figure 2). This homeostatic mechanism is altered in the elderly, with altered vitamin D synthesis in
Specific bone diseases
Neurofibromatosis results from deficiency in neurofibromin, an Nf1 protein product which is a tumour-suppressor protein. Mice with a specifically osteoblast ablated Nf1 gene displayed an increased bone mass phenotype, with increased bone formation and resorption. This bone phenotype can be rescued by nutritional restriction of protein intake.142 In contrast, an opposite phenotype was found in mice with ablation of the transcription factor ATF-4, a situation analogous to the Coffin–Lowry
Acknowledgements
Mrs M. Perez is gratefully acknowledged for her secretarial help.
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2024, Prostaglandins Leukotrienes and Essential Fatty AcidsEffects of Different Levels of Weightlifting Training on Bone Mineral Density in a Group of Adolescents
2022, Journal of Clinical DensitometryFGF21, not GCN2, influences bone morphology due to dietary protein restrictions
2020, Bone ReportsCitation Excerpt :Protein provides essential amino acids for the synthesis of bone collagen matrix, and dietary protein restriction has been associated with a reduction in bone density in humans (Ammann et al., 2000) and in animal models (Bourrin et al., 2000; Huang et al., 2014; Mardon et al., 2008). In an elderly population, protein malnutrition has been attributed to a reduction in bone mass and subsequent osteoporosis (Rizzoli and Bonjour, 2004; Rizzoli, 2008; Rizzoli et al., 2014). Similarly, a positive correlation between bone mineral density (BMD) and both energy and protein intake have been reported, especially in the aged population (Devine et al., 2005; Hannan et al., 2000).
Positive Correlations Between Free Vitamin D and Bone Variables in a Group of Young Lebanese Women
2018, Journal of Clinical DensitometryCitation Excerpt :Body weight was positively correlated with WB BMC, WB BMD, FN BMD, TBS, FN BMAD, FN CSA, and FN CSMI. Body weight is considered by several researchers as a strong predictor of bone mass and BMD (22,31–33). In fact, obesity and overweight are associated with higher BMC and BMD values and greater values of geometric indices of hip bone strength (22).
Dairy products and bone health: How strong is the scientific evidence?
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