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营养补充剂与骨骼健康。

Nutritional Supplements and Skeletal Health.

机构信息

Division of Endocrinology, Houston Methodist Hospital, Houston, TX, USA.

Division of Endocrinology, Gerontology, and Metabolism, School of Medicine, Stanford University, 300 Pasteur Drive, Room S025, Palo Alto, Stanford, CA, 94305-5103, USA.

出版信息

Curr Osteoporos Rep. 2021 Feb;19(1):23-33. doi: 10.1007/s11914-020-00651-x. Epub 2021 Jan 9.

Abstract

PURPOSE OF REVIEW

Nutrition influences skeletal health throughout the lifespan, from the impact of maternal intakes during development, through the development of peak bone mass, to the rate of bone loss during aging. However, there are limited data available on the effects of nutritional supplements on bone density, let alone fracture risk. This review will assess the current literature, focusing on human studies, and emphasizing nutrients where bone density or fracture data are available.

RECENT FINDINGS

Calcium and vitamin D supplements, in combination, reduce fracture risk, particularly in populations with low intakes. Extensive recent analyses have supported the safety of these interventions at recommended intakes. There is growing evidence that specific isoflavones may improve bone density although fracture data are lacking. Multiple other nutrient supplements may benefit skeletal health, but data are limited. The effect size of nutrient interventions are relatively small, requiring large sample sizes for trials with bone outcomes, may be difficult to blind, and the impact of supplementation may depend on baseline intake. However, nutrition is the only intervention that can be implemented life long and on a population wide basis. Further investigation is needed into the potential benefits of nutritional supplements to determine in which settings supplements may add benefit in addition to dietary intakes.

摘要

目的综述

营养会影响骨骼健康的一生,从发育过程中母体摄入的影响,到峰值骨量的发展,再到衰老过程中的骨丢失率。然而,关于营养补充剂对骨密度的影响,尤其是骨折风险的影响,数据有限。本综述将评估当前的文献,重点关注人体研究,并强调有骨密度或骨折数据的营养素。

最新发现

钙和维生素 D 补充剂联合使用可降低骨折风险,尤其是在摄入量低的人群中。最近的广泛分析支持在推荐摄入量下这些干预措施的安全性。越来越多的证据表明,特定的异黄酮可能会改善骨密度,尽管缺乏骨折数据。还有其他多种营养补充剂可能对骨骼健康有益,但数据有限。营养素干预的效果大小相对较小,需要有骨骼结果的试验具有较大的样本量,可能难以设盲,并且补充剂的影响可能取决于基线摄入量。然而,营养是唯一可以终生实施并在人群范围内实施的干预措施。需要进一步研究营养补充剂的潜在益处,以确定在哪些情况下补充剂除了饮食摄入外还可能增加益处。

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