Institute for Nutrition Research, School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia.
Medical School, The University of Western Australia, Perth, WA, Australia.
J Bone Miner Res. 2021 Feb;36(2):219-226. doi: 10.1002/jbmr.4236. Epub 2021 Jan 27.
A healthy diet is essential to attain genetically determined peak bone mass and maintain optimal skeletal health across the adult lifespan. Despite the importance of nutrition for bone health, many of the nutritional requirements of the skeleton across the lifespan remain underexplored, poorly understood, or controversial. With increasingly aging populations, combined with rapidly changing diets and lifestyles globally, one anticipates large increases in the prevalence of osteoporosis and incidence of osteoporotic fractures. Robust, transparent, and reproducible nutrition research is a cornerstone for developing reliable public health recommendations to prevent osteoporosis and osteoporotic fractures. However, nutrition research is often criticized or ignored by healthcare professionals due to the overemphasis of weak science, conflicting, confusing or implausible findings, industry interests, common misconceptions, and strong opinions. Conversely, spurious research findings are often overemphasized or misconstrued by the media or prominent figures especially via social media, potentially leading to confusion and a lack of trust by the general public. Recently, reforms of the broader discipline of nutrition science have been suggested and promoted, leading to new tools and recommendations to attempt to address these issues. In this perspective, we provide a brief overview of what has been achieved in the field on nutrition and bone health, focusing on osteoporosis and osteoporotic fractures. We discuss what we view as some of the challenges, including inherent difficulties in assessing diet and its change, disentangling complex interactions between dietary components and between diet and other factors, selection of bone-related outcomes for nutrition studies, obtaining evidence with more unbiased designs, and perhaps most importantly, ensuring the trust of the public and healthcare professionals. This perspective also provides specific recommendations and highlights new developments and future opportunities for scientists studying nutrition and bone health. © 2021 American Society for Bone and Mineral Research (ASBMR).
健康的饮食对于达到基因决定的峰值骨量和维持整个成年期的最佳骨骼健康至关重要。尽管营养对骨骼健康很重要，但骨骼在整个生命周期中的许多营养需求仍未得到充分探索、理解或存在争议。随着人口老龄化的加剧，加上全球饮食和生活方式的迅速变化，可以预见骨质疏松症的发病率和骨质疏松性骨折的发生率将会大幅上升。稳健、透明和可重复的营养研究是制定预防骨质疏松症和骨质疏松性骨折的可靠公共卫生建议的基石。然而，由于对薄弱科学的过分强调、相互矛盾、令人困惑或不可信的发现、行业利益、常见误解和强烈意见，营养研究经常受到医疗保健专业人员的批评或忽视。相反，虚假的研究结果经常被媒体或知名人士过分强调或误解，尤其是通过社交媒体，这可能导致公众的困惑和缺乏信任。最近，有人建议并推动了更广泛的营养科学学科改革，从而提出了新的工具和建议来尝试解决这些问题。在这篇观点文章中，我们简要概述了营养与骨骼健康领域所取得的成就，重点关注骨质疏松症和骨质疏松性骨折。我们讨论了一些我们认为的挑战，包括评估饮食及其变化的固有困难、厘清饮食成分之间以及饮食与其他因素之间的复杂相互作用、为营养研究选择与骨骼相关的结果、采用更无偏倚设计获得证据，以及最重要的是，确保公众和医疗保健专业人员的信任。这篇观点文章还为研究营养与骨骼健康的科学家提供了具体建议，并强调了新的发展和未来的机会。 © 2021 美国骨骼与矿物质研究协会（ASBMR）。
