Service of Bone Diseases, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland.
Service de rhumatologie, Inserm U 1153, université de Paris, AP-HP Centre, hôpital Cochin, Paris, France.
Joint Bone Spine. 2023 May;90(3):105521. doi: 10.1016/j.jbspin.2022.105521. Epub 2022 Dec 22.
This article presents the initial recommendations of the French Rheumatology Society (Société Française de Rhumatologie - SFR) and the Osteoporosis Research and Information Group (Groupe de Recherche et d'Informations sur les Ostéoporoses - GRIO) on the role of diet in the prevention and treatment of osteoporosis.
The recommendations were produced by a working group composed of rheumatologists, physician nutrition specialists and a geriatrician. Fifteen (15) questions pertaining to "daily practices" were preselected by the working group. For the literature review, the working group focussed mainly on the effects of diet on bone mineral density (BMD) and fractures, and primarily on meta-analyses of longitudinal studies and dietary intervention studies.
A Mediterranean-type diet and the daily consumption of 2 to 3 dairy products are recommended. Together, these provide the calcium and "high quality" protein required to maintain a normal calcium-phosphorus balance and bone metabolism, and are associated with lower fracture risk. Conversely, unbalanced Western diets, vegan diets, weight-loss diets in non-overweight individuals, alcohol consumption and daily consumption of sodas are advised against. In terms of the beneficial effects on bone mineral density and fracture risk, current scientific data are either insufficient or too divergent to recommend increasing or restricting the consumption of tea or coffee, vitamins other than vitamin D, vitamin D-enriched or phytoestrogen-rich foods, calcium-enriched plant-based beverages, oral nutritional supplements, or dietary sources of prebiotics and probiotics.
These are the first set of recommendations addressing the role of diet in the prevention and treatment of osteoporosis. More research is necessary to direct and support guidelines.
本文提出了法国风湿病学会（Société Française de Rhumatologie-SFR）和骨质疏松症研究与信息组（Groupe de Recherche et d'Informations sur les Ostéoporoses-GRIO）关于饮食在骨质疏松症预防和治疗中的作用的初步建议。
这些建议由一个由风湿病学家、医师营养专家和老年病学家组成的工作组制定。工作组预先选择了 15 个关于“日常实践”的问题。为了进行文献综述，工作组主要关注饮食对骨密度（BMD）和骨折的影响，主要是对纵向研究和饮食干预研究的荟萃分析。
建议采用地中海式饮食，每天食用 2 至 3 份乳制品。这两者提供了维持正常钙磷平衡和骨代谢所需的钙和“高质量”蛋白质，并与较低的骨折风险相关。相反，建议避免不均衡的西式饮食、素食饮食、非超重人群的减肥饮食、饮酒和每天饮用苏打水。就对骨密度和骨折风险的有益影响而言，目前的科学数据要么不足，要么差异太大，无法建议增加或限制茶或咖啡、除维生素 D 以外的维生素、富含维生素 D 或富含植物雌激素的食物、富含钙的植物性饮料、口服营养补充剂或益生菌和益生元的饮食来源的摄入量。
这些是关于饮食在骨质疏松症预防和治疗中的作用的第一组建议。需要进一步研究来指导和支持指南。
