Given this background, the aim of this narrative review is to evaluate the evidence regarding the ideal dietary therapy in order to reduce the risk of loss of bone mineral density (BMD) and to construct a food pyramid for osteopenic/osteoporotic subjects. Ī balanced nutritional intake of specific nutrients (from a specific diet and/or through a dietary integration) can be considered as the first step for an effective preventive strategy in an osteopenic state. Lifestyle measures, such as healthy and balanced diet and physical activity, begun in childhood and carried on throughout life, are factors that are well known as associated with better growth and aging of the bone. The major complication of osteopenia/osteoporosis is an increase in both traumatic and fragility fractures leading to morbidity, mortality, and decreased quality of life (depression, physical disability, loss of independence, and premature death). Osteopenia is considered as a state of lower-than-average bone density resulting in an intermediate risk similar to other clinical entities, such as prehypertension, impaired fasting glucose, and borderline high cholesterol. Osteoporosis has been defined by The World Health Organization (WHO) as: “the osteoporotic state of the bone is defined by the T-score variable, which is the number of standard deviations (SDs) by which a patient’s test differs from the mean of the young adult reference group (positive t-score values are associated with greater bone mass density than the reference group, negative ones with less bone density values)”. There are several clinical conditions that can lead to an imbalance in this remodeling process: old age and postmenopausal period are the major causes of osteoporosis, but other risk factors, including medications, endocrine disorders, immobilization, inflammatory arthropathy, hematopoietic disorders, and nutrition disorders, can also be involved. Osteoporosis is caused by an impaired balance of these two remodeling processes, resulting in more bone resorption than bone deposition. The balance between bone resorption and bone formation and its regulation are critical factors for maintaining adequate mineral homeostasis and bone density. Finally, three to four times per week of 30–40 min of aerobic and resistance exercises must be performed.īones are characterized by a dynamic structure continuously resorbed and rebuilt by osteoclasts and osteoblasts, respectively. At the top of the pyramid, there are two pennants: one green means that osteopenia/osteoporosis subjects need some personalized supplementation (if daily requirements cannot be satisfied through diet, calcium, vitamin D, boron, omega 3, and isoflavones supplementation could be an effective strategy with a great benefit/cost ratio), and one red means that there are some foods that are banned (salt, sugar, inorganic phosphate additives). The pyramid shows that carbohydrates should be consumed every day (3 portions of whole grains), together with fruits and vegetables (5 portions orange-colored fruits and vegetables and green leafy vegetables are to be preferred), light yogurt (125 mL), skim milk (200 mL,) extra virgin olive oil (almost 20 mg/day), and calcium water (almost 1 l/day) weekly portions should include fish (4 portions), white meat (3 portions), legumes (2 portions), eggs (2 portions), cheeses (2 portions), and red or processed meats (once/week). Given this background, aim of this review is to evaluate the latest data regarding ideal dietary approach in order to reduce bone mineral density loss and to construct a food pyramid that allows osteopenia/osteoporosis patients to easily figure out what to eat. Bone is a nutritionally modulated tissue.
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