Subscribe to RSS
DOI: 10.1055/s-0038-1656919
Der Einfluss der Gesamt-Ernährung auf die Knochengesundheit
The influence of nutritional patterns on bone healthPublication History
eingereicht:
01 January 2018
angenommen:
19 January 2018
Publication Date:
14 May 2018 (online)
![](https://www.thieme-connect.de/media/10.1055-s-00034914/201802/lookinside/thumbnails/10-1055-s-0038-1656919-1.jpg)
Zusammenfassung
Die Ernährungs-Forschung im Gebiet der Osteologie hat über Jahrzehnte die Wirkung von verschiedenen Nahrungsmitteln und Nährsubstanzen auf den Knochen aufgezeigt, und dies in allen Altersklassen. Das hat zur Erkenntnis geführt, dass z. Bsp. Milchprodukte, Früchte und Gemüse, genügend Protein und Kalziumreiche Mineralwasser der Knochendichte förderlich sind. Aber davon praktische Ernährungs-Empfehlungen abzuleiten, bleibt schwierig.
Nun sind aber in den letzten 15 Jahren zahlreiche Arbeiten – auch gross angelegte epidemiologische Studien - erschienen, welche verschiedene Ernährungs-Profile in Bezug auf die Knochengesundheit untersucht haben. Daraus ging hervor, dass eine Ernährung mit viel Früchten und Gemüsen, fettarmen Milchprodukten und mässig Fleisch die Knochendichte und sogar die Häufigkeit von Hüftfrakturen günstig beeinfllusst. Darunter findet sich auch die Mittelmeerdiät, während die vegetarische, und vor allem die veganische Diät die Gefahr von Osteoporose erhöhen wegen ihres niedrigen Kalzium- und Proteingehaltes.
Summary
Over decades the nutritional research in the field of bone has demonstrated the effect of various nutrients on bone, at all ages. This lead to the recognition of the beneficial bone effects of e.g. dairy products, fruits and vegetables, adequate protein intake and calcium-rich mineral waters. But it is difficult to derive practical recommendations from this knowledge.
In the last 15 years several studies - including large epidemiologic studies – have been published, which examined the effect of whole nutritional patterns or profiles on bone health. They showed that a nutrition rich in fruits and vegetables, low fat dairy products and moderate meat intake is associated with higher bone density, and even with lower incidence of hip fractures. Among these food patterns figures the Mediterranean Diet, while vegetarian diets, in particular the vegan diet, increase the risk of osteoporosis because of their low content of protein and Calcium.
-
Literatur
- 1 New S, Robins S, Campbell M. et al. Dietary influences on bone mass and bone metabolism: further evidence of a positive link between fruit and vegetable consumption and bone health?. Am J Clin Nutr 2000; 71: 142-151.
- 2 Macdonald HM, New SA, Golden MHN. et al. Nutritional associations with bone loss during the menopausal transition: evidence of a beneficial effect of calcium, alcohol, and fruit and vegetable nutrients and of a detrimental effect of fatty acids. Am J Clin Nutr 2004; 79: 155-165.
- 3 Macdonald HM, New SA, Fraser WD, Campbell MK, Reid DM. Low dietary potassium intakes and high dietary estimates of net endogenous acid production are associated with low bone mineral density in premenopausal women and increased markers of bone resorption in postmenopausal women. Am J Clin Nutr 2005; 81 (04) 923-933.
- 4 Macdonald HM, Black AJ, Aucott L. et al. Effect of potassium citrate supplementation or increased fruit and vegetable intake on bone metabolism in healthy postmenopausal women: A randomized controlled trial. Am J Clin Nutr 2008; 88: 465-474.
- 5 Hamidi M, Boucher BA, Cheung AM. et al. Fruit and vegetable intake and bone health in women aged 45 years and over: a systematic review. Osteoporos Int 2011; 22: 1681-1693.
- 6 Zhu K, Devine A, Prince R. The effects of high potassium consumption on BMD in a prospective cohort study of postmenopausal women. Osteoporos Int 2009; 20: 335-334.
- 7 Zittermann A, Ernst JB, Prokop S. et al. Effect of vitamin D on all-cause mortality in heart failure (EVITA): a 3-year randomized clinical trial with 4000IU vitamin D daily. European Heart Journal 2017; 38 (29) 2279-2286.
- 8 Durazo-Arvizu RA, Dawson-Hughes B, Kramer H. et al. The Reverse J-Shaped Association Between Serum Total 25-Hydroxyvitamin D Concentration and All-Cause Mortality: The of Assay Standardization. American Journal of Epidemiology 2017; 185 (08) 720-726.
- 9 Shin S, Sung J, Joung H. A fruit, milk and whole grain dietary pattern is positively associated with bone mineral density in Korean healthy adults. European Journal of Clinical Nutrition 2015; 69: 442-448.
- 10 Dawson-Hughes B, Harris SS. Calcium intake influences the association of protein intake with rates of bone loss in elderly men and women. Am J Clin Nutr 2002; 75: 773-779.
- 11 Sahni S, Cupples A, Mclean RC. et al. Protective Effect of High Protein and Calcium Intake on the Risk of Hip Fracture in the Framingham Offspring Cohort. J Bone Min Res 2010; 25 (12) 2770-2776.
- 12 Adatorwovor R, Roggenkamp K, Anderson JJ. Intakes of Calcium and Phosphorus and Calculated Calcium-to-Phosphorus Ratios of Older Adults: NHANES 2005-2006 Data. Nutrients 2015; 07 (11) 9633-9639.
- 13 Trichopoulou A, Kouris-Blazos A, Wahlqvist ML. et al. Diet and overall survival in elderly people. BMJ 1995; 311: 1457-1460.
- 14 Lin PH, Ginty F, Appel LJ. et al. The DASH diet and sodium reduction improve markers of bone turnover and calcium metabolism in adults. J Nutr 2003; 133: 3130-3136.
- 15 Bupathiraju SN, Lichtenstein AH, DawsonHughes B. et al. Adherence to the 2006 American Heart Association Diet and Lifestyle Recommendations for cardiovascular disease risk reduction is associated with bone health in older Puerto Ricans. Am J Clin Nutr 2013; 98 (05) 1309-1316.
- 16 Benetou V, Orfanos P, Pettersson-Kymmer U. et al. Mediterranean diet and incidence of hip fractures in a European cohort. Osteoporos Int 2013; 24: 1587-1598.
- 17 Tucker KL, Chen H, Hannan MT. et al. Bone mineral density and dietary patterns in older adults: the Framingham Osteoporosis Study. Am J Clin Nutr 2002; 76: 245-252.
- 18 New SA, Millward DJ. Calcium, protein, and fruit and vegetables as dietary determinants of bone health. Am J Clin Nutr 2003; 77 (05) 1340-1341 author reply 1341.
- 19 New SA, MacDonald HM, Campbell MK. et al. Lower estimates of net endogenous non-carbonic acid production are positively associated with indexes of bone health in premenopausal and perimenopausal women. Am J Clin Nutr 2004; 79 (01) 131-138.
- 20 Prynne CJ, Mishra GD, O’Connell MA. et al. Fruit and vegetable intakes and bone mineral status: a cross sectional study in 5 age and sex cohorts. Am J Clin Nutr 2006; 83 (06) 1420-1428.
- 21 Byberg L, Bellavia A, Orsini A. et al. Fruit and Vegetable Intake and Risk of Hip Fracture: A Cohort Study of Swedish Men and Women. J Bone Min Research 2015; 30 (06) 976-984.
- 22 Benetou V, Orfanos P, Feskanich D. et al. Fruit and Vegetable Intake and Hip Fracture Incidence in Older Men and Women: The CHANCES Project. J Bone Min Res 2016; 31 (09) 1743-1752.
- 23 Langsetmo L, Poliquin S, Hanley DA. et al. Dietary patterns in Canadian men and women ages 25 and older: relationship to demographics, body mass index, and bone mineral density. BMC Musculoskelet Disord 2010; 11: 20.
- 24 Hardcastle AC, Aucott L, Fraser WD. et al. Dietary patterns, bone resorption and bone mineral density in early post-menopausal Scottish women. Eur J Clin Nutr 2011; 65 (03) 378-385.
- 25 McNaughton SA, Wattanapenpaiboon N, Wark JD, Nowson CA. An energy-dense, nutrient-poor dietary pattern is inversely associated with bone health in women. J Nutr 2011; 141 (08) 1516-1523.
- 26 Langsetmo L, Hanley DA, Prior JC. et al. Dietary patterns and incident low-trauma fractures in postmenopausal women and men aged ‡50 y: a population-based cohort study. Am J Clin Nutr 2011; 93: 192-199.
- 27 Ward KA, Prentice A, Kuh DL. et al. Life Course Dietary Patterns and Bone Health in Later Life in a British Birth Cohort Study. J Bone Min Res 2016; 31 (06) 1167-1176.
- 28 Melaku YA, Gill TK, Adams R, Shi Z. Association between dietary patterns and low bone mineral density among adults aged 50 years and above: findings from the North West Adelaide Health Study (NWAHS). British Journal Nutrition 2016; 116 (08) 1437-1446.
- 29 Munshi R, Kochhar A, Garg V. Impact of Dietary Habits and Physical Activity on Bone Health among 40 to 60 Year Old Females at Risk of Osteoporosis in India. Ecology of Food and Nutrition 2015; 54 (05) 470-492.
- 30 Fang A, Li K, Guo M. et al. Long-Term Low Intake of Dietary Calcium and Fracture Risk in Older Adults With Plant-Based Diet: A Longitudinal Study From the China Health and Nutrition Survey. J Bone Min Res 2016; 31 (11) 2016-2023.
- 31 Warensjo E, Byberg L, Melhus H. et al. Dietary calcium intake and risk of fracture and osteoporosis: prospective longitudinal cohort study. BMJ 2011; 342: d1473.
- 32 de Jonge EA, Kiefte-de Jong JC, de Groot LC. et al. Development of a Food Group-Based Diet Score and Its Association with Bone Mineral Density in the Elderly: The Rotterdam Study. Nutrients 2015; 07 (08) 6974-6990.
- 33 Zeng FF, Xue WQ, Cao WT. et al. Diet-quality scores and risk of hip fractures in elderly urban Chinese in Guangdong, China: a case-control study. Osteoporos Int 2014; 25: 2131-2141.
- 34 Byberg L, Bellavia A, Larsson SC. et al. Mediterranean Diet and Hip Fracture in Swedish Men and Women. J Bone Min Res 2016; 31 (12) 2098-2105.
- 35 Zittlau J. Die Mittelmeerdiät nützt nur am Mittelmeer Von Jörg Zittlau. DIE WELT. 15.04.2005.
- 36 Fairweather-Rait SJ, Skinner J, Guile GR. et al. Diet and bone mineral density study in postmenopausal women from the Twins UK registry shows a negative association witha traditional English dietary pattern and a positive association with wine. Am J Clin Nutr 2011; 94 (05) 1371-1375.
- 37 Vogel C, Parsons C, Godfrey K. et al. Greater access to fast-food outlets is associated with poorer bone health in young children. Osteoporos Int 2016; 27: 1011-1019.
- 38 Movassagh EZ, Vatanparast H. Current Evidence on the Association of Dietary Patterns and Bone Health: A Scoping Review. [Review]. Advances in Nutrition 2017; 08 (01) 1-16.
- 39 Tucker KL. Vegetarian diets and bone status. Am J Clin Nutr 2014; 100 (Suppl.): 329S-335S.
- 40 Gunn CA, Weber JL, McGill A-Th, Kruger MC. Increased Intake of Selected Vegetables, Herbs and Fruit may Reduce Bone Turnover in Post-Menopausal Women. Nutrients 2015; 07: 2499-2517.
- 41 Burckhardt P. The role of low acid load in vegetarian diet on bone health: a narrative review. Swiss Med Wkly 2016; 146: w14277.