Diet for Osteopenia or Osteoporosis
Osteopenia is described as the early stages of osteoporosis with a bone mineral density (BMD) T-score between –1 and –2.5. Some risk factors for osteopenia include poor nutrition, inadequate protein intake, excessive alcohol intake, inadequate sleep, chronic inflammation, and sedentary lifestyle (1,2,3,4).
The inflammatory state of osteopenia or osteoporosis are correlated with increased levels of TNF-α. An anti-inflammatory diet can be beneficial in the prevention or reversal of osteopenia (1). Compounds known to have anti-inflammatory properties include phytoestrogens, such as resveratrol. Resveratrol can be found in small amounts in many foods, the highest (but still minute amounts) being red wine.
Juan et al. Conducted a study to investigate resveratrol’s effect on TNF-α-induced inflammation hypothesizing that resveratrol would positively regulate osteoblastic differentiation of human periodontal ligament stem cells (hPDLSC). They found that resveratrol was effective at attenuating hPDLSC inflammation induced by TNF-α and promoted osteogenesis when compared to control treated only with TNF-α (5). It may be more advantageous to supplement with resveratrol rather than increasing intake of red wine since the amounts in food are much less than clinical doses (6).
Vitamin D plays a critical role in maintaining BMD. Although sunlight exposure is the main source of vitamin D, vitamin D is also found in shitake and sun-exposed mushrooms, cooked eggs, and oil fish like tuna (7).
Minerals like magnesium, potassium, calcium, and boron are important for healthy bones. Magnesium-rich foods include spinach, nuts, seeds, and whole grains (8). Bananas are known for containing potassium, but some of the highest amounts of potassium are found in apricots, lentils, squash, and potatoes (9). Calcium is found in many non-dairy sources, such as sardines, soymilk, and kale (10).
In summary, I would recommend to a patient that they choose organic anti-inflammatory foods containing good sources of these minerals, vitamins, and other beneficial compounds. Supplementing with the compounds that are not attainable through diet, like resveratrol, is also an option to suggest.
Liao, L.-N., Li, C.-I., Wu, F.-Y., Yang, C.-W., Lin, C.-H., Liu, C.-S., Lin, W.-Y., Li, T.-C., & Lin, C.-C. (2019). Important gene-gene interaction of TNF-α and VDR on osteoporosis in community-dwelling elders. PloS One, 14(12), e0226973. Retrieved from https://doi-org.uws.idm.oclc.org/10.1371/journal.pone.0226973
Tomasevic-Todorovic, S., Vazic, A., Issaka, A., & Hanna, F. (2020). Comparative assessment of fracture risk among osteoporosis and osteopenia patients: a cross-sectional study. Open Access Rheumatology: Research and Reviews, 1. Retrieved from https://doi-org.uws.idm.oclc.org/10.2147/OARRR.S151307
Lucassen, E. A., de Mutsert, R., le Cessie, S., Appelman-Dijkstra, N. M., Rosendaal, F. R., van Heemst, D., den Heijer, M., & Biermasz, N. R. (2017). Poor sleep quality and later sleep timing are risk factors for osteopenia and sarcopenia in middle-aged men and women: The NEO study. PLoS ONE, 5. Retrieved from https://doi-org.uws.idm.oclc.org/10.1371/journal.pone.0176685
Maria, S., & Witt, E. P. A. (2014). Melatonin effects on bone: potential use for the prevention and treatment for osteopenia, osteoporosis, and periodontal disease and for use in bone-grafting procedures. Journal of Pineal Research, 56(2), 115–125. https://doi-org.uws.idm.oclc.org/10.1111/jpi.12116
Yuan, J., Wang, X., Ma, D., Gao, H., Zheng, D., & Zhang, J. (2020). Resveratrol rescues TNF-[alpha]-induced inhibition of osteogenesis in human periodontal ligament stem cells via the ERK1/2 pathway. Molecular Medicine Reports, 5, 2085. Retrieved from https://doi-org.uws.idm.oclc.org/10.3892/mmr.2020.11021
Atanacković, M., Petrović, A., Jović, S., Bukarica, L. G.-, Bursać, M., & Cvejić, J. (2012). Influence of winemaking techniques on the resveratrol content, total phenolic content and antioxidant potential of red wines. Food Chemistry, 131(2), 513–518. Retrieved from https://doi-org.uws.idm.oclc.org/10.1016/j.foodchem.2011.09.015
Amegah, A. K., Baffour, F. K., Appiah, A., Adu-Frimpong, E., & Wagner, C. L. (2020). Sunlight exposure, consumption of vitamin D-rich foods and vulvovaginal candidiasis in an African population: a prevalence case-control study. European Journal of Clinical Nutrition, 3, 518. Retrieved from https://doi-org.uws.idm.oclc.org/10.1038/s41430-019-0517-7
NIH: Magnesium. Accessed August 26th 2020, Retrieved from https://ods.od.nih.gov/factsheets/Magnesium-HealthProfessional/
NIH: Potassium. Accessed August 26th 2020, Retrieved from https://ods.od.nih.gov/factsheets/Potassium-HealthProfessional/
NIH: Calcium. Accessed 26th 2020, Retrieved from https://ods.od.nih.gov/factsheets/Calcium-HealthProfessional/