Osteoporosis is recognized as a major public health problem and its incidence is very likely to be exacerbated in the coming years, owing to the lack of prophylactic agents. Therefore, there is an urgent need to provide validated new tools for healthcare professionals in order to delay metabolic and functional alterations of the skeleton.

The major contribution of calcium is now well established. Nevertheless, for a multimodal approach to health, nutritional prevention of osteoporosis, typically involving calcium and vitamin D therapy, must evolve to new concepts which, in addition to fulfilling the metabolic needs related to each physiological stage, include the potential exerted by certain nutrients and micronutrients to modulate the plasticity of tissues. Indeed, research into human nutrition has led to an awareness of the health benefits that a diet rich in fruit and vegetables may provide protection against chronic diseases, including osteoporosis. The associative evidence comes from epidemiological studies reporting that consumption of fruit and vegetables is an independent predictor of bone size in early pubertal children. In the same way, some observational trials reported significant associations between past reported fruit intake and BMD in premenopausal women, and possibly in postmenopausal women.

To provide an update on this topic, Hamidi et al. carried out a meta-analysis of the existing literature. They reviewed observational and interventional studies dealing with the effect of fruit and vegetable intake on bone turnover, bone mineral density and the risk of fracture. It turns out that the scientific case is, actually, not sufficiently documented to draw definitive conclusions in women older than 45 years.

Nevertheless, Hardcastle et al. published the first epidemiological study providing evidence of a clear association of bone turnover and even bone mineral density and dietary flavonoids (key nutrients found widely in tea, fruits and vegetables, which are secondary metabolites involved in the defensive strategy of plant against environmental stresses) in over 3,000 postmenopausal women.

Besides, Mackinnon & Rao, investigated the effect of lycopene on bone health, an another hopeful player (carried by tomatoes and watermelon) in the prevention of degenerative diseases, because of its anti-oxidant properties. Both the cross-sectional study and the randomized controlled trial based on lycopene supplementation, they performed, demonstrate that lycopene can exhibit bone sparing effects.

In conclusion, fruit and vegetables do have a potential promise for the improvement of clinical practice to optimize bone health food strategies; nevertheless, we still need to gather more data targeting postmenopausal women.

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