FRUIT AND VEGETABLES AND BONE: THE OPPORTUNITIES AND CHALLENGES AHEAD

Osteoporosis, a global health problem, is increasingly significant as people live longer and the world’s population grows(1). Prevention and treatment of osteoporosis and its complications are essential socioeconomic priorities, calling for the development and implementation of strategies, in particular nutritional approaches and policies.

Increasing scientific evidence links high fruit and vegetable intake to more favourable bone health parameters in adults and in children/adolescents (cf. Steer & Goldberg article). This data is largely epidemiologic in nature.

While these findings are very encouraging, full elucidation of the underlying mechanism(s) of action is required. Fruit and vegetables are rich sources of nutrients and bioactive constituents for which various lines of evidence exist for effects on bone metabolism and bone mass (cf. Coxam & Horcajada articles). Fruit and vegetables also contribute to a lower potential renal acid load, which may have a positive impact on calcium and bone metabolism (cf. Steer & Goldberg article). Use of new tools such as microarray, proteomics and metabolomics may help enhance our understanding of the impact of fruit and vegetables to bone health.

It is possible that not all fruit or vegetables are equal in terms of the beneficial effects on bone, and the dose-response is unclear. These knowledge gaps need to be addressed before specific guidelines are formulated in relation to fruit and vegetables and bone health.

These recent findings on a beneficial effect of fruit and vegetables on bone health highlight the need for further investigation into a causal relationship, including intervention trials in human subjects. Until results emerge, recommending a diet high in fruit and vegetables is undeniably a prudent public health strategy.