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DOI: 10.1055/a-1916-8597
Ernährungsaspekte bei Osteoporose
Nutritional Aspects in OsteoporosisZusammenfassung
Osteoporose und Sarkopenie sind entscheidende Faktoren für den altersabhängigen Anstieg des Frakturrisikos. Eine knochenbewusste Ernährung ist entscheidender Bestandteil sowohl der Prävention als auch der Basistherapie der Osteoporose. Eine ausreichende Zufuhr von Calcium als wichtiger Bestandteil des Knochengewebes ist sowohl zur Erreichung der peak bone mass während der Wachstumsphase als auch bei Osteoporose essentiell. Gerade auch unter einer medikamentösen Osteoporosetherapie sollte auf eine ausreichende Zufuhr geachtet werden. Ein Großteil der europäischen Gesellschaft weist einen Vitamin-D-Mangel auf. Neben einem Effekt auf die Calciumhomöostase und die Knochenmineralisation, beeinflusst Vitamin D auch die Muskulatur und das Sturzrisiko. Gerade eine kombinierte Substitution von Calcium und Vitamin D scheint sich günstig auf das Frakturrisiko auszuwirken. Ebenso ist ein Mangel von Vitamin K weit verbreitet. Vitamin K hat eine relevante Funktion bei der Knochenmineralisation sowie bei der Verhinderung von ektopen Mineralisationen. Welche Wirkung eine Substitution auf das Frakturrisiko hat, wird aktuell noch kontrovers diskutiert. Proteine sind ein wesentlicher Baustein von Muskulatur und Knochen. Darüberhinaus führt eine erhöhte Zufuhr zur Sekretion von IGF-I, welches verschiedene günstige Effekte auf den Knochenstoffwechsel hat. Bezüglich einer Senkung des Frakturrisikos sind auch hier inkonsistente Studienergebnisse zu finden. Der über längere Zeit postulierte negative Effekt von tierischem Eiweiß auf die Knochenhomöostase konnte in neueren Studien nicht verifiziert werden.
Abstract
Osteoporosis and sarcopenia are critical factors in the age-related increase in fracture risk. A bone-conscious diet is a critical component of both prevention and basic treatment of osteoporosis. An adequate supply of calcium as an important component of bone tissue is essential both to achieve peak bone mass during the growth phase and in osteoporosis. Especially during osteoporosis drug therapy, adequate intake should be ensured, A large proportion of European society is vitamin D deficient. In addition to an effect on calcium homeostasis and bone mineralization, vitamin D also influences musculature and fall risk. Especially a combined substitution of calcium and vitamin D seems to have a favorable effect on the fracture risk. Similarly, a deficiency of vitamin K is widespread. Vitamin K has a relevant function in bone mineralization as well as in the prevention of ectopic mineralization. The effect of substitution on fracture risk is still controversial. Proteins are an essential building block of muscles and bones. Furthermore, an increased intake leads to the secretion of IGF-I, which has various beneficial effects on bone metabolism. Regarding a reduction of the fracture risk, inconsistent study results can be found here as well. The long postulated negative effect of animal protein on bone homeostasis could not be verified in recent studies.
Publication History
Received: 14 June 2022
Accepted: 01 August 2022
Article published online:
08 September 2022
© 2022. Thieme. All rights reserved.
Georg Thieme Verlag
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