Bone health

骨骼健康
  • 文章类型: Journal Article
    丹参酮,丹参的亲脂性成分,用于治疗动脉粥样硬化等疾病,高血压,老年痴呆症,和糖尿病通过其药理活性,如抗炎,抗氧化剂,和抗肿瘤。过度的炎症是骨质疏松和类风湿性关节炎等骨骼疾病的主要原因,影响着全球数百万人。最近,丹参酮通过调节负责骨细胞增殖和分化的信号通路显示出对骨骼疾病的潜在益处。体外和体内研究报道,丹参酮促进成骨细胞形成和矿化,并抑制疾病期间过度的骨吸收。在这次审查中,我们总结了丹参酮和其他丹参提取物对骨骼健康的有益作用及其潜在的信号传导分子靶标。
    Tanshinone, a lipophilic component of Salvia miltiorrhiza, is used to treat diseases like atherosclerosis, hypertension, Alzheimer\'s disease, and diabetes mellitus through its pharmacological activities like anti-inflammatory, anti-oxidant, and anti-tumor. Excessive inflammation is the primary cause of bone diseases such as osteoporosis and rheumatoid arthritis, affecting more than millions of people across the globe. Recently, tanshinone has shown potential benefits against bone diseases by modulating signaling pathways accountable for the proliferation and differentiation of bone cells. In vitro and in vivo studies reported that tanshinone promotes osteoblast formation and mineralization and suppresses excessive bone resorption during disease conditions. In this review, we have summarized the beneficial effects of tanshinone and other extracts of Salvia miltiorrhiza for bone health and their potential molecular targets in signaling.
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  • 文章类型: Journal Article
    这项研究的主要目的是探讨团队运动实践对从事团队运动的成年人骨骼健康指标的影响。次要目的是研究每种类型的团队运动的成骨作用。从2023年6月开始,使用通用电子数据库进行了系统的文献检索,使用关键术语(以及MeSH数据库检索的同义词),这些术语使用运算符“AND”组合在一起,\"OR\",\".NOT\":("男子\'\'或"男子\'\'或"女子\'\'或"女子\'\'\')和("骨矿物质密度\'\'或"BMD\'\'或"骨矿物质含量\'\'或"BMC\'\'或"峰值骨量\'\'\'\'或"机械负荷\'或"'''''筛选后,最终分析中包括16项研究(5大洲,2740名与会者)。培训时间为1至13年。团队运动训练对全身骨密度(WBBMD)有中等影响(1.07SMD;95%[0.77,1.37],p<0.00),但对全身骨矿物质含量(WBBMC)的影响更大(1.3SMD;95%[0.81,1.79],p<0.00)。亚组分析表明,橄榄球训练对WBBMD有中等但不显著的影响(1.19SMD;95%[-0.13,2.52],p=0.08),但对WBBMC的影响更大(2.12SMD;95%[0.84,3.39],p<0.00);篮球训练对WBBMD有中等但显著的影响(1SMD;95%[0.35,1.64],p<0.00)和对WBBMC的轻微非显著影响(0.18SMD;95%[-1.09,1.46],p=0.78);排球训练对WBBMD有中等但不显著的影响(0.63SMD;95%[-0.22,1.49],p=0.15)和对WBBMC的显著影响(2.39SMD;95%[1.45,3.33],p<0.00)。手球训练对WBBMD产生中等显著影响(1.02SMD;95%[0.33,1.71],p<0.00)和WBBMC(0.97SMD;95%[0.47,1.48],p<0.00),足球训练对WBBMD有中等但显著的影响(1.16SMD;95%[0.88,1.44],p<0.00),对WBBMC有很大影响(1.34SMD;95%[0.92,1.77],p<0.00)。与篮球训练相比,橄榄球训练与较高的WBBMC相关(p=0.03)。我们的系统评价和荟萃分析表明,团队运动,比如橄榄球,篮球,排球,手球和足球对WBBMD和WBBMC有中等到较大的影响。具体来说,我们的发现表明,手球和足球提高了WBBMD和WBBMC,而橄榄球只会增加WBBMC。目前没有足够的证据表明任何类型的运动训练都能改善成年人的骨骼健康。
    The primary aim of this study was to explore the effects of team sports practice on bone health indices in adults engaged in team sports. The secondary aim was to investigate the osteogenic effects of each type of team sport. This systematic literature search was conducted using common electronic databases from inception in June 2023, using key terms (and synonyms searched for by the MeSH database) that were combined using the operators \"AND\", \"OR\", \"NOT\": (``men\'\' OR ``man\'\' OR ``women\'\' OR ``woman\'\') AND (``bone mineral density\'\' OR ``BMD\'\' OR ``bone mineral content\'\' OR ``BMC\'\' OR ``peak bone mass\'\' OR ``mechanical loading\'\' OR ``osteoporosis\'\' OR ``bone geometry\'\' OR ``bone resistance\'\') AND (``team sport\'\' OR ``sport\'\' OR rugby OR basketball OR volleyball OR handball OR soccer OR football OR ``players\'\'). After screening, 16 studies were included in the final analysis (5 continents, 2740 participants). The training duration lasted 1 to 13 years. Team sport training had a moderate impact on whole body bone mineral density (WB BMD) (1.07 SMD; 95 % [0.77, 1.37], p < 0.00) but a more significant impact on whole body bone mineral content (WB BMC) (1.3 SMD; 95 % [0.81, 1.79], p < 0.00). Subgroup analyses indicated that rugby training had a moderate but non-significant impact on WB BMD (1.19 SMD; 95 % [-0.13, 2.52], p = 0.08) but a greater impact on WB BMC (2.12 SMD; 95 % [0.84, 3.39], p < 0.00); basketball training had a moderate but significant impact on WB BMD (1 SMD; 95 % [0.35, 1.64], p < 0.00) and a trivial non-significant impact on WB BMC (0.18 SMD; 95 % [-1.09, 1.46], p = 0.78); volleyball training had a moderate but non-significant impact on WB BMD (0.63 SMD; 95 % [-0.22, 1.49], p = 0.15) and a significant impact on WB BMC (2.39 SMD; 95 % [1.45, 3.33], p < 0.00). Handball training produced a moderate significant impact on WB BMD (1.02 SMD; 95 % [0.33, 1.71], p < 0.00) and WB BMC (0.97 SMD; 95 % [0.47, 1.48], p < 0.00), and soccer training led to moderate but significant effects on WB BMD (1.16 SMD; 95 % [0.88, 1.44], p < 0.00) and a large effect on WB BMC (1.34 SMD; 95 % [0.92, 1.77], p < 0.00). Rugby training was associated with a higher WB BMC compared to basketball training (p = 0.03). Our systematic review and meta-analysis suggests that team sports, such as rugby, basketball, volleyball, handball and soccer have moderate to large effects on WB BMD and WB BMC. Specifically, our findings indicate that handball and soccer enhance WB BMD and WB BMC, whereas rugby only increases WB BMC. There is currently insufficient evidence indicating the superiority of any type of sport training that improves bone health in adults.
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  • 文章类型: Journal Article
    衰老是一个复杂的过程,是慢性疾病的重要风险因素。更年期,女性衰老的一个组成部分,与几种重要的心脏代谢疾病有关,包括代谢综合征,骨质疏松,和心血管疾病。更年期妇女可以从预防策略中受益,这些策略可以降低发病率和死亡率并改善其生活质量。维生素D和K是骨骼健康所需的必需营养素,免疫功能,降低心血管风险,然而,它们的协同作用在老年女性中却鲜为人知。这是第一个全面的综述,总结了在随机临床试验中发现的维生素D和K共同治疗对绝经后妇女有益作用的证据。在我们对关键电子数据库如Cochrane的文献检索中,PubMed,而奥维德,我们确定了31项相关研究.总的来说,重要的发现表明,维生素D和K的联合摄入可能对绝经后妇女的心血管和骨骼健康产生积极影响。强调保持富含蔬菜和发酵乳制品的健康饮食的重要性。鉴于仅通过饮食获得所有必需营养素的挑战,建议绝经后妇女补充维生素D和K,以促进健康衰老和福祉。
    Aging is a complex process and a significant risk factor for chronic diseases. Menopause, a component of aging in women, is associated with several important cardiometabolic conditions including metabolic syndrome, osteoporosis, and cardiovascular diseases. Menopausal women could benefit from preventative strategies that may decrease morbidity and mortality and improve their quality of life. Vitamins D and K are essential nutrients required for bone health, immune function, and reducing cardiovascular risks, yet their synergistic effect is less understood in aging women. This is the first comprehensive review to summarize the evidence found in randomized clinical trials of the beneficial effects of vitamin D and K co-treatment in postmenopausal women. In our literature search across key electronic databases such as Cochrane, PubMed, and Ovid, we identified 31 pertinent studies. Overall, significant findings indicate that the combined intake of vitamins D and K may positively affect cardiovascular and bone health in postmenopausal women, emphasizing the importance of maintaining a healthy diet rich in vegetables and fermented dairy products. Given the challenges in obtaining all necessary nutrients solely through the diet, vitamin D and K supplements are recommended for postmenopausal women to promote healthy aging and well-being.
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  • 文章类型: Journal Article
    背景:女性骨骼健康受家族相似性的影响,健康参数和成熟期(青春期和更年期);这种组合已使用家族多代横断面研究进行了研究。
    目的:本范围审查旨在汇编使用性成熟(祖母)母女对(和三合会)的骨骼健康研究,并确定其方法和家族比较的趋势。
    方法:使用乔安娜·布里格斯研究所的范围审查方法。提取包括研究和人口特征,方法(重点是成像)和基于家庭的结果。
    结果:纳入了29项研究,他们的后代被分为四个发育类别:青春期晚期到年轻成人,绝经前,混合更年期,和绝经后。观察到11种不同的对/三联组组合;最常见的是绝经前的女儿和绝经后的母亲。双能X射线吸收法(DXA)是最常用的成像方式,髋关节是成像最多的感兴趣区域(ROI)。不管配对,成像模式和ROI,通常有明显的家族相似性和遗传力(h2和h2L)的趋势。
    结论:这项范围审查强调了与家族相似性相关的骨骼健康趋势,以及更年期和青春期后期的重要性。这篇综述汇编了这些研究中的共性和挑战,为未来的研究提供信息。
    BACKGROUND: Female bone health is influenced by familial resemblance, health parameters and maturational periods (puberty and menopause); this combination has been researched using familial multi-generational cross-sectional studies.
    OBJECTIVE: This scoping review aimed to compile bone health research which uses sexually mature (grandmother-) mother-daughter pairs (and triads) and to determine the trends in its methodologies and familial comparisons.
    METHODS: The Joanna Briggs Institute methodology for scoping reviews was used. Extraction included study and population characteristics, methodology (with an emphasis on imaging) and family-based results.
    RESULTS: Twenty-nine studies were included, and their generations were categorized into four developmental categories: late adolescent to young adult, pre-menopause, mixed-menopause, and post-menopause. Eleven different pair/triad combinations were observed; the most common was pre-menopausal daughters and post-menopausal mothers. Dual-energy X-ray absorptiometry (DXA) was the most utilized imaging modality, and the hip was the most imaged region of interest (ROI). Regardless of pairing, imaging modality and ROI, there was often a trend toward significant familial resemblance and heritability (h2 and h2L).
    CONCLUSIONS: This scoping review highlights the trends in bone health linked to familial resemblance, as well as the importance of menopause and late adolescence. This review compiles the commonalities and challenges within these studies to inform future research.
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  • 文章类型: Journal Article
    本系统评价旨在研究患有神经肌肉疾病的儿科人群中肌肉质量与特定健康结局之间的关系。在五个数据库中搜索了1996年至2023年以英文发表的任何相关研究。要包括在此分析中,文章必须有平均年龄≤21岁的参与者,重点关注神经肌肉残疾儿童,并主要检查肌肉质量与任何功能或健康结果之间的关系。包括典型发育中的儿童在内的研究被用来对比和增强研究结果。包括32项研究,有10,129个独特的个体代表:17项研究集中在健康/典型发育儿童;7项关于脑瘫儿童;3项关于Duchenne肌营养不良儿童;2项关于肌肉减少症儿童;和1项关于骨质疏松症儿童的研究,先天性肌营养不良,和其他各种神经系统疾病。13项研究评估了功能结果,十项评估的骨骼结果,9项评估了其他心血管/代谢结果。所有纳入的研究都以不同的措施证明了肌肉质量与各自结果之间的关系。这篇综述的结果表明,在儿童中,肌肉质量和重要的健康结果之间存在一致公认的关系。支持临床靶向肌肉质量作为优化预期结果的手段。
    This systematic review aims to investigate the relationship between muscle mass and specific health outcomes in pediatric populations with neuromuscular disorders. A search was performed for any relevant studies published in English from 1996 to 2023 in five databases. To be included in this analysis, articles must have had participants with an average age ≤21, focus on children with neuromuscular disabilities, and primarily examine relationships between muscle mass and any functional or health outcomes measure. Studies including typically developing children were used to contrast and enhance findings. Thirty-two studies were included, with 10,129 unique individuals represented: seventeen studies focused on healthy/typically developing children; seven on children with cerebral palsy; three on children with Duchenne muscular dystrophy; two on children with sarcopenia; and one study each on children with osteoporosis, congenital muscular dystrophy, and other various neurologic disorders. Thirteen studies assessed functional outcomes, ten assessed bone outcomes, and nine assessed other cardiovascular/metabolic outcomes. All of the included studies demonstrated relationships between muscle mass and respective outcomes in varying measures. The results of this review demonstrate that there is a consistently recognized relationship between muscle mass and important health outcomes in children, supporting clinically targeting muscle mass as a means to optimize desired outcomes.
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  • 文章类型: Journal Article
    骨骼健康是骨骼建模和骨骼重塑之间严格调节平衡的结果,在成人和儿科人群的几种疾病中都观察到了这些过程的改变。骨重建的不平衡最终会导致骨质疏松症,这通常与衰老有关,但是促成因素已经可以在发育时期起作用,当超过三分之一的骨量积累时。维持足够的骨量受遗传和环境因素的影响,比如身体活动和饮食,特别是摄入足够的钙和维生素D。据称,特定的营养品如白藜芦醇的整合,花青素,异黄酮,番茄红素,姜黄素,叶黄素,和β-胡萝卜素以及从饮食中摄入的生物活性化合物,如蜂蜜,茶,李子干,蓝莓,橄榄油可以有效的预防骨质流失的策略。营养食品和功能性食品主要用于提供医疗或健康益处,但是,人们迫切需要确定哪些产品具有足够的临床证据和强大的安全性。这篇综述的目的是探索营养品和功能性食品在骨骼健康中的积极作用的科学和临床证据。关注分子机制和现实世界的研究。
    Bone health is the result of a tightly regulated balance between bone modeling and bone remodeling, and alterations of these processes have been observed in several diseases both in adult and pediatric populations. The imbalance in bone remodeling can ultimately lead to osteoporosis, which is most often associated with aging, but contributing factors can already act during the developmental age, when over a third of bone mass is accumulated. The maintenance of an adequate bone mass is influenced by genetic and environmental factors, such as physical activity and diet, and particularly by an adequate intake of calcium and vitamin D. In addition, it has been claimed that the integration of specific nutraceuticals such as resveratrol, anthocyanins, isoflavones, lycopene, curcumin, lutein, and β-carotene and the intake of bioactive compounds from the diet such as honey, tea, dried plums, blueberry, and olive oil can be efficient strategies for bone loss prevention. Nutraceuticals and functional foods are largely used to provide medical or health benefits, but there is an urge to determine which products have adequate clinical evidence and a strong safety profile. The aim of this review is to explore the scientific and clinical evidence of the positive role of nutraceuticals and functional food in bone health, focusing both on molecular mechanisms and on real-world studies.
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  • 文章类型: Journal Article
    背景:甲状腺功能障碍在老年人中很常见,女性风险更高。证据表明,促甲状腺激素(TSH)水平随年龄自然增加。然而,作为统一的血清TSH参考范围适用于整个成人寿命,亚临床甲状腺功能减退症(SCH)诊断更可能发生在老年人中,一些人也开始用左甲状腺素(LT4)治疗。目前尚不清楚老年SCH患者的LT4治疗是否与不良心血管或骨骼健康结局相关。
    方法:进行了系统评价和荟萃分析,以综合评估老年人SCH心血管和骨骼健康结局的先前研究,比较LT4治疗与不治疗。PubMed,Embase,科克伦图书馆,MEDLINE,和WebofScience数据库从开始到2023年3月13日进行搜索,并选择了评估50岁以上SCH患者心血管和骨骼健康事件的研究。
    结果:找到了六篇招募3853名参与者的文章,从185到1642名参与者,女性的比例从45%到80%不等。数据的匮乏导致仅对65岁以上的人进行分析。此外,一项研究确定了12,212名18岁及以上的参与者;然而,本系统综述仅考虑纳入与65岁及以上患者相关的数据.在这7项研究中,4评估心血管结果,1评估骨骼健康结果,和2评估两者。心血管结局的荟萃分析显示,合并风险比为0.89(95%CI0.71-1.12),表明接受LT4治疗的SCH老年患者与未接受治疗者相比,心血管风险无显著差异.由于子研究重叠,骨健康结局的荟萃分析是不可能的。
    结论:这项系统评价和荟萃分析发现,65岁以上的SCH参与者使用LT4与心血管和骨骼健康结果之间没有显著关联。
    背景:PROSPEROCRD42022308006。
    BACKGROUND: Thyroid dysfunction is common in older people, with females at higher risk. Evidence suggests that thyroid-stimulating hormone (TSH) levels naturally increase with age. However, as uniform serum TSH reference ranges are applied across the adult lifespan, subclinical hypothyroidism (SCH) diagnosis is more likely in older people, with some individuals also being commenced treatment with levothyroxine (LT4). It is unclear whether LT4 treatment in older people with SCH is associated with adverse cardiovascular or bone health outcomes.
    METHODS: A systematic review and meta-analysis were performed to synthesise previous studies evaluating cardiovascular and bone health outcomes in older people with SCH, comparing LT4 treatment with no treatment. PubMed, Embase, Cochrane Library, MEDLINE, and Web of Science databases were searched from inception until March 13, 2023, and studies that evaluated cardiovascular and bone health events in people with SCH over 50 years old were selected.
    RESULTS: Six articles that recruited 3853 participants were found, ranging from 185 to 1642 participants, with the proportion of females ranging from 45 to 80%. The paucity of data resulted in analysis for those aged over 65 years only. Additionally, a study with 12,212 participants aged 18 years and older was identified; however, only data relevant to patients aged 65 years and older were considered for inclusion in the systematic review. Of these 7 studies, 4 assessed cardiovascular outcomes, 1 assessed bone health outcomes, and 2 assessed both. A meta-analysis of cardiovascular outcomes revealed a pooled hazard ratio of 0.89 (95% CI 0.71-1.12), indicating no significant difference in cardiovascular risk between older individuals with SCH treated with LT4 compared to those without treatment. Due to overlapping sub-studies, meta-analysis for bone health outcomes was not possible.
    CONCLUSIONS: This systematic review and meta-analysis found no significant association between LT4 use and cardiovascular and bone health outcomes in SCH participants over 65 years.
    BACKGROUND: PROSPERO CRD42022308006.
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  • 文章类型: Review
    骨健康不仅包括骨矿物质密度,还包括可以影响骨强度的骨结构和机械性能。虽然已经提出了特定的饮食干预措施来治疗各种疾病,如肥胖症和糖尿病,它们对骨骼健康的影响尚不清楚。这篇综述的目的是研究过去十年发表的文献,总结目前流行的饮食对骨骼健康的影响,阐明潜在的机制,并提供解决方案以中和副作用。这篇综述中讨论的饮食包括生酮饮食(KD),地中海饮食(MD),热量限制(CR),高蛋白饮食(HP),间歇性禁食(IF)。虽然在KD和CR饮食中已经注意到对骨骼健康的有害影响,它仍然有争议,虽然MD和HP饮食显示出保护作用,和IF饮食的影响仍然不确定。这些作用的机制和衰减方法已引起人们的关注,并已在近年来进行了讨论:KD饮食中断能量平衡和钙代谢,降低骨骼质量。人参皂苷-Rb2,二甲双胍,和辛伐他汀已被证明可以减轻KD期间的骨丢失。CR饮食影响能量失衡,糖皮质激素水平,和脂肪组织,导致骨质流失.充足的维生素D和钙补充剂以及运动训练可以减轻这些影响。MD中的橄榄油可能是保护骨骼健康的有效组分。HP饮食也有保护骨骼健康的成分,但是他们的机制需要进一步调查。在IF中,动物研究显示对骨骼健康有不利影响,而人类研究还没有。因此,饮食对骨骼健康的影响各不相同。
    Bone health encompasses not only bone mineral density but also bone architecture and mechanical properties that can impact bone strength. While specific dietary interventions have been proposed to treat various diseases such as obesity and diabetes, their effects on bone health remain unclear. The aim of this review is to examine literature published in the past decade, summarize the effects of currently popular diets on bone health, elucidate underlying mechanisms, and provide solutions to neutralize the side effects. The diets discussed in this review include a ketogenic diet (KD), a Mediterranean diet (MD), caloric restriction (CR), a high-protein diet (HP), and intermittent fasting (IF). Although detrimental effects on bone health have been noticed in the KD and CR diets, it is still controversial, while the MD and HP diets have shown protective effects, and the effects of IF diets are still uncertain. The mechanism of these effects and the attenuation methods have gained attention and have been discussed in recent years: the KD diet interrupts energy balance and calcium metabolism, which reduces bone quality. Ginsenoside-Rb2, metformin, and simvastatin have been shown to attenuate bone loss during KD. The CR diet influences energy imbalance, glucocorticoid levels, and adipose tissue, causing bone loss. Adequate vitamin D and calcium supplementation and exercise training can attenuate these effects. The olive oil in the MD may be an effective component that protects bone health. HP diets also have components that protect bone health, but their mechanism requires further investigation. In IF, animal studies have shown detrimental effects on bone health, while human studies have not. Therefore, the effects of diets on bone health vary accordingly.
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  • 文章类型: Journal Article
    绝经后骨质疏松症是发达国家主要的骨骼疾病,构成了重大的公共卫生挑战。营养因素在骨骼健康中起着至关重要的作用,并可能有助于其预防或治疗。钙和维生素D,用强有力的科学证据进行了广泛的研究,是这种疾病的非药物治疗的组成部分。然而,其他较少探索的营养元素似乎会影响骨代谢。这篇综述提供了有关各种营养素之间关系的最新证据的全面总结,比如磷,镁,维生素,植酸,和植物雌激素;特定食物,如乳制品或大豆,和饮食模式,如地中海饮食与骨骼健康和骨质疏松症。
    Postmenopausal osteoporosis stands as the predominant bone disorder in the developed world, posing a significant public health challenge. Nutritional factors play a crucial role in bone health and may contribute to its prevention or treatment. Calcium and vitamin D, extensively studied with robust scientific evidence, are integral components of the non-pharmacological treatment for this disorder. Nevertheless, other less-explored nutritional elements appear to influence bone metabolism. This review provides a comprehensive summary of the latest evidence concerning the relationship between various nutrients, such as phosphorus, magnesium, vitamins, phytate, and phytoestrogens; specific foods like dairy or soy, and dietary patterns such as the Mediterranean diet with bone health and osteoporosis.
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  • 文章类型: Systematic Review
    人们越来越多地被鼓励减少动物性食品的消费,转向植物性饮食;然而,对儿童健康的影响尚不清楚。在这篇关于高收入环境下研究的叙述性综述中,我们总结了儿童植物性饮食消费增加的证据,并更新了早期关于植物性饮食与儿童健康结局相关的系统评价。证据表明素食主义者,但不是素食主义者,饮食会限制杂食性儿童的生长,并增加发育迟缓和体重不足的风险,尽管受影响的百分比相对较小。素食的骨矿物质含量减少,特别是,素食儿童,与杂食动物相比。不使用维生素B12补充剂的素食和素食儿童都表现为B12缺乏症;然而,补充纠正了这个问题。如果不补充,素食者和纯素食者的25(OH)D浓度都较低,和下半身铁库,但通常有正常的铁代谢标记。两组都有缺碘的危险,这可能会影响甲状腺健康。食用纯素饮食的儿童比杂食儿童有更有利的血脂;然而,素食的结果是不一致的,并且因结果而异。基于同样的科学证据,国家和国际的饮食建议是不同的,一些国家支持婴儿植物性饮食,孩子们,和青少年,和其他人劝阻他们。我们提供研究路线图,强调需要提供足够的证据来协调儿童植物性饮食的饮食建议。应在国际和国家两级紧急采取一些措施,以改善儿童使用它们的安全性。
    People are increasingly encouraged to reduce animal food consumption and shift towards plant-based diets; however, the implications for children\'s health are unclear. In this narrative review of research in high-income settings, we summarize evidence on the increasing consumption of plant-based diets in children and update an earlier systematic review regarding their associations with children\'s health outcomes. The evidence indicates that vegan, but not vegetarian, diets can restrict growth relative to omnivorous children and increase the risk of being stunted and underweight, although the percentage affected is relatively small. Bone mineral content is reduced in vegetarian and, in particular, vegan children, compared to omnivores. Both vegetarian and vegan children who do not use vitamin B12 supplements manifest with B12 deficiency; however, supplementation rectifies this problem. Both vegetarians and vegans have lower concentrations of 25(OH)D if unsupplemented, and lower body iron stores, but usually have normal iron metabolism markers. Both groups are at risk of iodine deficiency, and this might affect thyroid health. Children consuming a vegan diet have a more favorable lipid profile than omnivorous children; however, the results for a vegetarian diet are inconsistent and vary by outcome. Based on the same scientific evidence, national and international dietary recommendations are heterogeneous, with some countries supporting plant-based diets among infants, children, and adolescents, and others discouraging them. We offer a research roadmap, highlighting what is needed to provide adequate evidence to harmonize dietary recommendations for plant-based diets in children. A number of measures should urgently be introduced at international and national levels to improve the safety of their use in children.
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