Nutrition and bone health in the elderly

ISSN： 1534-8644

Source： Clinical Review in Bone and Mineral Metabolism, Vol.1, Iss.3-4, 2002-09, pp. : 249-260

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Abstract

The interface between nutrition and bone health in the elderly includes factors that affect bone formation and remodeling. Insulin-like growth factor-I is a circulating and skeletal growth factor influenced by nutritional status and is important for osteoblast differentiation. It is necessary, although not sufficient, for periosteal apposition and longitudinal growth as well as skeletal maintenance with age. Decreased protein intake, with or without vitamin D deficiency in the elderly, reduces serum IGF-I, changes local IGF-I expression, and leads to lower rates of bone formation and decreased calcium absorption. Aging also decreases systemic hormones, such as DHEA, testosterone, and estrogen, as well as growth hormone, all of which negatively influence IGF-I. In the end, age-related changes in circulating and skeletal IGF-I resulting from heritable factors, environmental determinants, and inflammatory components lead to qualitative skeletal alterations that result in bone fragility. Nutritional supplementation, particularly with calcium and vitamin D, provides some hope for maintaining skeletal integrity and preventing fractures.