Purpose of review 

An increase in awareness of vegetarian and vegan (plant-based) diets has brought forth numerous studies on their effects on health. The study of nutrition-based factors affecting bone health is difficult, given the length of time before clinical effects are evident. Furthermore, population-based studies must account for strong confounding influences as effects may be because of association, not causality. Yet, it is highly plausible that dietary factors affect bone remodeling in multiple ways. Plant-based diets may alter macronutrient and micronutrient balance, may cause differences in prebiotic and probiotic effects on gut microbiota, and may subtly change the inflammatory and immune response.

Recent findings 

Several recent studies have looked at plant-based nutrition and markers of bone health, using measures such as bone turnover markers, bone mineral density, or fracture rates. Although population based and cross-sectional studies can be prone to confounding effects, a majority did not show differences in bone health between vegetarians/vegans and omnivores as long as calcium and vitamin D intake were adequate. A few prospective cohort or longitudinal studies even demonstrate some benefit to a plant-based diet, but this claim remains unproven.

Summary 

There is no evidence that a plant-based diet, when carefully chosen to maintain adequate calcium and vitamin D levels, has any detrimental effects on bone health. Theoretical findings suggest a long-term plant-based diet may reduce the risk of osteoporosis, through mechanisms that are currently speculative.

中文翻译：

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植物性饮食和骨骼健康：整理证据。

审查目的 

随着人们对素食和纯素（植物性）饮食意识的提高，人们对它们对健康的影响进行了大量研究。鉴于在临床效果明显之前的时间长度，研究影响骨骼健康的基于营养的因素是困难的。此外，基于人群的研究必须考虑强烈的混杂影响，因为影响可能是由于关联，而不是因果关系。然而，饮食因素以多种方式影响骨骼重塑是非常合理的。植物基 饮食可能会改变常量营养素和微量营养素的平衡，可能导致益生元和益生菌对肠道微生物群的影响不同，并可能微妙地改变炎症和免疫反应。

最近的发现 

最近的几项研究使用了骨转换标志物、骨矿物质密度或骨折率等指标，研究了植物性 营养和骨骼健康标志物。尽管基于人群和横断面研究可能容易产生混淆效应，但只要钙和维生素 D 的摄入量充足，大多数素食者/纯素食者和杂食者之间的骨骼健康并没有差异。一些前瞻性队列或纵向研究甚至证明植物性饮食有一些好处，但这种说法仍未得到证实。

概括 

没有证据表明植物性饮食在精心选择以保持足够的钙和维生素 D 水平时对骨骼健康有任何不利影响。理论研究结果表明，通过目前推测的机制，长期以植物为基础的饮食可能会降低骨质疏松症的风险。