Osteoporotic or fragility fractures affect one in two women and one in five men who are older than 50. These events are associated with substantial morbidity, increased mortality, and an impaired quality of life. Recommended general measures for fragility fracture prevention include a balanced diet with an optimal protein and calcium intake and vitamin D sufficiency, together with regular weight-bearing physical exercise. In this narrative Review, we discuss the role of nutrients, foods, and dietary patterns in maintaining bone health. Much of this information comes from observational studies. Bone mineral density, microstructure-estimated bone strength, and trabecular and cortical microstructure are positively associated with total protein intake. Several studies indicate that fracture risk might be lower with a higher dietary protein intake, provided that the calcium supply is sufficient. Dairy products are a valuable source of these two nutrients. Hip fracture risk appears to be lower in consumers of dairy products, particularly fermented dairy products. Consuming less than five servings per day of fruit and vegetables is associated with a higher hip fracture risk. Adherence to a Mediterranean diet or to a prudent diet is associated with a lower fracture risk. These various nutrients and dietary patterns influence gut microbiota composition or function, or both. The conclusions of this Review emphasise the importance of a balanced diet including minerals, protein, and fruit and vegetables for bone health and in the prevention of fragility fractures.

骨质疏松性或脆性骨折影响了 50 岁以上的女性和五分之一的女性。这些事件与大量发病率、死亡率增加和生活质量下降有关。预防脆性骨折的推荐一般措施包括均衡饮食，摄入最佳蛋白质和钙以及充足的维生素 D，以及定期进行负重体育锻炼。在这篇叙述性评论中，我们讨论了营养素、食物和饮食模式在维持骨骼健康方面的作用。这些信息大部分来自观察性研究。骨矿物质密度、微观结构估计的骨强度以及小梁和皮质微观结构与总蛋白质摄入量呈正相关。几项研究表明，较高的膳食蛋白质摄入量可能会降低骨折风险，只要钙供应充足。乳制品是这两种营养素的宝贵来源。乳制品消费者的髋部骨折风险似乎较低，尤其是发酵乳制品。每天食用少于五份的水果和蔬菜与较高的髋部骨折风险有关。坚持地中海饮食或谨慎饮食与较低的骨折风险有关。这些不同的营养素和饮食模式会影响肠道微生物群的组成或功能，或两者兼而有之。本综述的结论强调了均衡饮食（包括矿物质、蛋白质、水果和蔬菜）对骨骼健康和预防脆性骨折的重要性。乳制品消费者的髋部骨折风险似乎较低，尤其是发酵乳制品。每天食用少于五份的水果和蔬菜与较高的髋部骨折风险有关。坚持地中海饮食或谨慎饮食与较低的骨折风险有关。这些不同的营养素和饮食模式会影响肠道微生物群的组成或功能，或两者兼而有之。本综述的结论强调了均衡饮食（包括矿物质、蛋白质、水果和蔬菜）对骨骼健康和预防脆性骨折的重要性。乳制品消费者的髋部骨折风险似乎较低，尤其是发酵乳制品。每天食用少于五份的水果和蔬菜与较高的髋部骨折风险有关。坚持地中海饮食或谨慎饮食与较低的骨折风险有关。这些不同的营养素和饮食模式会影响肠道微生物群的组成或功能，或两者兼而有之。本综述的结论强调了均衡饮食（包括矿物质、蛋白质、水果和蔬菜）对骨骼健康和预防脆性骨折的重要性。坚持地中海饮食或谨慎饮食与较低的骨折风险有关。这些不同的营养素和饮食模式会影响肠道微生物群的组成或功能，或两者兼而有之。本综述的结论强调了均衡饮食（包括矿物质、蛋白质、水果和蔬菜）对骨骼健康和预防脆性骨折的重要性。坚持地中海饮食或谨慎饮食与较低的骨折风险有关。这些不同的营养素和饮食模式会影响肠道微生物群的组成或功能，或两者兼而有之。本综述的结论强调了均衡饮食（包括矿物质、蛋白质、水果和蔬菜）对骨骼健康和预防脆性骨折的重要性。