Nutrition plays an important role in osteoporosis prevention and treatment. Substantial progress in both laboratory analyses and clinical use\nof biochemical markers has modified the strategy of anti-osteoporotic drug development. The present review examines the use of biochemical\nmarkers in clinical research aimed at characterising the influence of foods or nutrients on bone metabolism. The two types of\nmarkers are: (i) specific hormonal factors related to bone; and (ii) bone turnover markers (BTM) that reflect bone cell metabolism. Of\nthe former, vitamin D metabolites, parathyroid hormone, and insulin-like growth factor-I indicate responses to variations in the supply\nof bone-related nutrients, such as vitamin D, Ca, inorganic phosphate and protein. Thus modification in bone remodelling, the key process\nupon which both pharmaceutical agents and nutrients exert their anti-catabolic or anabolic actions, is revealed. Circulating BTM reflect\neither osteoclastic resorption or osteoblastic formation. Intervention with pharmacological agents showed that early changes in BTM\npredicted bone loss and subsequent osteoporotic fracture risk. New trials have documented the influence of nutrition on bone-tropic\nhormonal factors and BTM in adults, including situations of body-weight change, such as anorexia nervosa, and weight loss by obese\nsubjects. In osteoporosis-prevention studies involving dietary manipulation, randomised cross-over trials are best suited to evaluate influences\non bone metabolism, and insight into effects on bone metabolism may be gained within a relatively short time when biochemical\nmarkers are monitored.
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