
Trends in Food Science & Technology 147 (2024) 104431
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Osteoporosis is induced by abnormal bone remodeling, i.e., the
disequilibrium between bone resorption by osteoclasts and bone for-
mation by osteoblasts. It can be inuenced by a variety of factors, such
as genetics, age, lifestyle and endocrine environment (Walker-Bone,
2012). Based on its pathogenesis, clinical drugs for osteoporosis treat-
ment are categorized into antiresorptive and osteoanabolic agents.
Bisphosphonates like alendronate sodium are commonly prescribed to
treat osteoporosis via effectively inhibiting osteoclast function and
reducing bone resorption (Khosla S, Bilezikian JP, & DW, 2012). On the
other hand, osteoanabolic agents like parathyroid hormone analogues
have positive effects in stimulating osteoblast activity and then pro-
moting bone formation, which is conducive to the integrity of bone
microarchitecture. Notably, both categories of drugs have advantages in
enhancing bone mass and lowering the incidence of fractures, but the
prolonged administration may raise the risks of diseases such as breast
cancer, osteosarcoma, and cardiovascular diseases (Tian, Ran, Zhang,
Yan, & Li, 2018). Consequently, exploring safer alternatives to prevent
osteoporosis and improve bone health is urgent.
There is growing evidence that dietary nutrients from natural foods
have great potential to positively regulate bone metabolism, providing
an opportunity for developing safe and cost-effective strategies for
osteoporosis management. Food ingredients such as minerals, vitamins,
phytoestrogens, proteins and peptides have been reported to act favor-
able roles in enhancing bone health (Guo et al., 2021). Among them,
bioactive peptides liberated from food proteins, generally composed of
2–20 amino acids, have aroused extensive interests in academia and
health care industry owing to their splendid absorptivity and biological
activities such as antioxidant, anti-inammatory, and antihypertensive
activities. More importantly, food-derived bioactive peptides have
exhibited good osteogenic effects both in vitro and in vivo, and their
anti-osteoporotic property has been gradually explored in recent years.
Herein, this review summarizes the current updates of food-derived
bioactive peptides against osteoporosis, with emphasis on their discov-
ery strategies, anti-osteoporosis effects and underlying molecular
mechanisms, aiming to provide systematic theoretical support for the
efcient implementation of food-derived peptides in osteoporosis
intervention.
2. Pathogenesis of osteoporosis
The skeleton of adult is consisted of cortical (~75%) and cancellous
bone (~25%), and their proportions vary according to the skeletal site.
The skeleton is renewed about every 10 years caused by bone remod-
eling process, which involves the replacement of old bone by new bone.
Specically, osteoclasts are recruited and then a quantum of mineralized
bone is resorbed, and this process lasts for approximately 1–3 weeks.
Subsequently, the apoptosis of osteoclasts and the recruitment of oste-
oblasts occur successively at the resorption cavity, which eventually
forms new osteoid and mineralized bone. This reversal phase is
completed within 3–6 months. Bone resorption always appears prior to
bone formation, with spatial and temporal coupling between the two
processes (Criseno, 2019). Bone remodeling results in the formation of
bone units in cortical bone and new bone trabeculae on the surface of
cancellous bone. Before adulthood, human bones are continuously
remodeled, and the amount of bone formed is greater than bone resor-
bed, contributing to a constant increase in bone mass until reaching the
peak. The remodeling balance between bone formation and resorption is
dynamically maintained in the adult skeleton. However, when this
balance is disrupted, bone quality is decreased and bone mass is lost,
furtherly leading to osteoporosis (Fig. 2). Obviously, the reduced
cortical thickness and increased cortical porosity can be observed in
cortical bone, whereas cancellous bone shows trabecular thinning and
loss of trabeculae (Zebaze, Ghasem-Zadeh, Bohte, Iuliano-Burns, &
Seeman, 2010).
Osteoporosis is generally classied into primary and secondary
osteoporosis. The former includes postmenopausal, senile, and idio-
pathic osteoporosis, which has a strong genetic susceptibility. Addi-
tionally, primary osteoporosis can also be induced under the conditions
of sex hormone deciency, cell function decline caused by aging, cal-
cium and vitamin D insufciency, muscle mass reduction, or bad living
habits. As the most crucial pathogenic factor, estrogen deciency makes
osteoclasts more active than osteoblasts, furtherly increasing overall
bone resorption and weakening bones in postmenopausal women
(Garnero, Sornay-Rendu, Chapuy, & Delmas, 2010). Postmenopausal
osteoporosis usually develops within 5–10 years after menopause.
During the process of aging, bone loss and microarchitecture disruption
Fig. 1. Global map of deaths caused by osteoporosis-related fractures in 2019 (adapted from Shen et al., 2022).
Y. Zhang et al.