Flavonoids and bone health in postmenopausal women

This review evaluates the impact of flavonoid-rich foods and compounds on bone mineral density (BMD) and fracture risk in postmenopausal women. Interventions studied include soy isoflavones (80–300 mg/day), genistein (54 mg/day), red clover isoflavones (37.1–60 mg/day), dried plum administration (100 g/day), hop extract (100 µg/day), and other flavonoids. Results on BMD were mixed. Notably, genistein consistently increased BMD at the lumbar spine, femoral neck, and total hip, while dried plum significantly increased lumbar spine BMD by approximately 6% and ulna BMD by 23%. Soy isoflavone trials reported variable outcomes, with some showing modest BMD improvements (particularly at the femoral neck) and others finding no significant effects. Red clover isoflavones and hop extract also demonstrated protective or enhancing effects on BMD in individual studies. Fracture risk outcomes primarily relied on surrogate markers (e.g., FRAX scores) or fracture incidence. Prune consumption maintained hip fracture risk scores in one trial, while a separate isoflavone study reported 15 fractures in the intervention group versus nine in controls (relative risk 1.64; 95% CI: 0.74–3.67), a non-significant difference. Regarding safety, all interventions were well tolerated, with only mild gastrointestinal complaints reported and no significant adverse effects observed on endometrial, cardiovascular, hepatic, or renal parameters.