Introduction
Importance of bone health
Bone health plays a crucial role in maintaining a healthy and productive lifestyle. Our bones play an integral part in our day-to-day activities, and these include:
- Protection of vital organs1
- Production of blood cells, i.e., white blood cells, red blood cells and platelets2
- Storage of minerals1
- Metabolic functions, i.e., regulation of calcium blood levels1
- Posture1,2
Furthermore, bone health can affect our quality of life; for example, poor bone health can lead to pain, a higher risk of fractures/injury and immobilisation.3 In addition, poor bone health can affect our ability to protect ourselves against disease.1 Hence, our bones can affect our overall health and well-being.
The role of nutrition in bone health
Nutrition has a vital role in achieving strong and healthy bones. Proper nutrition can help protect and prevent bone-related illnesses, such as osteoporosis (decreased bone minerals and density).3,4 One of the crucial nutrients required for bone growth and development is calcium.4 Calcium is considered the building block of bone tissue and is essential for building strong bones.1,4 Other vital components for the growth of bones are vitamin D, vitamin C, and potassium, which are involved in the absorption of calcium into the blood, collagen production, and neutralising acid in the body to prevent calcium loss from the bones.4
The potential benefits of strawberries for bone health
Fruits are known for their high nutritional components, containing plenty of vitamins, minerals and dietary fibre.4 Strawberries are a very popular fruit that can be bought commercially in both fresh and frozen forms.5 While they are perceived by many to be berries, they are actually an aggregate fruit.6 They contain vitamin C, antioxidants such as anthocyanins and quercetin, potassium and more.4,7 Many studies have shown that strawberries (among other foods, such as blueberries) are capable of reducing the risk of developing chronic diseases.7 Studies conducted in 2011 were able to demonstrate the ability of a strawberry beverage to act as an anti-inflammatory agent by decreasing different biomarkers of inflammation compared to a placebo group that had no effect.8 Another study in 2021 suggests that the consumption of fresh dried strawberry powder can increase IGF-1 (insulin-like growth factor 1), which is a hormone that has an important role in bone formation.9
Nutritional profile of strawberries
Overview of strawberry composition
The composition of strawberries can be summarised in the table below:
Table 1. Nutrient composition of fresh strawberries. Adapted from the U.S. Department of Agriculture, Agriculture Research Service10
| Type | Nutrient | Per 100 g |
| Proximates | Water (g) | 90.95 |
| Energy (kcal) | 32 | |
| Protein (g) | 0.67 | |
| Ash (g) | 0.40 | |
| Total lipid (g) | 0.30 | |
| Carbohydrate (g) | 7.68 | |
| Dietary fiber (g) | 2.0 | |
| Sugars (g) | 4.89 | |
| Sucrose (g) | 0.47 | |
| Glucose (g) | 1.99 | |
| Fructose (g) | 2.44 | |
| Minerals | Calcium (mg) | 16 |
| Iron (mg) | 0.41 | |
| Magnesium (mg) | 13 | |
| Phosphorus (mg) | 24 | |
| Potassium (mg) | 153 | |
| Sodium (mg) | 1 | |
| Zinc (mg) | 0.14 | |
| Copper (mg) | 0.048 | |
| Manganese (mg) | 0.386 | |
| Selenium (μg) | 0.4 | |
| Vitamins | Vitamin C (mg) | 58.8 |
| Thiamin (mg) | 0.024 | |
| Riboflavin (mg) | 0.022 | |
| Niacin (mg) | 0.386 | |
| Pantothenic acid (mg) | 0.125 | |
| Vitamin B6 (mg) | 0.047 | |
| Folate (μg) | 24 | |
| Choline (mg) | 5.7 | |
| Betaine (mg) | 0.2 | |
| Vitamin B12 (μg) | 0 | |
| Vitamin A, RAE (μg) | 1 | |
| Lutein + zeaxanthin (μg) | 26 | |
| Vitamin E, α-tocopherol (mg) | 0.29 | |
| β-tocopherol (mg) | 0.01 | |
| γ-tocopherol (mg) | 0.08 | |
| δ-tocopherol (mg) | 0.01 | |
| Vitamin K, phylloquinone (μg) | 2.2 |
How strawberries promote bone health
Strawberries contain many nutrients that can contribute to the health and development of bones; even though they are not the primary source of calcium, they have important constituents that can affect bone density and support overall bone health.4 These can include:
- Vitamin C is important for collagen production and providing bone structure11
- Vitamin B9, also known as folate, is essential for bone density. It can help prevent bone diseases such as osteoporosis12
- Potassium is vital for the removal of acid load in the body, consequently reducing bone calcium loss4
- Manganese is essential for bone formation and metabolism4,10
- Antioxidants, such as anthocyanins, quercetin and others, can help reduce inflammation in the body and, as a result, have a positive impact on bone health4,10
Incorporating strawberries into your diet
A. Strawberries can be incorporated into our diet in various forms, including fresh, frozen, and dried strawberries.5 Studies from 2015 demonstrate the ability of strawberries to affect bone and vascular health.13 Therefore, it would be an excellent option to incorporate strawberries into our diet through various recipes such as smoothies, meal toppings, salads, desserts, or snacks.14 It is recommended to eat a serving of 8 strawberries per day.14
Potential risks and considerations
While strawberries can be beneficial to health, it is essential to note that they can also be on the other side of the coin. Some things to consider before eating strawberries can be summarised below:
- Allergies: Some individuals may have allergic reactions to strawberries, which present themselves in the form of itching, hives, and breathing difficulties.15,16 Some people may have histamine intolerance, which can cause headaches and digestive issues when consumed.16 This is particularly important as strawberries contain histamine16
- Medicinal interactions: Strawberries can interfere with the efficacy of some medications, such as anticoagulants (blood-thinning medications); this is due to the vitamin K content found in strawberries4,17
- Moderate consumption: While strawberries are considered to be lower in sugar content than other fruits, it is important to be mindful of intake for some individuals with certain health conditions, such as diabetes10
It is worth noting that these situations are case-dependent and vary between individuals. It would be advisable to consult with a registered dietitian or healthcare professional for a tailored diet that covers your needs.
Other strategies for promoting bone health
Adequate intake of calcium and vitamin D
Calcium and vitamin D are both essential for bone growth and health.4 Calcium can be found in dairy products, leafy greens, tofu and others.18,19 Typically, 1000-1300 mg of calcium/day is required for adults.4 On the other hand, vitamin D is important for calcium absorption and can be found in fish, fortified dairy products, or supplements, but it can also be obtained through regular exposure to sunlight.4
Exercise
Regular exercise is a great way to stay in shape and improve bone health. Running, dancing, resistance training, or even walking can all stimulate bone remodelling and maintain bone density.20 Additionally, strength training, like weightlifting, increases muscle strength, which subsequently supports bone health.20
Diet
A balanced diet is essential for our over-all health and bones are no different. Hydration and well-balanced diets will reflect positively on bones and their health compared to poor diets that lack essential vitamins such as vitamin K and other minerals.4 Additionally, excessive consumption of caffeine and alcohol can interfere with calcium absorption and, as a result, can contribute to bone loss 4. Furthermore, supplements can be a good choice for specific individuals with the guidance of a healthcare professional.4
Education and awareness
Efforts to raise awareness in the community and spread it among people of all ages can significantly impact people’s approach to their health. Shedding light on the importance of bone health can motivate people to adopt a healthier lifestyle, which would provide them with stronger and more resilient bones.
FAQs
Do strawberries help your bones?
Strawberries can aid bone health by supporting higher bone mass and protecting against age-related bone loss. This is due to their high content of vitamin C, antioxidants, and bone-healthy polyphenols.4
Are strawberries good for fractures?
Strawberry's vitamin C content can be important in bone repair. Vitamin C is important for collagen synthesis, which can then be utilized in bone, tendon, and ligament repair.4
What is the quickest way to increase bone density?
There are many approaches that people can take to increase bone density. These include weightlifting and strength training, a balanced and adequate diet, supplements and a healthy lifestyle.4,20
Do strawberries have healing properties?
Strawberries are rich in vitamin C and many other nutrients, which help in reducing the risk of certain health conditions such as heart/vascular diseases, cancer, and diabetes.15
Summary
Strawberries can be a valuable addition to our diet for bone health. With their rich nutritional composition consisting of vitamin C, antioxidants, potassium and phytonutrients, strawberries can help improve bone health by stimulating bone growth and anti-inflammatory properties. Incorporating strawberries into our diet can have many benefits for our health, along with being a tasty treat! However, it is crucial to maintain bone health through other measures such as exercise, diet, and awareness.
References
- Ralston SH. Bone structure and metabolism. Medicine [Internet]. 2013 Oct 1 [cited 2023 Nov 10];41(10):581–5. Available from: https://www.sciencedirect.com/science/article/pii/S1357303913002120
- Del Fattore A, Capannolo M, Rucci N. Bone and bone marrow: The same organ. Archives of Biochemistry and Biophysics [Internet]. 2010 Nov 1 [cited 2023 Nov 10];503(1):28–34. Available from: https://www.sciencedirect.com/science/article/pii/S0003986110002997
- Seref-Ferlengez Z, Kennedy OD, Schaffler MB. Bone microdamage, remodeling and bone fragility: how much damage is too much damage? BoneKEy Reports [Internet]. 2015 [cited 2023 Nov 10];4. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4371415/
- Levis S, Lagari VS. The role of diet in osteoporosis prevention and management. Curr Osteoporos Rep [Internet]. 2012 Dec 1 [cited 2023 Nov 10];10(4):296–302. Available from: https://doi.org/10.1007/s11914-012-0119-y
- PDF4PRO [Internet]. 2018 [cited 2023 Nov 10]. Commodity Profile: Strawberries - University of California ... / commodity-profile-strawberries-university-of-california.pdf / PDF4PRO. Available from: https://pdf4pro.com/view/commodity-profile-strawberries-university-of-california-4f210c.html
- Carew JG, Morretini M, Battey NH. Misshapen fruits in strawberry. Small Fruits Review [Internet]. 2003 Oct 8 [cited 2023 Nov 10];2(2):37–50. Available from: http://www.tandfonline.com/doi/abs/10.1300/J301v02n02_03
- Miller K, Feucht W, Schmid M. Bioactive compounds of strawberry and blueberry and their potential health effects based on human intervention studies: a brief overview. Nutrients [Internet]. 2019 Jul 2 [cited 2023 Nov 10];11(7):1510. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6683271/
- Edirisinghe I, Banaszewski K, Cappozzo J, Sandhya K, Ellis CL, Tadapaneni R, et al. Strawberry anthocyanin and its association with postprandial inflammation and insulin. Br J Nutr. 2011 Sep;106(6):913–22. Available from: https://pubmed.ncbi.nlm.nih.gov/21736853/
- Feresin RG, Johnson SA, Elam ML, Pourafshar S, Navaei N, Akhavan NS, et al. Effects of strawberries on bone biomarkers in pre- and stage 1-hypertensive postmenopausal women: a secondary analysis. Food Funct [Internet]. 2021 Dec 13 [cited 2023 Nov 10];12(24):12526–34. Available from: https://pubs.rsc.org/en/content/articlelanding/2021/fo/d1fo01555a
- Giampieri F, Tulipani S, Alvarez-Suarez JM, Quiles JL, Mezzetti B, Battino M. The strawberry: Composition, nutritional quality, and impact on human health. Nutrition [Internet]. 2012 Jan 1 [cited 2023 Nov 10];28(1):9–19. Available from: https://www.sciencedirect.com/science/article/pii/S0899900711003066
- Gref R, Deloménie C, Maksimenko A, Gouadon E, Percoco G, Lati E, et al. Vitamin C–squalene bioconjugate promotes epidermal thickening and collagen production in human skin. Sci Rep [Internet]. 2020 Oct 9 [cited 2023 Nov 10];10(1):16883. Available from: https://www.nature.com/articles/s41598-020-72704-1
- Tucker KL. Osteoporosis prevention and nutrition. Curr Osteoporos Rep [Internet]. 2009 Dec 1 [cited 2023 Nov 10];7(4):111–7. Available from: https://doi.org/10.1007/s11914-009-0020-5
- Feresin RG. Effects of daily incorporation of strawberries into the diet on bone biomarkers and blood pressure in postmenopausal women with pre- and stage 1-hypertension. 2015 [cited 2023 Nov 10]; Available from: https://diginole.lib.fsu.edu/islandora/object/fsu%3A253448/
- Enjoy 8-a-day! | benefits of eating strawberries | california strawberries [Internet]. California Strawberry Commission. [cited 2023 Nov 10]. Available from: https://www.californiastrawberries.com/enjoy-8-a-day/
- Aninowski M, Kazimierczak R, Hallmann E, Rachtan-Janicka J, Fijoł-Adach E, Feledyn-Szewczyk B, et al. Evaluation of the potential allergenicity of strawberries in response to different farming practices. Metabolites [Internet]. 2020 Mar [cited 2023 Nov 10];10(3):102. Available from: https://www.mdpi.com/2218-1989/10/3/102
- Ibranji A, Nikolla E, Loloci G, Mingomataj E. A case report on transitory histamine intolerance from strawberry intake in a 15 month old child with acute gastroenteritis. Clinical and Translational Allergy [Internet]. 2015 Mar 30 [cited 2023 Nov 10];5(3):P61. Available from: https://doi.org/10.1186/2045-7022-5-S3-P61
- Chang CH, Wang YW, Yeh Liu PY, Kao Yang YH. A practical approach to minimize the interaction of dietary vitamin K with warfarin. J Clin Pharm Ther [Internet]. 2014 Feb [cited 2023 Nov 10];39(1):56–60. Available from: https://onlinelibrary.wiley.com/doi/10.1111/jcpt.12104
- Wang HL. Tofu and tempeh as potential protein sources in the western diet. J Am Oil Chem Soc [Internet]. 1984 Mar 1 [cited 2023 Nov 10];61(3):528–34. Available from: https://doi.org/10.1007/BF02677023
- Miller GD, Jarvis JK, McBean LD. The importance of meeting calcium needs with foods. Journal of the American College of Nutrition [Internet]. 2001 Apr [cited 2023 Nov 10];20(2):168S-185S. Available from: http://www.tandfonline.com/doi/abs/10.1080/07315724.2001.10719029
- Goolsby MA, Boniquit N. Bone health in athletes: the role of exercise, nutrition, and hormones. Sports Health [Internet]. 2017 Mar [cited 2023 Nov 10];9(2):108–17. Available from: http://journals.sagepub.com/doi/10.1177/1941738116677732
