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Accepted manuscript

Nutrients and food supplements for the prevention of musculoskeletal diseases: an umbrella review

Published online by Cambridge University Press:  06 March 2026

Marzia Pellegrini
Affiliation:
Department of Translational Research, School of Hygiene and Preventive Medicine, University of Pisa, Italy
Andrea Vecchietti
Affiliation:
Department of Diagnostics and Public Health, Hygiene Section - University of Verona
Giovanni Leonardo Briganti
Affiliation:
School of Hygiene and Preventive Medicine, Department of Medical and Surgical Sciences, Alma Mater Studiorum, University of Bologna, Via San Giacomo 12, Bologna 40126, Italy
Giuseppa Granvillano
Affiliation:
Department of Medical and Surgical Sciences and Advanced Technologies “GF Ingrassia”, University of Catania, Catania, 95123, Italy
Camilla Lugli
Affiliation:
Department of Biomedical, Metabolic, and Neural Sciences – International PhD Program in Clinical and Experimental Medicine - University of Modena and Reggio Emilia, Modena, Italy
Eleonora Raso
Affiliation:
Department of Public Health, Experimental and Forensic Medicine - University of Pavia, Pavia, Italy
Gloria Spatari
Affiliation:
Department of Health Sciences, University of Genoa, 16132 Genoa
Chiara Noviello
Affiliation:
Hygiene and Preventive Medicine, Interdisciplinary Department of Medicine, Aldo Moro University of Bari, Bari, Italy
Michelangelo Mercogliano
Affiliation:
Department of Public Health, University “Federico II” of Naples, 80131 Naples
Paolo Strano
Affiliation:
Department of Diagnostics and Public Health, Hygiene Section - University of Verona
Giorgia Cappuccio
Affiliation:
Department of Medical and Surgical Sciences and Advanced Technologies “GF Ingrassia”, University of Catania, Catania, 95123, Italy
Giuseppa Minutolo
Affiliation:
Food Hygiene, Nutritional Surveillance and Prevention, Department of Prevention, Provincial Healthcare Authority of Palermo, 90129 Palermo, Italy
Teresa Urbano*
Affiliation:
CREAGEN-Center for Environmental, Genetics, and Nutritional Epidemiology Research Center, University of Modena and Reggio Emilia, Modena, Italy School of Medicine, Università Vita-Salute San Raffaele, 20132 Milan, Italy
Antonio Lorenzon
Affiliation:
Department of Biomedical, Metabolic, and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy Department of Prevention, South Tyrolean Health Care Agency, Bolzano, Italy.
*
Corresponding Author: Dr. Teresa Urbano; Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, via Campi 287, 41125 Modena (MO), Italy. Tel. +39 059 205 5716. e-mail teresa.urbano@unimore.it
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Abstract

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Musculoskeletal disorders (MSDs) impact the locomotor system, causing pain and limiting movement, with significant consequences for autonomy and quality of life. Preventing MSDs is therefore a key public health priority. This umbrella review examines which dietary nutrients most effectively contribute to their primary prevention. Following PRISMA and Joanna Briggs Institute guidelines, and pre-registered on PROSPERO (CRD42024544780), we systematically searched PubMed, Web of Science, Embase, and Cochrane databases. Using a mixed-methods approach, we synthesized quantitative and qualitative data from 9 reviews out of 466 initial records, encompassing 128 studies and 661,705 participants. Frequently studied exposures included dairy products and mineral salts. Supplements derived from plant extracts, fruits, vegetables, meat, prebiotics, and probiotics were also assessed. Dosages ranged from 2.5 mg/kg/day for epicatechin to over three months for calcium. Outcomes included fractures, frailty, sarcopenia, muscle mass and strength, walking speed, inflammation, bone mineral density, and turnover markers. High consumption of cheese and yogurt reduced fracture risk by 8–11% and improved grip strength. Calcium supplementation had modest effects on bone mineral content. Fruit and vegetable intake correlated with improved gait speed (HR = 0.60; 95% CI: 0.42–0.84), while nut consumption was linked to reduced sarcopenia risk (HR = 0.72; 95% CI: 0.53–0.99). This review highlights the preventive potential of select nutrients against MSDs, though further research is needed to determine optimal dosages.

Information

Type
Review Article
Copyright
© The Author(s), 2026. Published by Cambridge University Press on behalf of The Nutrition Society