{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T16:04:23Z","timestamp":1791821063171,"version":"4.3.4"},"reference-count":100,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,12,10]],"date-time":"2025-12-10T00:00:00Z","timestamp":1765324800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec>\n                    <jats:title>Background and objective<\/jats:title>\n                    <jats:p>Low bone mass represents a critical period for \u201cwatchful waiting\u201d interventions to prevent osteoporosis. This systematic review provides a comprehensive overview of non-pharmacological interventions for patients with low bone mass.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We included randomized controlled trials (RCTs) investigating the efficacy of non-pharmacological interventions for improving bone health outcomes in participants with low bone mass. Publications were collected from three databases. A meta-analysis was performed for outcomes reported in three or more articles, with changes in outcomes expressed as mean differences (MD) or standardized mean differences (SMD) with 95% confidence intervals (CIs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 26 eligible articles were included. Exercise interventions increased serum osteocalcin levels (SMD = 1.26, 95% CI: 0.22\u20132.31) compared to the control group. Narrative synthesis of studies showed a protective effect of exercise on lumbar spine and femoral neck BMD. For nutrition interventions, polyphenol extracts showed efficacy in improving lumbar spine BMD. The results of collagen supplements were inconsistent, and the effects of micronutrients were limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In conclusion, more evidence from RCTs, particularly those investigating comprehensive lifestyle interventions and tailored prevention for moderate and severe low bone mass, especially among older men, is necessary.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fendo.2025.1612739","type":"journal-article","created":{"date-parts":[[2025,12,10]],"date-time":"2025-12-10T06:42:52Z","timestamp":1765348972000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["The effect of non-pharmacological interventions on bone health among patients with low bone mass: a systematic review and meta-analysis"],"prefix":"10.3389","volume":"16","author":[{"given":"Xiaona","family":"Na","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yucheng","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huanhuan","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zekun","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaochen","family":"Qu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jian","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mo","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dantong","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Denis","family":"Breuille","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kai","family":"Yu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ai","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhihui","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,12,10]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1002\/jbmr.5650090802","article-title":"The diagnosis of osteoporosis","volume":"9","author":"Kanis","year":"1994","journal-title":"J Bone mineral Res"},{"key":"B2","doi-asserted-by":"publisher","first-page":"58","DOI":"10.1007\/s11657-022-01061-5","article-title":"UK clinical guideline for the prevention and treatment of osteoporosis","volume":"17","author":"Gregson","year":"2022","journal-title":"Arch Osteoporos"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1007\/s00198-021-05900-y","article-title":"The clinician\u2019s guide to prevention and treatment of osteoporosis","volume":"33","author":"LeBoff","year":"2022","journal-title":"Osteoporosis Int"},{"key":"B4","doi-asserted-by":"publisher","first-page":"609","DOI":"10.1186\/s13018-021-02772-0","article-title":"The global prevalence of osteoporosis in the world: a comprehensive systematic review and meta-analysis","volume":"16","author":"Salari","year":"2021","journal-title":"J Orthop Surg Res"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1001\/jama.285.6.785","article-title":"Osteoporosis prevention, diagnosis, and therapy","volume":"285","author":"Klibanski","year":"2001","journal-title":"J Am Med Assoc"},{"key":"B6","doi-asserted-by":"publisher","first-page":"S3","DOI":"10.1016\/j.ajog.2005.08.047","article-title":"Epidemiology, etiology, and diagnosis of osteoporosis","volume":"194","author":"Lane","year":"2006","journal-title":"Am J Obstetrics Gynecology"},{"key":"B7","doi-asserted-by":"publisher","first-page":"694","DOI":"10.1016\/j.bone.2005.06.004","article-title":"Half the burden of fragility fractures in the community occur in women without osteoporosis. 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