THE EFFECT OF SALT INTAKE ON BONE HEALTH IN POSTMENOPAUSAL WOMEN: A SYSTEMATIC REVIEW AND META-ANALYSIS

Abstract

Introduction Osteoporosis is a common health concern among women after menopause partially due to declining estrogen levels, which are a major regulator of bone metabolism and calcium retention. This thesis examines the impact of dietary salt in maintaining bone tissue structure and relates it to calcium excretion through urine as a marker of bone demineralization. Understanding how modifiable dietary factors like sodium influence bone health can guide effective interventions to mitigate osteoporosis risk in this targeted population. Methods A systematic review and meta-analysis were conducted in accordance with the guidelines for reporting systematic reviews. This review was also prospectively registered in PROSPERO (CRD42025643910). Systematic searching of four major databases, i.e., PubMed, EMBASE, Web of Science, and the Cochrane Library, was done to find reports of randomized controlled trials estimating the influence of sodium intake on calcium excretion in urine and on bone health indicators. Meta-analysis was used to synthesize evidence to estimate the effect of sodium intake on calcium excretion. Results Six articles out of an initial 596 made it into the stringent selection criteria. The meta- analysis revealed that high sodium diets significantly increased urinary excretion of calcium in women after menopause, with a pooled mean difference of 29.38 mg/day (95% CI: 12.31 to 46.46, p < 0.01). These findings highlight the detrimental impact of excessive salt consumption on bone health, demonstrating a link between sodium consumption and accelerated loss of bone mass. Conclusion The findings highlight the need to moderate salt consumption to lower the likelihood of developing osteoporosis in postmenopausal women. Public health strategies should focus on dietary modifications to help mitigate this risk. Studies in the future should focus on longitudinal studies to study the consequences of salt consumption on bone health and incorporate other bone turnover markers to fully explore the impact of sodium.