Food and Medicine Homologous Plants in Osteoporosis: A Scoping Review of Preclinical Evidence.

Osteoporosis is a chronic systemic bone disease characterized by reduced bone density and an increased risk of fractures. This review summarizes the preclinical evidence for 61 FMH plants and their active ingredients. Its bone protection mechanism involves estrogen-like action, inhibition of oxidative stress, regulation of intestinal flora and metabolites, regulation of autophagy, and other pathways. Based on a tertiary level of evidence, 24 plants had only a single animal/in vitro study (level 1), 34 had consistent results from multiple independent animal studies (level 2), and a few had preliminary human trials with obvious limitations (level 3). The existing evidence does not support FMH to replace standard anti-osteoporotic drugs and should be positioned as an adjunctive strategy for long-term prevention and early intervention, with standardized extracts and clinical trials with fractures as the endpoint in the future.