Boning Up on Bone Health

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It takes more than just calcium to build strong bones

Bone health is all too easy to neglect, particularly in the younger years, when – unless one experiences a fracture or break – the body holds together quite well. With the continued process of age and other factors, however, bone strength and integrity will begin to decline for everyone. Whether the decline is fast or slow, mild or severe depends on multiple factors, including sex, nutritional status, medication use, lifestyle factors, and even body size.

Bone health factors

Primary factors that are associated with an increased risk of low bone mineral density (the measurable quantity which is assessed in screenings for osteoporosis) are female gender, postmenopausal status, advancing age, having a low body weight (<127 pounds), long-term use of glucocorticoid therapies (such as prednisone), smoking, and drinking excess alcohol.[1] Having a personal history of a fracture or family history of a hip fracture are also factors that predict future fracture risk.

Hormones play an important role in bone health: the absence of menstrual cycling, decreased estrogen and progesterone levels, and low testosterone can all diminish bone density. Both men and women experience a decrease in hormone levels with age. Nutritional status and nutrient absorption also decline with age, further contributing to osteoporosis. Co-morbidities – such as thyroid disease, celiac disease, Crohn’s disease, and rheumatoid arthritis – may also contribute to a loss of bone strength.

Boosting bone health – more than just vitamin D and calcium!

Most doctors and consumers understand the importance of vitamin D3 and calcium in bone health, yet there are many more vitamins and minerals of importance. Vitamin K plays a role in directing calcium deposition, ensuring that the calcium taken into the body ends up in the bone matrix and not in the soft tissue.[2],[3] Certain forms of vitamin K are more active in the body than others: Menaquinone-7, or MK-7, is a highly bioactive form of vitamin K2.[4] Similarly, vitamin D3 (cholecalciferol) is significantly more effective than vitamin D2 (ergocalciferol) at raising serum vitamin D 25(OH) levels, which are measured with vitamin D screening.[5]

Vitamin K plays a role in directing calcium deposition, ensuring that the calcium taken into the body ends up in the bone matrix and not in the soft tissue.

Magnesium, zinc, copper, boron, manganese, strontium and silica along with other trace minerals are necessary for bone health. [6],[7] Although they are not the primary elements contained in the bone matrix, a deficiency is correlated with reduced bone mass and/or slow healing of fractures. Many of these minerals serve as essential cofactors for enzymes involved in the synthesis of bone.[8],[9] Silicon is involved in bone formation through the synthesis and/or stabilization of collagen.[10] Boron is important for reducing bone breakdown (part of the constant remodeling process in the bones), also supporting blood levels of calcium, magnesium, phosphorus, and vitamin D.[11],[12],[13] Finally, delta and gamma tocotrienols, two forms of vitamin E, also help to improve bone health, increasing the ratio of osteoblast (the cells which produce new bone) to osteoclast (cells which break down old bone) activity.[14]

Improving nutrient absorption from the diet

There is concern that our diets are becoming deficient in trace minerals due to poor soil quality and the overconsumption of processed, nutritionally-void foods. If a bone-supportive nutritional supplement is utilized, it should contain all of these vitamins and minerals, as the sum is greater than the individual parts. In addition to consuming a diverse diet that contains all the nutrients necessary for bone health, adequate digestion of food is important for getting nutrients from the digestive tract into the bones.

In addition to consuming a diverse diet that contains all the nutrients necessary for bone health, adequate digestion of food is important for getting nutrients from the digestive tract into the bones.

Unfortunately, many individuals have compromised production of digestive enzymes, whether due to age, stress, medications such as proton-pump inhibitors, or a variety of chronic diseases.[15],[16],[17],[18],[19] Digestive enzymes that are produced by the pancreas and by the cells lining the digestive tract support the breakdown of food substances and thus the absorption of nutrients, as does stomach acid. A supplemental digestive enzyme and acidic substances like ascorbic acid (vitamin C) may improve the breakdown and absorption of nutrients in foods, as well as supplemental bone-supportive nutrients.

Summary

Many different vitamins and minerals are required for optimal bone health. In addition to vitamin D and calcium, this includes vitamin K, tocotrienols, magnesium, zinc, copper, boron, manganese, strontium and silica, and other trace minerals. The chemical form of vitamins is important: vitamin D3 is significantly more effective than vitamin D2, Menaquinone-7 is the more bioactive form of vitamin K2, and gamma and delta tocotrienols are the form of vitamin E with studies showing their importance for bone health. Supplemental digestive enzymes and acidic substances such as ascorbic acid (vitamin C) may support bone health by improving food breakdown and nutrient absorption.

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