Bone Health

Vitamins & Minerals for Bone Health

Though many people do not think about their bone health until they have a broken bone or they’re told they have osteoporosis, our eating habits and the nutrients we consume throughout our life have a dramatic effect on our bone health now and later in life.

What is bone?
Bone is a dynamic, metabolically active tissue – constantly being broken down and rebuilt with new bone tissue to meet the mechanical demands placed upon it, repair micro damage to the bone matrix and remove old bone tissue.

Age

Stage

Birth to early 30s

Bone building

18 years old (girls)
20 years old (boys)

Reaching peak bone mass

35 - 40+ years old

More bone is removed than formed

During the bone building years (from birth through our early 30s), bone formation exceeds bone resorption, though 90% of peak bone mass is built by age 18 in girls and 20 in boys. After this time, these processes become relatively equal and then, after age 35 - 40 more bone is removed than formed resulting in a net loss of bone tissue.

What is osteoporosis?
The brittle bone disease, osteoporosis, sets in when bone loss results in low bone mass and porous, fragile bones. People with osteoporosis have a greater risk of fractures of the hip, spine and wrist.

Several factors affect our ability to build bone and how quickly we lose it, including genetics, hormone levels, medication and two factors we can control – diet and exercise.

Calcium & Vitamin D
Most of the calcium in our body is stored in our bones and teeth where it supports structure and functioning. However, we also need calcium for other critical functions including nerve transmission, muscle functioning, blood vessel expansion and contraction, intracellular signaling and hormone secretion.

These functions require a constant concentration of calcium in our bloodstream and therefore, when we don’t consume enough calcium in our diet or through dietary supplements (or a combination of the two), calcium is pulled out of bone tissue to keep blood levels of calcium normal. Over time this can have a dramatic effect on our bone mineral density.

Despite the fact that calcium is critical to bone health, many people are not getting enough in their diet, especially women. In fact, only 28% of females ages 19-30 are consuming above the recommended intake set by the Institute of Medicine to ensure nutrition adequacy. That number jumps to 33% for women ages 31-50 and drops to just 8% for women ages 51-70.

Though calcium is essential, it can’t do its job very well without vitamin D.
Vitamin D is a fat-soluble vitamin that promotes calcium absorption and helps our body maintain adequate blood concentrations of calcium and phosphate. In addition, vitamin D promotes bone formation and mineralization, reduces the risk of bone fractures and together with calcium, vitamin D helps protect adults from osteoporosis. Insufficient levels of vitamin D can lead to softening of the bones and skeletal deformities.

Vitamin D is found naturally in very few foods (primarily fish) and therefore, the majority of the vitamin D we consume through our diet comes from fortified foods, especially milk and some yogurts. In addition, our body can produce it when our skin is exposed to UVB rays from the sun and we can obtain vitamin D through dietary supplements. However, recent studies have found that many people have insufficient or deficient levels of vitamin D. And because our intakes of calcium and vitamin D are so low, they are identified in the 2010 Dietary Guidelines for Americans as two of the four nutrients that are a public health concern in the United States.

Nutrients for bone health
Other nutrients we need for optimal bone health include magnesium and phosphorus, which contribute to the structural components of bone. And, though survey data indicates we are consuming plenty of phosphorus, many Americans are falling short on magnesium. In addition, several other nutrients are also important for bone mineralization including zinc, boron, copper, fluoride, manganese, silicon and vitamins C and K.

Bone tissue is a complex organ that requires a number of nutrients for optimal bone health in addition to weight bearing exercise (such as resistance training or lifting weights). The best approach for building strong bones is to consistently eat a well-rounded, varied diet packed with nutritious foods that include the bone building nutrients, especially calcium, vitamin D and magnesium, and makeup for any shortfalls with fortified foods or dietary supplements.

1 Raisz LG. Physiology and pathophysiology of bone remodeling. Clin Chem 1999;45:1353-58. http://www.clinchem.org/cgi/content/full/45/8/1353

2 Watts NB. Clinical Utility of Biochemical Markers of Bone Remodeling. Clin Chem 1999;45:1359-68. http://www.clinchem.org/cgi/content/full/45/8/1359

3 NIH Osteoporosis and Related Bone Diseases National Resource Center. 2011. Osteoporosis Overview. http://www.niams.nih.gov/Health_Info/Bone/Osteoporosis/overview.asp

4 Office of Dietary Supplements (ODS), National Institutes of Health (NIH)a. Calcium: Dietary Supplement Fact Sheet. http://ods.od.nih.gov/factsheets/calcium

5 NIH Publication No. 09–5186. NIH Osteoporosis and Related Bone Diseases National Resource Center. Kids and their Bones: A Guide for Parents.

6 Food and Nutrition Board. Institute of Medicine. Dietary reference intakes for calcium, phosphorus, magnesium, vitamin D, and fluoride. Washington, DC: National Academy Press, 1997. http://www.nap.edu/openbook.php?isbn=0309063507.

7 U.S. Department of Agriculture and U.S. Department of Health and Human Services. Dietary Guidelines for Americans, 2010. 7th Edition, Washington, DC: U.S. Government Printing Office, December 2010.

8 Office of Dietary Supplements (ODS). National Institutes of Health (NIH)b. Vitamin D: Dietary Supplement Fact Sheet. http://ods.od.nih.gov/factsheets/vitamind

9 NIH Osteoporosis and Related Bone Diseases National Resource Center. Other Nutrients and Bone Health at a Glance. http://www.niams.nih.gov/Health_Info/Bone/Bone_Health/Nutrition/other_nutrients.asp

10 Moshfegh, Alanna; Goldman, Joseph; Ahuja, Jaspreet; Rhodes, Donna; and LaComb, Randy. 2009. What We Eat in America, NHANES 2005-2006: Usual Nutrient Intakes from Food and Water Compared to 1997 Dietary Reference Intakes for Vitamin D, Calcium, Phosphorus, and Magnesium. U.S. Department of Agriculture, Agricultural Research Service. http://www.ars.usda.gov/SP2UserFiles/Place/12355000/pdf/0506/usual_nutrient_intake_vitD_ca_phos_mg_2005-06.pdf

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