Bone Health 101: Beyond Calcium

You know it's important to have strong bones, but do you know how to build and maintain them? Sorry, your morning glass of milk doesn't count. Furthermore, do you know the lifestyle, medical, and dietary factors that may weaken your bones? Unfortunately, many people don't know the answer to either of these questions, which may account for the large number of Americans who have osteoporosis, a disease characterized by low bone density and deterioration of bone tissue. According to the National Institutes of Health, around 10 million Americans (80 percent are women) have osteoporosis, a condition where bones become weak and brittle and can break from even a minor fall. Thirty-four million more are estimated to have low bone mass, or osteopenia, putting them at an increased risk for developing osteoporosis. But don’t let weak bones get the best of you—arm yourself with the knowledge you need to ensure that your bones stay strong and healthy throughout life.

Anatomy of a Bone

To understand bone health, it is important to understand exactly what bone is. Most people tend to think of bones as dry, hard, and inflexible things, but they are not. Bone is dynamic living tissue composed of a mineral matrix (including calcium, phosphorous, magnesium, silica, etc.) and a non-mineral matrix made mostly of protein, namely collagen. The minerals make bones hard and dense, while the proteins provide flexibility. Without protein, bones would become too brittle and break, and without minerals, bones would become too soft and lose their density. In optimal health, your bones have just the right balance of minerals and protein to maintain their strength, density, and flexibility.

Throughout your lifetime, the bone matrix is constantly being broken down and rebuilt in a two-part repair process called “remodeling.” This process consists of resorption and formation. During resorption, old bone tissue is broken down and removed by cells called osteoclasts. During bone formation, new bone tissue is laid down to replace the old by cells called osteoblasts.

During childhood and through the teenaged years, new bone is added faster than old bone is removed, resulting in bones becoming larger and denser. Osteoblasts outperform osteoclasts until peak bone mass is reached around age 30, then the activity of the osteoblasts and osteoclasts shifts, with more bone being broken down than formed, resulting in lost bone mass. Keep in mind that it is normal to lose bone mass as we age. In addition to aging and genetic makeup, there are many other factors involved that can either make, or break, the health of your bones.

Bone Health Breakers

There are a myriad of factors that can lead to weak bones including smoking, consumption of excess caffeine, salt, processed foods and sugar, the use of certain medications, compromised digestion, changing hormones, and even stress. These things may reduce the body’s ability to absorb minerals, can increase mineral excretion from the bones, and may damage bone cells, inhibiting new bone growth. Understanding, and then eliminating or addressing these factors, is the first step to healthier and stronger bones.

Bone Health Makers

Just as there are many factors that can harm your bones, there are also those that can improve their health, and calcium is just the tip of the proverbial bone health iceberg. A healthy diet that focuses on eating foods in their most natural forms and avoids processed and refined foods and regular weightbearing exercise such as walking, dancing, jogging, and weight lifting are two components for maintaining strong bones. A third component is to ensure that you provide your body with the key nutrients it needs to build and preserve healthy bones.

There are many nutrients crucial to bone health, some of which haven’t even been identified yet. Some of these nutrients may come from food, but for various reasons, we often don’t get optimal amounts of important bone-building nutrients from food alone. For this reason, you may consider implementing a supplement plan to support bone health.

Contrary to popular belief, one of the most important nutrients for bone health is not calcium, but vitamin D—without optimal levels of vitamin D your body cannot properly absorb calcium. Vitamin D not only aids absorption, but also ensures that calcium is delivered to the bones. It also regulates the production of the important bone-building protein, osteocalcin, the second most abundant protein in the bones after collagen. One study recently found that women with higher blood levels of vitamin D could take one-third the recommended amount of calcium without compromising the health of their bones.

Vitamin K is another often forgotten nutrient that plays a crucial role in bone health. Vitamin K is necessary for the activation of the proteins osteocalcin and matrix Gla. Once activated, osteocalcin holds calcium to the bone and matrix Gla ensures that calcium is delivered from the blood to the bones, and not deposited in places where it should not be, such as the arteries or joints. Additionally, vitamin K has been shown to increase the number of bone-building osteoblasts, while it decreases the number of osteoclasts, the cells responsible for breaking down bones.

Other important bone-building nutrients include magnesium, part of the mineral-protein matrix that regulates the transport of calcium to bones; calcium, the most abundant mineral in the bones and one that is easily depleted from our bodies; strontium, another part of the mineral-protein matrix that imparts strength to bone tissue and has been shown to increase bone formation and decrease bone resorption, resulting in increased bone density; and vitamin C, essential for the production of collagen, the most abundant protein in the bone matrix. Additionally, zinc, copper, silicon, boron, and vitamin B12 are also important bone-building nutrients; many of these can be found in combinations formulated specifically for bone health.

Losing some bone mass is an inevitable part of getting older, but by eliminating lifestyle factors like smoking, excess stress, processed and refined foods that can be detrimental to your bones and embracing a whole, natural-foods diet, enjoying regular weightbearing exercise, and supplementing your diet with specific bone-building nutrients, you can ensure a lifetime of strong, healthy bones.

For more on bone health in this month's Health Hotline:

• Why Flamingoes Don't Get Osteoperosis

• Eating for Strong Bones - There's More to it Than Dairy