Vitamins, Minerals and the Skeleton

This is part of our ongoing The Best Kept Secrets to Healthy Aging spotlight. Each day, we will be posting some of the great information that’s packed into our book, The Best Kept Secrets to Healthy Aging.

Today’s topic:
Vitamins, Minerals and the Skeleton

Of course, calcium is the major structural component supporting skeletal health. Increasing calcium intake (through foods or dietary supplements) increases bone integrity and provides a structure that is much less likely to fail (that is, break). This biological truism has been confirmed over and over by the results of “gold standard” randomized placebo-controlled clinical trials. As discussed in a detailed review published recently in the Brazilian Archives of Endocrinology and Metabolism, dietary supplementation with calcium prevents bone fractures – even in adults who already had suffered osteoporotic fractures (and therefore had very weak bones) before adding sufficient calcium to their diets.17

The U.S. Food and Drug Administration has recognized the relationship between good calcium nutrition and bone health by stating that “Adequate calcium throughout life, as part of a well-balanced diet, may reduce the risk of osteoporosis.”

Vitamin D
Although other nutrients are vital components of a strong skeletal structure, it is increasingly clear that vitamin D is the manager that orchestrates skeletal health. A deluge of new information emphasizes the importance of vitamin D – a degree of importance even greater than has been thought before. In fact, the results of the Women’s Health Initiative published recently in the New England Journal of Medicine proved that the need for vitamin D is much greater than previously believed.18 Fortunately, daily supplementation with enough vitamin D can be quite effective in promoting a strong long-lived skeleton.19 The question arises as to how much is enough? The independent Vitamin D Council suggests that otherwise healthy adults who get some sunshine every day should consume 1000 IU of vitamin D daily – if moderate sun exposure is not possible, 2000 IU would be preferable. These levels are very safe, despite the fact that they are much higher than was believed to be adequate just a few years ago. However, these levels may not be high enough for everyone. Individuals should check with their doctors about being tested for blood levels of vitamin D (a relatively easy test to conduct). If levels are low, an appropriate regimen should be instituted to raise vitamin D levels.

The third member of the major bone-building trio is magnesium. While calcium deficiency predisposes both men and women to thin bones and spontaneous fractures, this mineral is just as important as it promotes healthy mineral retention by bone tissue. Much more importantly, as shown in research results published recently in the Journal of the American Geriatric Society and the Journal of Clinical Endocrinology and Metabolism the density and strength of every bone in the human body is proportional to the intake of magnesium.20,21

Vitamin C
While most emphasis is placed on the mineral components of bone tissue, without vitamin C to band together the collagen fibers that actually form bones, there would be no guide to the placement of minerals and bone tissue would be fragmented and without mechanical strength. As vitamin C is required for collagen synthesis, bone strength is dependent on vitamin C supply.22

Strong bones require healthy joints in order for the skeleton to do more than simply support your weight against the pull of gravity. Modern research has shown that adequate consumption of vitamin C helps sustain healthy joints and promote their continued function.23,24

Vitamin E
The connection between maintaining oxidant/antioxidant balance and continuing skeletal health is only now being appreciated. This connection is underscored by the recent discovery that antioxidant capacity, especially vitamin E status, can be severely compromised in adults with joint issues.25 Enhancing antioxidant defense systems may indeed be a key factor in sustaining healthy joint and skeletal function as antioxidants can prevent damage to join tissue from free radicals.

Although the trace mineral boron is found within bone, its function there is not yet entirely clear. However, it is known that rats fed a boron-free diet develop weak bones. In fact, boron supplementation in rats and chicks has been found to increase bone strength. Furthermore, boron influences the metabolism of several metabolic enzymes in various ways as well as the metabolism of steroid hormones and nutrients including vitamin D, calcium and magnesium.26

Vitamin K
Vitamin K is required for the production of the non-collagen proteins in bone. This means that, because vitamin K helps determine the amount of non-mineral bone tissue that is available to be mineralized, human bone mineral density is proportional to vitamin K intake. The findings of an extensive analysis of published research have determined that poor vitamin K status dramatically increases the chances of bone fractures.27 A new concept in human nutrition is that because humans rely on gut bacteria to produce vitamin K from dietary fiber, the typical low-vegetable, low-fiber diet may be causing a form of undiagnosed vitamin K deficiency, manifested as impaired bone health. Of course, vitamin K is essential for other systems as well, an important one being the cardiovascular system. The preferred form of vitamin K seems to be vitamin K2, menaquinone, which is free of toxicity and has been shown to have the best bone-supportive and cardiovascular benefits. The optimal form of vitamin K2 is known as MK-7 and is derived from a fermented Asian soy food known as natto.

Next Best Kept Secrets to Healthy Aging topic:
Vitamins, Minerals and the Prostate Gland

17. Heaney RP. Calcium intake and disease prevention. Arq Bras Endocrinol Metabol 2006;50:685-693.
18. Jackson RD, LaCroix AZ, Gass M, Wallace RB, Robbins J, Lewis CE, Bassford T, Beresford SA, Black HR, Blanchette P, Bonds DE, Brunner RL, Brzyski RG, Caan B, Cauley JA, Chlebowski RT, Cummings SR, Granek I, Hays J, Heiss G, Hendrix SL, Howard BV, Hsia J, Hubbell FA, Johnson KC, Judd H, Kotchen JM, Kuller LH, Langer RD, Lasser NL, Limacher MC, Ludlam S, Manson JE, Margolis KL, McGowan J, Ockene JK, O’Sullivan MJ, Phillips L, Prentice RL, Sarto GE, Stefanick ML, Van Horn L, Wactawski-Wende J, Whitlock E, Anderson GL, Assaf AR, Barad D; Women’s Health Initiative Investigators. Calcium plus vitamin D supplementation and the risk of fractures. N Engl J Med 2006;354:669-683.
19. Bischoff-Ferrari HA, Willett WC, Wong JB, Giovannucci E, Dietrich T, Dawson-Hughes B. Fracture prevention with vitamin D supplementation: A meta-analysis of randomized controlled trials. JAMA 2005;293:2257-2264.
20. Ryder KM, Shorr RI, Bush AJ, Kritchevsky SB, Harris T, Stone K, Cauley J, Tylavsky FA. Magnesium intake from food and supplements is associated with bone mineral density in healthy older white subjects. J Am Geriatr Soc 2005;53:1875-1880.
21. Carpenter TO, DeLucia MC, Zhang JH, Bejnerowicz G, Tartamella L, Dziura J, Petersen KF, Befroy D, Cohen D. A randomized controlled study of effects of dietary magnesium oxide supplementation on bone mineral content in healthy girls. J Clin Endocrinol Metab 2006;91:4866-4872.
22. Macdonald HM, New SA, Golden MH, Campbell MK, Reid DM. Nutritional associations with bone loss during the menopausal transition: Evidence of a beneficial effect of calcium, alcohol, and fruit and vegetable nutrients and of a detrimental effect of fatty acids. Am J Clin Nutr 2004;79:155-165.
23. Cerhan JR, Saag KG, Merlino LA, Mikuls TR, Criswell LA. Antioxidant micronutrients and risk of rheumatoid arthritis in a cohort of older women. Am J Epidemiol 2003;157:345-354.
24. McAlindon TE, Jacques P, Zhang Y, Hannan MT, Aliabadi P, Weissman B, Rush D, Levy D, Felson DT. Do antioxidant micronutrients protect against the development and progression of knee osteoarthritis? Arthritis Rheum 1996;39:648-656.
25. Surapaneni KM, Venkataramana G. Status of lipid peroxidation, glutathione, ascorbic acid, vitamin E and antioxidant enzymes in patients with osteoarthritis. Indian J Med Sci 2007;61:9-14.
26. Devirian TA, Volpe SL. The physiological effects of dietary boron. Crit Rev Food Sci Nutr. 2003;43(2):219-31.
27. Cockayne S, Adamson J, Lanham-New S, Shearer MJ, Gilbody S, Torgerson DJ. Vitamin K and the prevention of fractures: Systematic review and meta-analysis of randomized controlled trials. Arch Intern Med 2006;166:1256-1261.

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