A comprehensive review of the essential ingredients for bone health and osteoporosis was recently published in the Open Orthopaedics Journal. The same article also provides a review of the availability of these essential nutrients in the average North American diet.
The review confirms many of the things published on this blog as they relate to diet and bone health and osteoporosis. It also offers some surprising findings regarding nutrients that are not well known but are important to building strong bones. In many cases, the average North American diet is deficient in these less well-known nutrients as well as being deficient in the more commonly known nutrients.
Essential Nutrients for Bone Health and Osteoporosis
The article also provides a comprehensive list of these essential nutrients, recommended dietary allowance and median intake (by a North American) for each nutrient. The authors provide their own suggested supplementation level for each nutrient – although they do not provide an explanation as to how they arrive at the specific amounts.
Finally, the authors provide a detailed table identifying each of the essential nutrients, popular dietary sources for each nutrient, and the content for each nutrient by source.
Access to the Article
Access to the full article is open and available. The review was prepared by several writers. One of the authors is Dr. Charles T. Price – an orthopaedic surgeon who practices in Florida. As well as being a practicing physician, Dr. Price is a co-founder of the Institute for Better Bone Health – a supplier of bone health supplements.
In the tables that accompany the article the authors provide the dietary sources for each of the nutrients. However, the authors state “supplementation of the average American diet is recommended for vitamin D, calcium, magnesium, silicon, vitamin K and boron.”
Keep in mind that your diet is probably not average and your needs will probably differ from the norm. Also, calcium supplementation has been linked with some health risks (as noted below).
I encourage you to read the article in detail. It is quite thorough and informative. However, keep in mind that the comparisons that the authors make are to the average North American. Your specific nutrient levels probably differ and you should consult with a health professional knowledgeable in nutrition if you want to know your specific needs.
The Role of Exercise in Bone Health
The authors point out that exercise plays a key role in the development of strong bones as well as being essential to general good health. They further point out that the average North American does not do enough exercise to benefit bone health and recommend an increase in the overall activity and exercise level of most people.
I would also suggest that the recommended increase in exercise activity level include bone-building activities such as weight bearing exercises and strength training.
Vitamin D and Calcium
Vitamin D and calcium are two of the better known essential nutrients for osteoporosis. The review states that both Vitamin D and calcium levels in the average North American diet are inadequate.
Kent MacLeod, Clinical Pharmacist at NutriChem Compounding Pharmacy and Clinic, states in his interview, Too Much Calcium and Too Little Vitamin D, that most of the clients he sees are taking in too much calcium – probably because there is such awareness of the nutrient and people have been overcompensating with supplements. On the other hand, he finds that most clients that visit his clinic a quite Vitamin D deficient.
The recommended vitamin D levels provided by the authors seem low. I am not sure where they are getting this data. Perhaps they live in southern climates and are influenced by the local sunny climate? They also do not take into account age considerations when recommending the Vitamin D levels.
The amount of Vitamin D recommendations varies dramatically from country to country. For example, the levels suggested by Osteoporosis Canada are much higher than suggested by the authors:
Osteoporosis Canada’s new guidelines (July 2010) recommend daily supplements of 400 to 1000 IU for adults under age 50 without osteoporosis or conditions affecting vitamin D absorption. For adults over 50, supplements of between 800 and 2000 IU are recommended. For people who need added supplementation to reach optimal vitamin D levels, doses up to the current “tolerable upper intake level” (2000 IU) are safely taken without medical supervision. Doses above that require medical supervision. A daily supplement of 800 IU should be regarded as a minimum dose for all adults with osteoporosis.
The authors are cautious about calcium supplementation since “very high levels of calcium supplementation have been associated with increased risks of myocardial infarction.”
Magnesium, Silicon, Vitamin K and Boron
While Vitamin D and calcium are well known to physicians as key nutrients for bone health and osteoporosis, other essential nutrients such as magnesium, silicon, vitamin K and boron are less well known and are often overlooked.
The median intake of each of these nutrients in the average North American diet is below the recommended dietary allowance.
Zinc, Manganese and Copper
The authors identify zinc, manganese and copper as essential nutrients but state that “these nutrients are usually consumed in amounts that meet or exceed the recommended dietary allowance”.
Interestingly, the authors do not mention or discuss the role of Omega-3. Recent research is showing that Omega 3 supplementation coupled with an osteoporosis exercise program yields better Bone Mineral Density or bone mass.
Remember that these are guidelines and your specific needs will probably vary from the average North American profile. You are encouraged to consult with a health professional trained in the area of nutrition.
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