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Bone Health 2

Building Bones

by Cristina Goodwin | February 27, 2015

Building strong bones and even reversing bone damage can be aided with a balanced diet and a variety of specialty supplements.

As people pass through their 20s, 30s and 40s into middle age, bone health seems to tip in favor of bone mineral loss––especially if the diet is inadequate or physical activity is lacking, according to Trisha Sugarek MacDonald, BS, MS, director of research and development/national educator for Texas-based Bluebonnet Nutrition Corporation.

Therefore, it comes as no surprise that the annual Consumer Survey on Dietary Supplements supported by the Council for Responsible Nutrition (CRN) in Washington, D.C., found that 29 percent of supplement users reported taking them specifically to improve their bone health. In addition, 36 percent of respondents taking supplements for bone health were over the age of 55, aka Baby Boomers, although trends show that a younger audience is looking for bone health supplements as well.

In fact, sales for supplements supporting bone health reached $1.8 billion in 2012 on a 2.2 percent growth, according to Nutrition Business Journal estimates, and the market is expected to reach $2 billion this year.

Health Hazard

The National Osteoporosis Foundation (NOF) found that 52 million Americans have low bone density or osteoporosis, and one in two women, and up to one in four men over the age of 50, will break a bone as a result. Additionally, by 2020, the NOF anticipates half of all Americans over the age of 50 will have osteoporosis or low bone density. And, approximately 25 percent of postmenopausal Caucasian women in the U.S. will develop osteoporosis, resulting with an estimated cost of $13.8 billion annually.

According to NOF, preventing osteoporosis should begin at childhood. Whatever your age, the habits you adopt now can affect your bone health for the rest of your life. Now is the time to take action, according to the foundation.

“Osteoporosis has become widely recognized as a major public health problem, which is partially related to deterioration of bone metabolism with increasing age and in postmenopausal women, a deficiency in estrogen,” MacDonald added. According to the review Diet, Nutrition, and Bone Health published in the Journal of Nutrition, osteoporosis is a systemic skeletal disease characterized by low bone mass and microarchitectural deterioration of bone disuse, with a consequent increase in bone fragility and susceptibility to fracture.

MacDonald noted that osteoporosis and low bone density is aggravated by abnormal wear-and tear of the cartilage that cushions joints, and the destruction or decrease of synovial fluid that lubricates those joints, making movement limited and uncomfortable. Other issues affecting bone health are social and environmental, which include gender, age, body size, genetics and ethnicity, as well as physical activity levels, smoking and alcohol consumption patterns and diet.

Natural Options

The journal Korean Neurosurgery stated that because of possible side effects associated with pharmaceuticals, natural alternatives for preventing and treating osteoporosis are highly desirable. However, NOF lists a number of ways to prevent this disease. First is to engage in regular exercise, eat foods that are good for bone health, such as fruits and vegetables, avoid smoking and limit alcohol intake to 2-3 drinks per day. Lastly, make sure you get enough calcium and vitamin D, in addition to a well-balanced diet.
Consumer awareness of bone health has improved, due, in part, to important reports, including the Reports on Osteoporosis in the European Community: Action for Prevention by the European Commission, the U.S. Surgeon General’s Report on Bone Health and Osteoporosis and the World Health Organization’s report on Diet, Nutrition and the Prevention of Chronic Diseases, which highlight the roles of calcium and vitamin D in helping to promote healthy bones.

Calcium

Calcium is the fifth most abundant element in the Earth’s crust, and the average adult body consists of anywhere from 1,000 to 1,500 grams, with the majority being in our teeth and bones. Although people do not naturally produce calcium, it is absorbed through foods and supplements.

Gene Bruno, MS, MHS, director of category management with New York-based Twinlab Corporation, said, “The data on calcium and osteoporosis is so compelling that the Food and Drug Administration (FDA) has approved either of these health claims: ‘Adequate calcium throughout life, as part of a well-balanced diet, may reduce the risk of osteoporosis,’ or ‘Adequate calcium as part of a healthful diet, along with physical activity, may reduce the risk of osteoporosis in later life.’”

Calcium comes in multiple forms to choose from, and research shows that calcium citrate is absorbed better than other forms of calcium tested. Studies have also shown that other forms are reasonably well-absorbed, including calcium carbonate, Bruno explained, noting that the best advice is to purchase calcium tablets from a company known to follow current good manufacturing practices (cGMPs) to ensure the tablet is properly manufactured. Twinlab offers two calcium citrate-based products, Twinlab Calcium Citrate Caps and Twinlab Calcium Citrate Chewable Wafers, in addition to its other products, which include Twinlab Bone Support with Ostivone, Twinlab Vitamin D 2000 IU, Twinlab Mega D3 Dots 5000 IU and Twinlab Vitamin D3 1000 + K2.

Vladimir Badmaev, MD, PhD, head of R&D at NattoPharma ASA (Oslo, Norway), producers of the branded vitamin K2 ingredient MenaQ7, said he believes that the effects of vitamin D and calcium cannot be separated, and are historically one of the most researched combinations to strengthen the bone structure in infants, children, women, men and diverse races or ethnic groups.

“Understanding that many seniors take calcium products to help strengthen their bones, Bluebonnet’s most popular calcium/magnesium plus D3 formula is our delicious Liquid Calcium Magnesium Citrate Plus Vitamin D3, which appeals to this audience since they are often saddled with a plethora of other oral medications making the liquid form much more palatable to them than having to take ‘yet another pill’,” MacDonald said. The bone specific supplement provides the body with 600 mg of calcium and 300 mg of magnesium in a 2:1 ratio, plus 400 IU of vitamin D3 from lanolin. In addition, it is offered in six flavors: blueberry, strawberry, lemon, orange, raspberry and mixed berry.

Vitamin D

Kevin D. Cashman, author of Diet, Nutrition and Bone Health, explained that vitamin D deficiency is characterized by inadequate mineralization, or demineralization, of the skeleton, and evidence has shown that vitamin D deficiency is a key contributor to osteoporosis through less efficient intestinal absorption of calcium, increased bone loss, muscle weakness and weakened bone microstructure. And, unfortunately, 41.6 percent of the adult population in the U.S. is vitamin D deficient, Twinlab’s Bruno noted. According to NOF, people who are at risk of vitamin D deficiency include those who do not get enough sun or who cover up in the summer sun, people who live in nursing homes, other institutions or who are homebound, people with certain medical conditions, such as celiac disease and inflammatory bowl disease, people taking medicines that affect vitamin D levels, people with very dark skin, obese and the elderly.

Without vitamin D, people can lose bone mass, have lower bone density and are more likely to break or facture bones, the NOF reported. The foundation estimates that men and women under the age of 50 need anywhere between 400 to 800 international units (IU) per day, and anyone over the age of 50 should take 800-1,000 IU daily.
Similar to calcium, vitamin D is found in a small variety of foods, including fatty fish, such as wild-caught mackerel, salmon and tuna. Milk is another source of vitamin D. Sunlight, however, is an all-natural source of vitamin D from endogenous synthesis in UVB radiation when exposed to skin. And, although doctors may disagree, sunscreen can only prohibit the benefits of vitamin D, even though there are health hazards, such as skin cancer. Cashman noted that supplementation is needed during the winter season.
Vitamin D is known for helping the absorption of calcium and phosphorus to promote bone health, Bruno said, noting the two forms of vitamin D available as a dietary supplement: vitamin D3 (cholecalciferol) and vitamin D2 (ergocalciferol). Vitamin D3 is made in the human body and is more active than vitamin D2, which has less than a third potency as vitamin D3. “Commercially, ergocalciferol is derived from yeast, and so is considered vegetarian, while cholecalciferol is derived from lanolin (from sheep) or fish oil,” he said.

Vitamin K

According to Ramona Billingslea, marketing manager for Betsy’s Health Foods in Houston, TX, her most popular bone health products are not only the ones that include vitamin D, but also vitamin K2, which research has shown is important to bone health.

In the journal Proceedings of the Nutrition Society, author Susan A. Lanham-New wrote that vitamin K (koagulation vitamin) was first defined as a dietary derived coagulation factor. “Vitamin K has an important function for the skeleton as it acts as a cofactor in the post-translational carboxylation of several bone proteins,” she said.

Recent reviews and studies have found that vitamin K, specifically vitamin K2 long-chain menaquinones-7 (MK-7), plays a crucial role of supporting skeletal health. She uses NattoPharma’s Badmaev’s nickname for vitamin K2, “chaperone,” or in some cases “the forgotten vitamin.” The vitamin works by directing calcium to strengthen the bone structure and prevent arterial deposition of calcium, or arterial calcification. In addition, it modifies multiple physiological functions of calcium underlying age-related deterioration of bone health.

According to Illinois-based Redd Remedies’ Founder and CEO Dan Chapman, “The most successful products in any category are the ones that are designed not on marketing strategy, but on effectiveness.” The company offers Redd Remedies’ Bone Health Original and Bone Health Advanced that utilize food-based, bioavailable calcium, vitamin K2 and boron to construct mineral balance within the bones and entire the body. Vitamin K2 supports healthy bone restructuring by maintaining the normal function of specialized bone cells called osteoclasts, according to the company.

“Vitamin K now is understood to offer additional benefits, including the role of vitamin-K dependent proteins, which are necessary for bone mineralization (e.g., helping to keep calcium in the bone),” Bruno said. Osteocalcin and matrix Gla protein (MGP) are vitamin-K dependent proteins, which have been isolated in the bone, he continued. Osteocalcin is a protein synthesized by osteoblasts, which are thought to be related to bone mineralization, and MGP has been found in bone, cartilage and soft tissue, including blood vessels.
“The two naturally occurring forms of vitamin K are K1 and K2. Plants synthesize phylloquinone, also known as vitamin K1. Friendly bacteria synthesize a range of vitamin K2 forms collectively referred to as menaquinones,” Bruno explained. “The menaquinones form of vitamin K2 will be designated according to the number of repeating 5-carbon units in the side chain of the molecule.”

A three-year study of the MenaQ7 brand, completed in 2012, suggested that daily supplementation with vitamin K2 as MK-7 was found to be more effective than placebo when supporting bone health in 244 healthy postmenopausal women. In the Framingham Heart Study, researchers found that elderly men and women in the highest quartile of vitamin K intake had significantly lower adjusted relative risk of hip fracture than those in the lowest quartile of intake. Overall, vitamin K is a new possible treatment for osteoporosis.

Help the Customer

“Bone health can be one of the most rewarding areas to work with a customer on because customers can take a bone density test with their doctors, make lifestyle, diet and supplement changes over several months and re-test to see if their changes are actually making a difference,” Billingslea said. However, in order for retailers to provide help to their customers, they need to be well educated themselves. Bluebonnet’s MacDonald suggested retailers check out websites, such as NOF, which focuses on bone health education. “In fact, if you go to their website you can download ready-made educational resources,” such as printouts. The site also offers educational seminars that promote healthy lifestyles.

“The biggest challenge with consumers and bone health,” Billingslea said, “is matching customers up to the right product for their preferences: size of tablet, how often the product has to be taken, what the product tastes like, if it is in powder or liquid form, getting the consumer to take the required amount of the product and stick with taking it.” VR

For More Information:
Twinlab Corporation, (800) 645-5626
Bluebonnet, (281) 240-3332
Redd Remedies, (888) 453-5058

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