Optimizing Bone Health

by Joy Choquette | May 4, 2021

Continued interest in bone health promotion and osteoporosis avoidance contribute to steady growth in this segment.

“The bone health status of Americans appears to be in jeopardy …” said the “Bone Health and Osteoporosis: A Report of the Surgeon General.” The report goes on to state that while bone health is critically important to one’s quality of life, 1.5 million individuals in the country suffer from osteoporosis and osteoporotic-related fractures.

So, what is one to do? Concerned individuals may reach for the milk jug but is that the best way to strengthen one’s bones? According to an article by the Harvard School of Public Health, dairy products are high in retinol, or vitamin A, which at increased levels can actually weaken bones. Additionally, dairy products can be high in saturated fats. However, there are food sources that can benefit bone health. The article stated that “Good, non-dairy sources of calcium include collards, bok choy, fortified soy milk, baked beans …”

In addition to foods, are there other options to potentially increase the health of one’s bones? Thankfully, the answer is yes. There are new products and trending ingredients for promoting bone health, as well as exciting studies on this topic.

What’s New and #Trending in Bone Health Supplements?

“One trend we’ve noticed in the vitamin/mineral side is the growing body of evidence for vitamin K2 to be added to bone health formulas that feature calcium and vitamin D,” said Annie Eng, CEO of HP Ingredients located in Bradenton, FL. “K2 activates the protein osteocalcin, which helps provide the maintenance of breakdown/rebuild balance,” she said.

This information is supported by the study, “Proper Calcium Use: Vitamin K2 As a Promoter of Bone and Cardiovascular Health,” originally published in Integrative Medicine. “Recent scientific evidence, however, suggests that elevated consumption of calcium supplements may raise the risk for heart disease and can be connected with accelerated deposit of calcium in blood-vessel walls and soft tissues. In contrast, vitamin K2 is associated with the inhibition of arterial calcification and arterial stiffening.”

Katherine Cole is the R&D manager at ChildLife Essentials in El Segundo, CA. She stated that the company has recently modified its Organic Vitamin K2 Drops. “This formula now utilizes an organic MCT oil as the carrier oil for a fresh new look and taste.” The product, which is organic and kosher certified, delivers 5 mcg of vitamin K2 as MK-7 per drop, Cole stated. “We’re definitely seeing a trend toward key vitamins for supporting bone health,” Cole said. “Minerals are essential for bone health, but now customers are asking questions like, ‘How do I ensure the minerals are going where they need to?’” Individuals want to optimize both the intake and uptake of minerals, Cole explained, and stated that the company has begun to see trends toward products that support those interests.

An increased focus on collagen production and protection is one of the trends that Richard Passwater, Jr., a product education director, has noticed. Bio Minerals, the maker of BioSil, is a specialty line of Natural Factors based out of Monroe, WA, where Passwater works. “I believe the bone health market is becoming more focused on viewing bone as dynamic living, collagen-based tissue that must be continuously remodeled or rejuvenated all throughout someone’s life,” Passwater said.

Another interesting trend he’s noticed is the crossover of information between groups that used to be more silo-like in their approaches. “Historically bone, muscle and joint research communities were separate and distinct groups. But now when I attend conferences specializing in one discipline, I see much more discussion and research investigating the relationships between these tissues and how the condition of one impacts the others,” Passwater said. Diet and exercise play an ever-increasing role in the health of one’s bones, Passwater believes, and trends in this area continue to grow.

According to an article, “Exercise and Bone Health,” from the American Academy of Orthopaedic Surgeons, “When you exercise regularly, your bone adapts by building more bone and becoming denser. This improvement in bone requires good nutrition, including adequate calcium and vitamin D.” Like our muscles developing with increased exercise, bones react similarly. And while a lot of emphasis has been placed on weight training for improved bone health—something that is key—weight-bearing exercise is also important. Activities, such as jogging, walking, aerobics, hiking, and even household chores, can all contribute to healthier bones.

How Strong Is the Bone Health Market?

Though not experiencing as much growth currently as the immune support segment, the bone health market is still strong. “Currently, the market for bone health remains steady,” said Eng. “There isn’t too much excitement as there is with immune or even sports health. People just don’t really think too much about supporting their bone structure when they’re healthy and younger. That said, the potential is truly outstanding,” Eng noted.

According to a report via Mordor Intelligence, the Global Bone Health and Joint Health Supplements Market is projected to grow at a CAGR of 6.6 percent during the forecasted period of 2019-2024, noted Vice President of Scientific & Regulatory Affairs, Gene Bruno, of Twinlab. The company, with headquarters in Boca Raton, FL, has two flagship bone health products, D3 + K2 Dots, and Tri-Boron Plus. “As the name suggests, D3 + K2 Dots provides these two vitamins in doses of 25 mcg (1,000 IU) and 90 mcg, respectively, per dot,” Bruno said. “Tri-Boron Plus is a comprehensive bone health formula providing vitamin D, calcium, magnesium, zinc, copper, manganese and boron,” he said.

“The market is steady for bone health products,” said Dan Chapman, founder and CEO at Redd Remedies located in Bradley, IL. “While the primary driver of sales in this segment remains women about the age of 40 and older, we see potential for growth in the younger Millennial segment. This particular group of consumers is more focused on prevention and maintaining health. Bone health remains a key focus for women overall.” In the younger Millennial segment noted above, many are very physically active and focused on the prevention of bone injuries or future bone health issues.

Christian Olsen, manager of Total Health Nutrition Center in Milwaukee, WI, agreed. He stated that while there has been an increase in demand for bone health products, it has been slight in the past year.

Bone Health Products and Ingredients in the Marketplace: New & Upcoming

Calcium remains king in the bone-health arena, stated Chapman. He noted that the triad of “tried and true” ingredients for promoting bone health are calcium, magnesium and vitamin D. Different types and sources of calcium come and go from the market, he explained, but calcium itself remains an essential ingredient for bone health. “At Redd Remedies, we use food-source calcium as ESC (eggshell calcium) and fully reacted magnesium and boron. We also recognize that if our goal is to build bone that we need more than minerals alone,” explained Chapman. “We continue to push and talk about the importance of vitamin K2 for bone health. Vitamin K2—as MenaQ7 brand—is one of the key ingredients in our Bone Health Advanced formula,” Chapman noted. “Vitamin K2 is a key companion nutrient to calcium and is not front and center, where we think it should be. Studies on MenaQ7 have shown its ability to promote healthy bones.”

While calcium remains a popular ingredient for promoting bone health, Cole stated that other ingredients are also gaining interest in the marketplace. “For children’s health, in particular, we’re noticing more interest in foundational products that support healthy growth and development.” As one of the first aspects parents consider in the health of their child, bone health, is key. Cole stated that there is great potential as parents learn more about vitamins and minerals for bone health. “Parents will be looking for products that contain more than just calcium—like our ChildLife Essentials Liquid Calcium with Magnesium, which contains calcium, magnesium, zinc and vitamin D,” Cole noted.

Jolie Root, senior nutritionist, and educator with Carlson Laboratories in Arlington Heights, IL, stated that the company is excited about a new bone health promotion product it recently released. “Adding to the Carlson formula, Nutra Support Bone, we recently launched Carlson Super Daily D3 and K2,” said Root. “With the realization that a large number of people do not meet daily requirements for intake of D3 and K2, Carlson Super Daily D3 and K2 makes it easy to get the targeted bone support you need in a single drop dose.”

At HP Ingredients, Eng stated that the company is encouraged by the positive results that the ingredient, ParActin, and LJ100 show, both of which Eng stated appear to benefit bone health. “Several studies on ParActin show MOA (mechanism of action) in preserving bone health,” Eng noted. “Specifically, the ParActin group [within the study] showed a significant increase in bone mass, trabecular thickness and number, and a decrease in trabecular separation compared to control mice. The authors concluded that andrographolide inhibits estrogen deficiency-induced bone loss in mice and may have supplemental potential for osteoarthritis.”

Olsen stated that he hasn’t noticed any new trends in bone health promotion products at Total Health Nutrition Center. “While there are no new trends, we are selling more of our algae-based bone supplements,” Olsen said. Algae-based bone supplements utilize marine algae or seaweed, usually in combination with vitamin D and/or vitamin K. Proponents believe that this is a more easily assimilated form of calcium for the body. Additionally, Olsen stated that he wished more companies focused on the overall health goals of customers. “Regarding manufacturing, I wish companies would spend more time thinking about the big picture and long-term solutions regarding raw ingredients,” he said. “So many ingredients are limestone that do not absorb nor assimilate well in the body.”

At Natural Factors, Passwater stated there has been a recent revamp of its product, BioSil Bone Collagenizer Ultra. This product contains ch-OSA complex and vitamin K2, inositol, and vitamin B12. “The ch-OSA complex’s two-in-one action helping to grow new collagen and protect existing collagen is clinically proven to increase bone collagen production and increase bone mineral density (BMD) at the critical hip region,” stated Passwater.

Simultaneously, the vitamin K2 helps to activate important bone-building proteins while osteocalcin helps more calcium to be properly incorporated into the bone and protects the soft tissues from becoming calcified, according to Passwater. “Vitamin B12 is often overlooked as a critical bone nutrient,” he explained. “In addition to its ability to help protect bone collagen from being damaged by homocysteine, vitamin B12 also promotes the formation of bone-building osteoblast cells. In addition, osteoblast cells need vitamin B12 to function properly building bone.”

The company recently introduced a vegan liquid capsule, BioSil. “Patent-pending technology now allows Bio Minerals to directly fill clinically proven, liquid choline-stabilized orthosilicic acid, the active nutrient-complex in BioSil, into very small size-three plant-based vegan capsules. These new BioSil liquid vegan capsules are less than half the size of the first generation BioSil capsules and also elegantly display the liquid BioSil they contain,” Passwater stated.

“While it is exciting to consider the use of ‘sexy’ new nutraceuticals for addressing any given health issue, it is important not to forget that the fundamental nutrients should be given first consideration,” said Bruno. “This includes vitamin D3, vitamin K2, calcium, magnesium, zinc, copper, manganese and boron,” he noted.

Studies Regarding Bone Health Products

“Bone is a two-phase system,” noted Passwater. Bone’s collagen framework provides strength, flexibility, and the ability to absorb impact, he stated, while its mineral parts give bone its shape and add some additional strength. “The remarkable physical properties of bone are due to this unique two-phase composite construction. Both phases require nutrients,” he said.

He explained that when building new bone, osteoblast cells first make a bone collagen matrix called “osteoid” and then minerals are added to the collagen framework. “Nutrients required for the mineralization process have historically received most of the attention,” Passwater stated. “But nutrients involved in supporting the natural biological pathways that generate new collagen can also be very helpful and are perhaps even more important.”

“We call BioSil the ‘advanced collagen generator’ because its choline-stabilized orthosilicic acid is clinically proven to activate, support and protect enzymes the body uses to make new collagen. BioSil can also help protect bone collagen by neutralizing collagen-destroying homocysteine and help regulate cortisol levels,” Passwater said.

He stated that a human clinical study performed at the University of London’s St. Thomas Hospital and published in BMC Musculoskeletal Disorders is a great example. “In this study, a group of women recently diagnosed with osteopenia was given 1,000 mg of calcium and 800 IU of vitamin D3.” Some of the women took a placebo while others took BioSil. “The study demonstrated that adding BioSil to a standard calcium and vitamin D supplement regimen increased the production of bone collagen by 15 percent (measured as P1NP) and bone mineral density (BMD) at the critical hip region by 2 percent compared to calcium and vitamin D supplements alone.”

Bruno noted that a 2020 study in the journal, Diabetes Care, indicated that a shift toward lower BMD has been observed. “This research suggests that there is a continuing need for effective bone health supplements to help stave off the development of osteopenia/osteoporosis—especially among people with prediabetes/metabolic syndrome,” Bruno said.

Help for Retailers: Tips for Promoting Bone Health Products

Retailers today are busier than ever, dealing with COVID-19 protocols and, in some cases, a reduced workforce. How can manufacturers best support these hard-working individuals?

“We provide support in many ways including in-person and Zoom trainings as well as consumer lectures, written educational materials for store customers, discounts and displays, and a sales team ready to support,” said Chapman.

Eng stated that HP Ingredients supports retailers in a variety of ways. “There are novel products with ingredients shown to work to help bone maintain its dynamism, and its balance of breakdown and rebuild,” Eng noted. “Retailers can freshen up bone health by making it appealing to younger adults who are health and fitness-minded, and who understand the concept of ‘balance’ more so than their parents (Generation X).” That said, Generation X women are the prime target to prevent bone loss, Eng said, and more of them are into fitness than the previous generation of women. This interest goes hand-in-hand with a focus on supporting bone health.

Another segment of the population that Eng encourages retailers to cater to is postmenopausal women. “Osteoporosis is the most common bone disorder and is caused by excessive bone resorption by osteoclasts without adequate bone formation by osteoblasts,” Eng stated. “Increased bone resorption, among other actions, is predominantly caused by the decline of estrogen production in postmenopausal women, who tend to develop porous bones more often than aging men.” Education around these facts is one way in which retailers can help customers find bone health-promoting products that meet their needs.

Bruno said that TwinLab utilizes several tactics to drive consumer trials and sales, some of which may be beneficial to retailers. The company utilizes on-pack coupons, public relations and a strong digital presence to market its products. In-store takeovers, direct mail and bloggers, and social media—both paid and organic—are other areas where the company focuses its attention.

Carlson Laboratories supports retailers in a number of ways. “Carlson offers advertising co-op dollars, attractive pricing on initial orders, ongoing volume discounts, strict MAP policies and a commitment to ongoing education with samples to team members who participate,” said Root. For ChildLife Essentials, Cole stated that retailers are supported through a combination of key quality documentation (GMP) and third-party certifications as well as coupons and other sales incentives.

While promoting bone health may not be gaining the type of publicity that the immune health segment is currently, it remains a strong market and one that is expected to continue experiencing slow, steady growth. Driven by a growing demand for dietary supplements for the geriatric population, Millennials and post-menopausal women, among others, this market is expected to continue to see continued revenue growth in the next several years, according to experts. VR