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Calcium & Vitamin D: the backbones of bone health

When it comes to health and wellness, the skeletal system is truly an unsung hero. All too often, bone health doesn’t receive the attention it deserves until later in people’s lives--only after the opportunity to support long-term bone health has passed.

Your bones give your body shape, produce red blood cells, store crucial minerals, protect vital organs, and enable the movement of work and play. Over the course of your life, your body will constantly break down and regenerate your bone tissue. Understanding and supporting this process is important for maintaining a high quality of life as you age.

Dietary calcium: the foundation for lifelong wellness

As you probably know, calcium makes up a significant portion of your bones and teeth. Calcium is actually the most abundant mineral in the body, and well-known for its importance to bone health. Adequate calcium intake is the most important factor in building a strong skeletal system. Among its bone-supporting function, calcium also aids in muscle contraction, blood clotting, and signaling between cells.

A tall, calcium-packed glass of milk is iconic for its bone benefits. In addition to dairy, leafy greens, like kale and spinach, are other reliable sources of calcium. Soy beans and broccoli also contain significant amounts.

Not eating these too often or enough? Fortunately, many cereals, breads and juices are fortified with calcium. Additionally, calcium supplements can also increase your intake and help avoid a potential deficiency.

By paying attention to calcium intake in your 20s, you can get a head start building up calcium reserves that your body will utilize well into the future. Support your bones with calcium, and they will support you for life!

Osteoporosis: start early to avoid this serious condition

Before reaching peak bone mass around age 30, most healthy people build more bone tissue than they break down. Osteoblasts and osteocytes are the cell types that synthesize bone, while osteoclasts break down bone. Bone resorption is the process by which osteoclasts break down bone tissue to release the mineral contents into the bloodstream.

Your bone production naturally begins to slow down around age 30, which can cause an overall loss of bone mass for some people. In severe cases, if no intervention is taken, this can eventually lead to osteoporosis.

Osteoporosis is a disease that results in fragile bones. Over time, bones affected by osteoporosis are more prone to breaking. Bone loss is not something that you will feel happening, so the first sign of osteoporosis is often a broken bone.

According to the National Osteoporosis Foundation website, approximately 54 million Americans have either osteoporosis or low bone mass which increases their risk of osteoporosis.

Building the foundation for bone health early in life--before it poses a serious risk--is an investment in your longevity and quality of life. Regular exercise is another positive step towards improving your bone density and reducing your risk of osteoporosis.

Factors that influence calcium intake and bone density

For most people, calcium intake will be the most important factor in managing bone health. However, other factors should be taken into consideration: gender, age, ethnicity, and family history all influence your unique needs.

For example, if you have a family history of osteoporosis, this can put you at greater personal risk. While osteoporosis is typically viewed as a women’s health issue, the reality is that it affects men also. Everyone over 50, particularly women of Asian and European descent, should consult their physician about their bone health. Osteoporosis is easily diagnosed with a bone density test. A bone density test is conducted via x-ray, so it is a non-invasive procedure and generally takes under 30 minutes.

If you have a slender frame (i.e. your body mass index is <19), you’ll generally have less bone mass in reserve. (Calculate your BMI <a href="https://www.nhlbi.nih.gov/health/educational/lose_wt/BMI/bmicalc.htm">here.) While this type of build decreases your chances of many health problems, it is also associated with an increased risk of osteoporosis.

Certain medical conditions and medications will influence your body’s ability to utilize calcium properly. Eating disorders, and digestive conditions also decrease the body’s ability absorb calcium. The prolonged use of corticosteroids, acid suppressors, and several anti-seizure medications are also thought to affect bone density negatively.

Sudden changes or imbalances in hormone production can increase the risk of osteoporosis. It is widely known that menopause decreases bone density, as the body’s production of estrogen diminishes. Similarly, men with low testosterone levels may experience a decrease in bone density. Similarly, an imbalance of thyroid hormones can also lead to bone loss.

Of course, there are the usual culprits as well: heavy alcohol use, smoking, and excessive caffeine consumption all interfere with calcium intake, and thus, bone health.

The top 4 vitamins and supplements for supporting bone density and health

1. Calcium: the building block of bone health

Because the bones and teeth are made up of calcium, the body will take calcium from those places if there’s not enough in storage or consumed through the diet. It is recommended that women consume 1,000-1,200 mg of calcium per day through a combination of food and, if needed, supplements. Pro tip: take half of your daily calcium dosage at a time, since calcium supplements can cause digestive upset.

It is believed that men need slightly less calcium, though they may still benefit from supplementation. There is some evidence to suggest an increased risk of prostate cancer for men who consume high amounts of dairy. However, calcium from nondairy foods was shown to decrease cancer risk in the same study.

There are many studies supporting the importance of adequate daily calcium intake in the prevention of osteoporosis. In a 1997 study, 318 volunteers over the age of 65 participated in a double-blind, placebo-controlled study. This three-year study found that total body bone mineral density was improved in the group receiving calcium and vitamin D. Fracture rates were also lower for the calcium and vitamin D group when compared to the placebo group.

In an even larger study of 1,765 elderly women in 1992, there were 32% fewer non-vertebral fractures and 43% fewer hip fractures, when calcium and vitamin D were taken together.

Though proper intake of calcium is essential, its dosage does have an Upper Limit (UL). Going past this limit can cause discomfort such as constipation or complications including kidney stones and increased risk of prostate cancer. For adults ages 19 to 50 years old, the UL for calcium intake is 2,500 mg, and for those 51 and over, the UL is 2,000 mg.

Dr. Jeffrey Gladd, an integrative physician, says, “Remember that when you read about calcium totals it almost always refers to food sources plus supplementation. Spend some time with a food/calcium amount list and estimate your average daily calcium intake from foods in order to better dial in your ideal supplement dosage.”

2. Vitamin D: Calcium’s trusted companion

As noted above, vitamin D plays a crucial role in bone health — think of it as the Gayle to calcium’s Oprah. Emerging science has shown that vitamin D allows calcium to be sufficiently absorbed in the gut and used by the body.

In addition to supporting the absorption of calcium, vitamin D also aids in bone growth and remodeling. Without adequate vitamin D, bones can break more easily, and even become misshapen.

A 2010 study showed that vitamin D supplementation alone does not significantly decrease fracture rates. But, the combination of vitamin D and calcium did effectively reduce fracture rates. These findings further support the combination of the two.

Vitamin D does not occur naturally in many foods. The best source of vitamin D is through direct sun exposure during the brightest part of the day. Of course, not everyone is fortunate enough to reside in a region where this is possible year round. For this reason, supplementation is often recommended. The recommended dose range for ages 9 through 70 is between 600 and 4,000 IU per day.

Dr. Gladd adds: “Since there are so many variables involved in a person’s ability to make and use vitamin D, it is best to have your blood levels measured seasonally to make sure you are in the ranges that are optimal for bone and overall health 365 days a year. Ask your doctor for a 25-hydroxyvitamin D level regularly, or most states now allow you to order your own blood testing to monitor this, aiming for a normal level.”

3. Magnesium: the unsung hero

Magnesium, a wonder-mineral for the overall health of the body, aids the body in regulating calcium levels. Approximately 50-60% of the body’s magnesium is stored in the skeletal system. Due to its importance to the skeletal system, both structurally and functionally, it cannot be left out of any discussion of bone health.

Like vitamin D, magnesium supports calcium’s functions. Specifically, it is active in the transport of calcium across cell membranes. Additionally, it is a critical component in the structural development of new bone tissue.

Magnesium is plentiful in nuts, leafy green vegetables, and beans. If you aren’t regularly eating these foods, consider a magnesium supplement, especially if you consume alcohol or caffeine, which both deplete magnesium levels in the body.

4. Vitamin K2: a key marker of bone health

Vitamin K exists in two forms: vitamin K1 (phylliquinone) and vitamin K2 (menaquinone). Vitamin K2 protects the cardiovascular system from damage cuased by calcium in the bloodstream. It also acts as a coenzyme for proteins required in bone metabolism.

In a 1991 study, researchers found that blood levels of vitamin K2 were significantly higher in the women who did not have osteoporosis. Of the 29 participants with osteoporosis, only 2 were consuming adequate amounts of vitamin K2.

These findings were expanded upon in a 2013 study that showed vitamin K2 supplements may help prevent bone loss in postmenopausal women.

Conclusion

Building and maintaining healthy bones is important regardless of your age or gender. It is never too early to prepare for the inevitable decrease in bone density that accompanies aging. Many factors influence your bone health, but one important aspect to focus on is getting the vitamins and minerals your body needs to feel strong at every age.

Because your bones are made up of calcium, calcium is of the utmost importance in your health routine. Recent studies show that consuming vitamin D alongside magnesium and vitamin K2, in addition to calcium, is the ticket for healthy bones. If you decide to supplement, make sure the doses, particularly of calcium and vitamin D, don’t go overboard.

To determine if supplementation is necessary based on your lifestyle and other risk factors, you can take an online lifestyle assessment. Feel the difference in your bones.