According to the U.S. Department of Agriculture (USDA), Americans have failed to meet the RDA for several key nutrients, including calcium, magnesium, and zinc.1 Other research on both athletes and sedentary individuals indicated that their food intake was RDA-deficient in more than one-third of the seven minerals analyzed.2 In addition, research done by the USDA has shown that over a period of about 90 years, a 3–7 percent decrease in magnesium, zinc and potassium levels occurred in our food supply.3 Furthermore, studies from various sources demonstrated that growing conditions, agricultural technologies and nutrient content of the soil can reduce some minerals in some crops by as much as 300 percent.4,5,6,7,8
This data clearly indicates that Americans are not getting sufficient minerals in their diet, which can have a number of health implications. One such implication is the loss of bone mineral density, a common occurrence as we age, and more prevalent in women than men.9 Consequently, supplementation with mineral supplements can help to fill the missing mineral gap and promote healthy bone density. In doing so, it is important to note that calcium is not the only nutrient necessary for helping to build bone density. The following text will elucidate some of the key nutrients necessary for healthy bone density, including calcium.
Potassium is necessary to help maintain normal osmotic pressure of body fluids, the acid-base balance of the body, and for transmission of nerve impulses and muscle contraction. In addition, at least four cross-sectional studies have reported significant positive associations between dietary potassium intake and bone mineral density (BMD) in populations of premenopausal, perimenopausal, and postmenopausal women as well as elderly men.10,11,12In studies on postmenopausal women, supplementation with potassium decreased urinary acid and calcium excretion, resulting in increased biomarkers of bone formation and decreased biomarkers of bone resorption.13 Other studies have reported that supplementation with potassium decreased urinary acid excretion and biomarkers of bone resorption in postmenopausal women.14
Calcium is necessary for the formation of bones and teeth, blood clotting, and for normal muscle and nerve activity. Adequate calcium, along with regular exercise and a healthy diet, helps maintain good bone health, and may help teen and young adult women reduce their high risk for osteoporosis later in life.15,16,17 Furthermore, daily calcium supplementation has been shown to effectively slow bone loss.18,19,20,21 Calcium’s role in the prevention and treatment of osteoporosis is also well established.22 Research overwhelmingly supports the use of calcium supplementation, alone or in combination with other therapies, for slowing or stopping the progression of osteoporosis.23 As a matter of fact, FDA-approved therapy for the treatment of postmenopausal osteoporosis includes calcium supplementation.24 In addition, osteoporosis can lead to an increased incidence of fractures. Research has clearly shown that calcium supplementation can help to reduce the risk of, and even prevent fractures in osteoporosis.25,26,27,28
Regarding the types of calcium, hydroxyapatite, calcium citrate, and calcium malate are good choices. Research using calcium citrate/malate has demonstrated a high level of absorption and an ability to effectively promote the consolidation and maintenance of bone mass in adults.29
In addition, some research has shown that calcium citrate has greater absorption than other forms such as calcium gluconolactate and carbonate.30,31,32 Then, there is hydroxyapatite (HA), a whole bone concentrate that provides calcium, phosphorus and a variety of other naturally occurring bone nutrients. Research indicates that women who use HA gain significant cortical bone thickness as compared to women who used calcium alone (as calcium gluconate).33
Iodine is an essential component of thyroid hormones, which regulate metabolic rate and other functions. Thyroid hormones have many interactions with the skeleton, and play a role in bone growth and development in the fetal growth plate and the normal mechanisms of mature bone remodeling.34
Magnesium is necessary for normal functioning of muscle and nervous tissue and participates in the formation of bones and teeth.35,36 Given its role in bone health, it is not surprising that people with osteoporosis were reported to be at high risk for magnesium malabsorption.37 Furthermore, bone38 and blood levels of magnesium have also been reported to be low in people with osteoporosis.39 Research has shown that supplementing with magnesium reduces indications of bone loss.40 Other research has shown that supplementing with magnesium daily also stopped bone loss, and even increased bone mass in twenty-seven of thirty-one people with osteoporosis in a two-year study.41
Zinc is a versatile trace mineral required as a cofactor by more than 100 enzymes in every organ of the body. It is also associated with the hormone insulin, involved in making genetic material and proteins, immune reactions, transport of vitamin A, taste perception, wound healing, the making of sperm, and the normal development of the fetus. The highest concentrations of zinc in the body are in bone, the prostate gland, and the eyes.42
Low blood and bone levels of zinc have been reported in people with osteoporosis.43 Also, research indicates that urinary loss of zinc may be high in people with osteoporosis.44 Other research found that men consuming a good amount of zinc in their diet had almost half the risk of osteoporosis-related fractures compared with those consuming significantly less dietary zinc.45 Furthermore, in one study the use of supplemental zinc with calcium was more effective than calcium supplementation by itself in protecting against the loss of bone density.46
Selenium functions as a constituent of the antioxidant enzyme glutathione peroxidase, which detoxifies products of oxidized fats, and is found in the red blood cells. Selenium plays a fundamental role in regulating thyroid and other functions of the human body including reproduction, autoimmunity, glucose metabolism and bone metabolism.47 Specifically, it is the selenoproteins that are involved in bone metabolism.48
Copper is necessary with iron for the formation of red blood cells and nerve fibers. It is also necessary in the formation of the hair and skin pigment melanin. Furthermore, copper is needed for normal bone synthesis, and one study reported that daily copper prevented bone loss.49 The potential importance of copper for people with osteoporosis requires further research, although consumption of some copper can still be recommended at this time at least for general nutritional purposes.
Manganese is an activator of enzymes (cofactor), and is involved in fatty acid metabolism and protein synthesis. It also plays a role in bone health.50 Unpublished research indicated that manganese deficiency occurred in a small group of women with osteoporosis,51 and published research using a combination of minerals including manganese was reported to halt bone loss.52
Chromium participates in glucose metabolism by enhancing the effects of insulin.53 Since some data suggest that insulin is a potential anabolic agent in bone, this insulin-enhancing effect of chromium may contribute to bone health.54
In humans, molybdenum is known to function as a cofactor for three enzymes: sulfite oxidase, xanthine oxidase, and aldehyde oxidase. Sulfite oxidase catalyzes the transformation of sulfite to sulfate, a reaction that is necessary for the metabolism of sulfur-containing amino acids (methionine and cysteine). Xanthine oxidase catalyzes the breakdown of nucleotides (precursors to DNA and RNA) to form uric acid, which contributes to the plasma antioxidant capacity of the blood. Aldehyde oxidase and xanthine oxidase catalyze hydroxylation reactions that involve a number of different molecules with similar chemical structures. Xanthine oxidase and aldehyde oxidase also play a role in the metabolism of drugs and toxins.55
Silica has been recognized as playing a significant role in bone formation.56 Also, supplementation with silica has increased bone formation in animal research.57 In human research, supplementation with silica increased bone mineral density in a group of eight women with osteoporosis.58 Bamboo stem extract is a rich source of silica, and is used in this formulation.
Chronically low intakes of the trace mineral boron may predispose people to osteoporosis.59Changes caused by boron deprivation include reduced blood levels of calcium, as well as an increase in urinary excretion of calcium. Boron deprivation causes changes similar to those seen in women with postmenopausal osteoporosis, and this mineral is needed to prevent the excessive bone loss, which often occurs in postmenopausal women and older men.60 In addition, studies have reported possible improvements in bone mineral density in women who were supplemented with boron.61 For example, research has found that supplementation with 3 mg daily of the boron reduced urinary loss of both calcium and magnesium.62
Vanadium is a trace mineral that appears to be important in normal bone growth and as a cofactor for various enzyme reactions. The highest concentrations of vanadium are found in the liver, kidney, and bone.63 Some evidence suggests that vanadium can mimic the actions of insulin, possibly by causing phosphorylation of insulin receptor proteins.64 Since some data suggest that insulin is a potential anabolic agent in bone, this insulin-mimicking action of vanadium may further contribute to bone health.65
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- Sebastian A, Harris ST, Ottaway JH, Todd KM, Morris RC, Jr. Improved mineral balance and skeletal metabolism in postmenopausal women treated with potassium bicarbonate. N Engl J Med 1994;330(25):1776–81.
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Author: Gene Bruno, MS, MHS