Optimal Bone Health: Vitamins, Minerals, Exercise and More… What You Need to Know

If the body is experiencing excess acidity, it will take calcium and other minerals from the bones.

Bone health is an important wellness issue for everyone. Building and maintaining healthy bones throughout your life will reduce your risk of later developing osteoporosis  and osteopenia.

Osteoporosis is a degenerative condition in which bones become porous, fragile, and prone to fractures. Osteopenia is the early stage of bone loss and is considered to be a precursor to osteoporosis. The main areas of the body at risk include hips, wrists, and spine. These conditions are especially prevalent among post-menopausal women.

In healthy individuals, a dynamic process called “bone remodelling” occurs in which bones are continually broken down by osteoclasts (bone breakdown cells responsible for bone resorption) and replaced by osteoblasts (bone building cells responsible for bone deposition). It is this balance of osteoclasts and osteoblasts that is vital to bone health. Pathology occurs in individuals whose bone breakdown exceeds the rate of replacement during their adult life.

Pharmaceutical options to treat osteopenia and osteoporosis are focused only on one aspect of bone remodelling – reducing the breakdown of bone. They do not enhance bone density. Furthermore, these medications have potentially serious side effects. Drugs such as Fosamax and Actonel can cause bone and joint pain, flu-like symptoms, fatigue, kidney damage, osteonecrosis of the jaw, constipation, and diarrhea.

Bone Health depends on Many Factors

There are many natural ways to prevent osteopenia and osteoporosis. There are also many ways to inhibit further loss of bone density if you are diagnosed with one of these conditions.

Bone health is dependent on several vitamins and minerals. Calcium is perhaps the most well known, but ongoing research is revealing that calcium taken with certain trace minerals is far more effective for bone density. As with everything in nature, there are synergistic relationships between nutrients, hence the importance of consuming nutrients together, rather than in isolation.

Also critical is the ability to properly absorb these vitamins and minerals, and to prevent excess excretion in the urine – something which is often overlooked. With respect to calcium, for instance, certain carbonated and caffeinated beverages like pop and coffee can interfere with absorption. These substances have been proven to increase acidity in the blood. If the body is experiencing excess acidity, it will take calcium, as well as other minerals, from the bones to “buffer” this acidity and balance out the blood’s pH. The bones act as a reservoir for many vitamins and minerals in times of need. So some acid-forming foods and substances in foods, like preservatives found in packaged products, end up contributing to the excretion of calcium in urine. This in turn contributes to degenerative health conditions such as osteopenia and osteoporosis.

In addition to caffeine and carbonated products, some other factors that impair absorption and lead to loss of bone density include:
• consumption of alcohol;
• long-term use of certain drugs such as aspirin and corticosteroids;
• smoking or usage of nicotine products;
• diets high in salt, sugar, and animal proteins;
• lack of exercise and sedentary lifestyle;
• excessive stress.
Aside from bone health, each of these affects the absorption of all vitamins and minerals.

Creating a Comprehensive Bone Health Regime

Nutrition is an important determinant of bone health. A varied, healthful diet that has adequate levels of protein and essential fatty acids, and is high in vegetables, fruits, and legumes is integral for bone health. This type of diet is also preventive against all disease in general by contributing to higher antioxidant levels and creating an alkaline environment in the body. Dark, leafy green vegetables are good sources of bone minerals, as are most fibrous foods, nuts, seeds, beans and legumes. Herbs such as stinging nettle, oat straw, and red clover are also mineral powerhouses.

On the other hand, dairy products are controversial since many people do not have the enzyme capacity to digest and absorb the calcium and minerals.

In addition to diet, routine exercise, particularly gentle weight-bearing activity, is an important contributor to bone health. Aim to exercise for at least thirty minutes, three to five times per week. Gentle weight-bearing activities include walking, biking, dancing, yoga, pilates, and tai chi.

Physical activity benefits bones by putting strain on them, which activates the osteoblast cells in the bones. Developing muscle is also important because with increased muscle strength, stability and balance are improved, strengthening the structures that support and surround bone, and greatly reducing the likelihood of falls.

A comprehensive approach to bone health must factor each individual as a whole. Bone supplementation, as with all other supplementation, must take the individual into account. Each person has different requirements depending on diet and nutrition, lifestyle, exercise habits, body frame, pharmaceutical and/or other medications or supplements (i.e. iron supplements), level of inflammation in the body, kidney and liver health, digestive functioning, and more.

Essential Vitamins and Minerals

Here is a list of the essential vitamins and minerals to include in any comprehensive bone health regime:

Calcium – we have all heard about calcium, but what is the best form to take? Most calcium supplements contain calcium carbonate and calcium citrate, however it’s possible that only 20-25% of this calcium is easily absorbed. Absorption rates depend on the stomach’s pH. These are not ideal forms if you have digestive problems such as heartburn or gastroesophageal reflux disease, regular gas and bloating, or require medications such as Tums or Nexium (which decrease the stomach acid required for absorption of minerals). Those who are deficient in stomach acids may absorb more calcium from citrate malate, which is a water-soluble supplement. However, it is important to strengthen digestive functioning in order to properly absorb calcium from both food and supplements. (Editor’s note: Digestive enzymes are invaluable in helping those with weak digestion to assimilate vitamins and minerals. Usually one or two capsules with meals is all that’s needed.)

The most highly absorbable form of calcium is ossein microcrystalline hydroxyapatite complex (MCHC), an extract from young bovine. MCHC is extremely bioavailable, well tolerated, and found to prevent bone loss, as well as to restore bone mineral density. MCHC should come from a professional brand to ensure a high-quality source that has not been subjected to hormones, antibiotics, etc.

Vitamin D – this vitamin plays an important role in many vital body functions, and has a well-established role in calcium homeostasis and the maintenance of healthy bones. It is crucial for calcium absorption, and it also promotes bone mineralization. Twenty minutes of sun exposure each day is the optimal way to get vitamin D because when sunlight touches the skin, it produces vitamin D3 (cholecalciferol), converting it into a form that can be metabolized by the liver and kidneys. Cholecalciferol is the naturally occurring form of vitamin D that can also be taken as a supplement. Emulsified supplement forms of vitamin D3 are well absorbed by the body (emulsification is a method of processing that dissolves a substance into an emulsifying liquid to increase surface area for more effective absorption and digestion).
(Ed note: Also, the addition of vitamins E (mixed tocopherols) and K2 has a synergistic effect which increases absorption of D3.)

Magnesium – this is an essential macromineral that is involved in many enzymatic reactions in the body. Magnesium mediates two hormones that are integral to bone remodelling – calcitonin and the parathyroid hormone. It is also needed to convert vitamin D into its active form. Similar to calcium, magnesium also requires an acidic stomach environment for optimal absorption. The most absorbable supplement form is generally considered to be magnesium citrate. Calcium-magnesium balance is important and the suggested intake ratio is approximately 2:1 (Ca:Mg). It is often beneficial to take magnesium before bedtime as it induces muscle relaxation.

Vitamin K – this vitamin is also required for bone maintenance and to balance calcium. Vitamin K was first identified as necessary for normal blood clotting. It is now known to be essential for bone and artery health (keeping calcium in the bones and out of the arteries). Caution should be taken with vitamin K, as with any anticoagulant (blood-thinning) medications, since it can reverse the effects of these medications. Low serum concentrations of vitamin K have been found to be associated with lower bone mineral density and increased risk of hip fracture.

Strontium – this trace mineral is essential for bone health. Ongoing research is highlighting strontium’s potential to both increase the activity of the bone-forming osteoblasts and decrease the bone-dissolving osteoclasts – ultimately enhancing bone strength. Strontium is absorbed in the bowels using the same mechanism as calcium, so they may compete against one another. Because of this, strontium supplements should not be taken at the same time as calcium supplements. Adequate calcium (intake and absorption, whether from food or supplements) is necessary if choosing to additionally supplement with strontium.

Boron – this mineral also plays an integral part in bone health. Boron reduces urinary excretion of both calcium and magnesium, and stimulates vitamin D activation.

Silicon – this is another important component of bone and is integral to bone mineral density. Accumulating research suggests that silicon is also involved in collagen synthesis and beneficial to connective tissue health (muscles and ligaments).

Manganese, zinc, copper – these trace minerals are important co-factors for enzymes in our bodies. Each of these trace minerals is essential for maintaining bone density. Zinc in particular is important in the formation of osteoblasts and aiding in the activity of vitamin D, not to mention its crucial role in supporting the immune system.

It is important to note that a single multivitamin or calcium supplement will not provide these vitamins and minerals in the dosages that are required for optimal bone health. It is best to take supplements in divided doses throughout the day to achieve adequate intake. As well, taking anything in excess will not increase bone density, but will only put strain on the organs, mainly the kidneys, to rid the body of the excess that it can not absorb.

For guidance and individualized advice on how to ensure optimal bone health, consult with a naturopathic doctor. Naturopathic doctors are aided by current scientific research and are trained to combine clinical nutrition, acupuncture, herbal medicine, homeopathy, and other preventative measures to restore, as well as to maintain, health. Naturopathic medicine seeks to uncover the underlying cause of illness, and to restore optimal health and vitality.

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Dr. Bartolini is a Naturopathic Doctor in Mississauga at Rebound Health & Wellness Clinic. For more information, please visit www.reboundwellness.ca. She can be reached at (416) 407-0845 or by email at doctorbartolini@gmail.com For additional information, please visit her website at doctorbartolini.com

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