We often tend to think of bone health to be synonymous with calcium intake and calcium inside the bones. This relationship is only partially true. In fact, if we rely on calcium alone to build great bones, we may find ourselves dealing with some serious health issues. It is critical not to miss the bigger picture to building better bones.
Decreased bone density occurs with age. According to the National Osteoporosis Foundation, osteoporosis is a bone disease that occurs when the body loses too much bone, makes too little bone, or both. Bone health status is a complex interaction of nutritional, physical, mineral, and hormonal activity. In order to understand how to keep bones healthy, a little overview of bone formation is needed. According to Guyton, “Bones can be thought of as reinforced concrete. The steel provides tensile strength while the cement, sand and rock provide the compressional strength”. The tensile strength is provided by cells in the bone called osteotoblasts. They are responsible for laying down the organic part of the bone, mainly consisting of collagen. Collagen comprises 33% of bone and it is made up of chains of amino acids. This type of extra strong collagen in bone is called Type I. Vitamin C is crucial to making good collagen to ensure that bone has pliable strength.
Once the osteoblasts do their job, then the compressive strength of bone is added. After the collagen is laid down, calcium and phosphate salts are deposited along the collagen. This calcium gives bones its hardness.
Just as osteoblasts lay down new bone, osteoclasts resorb old, damaged bone. Osteoclasts actually dig little tunnels inside the bone to eat away the aged bone. Then, the osteoblasts can come in from behind and fill in with newly formed collagen. The new bone is complete as the calcium and phosphate salts are then deposited.
This balance between osteoblast and osteoclast activity is essential to prime bone health. Healthy bone is constantly in this remodeling and too much or too little activity at either end can result in poor bone structure and density.
A dense bone may not necessarily be a strong bone. Without sufficient collagen, the bones become brittle and shatter easily. Without sufficient minerals, the bones become soft and rubbery.
And, vice versa, just because a bone has low bone mass density, does not mean it is necessarily weak.
Bisphosphonate drugs are prescribed in osteoporosis to increase bone mass density. These drugs kill the osteoclasts, which stops removal of old bone while the osteoblasts continue to lay down new bone. Thus, the overall bone density may increase, but the old damaged bone remains. The balance between laying down old and new bone is disrupted. There are studies that both substantiate and refute the efficacy of bisphosphonates to reduce bone fracture.
Feeding Your Bones
There are some nutritional tactics you can use to build better bones.
Eat sufficient dietary protein, not too much and not too little. An appropriate portion size of protein can be that of the thickness and size of the palm of your hand. Keep up the tensile strength of bone by adding some collagen from bone broth or gelatin supplements. Make and stabilize healthy collagen with foods high in Vitamin C to help prevent brittle bones.
Vitamin D3 is needed for calcium to be absorbed in the GI tract. Vitamin D3 can be made in the body via modest sun exposure, or through diet and supplementation. Deficiency of D3 may cause hyperparathyroidism which stimulates osteoclasts and excess bone resorption.
Although vitamin D has been touted as a superhero as of late, it is only as great as its fellow players in the balance of overall health. Vitamin K2 (different than K1 known for its activity in clot formation) and magnesium are key players on the bone health team. 150 mcg of vitamin K2 every day promotes osteocalcin formation from the osteoblasts. Osteocalcin acts to bring calcium into the bone, and also as a hormone to stimulate the pancreas. Taken without vitamin K2, excess calcium can end up in the wrong places in your body, such as the walls of your arteries. Taking mega doses of vitamin D supplements without sufficient amounts of K2 and magnesium can lead to vitamin D toxicity and magnesium deficiency symptoms. This leads to inappropriate calcification of your joint spaces, organs and arteries(arteriosclerosis), and also contributes to such conditions as heel spurs and kidney stones. Adding supplemental calcium alone to your health routine to help bones grow is a recipe for disaster. Excessive amounts of calcium without the counterbalance of magnesium can lead to a heart attack or stroke. Magnesium also contributes to the tensile, pliable strength of the bones. Vitamin K2 is made by bacteria in the gut, and also can be found in grass-fed organic animal products like egg yolks, butter, cow liver, fermented dairy, fermented vegetables, and natto. According to Dr. Mercola, if you choose to supplement in pill form with K2, look for the MK-7 form rather than the MK-4, which is synthetic.
Boron helps the body to absorb both calcium and magnesium, while Vitamin B12 and folate (not folic acid), DHA (an Omega-3 essential fatty acid), strontium and copper all contribute to overall bone health.
Outside of nutrition, bones need to be properly stressed physically to encourage healthy remodeling. Many studies confirm the importance of strength training and weight bearing resistance exercise to maintain optimal bone health. Without it, bones get smaller and less dense.
The hormones testosterone, estrogen, progesterone, parathyroid hormone and many others all influence bone growth and bone remodeling.