Special Report: Bone Health Supplementation Moves Beyond Dairy

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22 May 2017 --- Bone health is becoming an increasingly researched topic, particularly as populations around the globe are becoming more aged. Consuming dairy products for strong bones has long been encouraged by governments and parents alike. However, as consumer preferences change, there is a growing need for non-dairy supplementation that can improve bone density. According to Innova Market Insights data, the number of product launches featuring bone health claims rose drastically from 364 in 2015, to 571 in 2016. NutritionInsight looks at some of the most recent bone health related product launches and studies.

Going Beyond Calcium
Calcium and vitamin D are well known for their positive effect on bone health. The US’ National Osteoporosis Foundation calls for a daily intake of 1,000 mg of calcium for men under the age of 70 and women under 50, and 1,2000 mg daily for men over the age of 70 and women over 50. With regards to vitamin D, the foundation advises a daily intake of 400-800 international units (IU) for adults under the age of 50, and 800-1,000 IU daily for those over 50. 

Recent examples of products featuring these nutrients include Gelita’s Bone Health Triangle Stick Forte, which combines calcium, vitamin D3, vitamin K2 and the company’s Fortibone, as well as PPF Hasco-Lek’s C20 Vitamin D3 2000 IU soft gelatin capsules. These capsules aim to “maintain proper calcium blood levels, thus affecting bone and teeth mineralization.”

Although calcium and vitamin D have traditionally played a starring role in the nutritional prevention of bone health-related ailments such as osteoporosis, several additional nutrients and food constituents have over the years been increasingly recognized for their beneficial effect on bone health. 

“In addition to dairy, fruit and vegetable intake has emerged as an important modifiable protective factor for bone health. Several nutrients, including magnesium, potassium, vitamin C, vitamin K, several B vitamins and carotenoids have been shown to be more important than previously realized,” according to 2009 research by Katherine Tucker of the USDA Human Nutrition Research Center on Aging at Tufts University.

Click to EnlargeSuppliers have increasingly been exploring nutritional options for bone health, outside of the classical calcium and vitamin D combination. An example of this would be Evolva’s Veri-te resveratrol capsules, for which the company has underscored clinical data suggesting that “resveratrol can play a role in healthy aging through bone health.” 

Kappa Bioscience and Capsugel have joined forces and created Bone4Kardio, a dietary supplement targeted at bone and cardiovascular health. This supplement contains omega 3, magnesium, vitamin B and vitamin K2. Moreover, a recent pilot human study has shown that a curcumin-based product produced by Indena may be helpful in maintaining bone density. The study found that when combined with standard management for bone density, test subjects who used the curcumin product over a period of 6 months experienced +7,1% and 4,8% levels of bone density in the small finger and upper jaw.

Childhood Bone Health
Although supplementation to improve bone health is often associated with aging populations, an increasing amount of research is pointing to the idea that a child’s bone health is determined during the pregnancy and that supplementation could improve a child’s bones, even before he or she is born. 

Researchers at the University of Southampton studied whether bone health might be influenced by epigenetic modifications of DNA early in life. The study provides an insight into the early determinants of skeletal growth and improves the understanding of how osteoporosis could be prevented in future generations.

Growing evidence points to the idea that whether genes are expressed or not in particular human cells can be affected by a range of environmental factors even before birth, such as their parents’ health, diet and lifestyle before and during pregnancy. This switching on or off of genes is known as “epigenetic modification,” and an important epigenetic mechanism is DNA methylation.

The researchers studied umbilical cord tissue of 669 babies to determine the levels of DNA methylation. They subsequently compared the DNA methylation levels in the CDKN2A gene to the bone mass of the child at ages four and six, measured using DXA bone densitometry. 

The researchers discovered that higher DNA methylation in particular parts of the CDKN2A gene, which is known to play a role in development and aging, was associated with a lower bone mass at four and six years. 

Analysis showed that a 10 percent increase in methylation was associated with a decrease in total bone mass of around 4-9g at age four. Methylation of the CDKN2A region has been found to be important for the function and survival of bone cells.

The research highlights the role of epigenetics in bone health and may help accurately predict an inpidual’s future risk of osteoporosis. Ongoing studies will need to be conducted to determine the effects of interventions during pregnancy (for example, vitamin D supplementation) on the epigenetic marks and improved bone health in the offspring.

Effects of a Plant-Based Diet
In recent years, an increasing number of people have turned toward a more plant-based lifestyle. Diets such as vegetarianism and veganism may have a positive effect on the environment and are in some aspects healthier than diets that include meat. However, research has shown that eliminating animal products from the diet can lead to a decrease in the intake of certain nutrients, including calcium and vitamin D, and may, therefore, influence bone metabolism.

As Dr. Paul Lohmann Sales Director Klaus Brockhausen points out in an interview with NutritionInsight earlier this month, generally speaking, varied diets provide sufficient nutrients, but “sooner or later, if parts of the population become vegan, there will be a lack of [certain] nutrients across the board. On the one hand, you can [remedy this] with tablets or food supplements, but we think that the option to fortify food products with zinc, iron and other vitamins is also a good way to go.”

Suppliers are responding to the needs of this part of the population by creating products that target the nutrient deficiencies specific to those who adhere to a plant-based diet. Dairy-free milk products, such as nut milks and soy yogurts, are increasingly being fortified with calcium and vitamins, creating milk alternatives that are suitable for vegans and vegetarians but play a similar nutritional role as their dairy counterparts. 

Click to EnlargeThe Need for a Healthy Lifestyle
Although there are many supplements available for the improvement of bone health, the importance of leading a healthy overall lifestyle should not be overlooked. A varied diet and regular exercise has been found to be key factor for maintaining bone health, regardless of age and sex.

Recently, UNC School of Medicine researchers showed that exercising burns the fat found within bone marrow and that this process improves bone quality and the amount of bone in a matter of weeks. 

“One of the main clinical implications of this research is that exercise is not just good, but amazing for bone health,” said lead author Maya Styner, MD, a physician and assistant professor of endocrinology and metabolism at the University of North Carolina at Chapel Hill. “In just a very short period of time, we saw that running was building bone significantly in mice.”

Although it must be noted that research in mice is not directly translatable to humans, researchers say the kinds of stem cells that produce bone and fat in mice are the same kind that produce bone and fat in humans.

As with most health issues, maintaining bone health involves a combination of the right nutrition and regular exercise. For those needing to boost their intake of bone health supporting nutrients there is a range of supplements and fortified foods available on the market, and with research continuing and lifestyles evolving, the range of products is only set to grow.  

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