Nutritional Outlook

Nutritional Outlook, September 2013

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bone Health Make It or Break It Taking a broader view of bone health. BY KIMBERLY J. DECKER 40 magenta cyan yellow black sponse to diet, illness, smoking status, and activity level, among other factors. "It's well known that estrogen and other hormones, such as parathyroid hormone, play a signifcant role in bone health," notes Lew Hendricks, technical services manager at Innophos Inc. (Cranbury, NJ). "Not surprisingly, we are learning to see bone health from a holistic health perspective." Perhaps the strongest shaper of bone health—certainly the most inevitable—is age. During childhood and adolescence, our bones grow vigorously, attaining peak mass between ages 18 and 25. Tereafter, says Lund, "Te balance between bone formation and bone loss starts to change by slowly losing more bone than is formed." Tis process accelerates in men and women during midlife and really takes of in women following menopause, when estrogen levels drop sharply. "In fact," Lund says, "in the fve to seven years after menopause, women can lose up to 20% or more of their bone." Sometimes this results in osteoporosis, a disease in which reduced mass and structural deterioration weaken bones so much that they can break from even minor falls. And osteoporosis is a major public health threat. Te World Health Organization places the number of people with osteoporosis at 200 million globally. Teir lifetime risk of fracture is nearly one in two for women and one in three for men. And, even if diet, in theory, were sufcient to turn those numbers around, the typical American diet in practice does not. Which makes the same strong case for supplementation that we've been making all along. At an estimated cost of $13.8 billion annually, the disease burdens not just its suferers, but our entire healthcare system. Osteoporosis is not solely a concern of the elderly. "Te idea that women don't have to worry about osteoporosis until later is grossly misunderstood and wrong," says Jason Kwon, technical support, Vesta Pharmaceuticals Inc. (Indianapolis). "What recent research has shown is that women who have healthy and higher bone mineral density at a younger age—say, 19 to 23—tend to be less susceptible to fractures and osteoporosis at later ages." Evidence also suggests that what best develops this bone mineral density is regular weight-bearing exercise and sufcient intake of bone-building nutrients. Calcium, and Then Some Of course, the highest-profle bone-building nutrient is calcium. But calcium is hardly a solo act in fostering skeletal wellness. Calcium relies on an extensive supporting cast. As Dockery says, "Tough many still associate bone health with calcium supplementation alone, most scientists have known for decades that other nutrients are crucial to the functioning of calcium in bone health." Take vitamin D. Tis steroid hormone aids in the mineralization of the bone matrix "partially through stimulating intestinal absorption of calcium," Dockery says. It also participates in healthy bone resorption and helps maintain adequate blood serum calcium and phosphorus levels, she adds. Vitamin D in its cholecalciferol (or vitamin D3 ) form, is just one component of a patented bone-health supplement from September 2013 ■ ArCHIVeS/IStOCKpHOtO.COm E ven in the broad view, misconceptions about bones abound. "Bones are often thought of as hard and lifeless, but bones are actually living, growing tissue," says Kathy Lund, vice president of business development and marketing at AIDP Inc. (City of Industry, CA). Roughly half of bone mass is made up of inorganic minerals, mainly calcium-phosphate crystals that give bone its density, while the other half comprises mostly collagen, providing calcium with a sturdy yet fexible structure for attachment. Lund likens the arrangement to that of a skyscraper: "Collagen is the steel frame, and calcium is the cement." As living, growing tissue, these skeletal skyscrapers are in continuous remodeling mode, with cells called osteoblasts directing the production of new bone through synthesis of collagen matrix and bone mineralization, and other cells, called osteoclasts, resorbing old bone—that is, breaking it down. Tough this breakdown may sound harmful to bone health, it's a fundamental component. "If micro-damaged bone is not resorbed and efectively removed from the bone matrix, bones may continue to increase in density due to the bone-building process, but they may lose their pliability and strength because of the presence of the old, damaged, or weakened bone," explains Nena Dockery, technical support for ESM, Stratum Nutrition (St. Charles, MO). Te upshot: "Te risk of fractures increases." Ultimately, healthy bones are those in which resorption more or less balances formation. But that equilibrium can shift in re- NUTRITIONAL OUTLOOK ES314197_NO1309_040.pgs 08.30.2013 23:49 UBM

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