Calcium is only one of many different components necessary to help build and maintain strong bones. It accounts for approximately 20% of the entire makeup of bone, while the other 80% is made up of phosphorus, zinc, magnesium, and many other minerals, as well as collagen protein. Several other bone building nutrients that significantly influence bone building and bone health include: magnesium, boron, strontium, vitamin D, vitamin K and Milk Basic Protein. This article presents a snapshot of the most important bone health nutrients and their roles in influencing bone development.

The Many Roles of Calcium

Calcium is a mineral involved in many different functions of the body including muscle contraction, nerve impulse transmission, maintenance of strong bones, immunity and hundreds of others. The adult human body contains approximately 1,200 g of calcium, about 99% of which is present in the skeleton and teeth.1 The body loses calcium every day, so it is important to get enough calcium in your diet, or to complement it with a high-quality nutritional supplement. It is generally accepted that obtaining sufficient calcium throughout life can significantly decrease the risk of developing osteoporosis. Among other factors, such as regular exercise, gender and race, calcium supplementation during childhood and adolescence appears to be a prerequisite for maintaining adequate bone density later in life. Even elderly osteoporotic patients can benefit significantly from supplementation with dietary calcium. For more information on calcium, see the article titled “Choosing the Right Calcium Supplement”.

Magnesium Rich Bones

Magnesium plays a structural role in bone, as approximately 60% of our total magnesium is stored in our bones.2 A deficiency in this key mineral has been shown to decrease parathyroid hormone (an important hormone involved in calcium regulation), increase inflammation, increase oxidative stress and increase osteoclastic activity.2 Moreover, supplemental magnesium in osteoporotic women has been shown to increase bone mineral density.2

Boron Aids in Absorption

As  one  of  the  minerals  naturally occurring in bones, boron is necessary for calcium and magnesium absorption, their adequate reabsorption in the kidneys, and their incorporation into the bone matrix. In a clinical study among post-menopausal women who were not undergoing Hormone Replacement Therapy (HRT), boron was not only shown to significantly diminish urinary losses of calcium and magnesium, but it also raised levels of plasma ionized calcium, beta-estradiol, and testosterone. Boron has been shown to extend the half-life of vitamin D and estrogen, meaning that it helps the body utilize these more efficiently. Supplementation with boron has been found to help retain magnesium and calcium in the kidneys in post-menopausal women.3

Strontium’s Role in Bone Health

Strontium is an essential nutrient in the development, structure, function and health of the skeletal system. It was the first mineral shown to rebuild bone while simultaneously reducing its resorption. It accomplishes that by making osteoblasts multiply more quickly while slowing down the osteoclasts’ activity. Strontium also improves the retention of calcium, phosphorus and protein in the bone, thereby increasing bone strength without lowering their quality.4 The efficacy of this essential mineral in reducing the risk of fracture in women with osteoporosis has been demonstrated in many clinical trials. Calcium and strontium are both key-players in keeping your bones healthy. These two supplements potentiate each other’s action, but they have to be taken separately since they use the same pathways for absorption in the intestinal tract. For more information on strontium, see the article titled “Strontium Citrate: Truly Safe and Effective’’.

Vitamin D and Bone health

Vitamin D along with vitamin K are the biological signals that direct calcium from the digestive tract where it is absorbed and into the bones.5 With insufficient (or deficient) levels of these vitamins, calcium is poorly absorbed and can be inappropriately stored in areas such as blood vessels. The 2 ways the body obtains vitamin D are either through a conversion process in the skin or absorption through the digestive system. However, once produced or absorbed it still must undergo further conversion by the liver and kidneys before it reaches the fully activated form known as calcitrol.5 We now know that vitamin D has multiple actions throughout the body. When vitamin D levels are deficient (below 80nmol/L or 32ng/mL) then calcium absorption can fall from 30-40% to 10-15%.6 This means that even though a person is supplementing with the recommended 1000mg/day of calcium, they may only be getting 100mg that is actually absorbed. There is strong evidence that supports the supplementation of vitamin D and calcium together to reduce the risk of fractures.5,7 Vitamin D levels of at least 80nmol/L have been shown to optimally absorb calcium.3 This underscores the importance of measuring a person’s plasma levels in order to determine what dose is required to reach an optimal vitamin D level. Vitamin D has also been shown to improve muscle pain, posture, and balance all of which are key in preventing falls which can lead to fracture.6,8

The Different Forms and Functions of Vitamin K

Vitamin K consists of a group of structurally similar, fat-soluble vitamins required for blood coagulation, bone, and liver health and is responsible for a process called carboxylation. This process is essential for activating proteins important for bone mineralization.9,10 Osteocalcin is the second most abundant protein in bone, after collagen. Its role is to bind calcium in the bone structure or “lattice.” 9,10 The other essential role of vitamin K in relation to calcium balance is that it can prevent soft tissue calcification. Vitamin K controls a protein called Matrix GLA.9 This protein is responsible for protecting soft tissues like blood vessel walls and preventing excess calcium from being deposited. It acts as a calcium mop in areas of the body that should not be hardened or calcified. The ability of vitamin K to not only increase calcium usage in bone formation but also prevent the calcification of arteries clearly highlights its importance in both bone and cardiovascular health. Vitamin K1 is the more prevalent form in our diet, and is found primarily in leafy green vegetables. Vitamin K2 has several forms, two of which are commonly used as supplements: menatetrenone (MK-4) and menaquinone-7 (MK-7). Over 90% of all studies on bone health have been done with MK-4, but MK-7 has been the subject of more research over the past several years. Vitamin K2 is linked with bone mineral density in the elderly, and correlative studies have noted decreased vitamin K dependent enzyme activity in individuals with kidney stones. MK-4 has been shown in numerous studies to reduce fracture risk, and stop and reverse bone loss. MK-7 has been demonstrated to stimulate osteoblastic bone formation and to inhibit osteoclastic bone resorption.11,12 In another study, MK-7 caused significant elevations of serum osteocalcin concentration, a biomarker of bone formation.11,12 Based on the strong historical clinical use and effectiveness of MK-4 and the significance of the new research on MK- 7, the best option at this time would be to opt for a supplement containing a high dose of the MK-4 and/or a low dose of the MK-7 forms of Vitamin K2. Silicon for Skeletal Development This mineral helps to initiate the mineralization process of bone, and it is no surprise that silicon deficiency is associated with poor skeletal development. (A fun fact for beer lovers: beer contains a relatively high amount of silicon due to the processing of barley and hops).4 A Miracle Protein Called Milk Basic Protein Scientists in Japan have isolated a specific fraction from whey protein called Milk Basic Protein (MBP®), which they have determined to have positive metabolic effects on bone health. MBP
has undergone at least six human clinical trials and shows excellent potential to protect bone health and counteract the damaging effects of osteoporosis. The mode of action is thought to be via multiple mechanisms. Simply put, MBP stimulates the activity and proliferation of osteoblasts while simultaneously suppressing the activity and proliferation of osteoclasts. It assists in the absorption and retention of calcium, thereby increasing the preservation of the architecture of the bone matrix including collagen.13,14,15 MBP does so in a similar, albeit different mechanism than vitamin D. The miracle protein has been shown to increase serum concentrations of osteocalcin, the major non-collagenous protein in bone. Finally, MBP improves the utilization of calcium by virtually “catching” calcium ions, thereby preventing their deposition in other tissues such as arteries and kidneys and maximizing their incorporation into the bones. Bones are composed of dynamic tissues which need a broad range of nutrients to perform their function. Calcium is not the only critical nutrient that is needed for healthy bones. The diet must also contain a wide variety of nutrients including magnesium, boron, vitamin D, vitamin K and, if possible, other complementary proven bone builders such as strontium and milk basic protein.

What You Need to Know

Calcium is a crucial mineral, but for optimal bone health, we have to consider a broader approach which encompasses diet, exercise, stress management and supplements such as vitamin D3, silicon, boron, vitamin K2, strontium and Milk Basic Protein. Some of these supplements may seem to have overlapping actions, but they all act in specific and complementary ways. The best supplement protocol is one that combines all of them and that is elaborated according to your own individual needs.