Nutrition
alone cannot cure or completely prevent osteoporosis. However, it can play a key
role in disease management and prevention.
Osteoporosis is a progressive
disorder that affects bone density and quality, leading to an increased risk of
fractures and a decrease in quality of life. （1, 2, 3）。
The bones are always in
a cycle of being broken down and recombined. This process is called bone remodeling
and requires an adequate supply of certain nutrients (4).
Therefore, some people
may wonder whether certain dietary supplements can help prevent and control the
disease in addition to an overall healthy diet.
This article examines the
research behind 11 supplements related to the management and prevention of osteoporosis,
including any potential drawbacks.
1. Vitamin D
Vitamin D is essential
for bone health. It plays a key role in calcium absorption and helps regulate bone
transitions (5).
Given the limited number
of food sources of this vitamin, including fatty fish, fortified dairy products,
and grains, most people get their Vitamin D through sun exposure.
However, people who spend
the winter and most of their time indoors may have difficulty getting adequate amounts
of Vitamin D through sun exposure。
In addition, people living
north or south of the equator are at greater risk of Vitamin D deficiency due to
limited sun exposure for up to 2-5 months per year.
One study involving 400
older adults found that people with osteoporosis were more likely to have Vitamin
D deficiencies. In those who were deficient in Vitamin D, daily Vitamin D supplementation
was also associated with a reduced incidence of osteoporosis over 8 weeks. (6）。
That said, while Vitamin
D supplementation may be beneficial for people with Vitamin D deficiency, studies
have not observed the benefits of Vitamin D supplementation once blood levels reach
or exceed adequate levels. （7, 8）。
The current reference daily
value (RDI) for Vitamin D is 600 iu for children and adults aged 1 to 70 years,
and 800 iu for pregnant or lactating adults and people aged 71 years or older(9).
To reduce the risk of fractures
and ensure adequate blood levels, studies suggest that a daily intake of 400-800
iu of Vitamin D may be sufficient (10).
Interestingly, a study
that included 311 healthy adults found that taking high doses of vitamin 4,000 and
10,000 IU per day resulted in greater bone density loss over 3 years compared to
taking a smaller 400 iu of Vitamin D per day。
Nonetheless, while studies
suggest that smaller doses may be better for bone density in the long run, in more
severe cases of Vitamin D deficiency, higher doses may be temporarily required.
Given that an estimated
50% of the population has low Vitamin D levels, it's worth talking to a healthcare
provider if you're worried about not getting enough Vitamin D throughout the year
(11).
Summary: Vitamin D is essential for bone health. Vitamin D supplementation
may be beneficial for people who are deficient or deficient in this vitamin.
2. Magnesium
Magnesium is an essential
mineral that participates in more than 300 reactions in your body. It is also important
for bone health, with approximately 60% of this mineral found in bone tissue
The RDI for magnesium is
310-320 mg per day for people aged 19 to 30 years and 400 to 420 mg for those aged 31 years and older. There was also a slight increase in demand during
pregnancy and lactation
A study of 51 postmenopausal women found that 40% of women with osteoporosis or low bone density had low circulating magnesium levels. （14）。
In addition, several studies
on adults have found that people who consume more magnesium through diet or supplements
have better bone density than those who consume less magnesium. （15, 16）。
While adequate magnesium
intake has been linked to a bone density benefit, there are divergent studies on
whether this benefit translates to a reduced risk of fracture. （15, 16, 17, 18）。
Due to the need for more
research on the effects and optimal dosages of magnesium supplementation on osteoporosis
and fracture risk, it is best to focus on foods rich in magnesium, such as nuts,
seeds, whole grains, and legumes. (19）。
If you are concerned about
meeting your magnesium needs through diet alone, you should consult your healthcare
provider for personalized advice on magnesium supplements.
Summary: adequate magnesium intake is important for overall bone health and
bone density. However, more research is needed on the role of magnesium supplementation
in preventing fractures.
3. Boron
The development and maintenance
of bones have been linked to the trace element boron. It impacts how other nutrients,
such as calcium, magnesium, and Vitamin D, which are necessary for healthy bones,
are used(20, 21, 22).
Currently, there is no
established RDI for boron. Nonetheless, based on current research, it is thought
that 1-3 mg of boron per day may be beneficial (22).
An earlier study of postmenopausal
women found that taking 3 mg of boron daily significantly reduced the excretion
of calcium and magnesium in the kidneys. （2, 22）。
Additionally, boron supplementation
was found to drastically prevent bone loss in rats with osteoporosis. However, there
is currently a lack of studies on humans to confirm this effect (23).
Since dried plums are one
of the best dietary sources of boron, limited studies have examined the relationship
between dried plums intake and human bone density. （24, 25, 26）。
For example, a study of
48 postmenopausal women with low bone density found that consuming 50-100 grams
of dried plums per day significantly improved bone density within 6 months. （25）。
While the exact mechanism
is not fully understood, it is thought that the amount of boron in dried plums may
partly explain why these fruits are beneficial for bone health.
Boron is not common in
multivitamin supplements. Therefore, it may be easier to ingest it through foods,
including plums, raisins, and dried apricots.
Summary: boron is a trace element that helps maintain and develop bones.
While more research is needed, it has been suggested that 1-3 mg of boron per day
can support bone health.
4. Vitamin K
To preserve bone mass and
stop bone deterioration, Vitamin K is essential. Low bone density and a higher risk
of fractures are linked to low Vitamin K levels. （27, 28, 29）。
There is currently no RDI
defining Vitamin K. In contrast, adequate intake (ai) for adults over the age of
18 is set at 90 micrograms per day for women and 120 micrograms per day (30) for men.
While studies have shown
that adequate Vitamin K intake is protective of bone density and fractures, it remains
inconclusive whether Vitamin K supplementation can protect bone health. （31, 32, 33）。
Given the need for more
research on the effects of Vitamin K supplementation on osteoporosis and related
fractures, it is best to consume Vitamin K-rich foods such as leafy greens, broccoli, and Brussels sprouts.
It is important to note
that Vitamin K interferes with many medications, including blood thinners such as
warfarin. Therefore, it is important to speak to your healthcare provider before
taking Vitamin K supplements (33).
Summary: low levels of Vitamin K are associated with low bone density and
fracture risk. More research is needed to determine whether taking Vitamin K supplements
can help prevent bone loss and fractures.
5. Soy isoflavones
Isoflavones are a class
of antioxidants commonly referred to as phytoestrogens. Their structure is similar
to that of estrogen, which can attach to and activate estrogen receptors in the
body. （34）。
The body's estrogen levels
drop throughout menopause. This decline in estrogen causes bones to break down faster
than they form, increasing the risk of osteoporosis. （35, 36）。
Studies have shown that
soy isoflavones may help prevent calcium loss from bone and reduce bone conversion
rates. （37）。
A review of 19 studies
in postmenopausal women found a significant 54% increase in bone mineral density
and a 23% reduction in bone resorption markers through supplemental intake of soy
isoflavones compared to baseline values. （38）。
Similarly, another review
of 52 studies showed that supplementation with soy isoflavones significantly improved
bone density in studies lasting at least a year. （39）。
While promising, it is
important to note the huge differences in dosage and supplement form used between
studies. Therefore, the recommended dose based on the current study is quite extensive.
It is currently thought
that consuming 40-110 mg of soy isoflavones per day for at least one year may help
prevent bone loss and prevent osteoporosis (37).
Keep in mind that more
research is needed on differences in dosage requirements for different age groups
and ethnicities, duration of supplements, and forms of use.
Summary: soy isolate supplements have been demonstrated
to increase bone density and minimize bone turnover in postmenopausal women. To
identify the ideal dosage and supplement type, more research is required.
6. Calcium
A significant portion of
bone tissue, calcium is necessary for the strength and structure of bones. As a
matter of fact, your bones store 99% of the calcium in your body. (40).
The recommended daily intake
(RDI) for calcium is currently between 700 and 1200 mg, with higher requirements
for specific life phases such as childhood and adolescence, pregnancy and breastfeeding,
women over 50, and all people 70 years of age or older (40).
While adequate calcium
intake throughout a lifetime is important for bone health, there are mixed studies
on the potential benefits of taking calcium supplements to prevent and manage osteoporosis.
（41, 42, 43）。
A review of eight studies
found that calcium plus Vitamin D supplementation was associated with a 15 to 30%
reduction in fracture risk among community residents and institutionalized middle-aged
and older adults. （44）。
However, another review
of 33 studies found that calcium supplements— whether taken alone or in combination
with Vitamin D—were not associated with reducing the risk of fractures in older
people at home compared with placebo. （45）。
Similarly, a review of
59 studies found that increasing calcium intake through supplements or food sources
resulted in a small but not clinically significant improvement in bone mass density.
（46）。
Overall, while calcium
supplements may be appropriate for individuals at increased risk of deficiency,
there is currently insufficient evidence to recommend calcium supplements to prevent
or control osteoporosis in the general population.
Potential
problems with calcium supplements
There are some concerns
about consuming high doses of calcium through supplementation.
For example, calcium supplementation
has been linked to symptoms such as constipation, kidney stones, and other digestive
problems. There are also concerns that they may be harmful to heart health.
One review found that people
who took calcium supplements had an increased risk of a heart attack. That said,
other studies have not shown a link between calcium supplementation and negative
heart health outcomes (47, 48, 49).
Since calcium intake in
your diet is not associated with these side effects, it's best to focus on meeting
your calcium needs through your diet and discuss the potential need for supplements
with your healthcare provider.
Summary: While calcium supplements may be required in some cases, current
research does not support the use of calcium supplements to prevent or control osteoporosis.
7-11。 Other supplements
Several trace minerals
and elements play a vital role in bone health to support bone density and reduce
the risk of fractures. They include:
- Zinc. Zinc is important for bone
growth, and higher zinc levels are associated with better bone density scores.
In addition, low levels of zinc were found in women with osteoporosis and low
bone density. （50, 51）。
- Selenium. Observational
studies have shown a link between higher selenium intake and bone density and
osteoporosis risk benefits. However, studies on the effectiveness of selenium
supplements are lacking (52, 53, 54)).
- Copper. One
study discovered a connection between reduced bone density assessments and
low copper levels. However, research on the use of copper for osteoporosis
prevention and management has been limited and inconsistent overall. （55）。
- Manganese. Observational
studies have linked adequate manganese levels to the benefits of bone density.
To fully understand how manganese supplements affect bone health, more research
is required. （56）。
- Silicon. In
animal studies, silicon supplements have been shown to increase bone density
and reduce brittleness. However, research on humans is limited to some earlier
studies (57, 58).
While it is important to
consume adequate amounts of these minerals in your diet, more research is needed
to understand whether these supplements can help prevent osteoporosis and the associated
fracture risk.
In alternative medicine,
several herbal supplements are also utilized to treat osteoporosis. However,
there is currently no evidence to support these supplements' efficacy in humans. (59).
Summary: overall, more research is needed to determine whether taking
certain trace minerals and elements as supplements can help prevent or control osteoporosis.
Who can benefit from supplements?
Meeting the nutritional
needs of bone health through a healthy, balanced diet is often recommended. However,
some people may have a hard time doing this.
In particular, Vitamin
D is difficult to obtain through diet alone.
While it can be synthesized
from sunlight at certain times of the year, Vitamin D supplements may be appropriate
for people with limited sun exposure due to their location, lifestyle, or time of
year.
In addition, because the
skin changes naturally with age, older adults may be less efficient at synthesizing
Vitamin D. （60）。
Other compounds important
for bone health, including magnesium, calcium, Vitamin K, and soy isoflavones, are
widely present in foods.
However, some of the circumstances
in which supplementation with these nutrients may be required include (61, 62):
- Restrict access to food
- Prolonged loss of appetite
- Conditions that lead to malabsorption of nutrients
- Pregnancy and breastfeeding
- Bariatric surgery, such as gastric bypass surgery
- Some vegan or vegetarian diets
- Restrictive diets
It is important to remember
that many supplements may have unexpected side effects and interact with certain
medications.
Overall, if you're concerned
about getting enough nutrients to support bone health, it's important to discuss
personalized recommendations with your healthcare provider before taking supplements.
Summary: diet is the preferred way to get essential nutrients for bone health.
But occasionally, supplements might be necessary. Be sure to speak with your
healthcare provider before adding any supplements to your treatment plan.
Conclusion
Nutrition alone cannot
cure or completely prevent osteoporosis. However, it can play a key role in disease
management and prevention.
While certain nutrients
are important for bone health, including Vitamin D, magnesium, boron, and Vitamin
K, more research is needed to understand how effective they are when consumed as
a supplement.
If you're concerned about
getting enough bone health nutrition through diet alone, it's best to talk to a
trusted healthcare provider for specific advice before taking any supplements.