This is a very good review of such an important topic. Very thoughtful
Nutrition is important to bone health, and a number of minerals and vitamins have been identified as playing a potential role in the prevention of bone diseases, particularly osteoporosis. Despite this, there is currently no consensus on maximum levels to allow in food or as dietary supplements. The benefits of supplementation of populations at risk of osteoporosis with Calcium and vitamin D are well established. Prolonged supplementation of Ca and vitamin D in elderly bas been shown to prevent bone loss, and in some intervention studies to prevent fragility fractures.
Calcium intakes and recommendations vary form country to country but range between 700 mg/d to 1200 mg depending on age and gender.
Vitamin D 1000 IU ( 25 μg/d ) has been recommended but not yet achieved.
Although Phosphorous is essential to bone health, the average intake is considered to be more than sufficient and supplementation could raise intake to adverse levels. The role of vitamin K in bone health is less well defined, though it may enhance the actions of Calcium and vitamin D. Strontium administered in pharmacological doses as the ranelate salt was shown to prevent fragility fractures in postmenopausal osteoporosis. However, there is no hard evidence that supplementation with Strontium salts would be beneficial in the general population. Magnesium is a nutrient implicated in bone quality, but the benefit of supplementation with foodstuffs remains to be established. A consensus on dietary supplementation for bone health should balance the risks, for example, exposure of vulnerable populations to values close to maximal tolerated doses, against evidence for benefits from randomised clinical trials, such as those for Ca and vitamin D. Feedback from community studies should direct further investigations and help formulate a consensus on dietary supplementation for bone health.
Bonjour J-P et al 2009 Minerals and vitamins in bone health : the potential value of dietary enhancement. Brit J Nutrition vol 101 pp 1581-1596
- Martin Eastwood