One of the major health challenges that arises as we age, and our dietary habits and hormones change is maintaining the health and strength of our bones. While certainly well-known as a challenge for women, reduced bone strength is also an issue for men. Women experience significant bone loss after menopause with the corresponding hormonal changes that take place; however, by their mid-60’s, men and women lose bone at similar rates. Decreased bone health and enhanced bone loss are significant challenges in both genders and are significant risk factors affecting people’s mobility and independence as they grow older. For these reasons, both men and women need to take steps earlier in life to ensure they maintain optimal bone density and strength and experience healthy aging.

Osteoporosis Causes and Prevention

Osteoporosis is the most commonly occurring bone disease and consists of weakening of bone tissue, bone structure and strength. Osteoporosis symptoms often lead to an increased risk of fractures. However, prior to a diagnosis of osteoporosis, bone mass and strength have likely been decreasing for years. The incidence of osteoporosis has also been on the rise in the US over the last decade. In 2017-18, nearly 13.6% of all US adults over 50 were diagnosed with osteoporosis while 43% had low bone mass. The numbers were higher in women than men and the incidence of both low bone mass and osteoporosis was substantially higher in individuals aged 65 and over.

Osteoporosis causes vary by gender. Our bones are in a constant state of breakdown, repair and renewal across the lifespan. However, aging as well as race, family history of osteoporosis and hormonal changes are a few risk factors for developing this condition. Similarly, the use of certain medications can influence bone turnover. Chronic use of steroid medications, for example, interfere with the bone building process. Some other classes of medications that can impact bone health include those prescribed for seizures, acid reflux, and others.

Strategies for osteoporosis prevention include diet, lifestyle, and nutritional supplementation. An important factor in bone loss are lifestyle choices. Sedentary lifestyles with a lack of exercise (especially weight-bearing), increased consumption of alcohol, as well as tobacco use all contribute to weak bones. A further critical factor is nutrition and diet. Intake of adequate protein is necessary for bone strength as well as supporting the strength of muscles that enhance structural integrity of the bones. As calcium is an essential mineral for bone health, ensuring adequate intake of this mineral from the diet is critical for bone strength.

In addition to calcium, ensuring sufficient intake of the nutritional cofactors that help calcium perform its function in the body is essential for bone health. Some of the most important vitamins for bone health as well as minerals are vitamin D3, vitamin K2, and magnesium. All three act synergistically and work together to optimize the function of calcium in the body as well as support bone building and bone strength.

Vitamin D Benefits

Vitamin D is well-recognized as a key vitamin for bone formation. It has both direct and indirect effects on bone building. Its indirect effects which help support bone health include its necessity for enhancing the absorption of calcium from the diet. Since calcium is the predominant mineral in bone tissue, by increasing calcium absorption, vitamin D benefits enhanced bone structure and strength. Directly, however, cells related to bone remodeling, including osteoblasts (bone building cells) and osteoclasts (bone resorbing cells) have vitamin D receptors on their surface. In this way, vitamin D facilitates and directs the body’s bone remodeling activity. Vitamin D receptors also control calcium entering through the plasma membranes of bone cells, thus facilitating calcium to be incorporated into bone tissue.

Vitamin D deficiency is highly prevalent in large proportions of the population. When considering a vitamin D supplement, it is important to note that vitamin D3 is a more potent and active form of vitamin D than D2, which is commonly available in some supplements. In addition, remember that most vitamin D3 on the market is animal-sourced, so look for vitamin D3 that comes from a vegan source to meet your needs for this crucial vitamin.

Vitamin K2 Benefits

When you consider vitamin D3 supplementation, it’s critically important not to neglect its synergistic partners vitamin K2 and magnesium. These three nutrients are often deficient in our modern diets and the three work together to facilitate the health benefits we commonly attribute to vitamin D. Without each other, they can’t perform their optimal functions. Vitamin K2 (specifically in the form of menaquinone-7 (or MK-7)) is a long chain form of vitamin K that is distinct from vitamin K1 in that it has an extended half-life, ensuring that it is active for several hours in the body. Unknown to many is the critical role that vitamin K2 plays in bone health. Vitamin K2 benefits include activation of two critical calcium transport proteins that are located in the body. These include matrix Gla protein (MGP) and osteocalcin. MGP is generally found in the circulation (blood vessels such as arteries) and osteocalcin is mainly found in bone tissue.

When calcium enters circulation, these proteins go to work to move it from the blood vessel to the bone, where it belongs and is needed for strong bones and bone building. Since most of us don’t consume enough vitamin K2 from our diet (K2 is often found in fermented foods which most of us don’t get enough of), these proteins are generally in a partially inactive state. This means that calcium sticks around in the bloodstream and has a tendency to accumulate on the walls of blood vessels, making them hard (calcified) and unable to perform their functions. At the same time, as calcium is hanging out in the bloodstream it is unable to get to the bone, so bones become weak. Providing adequate vitamin K2 (as MK-7) activates these proteins, leading to calcium moving efficiently out of the arteries and into bone tissue, where vitamin D can let it in to bone cells. In this way, vitamin K2 is a crucial partner to vitamin D, allowing it to perform key functions for bone building.

Remember that not just any vitamin K will do. You need a vitamin K2 supplement (as MK-7) because of its long half-life, meaning it stays active in the body for several hours. In addition, regular vitamin K2 is somewhat unstable in supplement form and degrades in the presence of other nutrients such as magnesium and other minerals. Look for a stabilized form of vitamin K2 which is double microencapsulated. This helps protect the K2 from degradation and ensures it is available to optimally activate the calcium transport proteins in the body.

Magnesium for Bones

While calcium is known as the primary mineral in bone tissue, the body stores nearly 60% of its total magnesium content in the bones. Magnesium is such an important mineral for metabolic health that hundreds of biochemical reactions in the body require magnesium as cofactor. Studies have repeatedly indicated the necessity of adequate magnesium and its importance to healthy bone structure, strength, and function. Magnesium deficiency leads to brittle bones and changes that are reminiscent of osteoporosis. When bones become brittle, they are more at risk of fractures. Research shows that without adequate magnesium in the body, vitamin D is unable to efficiently function, leading to increased bone loss. Moreover, increased dietary magnesium intakes are associated with improved total bone mineral density in older adults, supporting its highly beneficial effects on bone health.

Low magnesium levels are also closely associated with increased levels of inflammation in the body. This is another factor detrimental to bone health. Animal studies have found that increased inflammatory markers can have a direct impact on enhancing the activity of osteoclasts, leading to bone breakdown. Another effect of low magnesium levels is that this promotes free radical activity and leads to increased oxidative stress. Enhanced activity of free radicals also stimulates the activity of osteoclasts (cells that break down bone tissue) and inhibits the activity of osteoblasts (cells that build bone), resulting in a net decrease in bone strength.

Since 50% of US adults fail to get an adequate amount of magnesium from the diet, magnesium supplements can help fill the gap. It is important to supplement with this nutrient in combination with vitamin D3 and vitamin K2. Magnesium works hand in hand with vitamin D in the body. When magnesium levels are inadequate, vitamin D is stored by the body and not used. Magnesium benefits include the conversion of vitamin D to its active form, and it is magnesium that helps vitamin D bind to target receptors in cells.

Maintaining strong bones is a key goal for healthy aging in men and women. This ensures we remain mobile, active, and independent as we age. Dietary and lifestyle factors are critical to achieving this goal. Bone health supplements with three critical nutrients, namely vitamin D3, vitamin K2 and the mineral magnesium, are an important strategy to support dietary and lifestyle efforts to optimize bone health throughout life.

References

• Osteoporosis in Men. https://www.bones.nih.gov/health-info/bone/osteoporosis/men. Accessed on January 11, 2022.
• Osteoporosis or Low Bone mass in Older Adults: United States, 2017-2018. https://www.cdc.gov/nchs/products/databriefs/db405.htm. Accessed on January 11, 2022.
• https://www.mayoclinic.org/diseases-conditions/osteoporosis/symptoms-causes/syc-20351968. Accessed on January 11, 2022.
• Bikle DD. Vitamin D and bone. Curr Osteoporos Rep. 2012;10(2):151-159.
• Akbari S, Rasouli-Ghahroudi AA. Vitamin K and Bone Metabolism: A Review of the Latest Evidence in Preclinical Studies. Biomed Res Int. 2018;2018:4629383. Published 2018 Jun 27. doi:10.1155/2018/4629383
• Castiglioni S, Cazzaniga A, Albisetti W, Maier JA. Magnesium and osteoporosis: current state of knowledge and future research directions. Nutrients. 2013;5(8):3022-3033. Published 2013 Jul 31. doi:10.3390/nu5083022