As chiropractors, we know the importance of structural integrity and balance. Through our adjustments, we ensure proper alignment of the skeletal system. We are also aware of the importance of strong bones to help ensure longevity and health. This is why it is particularly important that patients with osteoporosis watch their diet and take supplements on a daily basis, to ensure the availability of nutrients necessary for bone health.

Three minerals are vital for bone health: calcium, magnesium, and phosphorus. They are all essential, but how much of each should we take? Calcium and magnesium come in many forms, and too much of either can cause problems. In addition, the American diet is full of phosphorus; hence, supplementation with this mineral can cause severe system imbalance, including gum inflammation and a worsening of osteoporosis.

The ideal way to rebuild the bones is to restore the body's naturally occurring balance of calcium, magnesium, and other minerals. Because bones already contain the minerals in a perfect balance, I recommend using raw bone powder, but this is not easy to obtain. Standard Process has developed a unique way to produce this in a time-consuming procedure that involves raw bone and the marrow without heating, denaturing, or chemical damage. The name of this product is Calcifood Wafers. I use these wafers with both osteoporotic and arthritic patients, and anyone needing bone healing and overall health.

Vitamins and Bone Health

Vitamin D
Vitamin D, which is manufactured through the skin and obtained from the diet, allows for the absorption of calcium and phosphorus in the bones and teeth. Vitamin D is particularly important for the bone health of older people, and has been shown in trials to enhance bone health among elderly individuals.¹ Certain studies, however, claim that calcium supplementation is more effective than supplemental Vitamin D in reducing the loss of hipbone.²

It is now known that a combination of Vitamin D and calcium is very effective for the enhancement of bone health.¹ When this combination was studied in elderly men and women, improved bone density and fewer osteoporotic fractures were seen when compared to the numbers among the control subjects.^3-6 It was also noted that a Vitamin D and calcium supplement decreased the amount of body sway in elderly women after an 8-week period, resulting in an improvement in the prevention of falling and additional osteoporotic fractures.⁷

To learn more about minerals and health, go to "What's Not in Your Food (or Supplements)".

Most people find that their Vitamin D requirements are met from sun exposure,⁸ with limiting factors that include living in far northern or far southern latitudes, as well as highly pigmented skin, and the frequent use of sunscreens.⁹

Calcium
Just how efficiently calcium is absorbed depends on factors such as how much Vitamin D is available and the diet. It was found that an efficient absorption of calcium is achieved from several calcium-rich and calcium-fortified foods, as well as dietary supplements.¹⁰ Unfortunately, calcium isn't especially absorbed from foods that include sweet potatoes, rhubarb, spinach, and dried beans, the latter of which is rich in oxalate, known to inhibit calcium absorption.¹¹ However, phytate, which is found in raw beans, nuts, grains, and soy isolates, is less likely to inhibit the absorption of calcium.^12-13

Phosphorus
Our food supply is resplendent with phosphorus, which is well-absorbed (up to 70%) and found in almost all food sources, except for phytate-rich foods such as raw beans, nuts, grains, and soy isolates.¹⁴

Half of the dietary phosphorus in the United States comes from foods that are rich in protein, including meat, poultry, milk, and fish. It is estimated that cereals provide up to 12% of our phosphorus needs.¹⁵ Phosphorus is also found in soft drinks as phosphoric acid.

Our intestinal phosphorus absorption is regulated by Vitamin D.⁸ Phosphorus absorption does not, however, vary on the amount consumed. Magnesium, when consumed in high amounts with phosphorus, does decrease the amount of phosphorus absorbed.¹⁶ It appears that calcium, when taken in reasonable amounts, does not interfere with the absorption of phosphorus.¹⁷

Biotics Research offers a range of products that address bone health, including a formula that combines several bone-friendly nutrients.

Magnesium
Magnesium plays a major role in bone cell function, as well as in hydroxyapatite crystallization and growth. More than 300 enzymatic reactions depend on magnesium, and almost half of the body's magnesium resides in the bones.¹⁸ This bone magnesium is also a place where normal serum magnesium levels are maintained.¹⁹

Magnesium enjoys a healthy relationship with many foods. Roughly 20% of dietary magnesium for teenagers and 10% for adults is found in dairy foods,²⁰ and up to 16% of dietary magnesium comes from animal products, vegetables, fruits, and grains. High-fiber diets (39 to 59 g/d), however, have been shown to decrease magnesium absorption and retention levels.

Support Bone Health with Mineral Supplementation

So, one can see that an integral part of bone health is the nutrients that we absorb and need on a daily basis through diet and supplementation. It is very difficult to obtain these nutrients in sufficient amounts through diet alone, and therefore it is important to understand the impact of the various nutrients on our patients when we need to recommend nutritional supplements in our practice. Good bone health is imperative to overall health and well-being. As chiropractors, we need to be the experts and educate our patients on how to attain a healthy skeletal system that will support us for life.

Carl T. Amodio, BA, DC, is founder and director of Whole Body Health Inc, an Atlanta-based clinic specializing in total health techniques. He is a chiropractic kinesiologist and specializes in nutritional balancing that is individually targeted to each person. Contact him at www.wholebodyhealth.org.

References

1. Reid IR. The roles of calcium and vitamin D in the prevention of osteoporosis. Endocrinol Metab Clin North Am. 1998;27(2):389-398.
2. Peacock M, Liu G, Carey M, et al. Effect of calcium or 25OH vitamin D3 dietary supplementation on bone loss at the hip in men and women over the age of 60. J Clin Endocrinol Metab. 2000;85(9):3011-3019.
3. Chapuy MC, Arlot ME, Duboeuf F, et al. Vitamin D3 and calcium to prevent hip fractures in elderly women. N Engl J Med. 1992;32(23):1637-1642.
4. Dawson-Hughes B, Harris SS, Krall EA, Dallal GE. Effect of calcium and vitamin D supplementation on bone density in men and women 65 years of age or older. N Engl J Med. 1997;337(10):670-676.
5. Baeksgaard L, Andersen KP, Hyldstrup L. Calcium and vitamin D supplementation increases spinal BMD in healthy, postmenopausal women. Osteoporos Int. 1998;8(3):255-260.
6. O'Brien KO. Combined calcium and vitamin D supplementation reduces bone loss and fracture incidence in older men and women. Nutr Rev. 1998;56(5 part 1):148-150.
7. Pfeifer M, Begerow B, Minne HW, Abrams C, Nachtigall D, Hansen C. Effects of short-term vitamin D and calcium supplementation on body sway and secondary hyperparathryoidism in elderly women. J Bone Miner Res. 2000;15(6):1113-1118.
8. Institute of Medicine. Dietary Reference Intakes for Calcium, Phosphorous, Magnesium, Vitamin D, and Fluoride. Standing Committee on the Scientific Evaluation of Dietary Reference Intakes, Food and Nutrition Board. Washington, DC: National Academy Press; 1997.
9. Holick D. Vitamin D. In: Modern Nutrition in Health and Disease. 9th ed. Shils ME, Shike M, Olson J, Ross AC, eds. Lippincott, Williams & Wilkins; 1999.
10. Institute of Medicine. Dietary Reference Intakes for Calcium, Phosphorous, Magnesium, Vitamin D, and Fluoride. Standing Committee on the Scientific Evaluation of Dietary Reference Intakes, Food and Nutrition Board. Washington, DC: National Academy Press; 1997:73-74.
11. Weaver CM, Heaney RP. Calcium. In: Modern Nutrition in Health and Disease. 9th ed. Shils ME, Shike M, Olson J, Ross AC, eds. Lippincott, Williams & Wilkins; 1999.
12. Institute of Medicine. Dietary Reference Intakes for Calcium, Phosphorous, Magnesium, Vitamin D, and Fluoride. Standing Committee on the Scientific Evaluation of Dietary Reference Intakes, Food and Nutrition Board. Washington, DC: National Academy Press; 1997:73.
13. Weaver CM, Heaney RP. Calcium. In: Modern Nutrition in Health and Disease. 9th ed. Shils ME, Shike M, Olson J, Ross AC, eds. Lippincott, Williams & Wilkins; 1999:147.
14. Institute of Medicine. Dietary Reference Intakes for Calcium, Phosphorous, Magnesium, Vitamin D, and Fluoride. Standing Committee on the Scientific Evaluation of Dietary Reference Intakes, Food and Nutrition Board. Washington, DC: National Academy Press; 1997:147.
15. Knochel JP. Phosphorus. In: Modern Nutrition in Health and Disease. 9th ed. Shils ME, Shike M, Olson J, Ross AC, eds. Lippincott, Williams & Wilkins; 1999:157-158.
16. Shils ME. Magnesium. In: Modern Nutrition in Health and Disease. 9th ed. Shils ME, Shike M, Olson J, Ross AC, eds. Lippincott, Williams & Wilkins; 1999:174.
17. Institute of Medicine. Dietary Reference Intakes for Calcium, Phosphorous, Magnesium, Vitamin D, and Fluoride. Standing Committee on the Scientific Evaluation of Dietary Reference Intakes, Food and Nutrition Board. Washington, DC: National Academy Press; 1997:149.
18. Shils ME. Magnesium. In: Modern Nutrition in Health and Disease. 9th ed. Shils ME, Shike M, Olson J, Ross AC, eds. Lippincott, Williams & Wilkins; 1999:169.
19. Institute of Medicine. Dietary Reference Intakes for Calcium, Phosphorous, Magnesium, Vitamin D, and Fluoride. Standing Committee on the Scientific Evaluation of Dietary Reference Intakes, Food and Nutrition Board. Washington, DC: National Academy Press; 1997:191.
20. Shils ME. Magnesium. In: Modern Nutrition in Health and Disease. 9th ed. Shils ME, Shike M, Olson J, Ross AC, eds. Lippincott, Williams & Wilkins; 1999:172-173.