Bone strength improvement with dietary supplements, natural remedy for bone loss
August 6 2018 by Ray Sahelian, M.D.

Bone is a type of hard connective tissue found in many vertebrate animals. Bones support body structures, protect internal organs, and (in conjunction with muscles) facilitate movement; are also involved with cell formation, calcium metabolism, and mineral storage. The bones of an animal are, collectively, known as the skeleton. Bone has a different composition than cartilage.

Foods for strong bones, diet makes a difference
Consider consuming some of the following foods: Milk and dairy products, sardines, green vegetables such as bok choy, Chinese cabbage, kale, collard and turnip greens.

Antioxidants (Basel). 2014. Dietary Polyphenols, Berries, and Age-Related Bone Loss: A Review Based on Human, Animal, and Cell Studies. Natural antioxidant supplementation has been researched to aid in reducing bone loss caused by oxidative stress. Naturally occurring polyphenols, such as anthocyanins rich in berries, are known to have anti-oxidative properties. Several studies have been reviewed to determine the impact polyphenol intake-particularly that of berries-has on bone health. Studies reveal a positive association of high berry intake and higher bone mass, implicating berries as possible inexpensive alternatives in reducing the risk of age related bone loss.

J Clin Densitom. 2013; Does a high dietary acid content cause bone loss, and can bone loss be prevented with an alkaline diet? A popular concept in nutrition and lay literature is that of the role of a diet high in acid or protein in the pathogenesis of osteoporosis. A diet rich in fruit and vegetable intake is thought to enhance bone health as the result of its greater potassium and lower "acidic" content than a diet rich in animal protein and sodium. Consequently, there have been a number of studies of diet manipulation to enhance potassium and "alkaline" content of the diet to improve bone density or other parameters of bone health. Although acid loading or an acidic diet featuring a high protein intake may be associated with an increase in calciuria, the evidence supporting a role of these variables in the development of osteoporosis is not consistent. Similarly, intervention studies with a more alkaline diet or use of supplements of potassium citrate or bicarbonate have not consistently shown a bone health benefit. In the elderly, inadequate protein intake is a greater problem for bone health than protein excess.

Nutritional products promoted for bone strength
Boron has been mentioned but little human research is available
Calcium of course

Magnesium may help

Strontium is used

Vitamin K

MBP Osteo with Calcium Advanced Bone Density Support - Formulated using the newest discovery and latest scientific insights in bone health • Combines the breakthrough ingredient MBP (Milk Basic Protein) with key bone nutrients• MBP is shown to support healthy bone density after just six months of use.

Childhood exercise
Running, jumping and other high impact activities during childhood benefits bone health by increasing the size and strength of the growing skeleton. The benefits in bone size and strength induced by exercise during growth persist lifelong -- even if exercise is ceased. Weight-bearing exercises, including weightlifting and high-impact activities like jumping, build and maintain bone mass.

Bone Density and Androgen Deprivation
Bone mineral density (BMD) decreases during the first 2 years of androgen deprivation therapy in men with prostate cancer. Dr. Morote and colleagues from Vall d'Hebron Hospital, Autonoma University School of Medicine, Barcelona, Spain evaluated the dynamics of BMD in the lumbar spine and four hip sites over a 2-year period in 62 men with locally advanced nonmetastatic prostate cancer. Men receiving androgen deprivation therapy experienced bone mineral density losses ranging from 2% to 5% at all analyzed locations at 12 months. Bone mineral density did not change significantly in men not on androgen suppression. The area that best reflected the ADT-induced bone loss was Ward's triangle,a region between the principal compressive group of the femoral head and the principal tensile group and the secondary compressive group of the femoral neck. A DEXA scan of the wrist may not accurately reflect the greatest extent of bone loss which may lead to a delay in appropriate treatment. Journal of Urology 2006.
   In the year following coronary artery bypass grafting (CABG), bone mineral content declines significantly in men. A decline in bone mineral density increases the risk of bone fracture.

Measuring bone mineral density

Several methods are available to measure bone density, but currently the most widely used technique is DEXA (Dual Energy Xray Absorptiometry). Older methods such as single photon absorptiometry do not predict hip fractures as well as DEXA. Three companies manufacture these densitometers: Hologic, Norland, and Lunar.
   Repeat bone density testing in middle-aged and older adults can be delayed for intervals of up to 5 to 7 years if they don't have risk factors for bone loss.

Bone density
The high-impact tumbling of gymnastics increases young girls' muscle mass and bone density. The more time young men spend engaging in high-impact physical exercise, the greater their bone mineral density.

Bone density with high impact exercise
Men who want to keep their bones strong may want to add running to their exercise routine. In a study of 42 athletic men ages 19 to 45, researchers found that running seemed to have even bigger benefits for bone mass than strength training did. Both runners and weight trainers had greater bone density in the spine compared with road cyclists, but much of the benefit in weight trainers seemed to stem from their greater muscle mass. In contrast, running appeared to build bone density regardless of the men's muscle mass. Journal of Strength and Conditioning Research, 2009.

Sun exposure
Women who get some sun during the last trimester of pregnancy may have children with stronger bones. Bone mass acquired earlier in life is important to fracture risk in later years. Journal of Clinical Endocrinology and Metabolism, March 2009.

Bone density loss with weight reduction
When people lose weight, they often lose some bone mass as well. Changes in bone metabolism may persist even after the weight loss stops. Even after dieters stop shedding pounds and enter a "weight maintenance" phase, changes in bone turnover remains. To counteract the bone loss, regular exercise and weight training is essential.

New findings call into question the idea that being overweight or obese might protect people from developing brittle bones. Dr. Jean-Marc Kaufman of Ghent University Hospital in Belgium and his colleagues found that fattier men had smaller, thinner bones, while those with more lean mass had larger, denser skeletons.High body mass index (BMI) has been thought to protect both men and women against the bone-thinning disease osteoporosis, while being thin boosts a person's likelihood of fractures due to this condition. The idea behind the theory is that extra weight stresses the bone, stimulating the formation of new bone tissue.But new evidence suggests that fat mass might affect bones differently than muscle mass does, Kaufman and his team note in the Journal of Clinical Endocrinology and Metabolism.To investigate the issue further, the researchers looked at bone density and volume, as well as lean and fat mass, in 768 men aged 25 to 45, including 296 pairs of brothers.After the researchers adjusted for weight, they found that men's bone mass and volume fell steadily as their percentage of fat mass increased, while bone size rose in tandem with lean mass. Fat in the trunk area had a stronger influence on bone size than fat on the arms and legs."Lean mass," the researchers conclude, "is the major determinant of bone size, providing further evidence that bone size is adapted to the dynamic load imposed by muscle force rather than passive loading" by fat. Journal of Clinical Endocrinology and Metabolism, 2009.

Astronauts lose bone strength
Astronauts on long-term missions in space have a decline in bone strength once they return to Earth. Researchers found that 13 astronauts who spent 4 to 6 months on the International Space Station showed significant dips in bone strength around the hip. A few had strength reductions comparable to those seen over a lifetime in people who keep their feet on Earth. Bone 2009.

Premenopausal women
Young women who eat a typical high protein Western diet need not worry that their protein consumption will harm their bone health. A higher intake of protein does not have a deleterious effect on bone density in premenopausal women. American Journal of Clinical Nutrition, March 2010.

How often to take a bone test
Repeat bone mineral density testing up to 8 years after the initial bone test does not improve the ability of doctors to predict fractures in older women. Dr. Teresa A. Hillier, from Kaiser Permanente Northwest/Hawaii in Portland, Oregon, and colleagues assessed the predictive ability of repeat bone mineral density testing in 4,124 women with an average age of 72 years. Bone mineral density testing was first performed from 1989 to 1990 and then again 8 years later. During an average follow-up period of over 5 years after the second bone mineral density test, 877 women sustained a nontraumatic nonspine fracture and 340 sustained a spine fracture. Adding a second bone mineral density test did not improve the predictive ability of the first for future fracture. This held true even after adjusting for initial bone mineral density scores, hormonal therapy, or high bone loss. Archives of Internal Medicine, 2007.

Smoking and Bone Healing
Exposure to cigarette smoke delays the early phases of bone and ligament repair in mice. Dr. Linda J. Sandell and colleagues from Washington University School of Medicine at Barnes-Jewish Hospital, St. Louis, Missouri investigated the effects of cigarette smoke exposure on early events in bone fracture healing, especially cartilage formation. Mice were randomly assigned to a control group or to a group in which they were exposed to smoke in a chamber for 6 days per week for a month, before experiment leg fracture under anesthesia. Smoking significantly reduced cartilage formation, an important step in bone healing. By day 14 after bone fracture, the cartilage was still developing in the smoke-exposed animals, whereas it had already been replaced by bone in the normal controls. In the second study, the same team of researchers investigated whether smoking cigarettes would interfere with the ability of mice to synthesize support tissue at the site of ligament injury. Ligaments are tough fibrous bands that hold bone to bone, whereas tendons are bands that hold muscle to bone. Synthesis of the support tissue needed for ligament repair was significantly delayed in the animals exposed to smoke. Journal of Orthopedic Research, December 2006.

Bone mass and cycling, biking
Compared with men who run, men whose prim0o-ary physical activity is bicycling are much more likely to have low bone density in the hips or spine. In general, cyclists have lower bone mass throughout the body and a higher incidence of osteopenia in the spine or hip. Osteopenia refers to abnormally low bone mass that could progress to the brittle-bone disease osteoporosis. Running, jumping and other weight-bearing activities put the bones under stress. This forces the bones to respond by becoming stronger; whereas low-impact exercise, like biking or swimming, works the heart and trims the waistline, but puts little strain on the bones. Metabolism, 2007.

Hip bone fracture protection
Padded undergarments meant to protect against hip bone fractures could help elderly adults stay out of the nursing home, and cut healthcare costs along the way. The garments, known as hip protectors, are designed to cushion a fall, which for elderly adults -- particularly those with osteoporosis -- can lead to a disabling hip bone fractures. Widely used in Europe, hip protectors are less popular in North America, though, several studies have suggested they can prevent bone fractures and save medical costs although other studies have disputed these claims.
 

Questions
Q. Seems bone broth is all the rage but I don't see anything about it on your website. Maybe because it's all hype? What are your thoughts on bone broth for tendon repair?
   A. I have not seen enough research on this topic to have an informed opinion regarding the benefits of bone broth for tendon repair.

Osteopontin plays roles in a variety of cellular processes from bone resorption and extracellular matrix (ECM) remodeling to immune cell activation and inhibition of apoptosis.