Bones: Specialty and Macronutrients

Protein Power

Protein may also help build stronger bones. One recent study, published in the American Journal of Clinical Nutrition, suggested a low vegetable protein intake is associated with lower BMD in premenopausal women.¹ The other study, published by Osteoporosis International, found consuming higher levels of dietary protein may help seniors suffer fewer hip fractures than their peers who have the lowest intake of protein.² They found seniors in the lowest 25 percent of dietary protein intake had approximately 50-percent more hip fractures than those who higher intakes, although all intakes were in the range of what would be considered normal, the researchers noted. Those who suffered hip fractures were more likely to take in less than 46 g/d of protein, the amount recommended for adults.

Also in 2010, seniors were told to focus on protein and vitamin D during the 32nd European Society for Clinical Nutrition and Metabolism (ESPEN) Congress in September. Nutrition, specifically protein and vitamin D, have been shown to play an important role in preventing falls and fractures through the improvement of BMD, said René Rizzoli, professor in the Division of Bone Diseases, Department of Rehabilitation and Geriatrics, Geneva University Hospitals. Dorothee Volkert, professor at the Institute for Biomedicine of Aging at the University of Erlangen-Nürnberg, Germany, added protein intake is seen as an important determinant of optimal physical function and prevention of sarcopenia (degenerative loss of skeletal mass).

Fat-tastic

Numerous studies have shown a high-fat diet inhibits bone formation and enhances bone resorption, in addition to impairing the bone antioxidant system,³ and that saturated fatty acid intake may significantly increase hip fracture risk in postmenopausal women.⁴ However monounsaturated and polyunsaturated fatty acid intakes may decrease total fracture risk.

In 2008, researchers from Iran reviewed studies on the effects of omega-3 fatty acids on osteoporosis between 1963 and 2007 and found animal studies support the beneficial effects of omega-3s on bone health and osteoporosis.⁵

A 2009 article by Italian researchers noted long-chain polyunsaturated fatty acids (LCPUFAs) and lipid mediators derived from LCPUFAs have critical roles in the regulation of a variety of biological processes, including bone metabolism, demonstrating an effect on calcium balance, an effect on osteoblastogenesis and osteoblast activity, a change of membrane function, a decrease in inflammatory cytokines such as interleukin-1 (IL-1), interleukin-6 (IL-6) and tumor necrosis factor alpha (TNFa).⁶ Further, they noted animal studies have shown a higher dietary omega-3/omega-6 fatty acids ratio is associated with beneficial effects on bone health.

Omega-3s in general and docosahexaenoic acid (DHA) in particular, were positively associated with bone mineral accrual and with peak BMD in a study of 78 healthy young men with a mean age of 16.7 years.⁷

Fungi Formation

A beta-glucan from Aureobasidium pullulans, a yeast-like fungus fermented from black yeast can also support bone health. In particular, Polycan, from Anderson Global Group, was found in a Korean study to significantly and dose-dependently suppressed decreases in bone weight, bone mineral content, failure load, BMD, and serum calcium and phosphorus levels.⁸ Additionally, researchers found the branded ingredient increased serum osteocalcin levels and suppressed decreases in histomorphometric parameters such as volume, length and thickness of trabecular bone and thickness of cortical bone. A 2006 study reported treatment with Polycan improved effects on femur weight and histomorphometric changes of femur such as trabecular bone volume (TBV), trabecular bone thickness (TBT) and cortical bone thickness (CBT) in OVX mice.⁹

An additional 2009 unpublished 12-week, randomized, 60-person double blind clinical study conducted by Chonbuk National University, Jeonju, South Korea, indicated significant gains in osteoblast formation and the suppression of osteoclasts. Anderson Global Group reported a second human clinical trial featuring 90 test subjects is currently ongoing in Korea with results expected by the second quarter of 2011.

Prebiotic Prevention

Prebiotic fibers may also help bones by increasing the amount of fatty acids in the colon and thereby increasing the amount of calcium absorbed. Galactooligosaccharides (GOS) , an animal-derived prebiotic manufactured by extracting milk sugars from dairy products and using enzymes to break them down, is fermented by various bacteria in the colon, which creates short-chain fatty acids (SCFAs). These acids lower the pH of the colon creating an environment that improves the absorption of calcium.

In a Netherlands study of postmenopausal women, greater calcium absorption was observed after consumption of a product rich in transgalactooligosaccharides (TOS) compared control.¹⁰ Researchers noted the increased calcium absorption was not accompanied by increased urinary calcium excretion, meaning that TOS also may increase the uptake of calcium by bones and/or inhibit bone resorption. A 2006 Spanish study found infant formulas supplemented with probiotics (Bifidobacterium bifidum and Bifidobacterium longum) and/or GOS at 12 gkg, 50 gkg and 100 gkg for 30 days increased calcium, magnesium and phosphorus bioavailability in rats.¹¹ And, a 1995 Japanese study determined GOS enhanced volatile fatty acid production, and thus prevented bone loss and lower serum total cholesterol concentration in OVX Wistar rats.¹² Rats fed a diet containing GOS absorbed calcium more efficiently than those on the control diet after eight to 10 days and 18 to 20 days, and the bone (femur and tibia) ash weight and tibia calcium content of rats on the GOS diet were significantly higher than those of the control animals.

Another popular prebiotic, inulin, when added to oligofructose, increased calcium absorption in girls at or near menarche who consumed 1,500 mg/d dietary calcium from fortified orange juice.¹³ Calcium absorption was significantly higher in a group of girls receiving 8 g/d inulin+oligofructose mixture than in the placebo group. Inulin also helps bone health in boys as well as girls as an-8 g/d dose of the prebioitic significantly increased calcium absorption and enhanced bone mineralization during pubertal growth in both sexes.

If those children stick to their daily probiotics, add some healthy fats, essential vitamins and minerals, and plant-based compounds to their diets, they will surely be feeling the weather in their bones when they reach a ripe old age. However, those bones wont be feeling pain or fracturing as easy as the skeletons of their non-supplementing retired friends.

References are on the next page...

References for Bone: Specialty and Macronutrients

1.       Beasley JM, et al. Is protein intake associated with bone mineral density in young women? Am J Clin Nutr. 2010 May;91(5):1311-6.

2.       Misra D, et al. Does dietary protein reduce hip fracture risk in elders? The Framingham osteoporosis study. Osteoporos Int. 2011 Jan;22(1):345-9.

3.       Xiao Y, et al. Dyslipidemic high-fat diet affects adversely bone metabolism in mice associated with impaired antioxidant capacity. Nutrition. 2011 Feb;27(2):214-20.

4.       Orchard TS, et al. Fatty acid consumption and risk of fracture in the Women's Health Initiative. Am J Clin Nutr. 2010 Dec;92(6):1452-60.

5.       Salari P, et al. A systematic review of the impact of n-3 fatty acids in bone health and osteoporosis. Med Sci Monit. 2008 Mar;14(3):RA37-44.

6.       Maggio M, et al. The impact of omega-3 fatty acids on osteoporosis. Curr Pharm Des. 2009;15(36):4157-64.

7.       Högström M, Nordström P, Nordström A. n-3 Fatty acids are positively associated with peak bone mineral density and bone accrual in healthy men: the NO2 Study. Am J Clin Nutr. 2007 Mar;85(3):803-7.

8.       Shin HD, et al. Antiosteoporotic effect of Polycan, beta-glucan from Aureobasidium, in ovariectomized osteoporotic mice. Nutrition. 2007 Nov-Dec;23(11-12):853-60.

9.       Song, H., et al. Effect of Exopolymers of Aureobasidium pullulans on Improving Osteoporosis Induced in Ovariectomized Mice. J. Microbiol. Biotechnol. (2006), 16(1), 3745

10.   van den Heuvel EG, Schoterman MH, Muijs T. Transgalactooligosaccharides stimulate calcium absorption in postmenopausal women. J Nutr. 2000 Dec;130(12):2938-42.

11.   Pérez-Conesa, D. et al. Bioavailability of calcium, magnesium and phosphorus in rats fed probiotic, prebiotic and synbiotic powder follow-up infant formulas and their effect on physiological and nutritional parameters. J Sci Food Agric. 2006 Sep 25;86(14):2327-2336

12.   Chonan O, Matsumoto K, Watanuki M. Effect of galactooligosaccharides on calcium absorption and preventing bone loss in ovariectomized rats. Biosci Biotechnol Biochem. 1995 Feb;59(2):236-9.

13.   Griffin IJ, Davila PM, Abrams SA. Non-digestible oligosaccharides and calcium absorption in girls with adequate calcium intakes. Br J Nutr. 2002 May;87 Suppl 2:S187-91.