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Calcium & Bone Health
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Calcium & Bone Health |
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Most people, especially females, are aware of osteoporosis and the role that calcium plays in it. This essay will review the key health factors known to affect the bones and how bone health can be maintained. It will end with a discussion of the newer prebiotics food fibers, especially the oligofructose enriched inulin and its newly discovered role in improving the bone health in young teenage girls.
Calcium
Calcium is one of the most common elements in nature and our bodies. Even so, a steady intake of calcium is needed to maintain bone strength and prevent osteoporosis. Since this disorder is primarily a problem for females, they, in particular, should be aware of just how much calcium they ingest each day. The following daily intake of calcium has been recommended by the U.S. Department of Agriculture.
| |
Age |
Mg Calcium/day |
| Children |
1-5
6-10 |
800
800-1,200 |
Adolescents/
Young Adults |
11-24 |
1,200-1,500 |
| Male Adults |
25-64
65+ |
1,000
1,500 |
| Female Adults |
25-49
50-64 (on estrogen)
50-64 (not on estrogen)
65+ |
1,000
1,000
1,500
1,500 |
Click here for the amount of calcium in various foods. Be sure you are getting enough.
Vitamin D < Back to Top >
Vitamin D is essential to bone health. It encourages absorption of calcium. You get vitamin D from exposure of the skin to the sun, from a limited number of foods and from dietary supplements. A remarkable recent finding is that there are receptors for vitamin D in many other tissues than the small intestine, where calcium from food is absorbed. These include the muscles, brain, prostate, breast, colon, as well as immune cells. We have to believe that there is a function served by the presence of these receptors where vitamin D attaches to cells. Indeed, disorders or diseases in these organs have been associated with vitamin D deficiency.
Additionally, vitamin D has now been found to be significantly low in many patient and age groups. The previous recommendation of 400 IU per day is felt by many authorities to be too low. 800-1200 IU is recommended as a daily dose, especially in those people who do not have significant skin sun exposure as in the elderly or those who are inactive. Vitamin D is found in a limited number of foods such as cheese, butter, vitamin D fortified milk, oily fish and eggs.
Exercise < Back to Top >
 We know that astronauts in the weightlessness of space lose calcium from their bones at a remarkably fast rate. This means, as we have known for a long time, that the force of gravity exerts a strong beneficial effect on our bones. Exercise and gravity together help to build bone strength in the young and maintain it thereafter. The type of exercise is important. It should be exercise where the long bones of the legs and those of the spine are stressed. Walking, running, yard work, sports of any type where running is a prominent feature are particularly good, including field hockey, soccer, track, basketball, tennis, etc. Bicycling and weight lifting are not quite as helpful for strengthening bones. Young girls are especially encouraged to engage in these sports as their bones never become as large or as strong as mens. A girl reaches her maximum bone density at about age 20. Thereafter, there is a steady loss of calcium in bone until menopause when it worsens.
Medications < Back to Top >
Cortisone and prednisone belong to a group of medications that are used for a variety of conditions such as asthma and intestinal disorders like Crohn's disease. When these steroid-like, anti-inflammatory drugs are taken for a prolonged period, even in very small doses, they will lead to bone loss. These patients, in particular, need to keep track of their bone density and maintain a good intake of food and supplemental calcium, exercise, vitamin D and now perhaps prebiotic soluble plant fiber.
The Don'ts < Back to Top >
Yes, there are a number of things one should not do if there is a concern about osteoporosis. These include:
- Excessive alcohol
- Cigarette smoking
- Excessive caffeine
These all aggravate bone loss and promote osteoporosis.
Medical Testing < Back to Top >
For those concerned about how their bones will look in the future, it may not be too soon to get baseline testing as a reference point. A bone density test may be appropriate. In addition, since vitamin D deficiency has been found to be so prevalent by current standards, a blood measurement of vitamin D may be warranted.
It is mothers with teenage or soon to be teenage girls who will guide the health of their daughters. As noted, a girl will reach her maximum bone density at about age 20. Thereafter, it cannot be increased. Indeed, even at this early age, there is a steady, slow decline of bone density until menopause when it usually increases more rapidly. So, it is the mother's responsibility to make her daughter's bones as strong as possible when they are young.
- Adequate calcium in food and even supplements
- Adequate vitamin D
- Leg and spine stressing exercise
- Increased intake of foods or supplements that contain prebiotics fibers
Prebiotic Foods < Back to Top >
 A prebiotic is a fiber found in some plants that reaches the colon undigested. There it is fermented by colon bacteria. This results in certain significant health benefits to the colon and the body. Inulin, a part of which is called oligofructose, is by far the most researched of these food fibers. Presently, most Americans ingest only 1-2 grams a day of this fiber. Europeans eat three times this amount. Inulin is found in small quantities in wheat and onions where Americans get 90% of their inulin. It is also found in bananas, leeks, chicory, artichokes, garlic among others.
For a full essay on prebiotics please click here.
Oligofructose Enriched Inulin - A Prebiotic Food Fiber < Back to Top >
A mixture of two prebiotics fibers called oligofructose and inulin has been studied by medical researchers as to its affect on calcium and magnesium absorption. Surprisingly, it has been found to significantly increase calcium absorption in the colon. When these fibers are fermented by the good colon bacteria, the acidity in the colon increases. This acidity appears to be related to increased calcium absorption.
Whatever the reason, some remarkable things have now been demonstrated. In young teenage girls who took oligofructose enriched inulin (our product is Prebiotin™) for one year, there was significantly increased absorption of calcium. Along with this, even more remarkably, the bone density of these young girls increased 20%.
Any increase in bone density that can be given to adolescent females should be an asset for the rest of the person's life. It means that the gradual downhill loss of bone mass begins at a higher level and so the girl should have stronger bones the rest of her life.
Oligofructose enriched inulin (Prebiotin™) is the only prebiotics food fiber with this demonstrated benefit. The recommended dose is 8 grams per day.
For a full essay on prebiotics please click here.
Summary < Back to Top >
DO
- Eat and drink adequate calcium containing foods
- Calcium supplements if needed
- Leg and spine stressing exercise
- Adequate vitamin D from sun, food and/or supplements
- Increase intake of foods that contain prebiotics fibers. Consider a supplement
DON'T
- Excessive caffeine or alcohol
- Cigarette smoking
DILEMMA
- When cortisone, prednisone, steroids are needed, consultation with physician is needed.
POSSIBLE PERIODIC TESTING
- Bone Density
- Vitamin D blood level
Medical References
Several studies in animals and humans have shown positive effects of nondigestible oligosaccharides (NDO) on mineral absorption and metabolism and bone composition and architecture. These include inulin, oligofructose, fructooligosaccharides, galactooligosaccharides, soybean oligosaccharide, and also resistant starches, sugar alcohols, and difructose anhydride. A positive outcome of dietary prebiotics is promoted by a high dietary calcium content up to a threshold level and an optimum amount and composition of supplemented prebiotics. There might be an optimum composition of fructooligosaccharides with different chain lengths (synergy products). The efficacy of dietary prebiotics depends on chronological age, physiological age, menopausal status, and calcium absorption capacity. There is evidence for an independent probiotic effect on facilitating mineral absorption. Synbiotics, i.e., a combination of probiotics and prebiotics, can induce additional effects. Wheth er a low content of habitual NDO would augment the effect of dietary prebiotics or synbiotics remains to be studied. The underlying mechanisms are manifold: increased solubility of minerals because of increased bacterial production of short-chain fatty acids, which is promoted by the greater supply of substrate; an enlargement of the absorption surface by promoting proliferation of enterocytes mediated by bacterial fermentation products, predominantly lactate and butyrate; increased expression of calcium-binding proteins; improvement of gut health; degradation of mineral complexing phytic acid; release of bone-modulating factors such as phytoestrogens from foods; stabilization of the intestinal flora and ecology, also in the presence of antibiotics; stabilization of the intestinal mucus; and impact of modulating growth factors such as polyamines. In conclusion, prebiotics are the most promising but also best investigated substances with respect to a bone-health-promoting potential, compared with probiotics and synbiotics. The results are more prominent in animal models, where more studies have been performed, than in human studies, where experimental conditions are more difficult to control.
BACKGROUND: Short-term studies in adolescents have generally shown an enhancement of calcium absorption by inulin-type fructans. Results have been inconsistent; however, and no studies have been conducted to determine whether this effect persists with long-term use. OBJECTIVE: The objective was to assess the effects on calcium absorption and bone mineral accretion after 8 wk and 1 y of supplementation with an inulin-type fructan. DESIGN: Pubertal adolescents were randomly assigned to receive 8 g/d of a mixed short and long degree of polymerization inulin-type fructan product (fructan group) or maltodextrin placebo (control group). Bone mineral content and bone mineral density were measured before randomization and after 1 y. Calcium absorption was measured with the use of stable isotopes at baseline and 8 wk and 1 y after supplementation. Polymorphisms of the Fok1 vitamin D receptor gene were determined. RESULTS: Calcium absorption was significantly g reater in the fructan group than in the control group at 8 wk (difference: 8.5 +/- 1.6%; P < 0.001) and at 1 y (difference: 5.9 +/- 2.8%; P = 0.04). An interaction with Fok1 genotype was present such that subjects with an ff genotype had the least initial response to fructan. After 1 y, the fructan group had a greater increment in both whole-body bone mineral content (difference: 35 +/- 16 g; P = 0.03) and whole-body bone mineral density (difference: 0.015 +/- 0.004 g/cm(2); P = 0.01) than did the control group. CONCLUSION: Daily consumption of a combination of prebiotic short- and long-chain inulin-type fructans significantly increases calcium absorption and enhances bone mineralization during pubertal growth. Effects of dietary factors on calcium absorption may be modulated by genetic factors, including specific vitamin D receptor gene polymorphisms.
In humans, there is increasing evidence that the colon can absorb nutritionally significant amounts of calcium, and this process may be susceptible to dietary manipulation by fermentable substrates, especially inulin-type fructans. Inulin-type fructans can modulate calcium absorption because they are resistant to hydrolysis by mammalian enzymes and are fermented in the large intestine to produce short-chain fatty acids, which in turn reduce luminal pH and modify calcium speciation, and hence solubility, or exert a direct effect on the mucosal transport pathway. Quite a few intervention studies showed an improvement of calcium absorption in adolescents or young adults by inulin-type fructans. In the same way, a positive effect has been reported in older women.
Nondigestible oligosaccharides (NDOs) have been found to stimulate absorption of several minerals and to improve mineralization of bone. Hence, these substances are potential ingredients for "functional foods." In addition to a nutritional effect, functional foods have physiologic and psychological benefits that result in improved health or reduced risk of chronic disease. Most of the scientific evidence for the functional effects of NDOs is based on animal experiments in which NDOs increased the availability of calcium, magnesium, zinc, and iron. This stimulatory effect of some NDOs is assumed to be mainly due to their prebiotic character. A prebiotic is defined as a substrate or food ingredient that is nondigestible for the host but is fermented selectively by some of the intestinal microflora. Thus, it stimulates the growth and activity of bacteria with beneficial consequences for the host's health. Recently, these findings were confirmed in human studies for s ome NDOs. The effects seem to be specific for the type of carbohydrate and are likely related to the rate of fermentation by the intestinal flora and appear to depend on the ingested dose. Contradictory results of the effect of prebiotics in literature may be due to the experimental design because the effect of NDOs depends on the dose, the time of administration, the content of calcium in the diet, the part of the skeleton investigated, and the age of the subjects studied.
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Click here to check out our prebiotic powder, Prebiotin™
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