Bone Health Support | Elite Nutrition Serv

Bone Health Protocol

Fragility fractures, a marker of weakened bone structure, result in an increased risk of future fractures 1 and are a risk factor for disability, morbidity, and mortality (2-3). The risk of fracture increases with age, with an approximate rate of bone loss of 0.5 to 1% yearly, after reaching peak bone mass (4). These effects are seen particularly after the age of 50 and in postmenopausal women. 3,5 Further evidence shows that elderly individuals are especially vulnerable to hip fractures, which affect approximately 30% of women and 15% of men by the age of 90 (2).

Fracture rates increase when there is a disparity between bone formation by osteoblasts and bone resorption by osteoclasts, leading to decreases in bone mineral density (BMD) and increased bone fragility (4,6). Therefore, improvements in bone mineral density and bone turnover may reduce the risk of frailty and fracture. The protocol presented below includes ingredients and supportive evidence focused on improving bone integrity and decreasing fracture risk.

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About the Protocol

Vitamin D – Vitamin D3 1000

Recommended Dose: 400-2,000 IU, total per day, minimum 1 year (2,7-10)

*Note, combination with Calcium may improve efficacy

D3 1000™ features high potency vitamin D3—the most bioactive form of supplemental vitamin D—in easy-to-swallow microtablets.
Vitamin D is important for maintaining healthy bone strength and immune function.

Benefits of Vitamin D:

Associated with 70% better probability than placebo for the prevention of non-vertebral fractures, hip fractures, and non-vertebral, non-hip fractures in postmenopausal women (7)
Research trials found high dose vitamin D supplementation (400 IU/day or more) decreased fracture risk in community-dwelling individuals by 29% and institutionalized older individuals by 15% (2)

Vitamin K- Vitamin D3 + K2

Recommended Dose: Vitamin K2: 45-90 mg per day as menatetrenone (MK-4), or 100-300 µg per day as MK-7 for 6-48 months (11-13)

Vitamin D3 and Vitamin K2-7 complement each other to support bone health. D3 enhances calcium absorption and reduces excretion, maintaining healthy serum levels.
K2-7 aids bone mineralization by activating osteocalcin, promoting calcium binding in bone.
It also supports cardiovascular health by aiding Matrix Gla Protein carboxylation, maintaining normal calcium metabolism and vascular elasticity.
K2 may additionally support healthy lipid and glucose metabolism.

Potassium Citrate

Recommended Dose: 90 mmol (3,500 mg), total per day, for six months (13); 50-60 mEq, total per day, for one year (14,15)

Potassium is an important mineral required by the body in relatively large amount. Potassium Citrate is a pure source of potassium, with good bioavailability.

Magnesium Glycinate Complex (formerly Magnesium Buffered Chelate)

Recommended Dose: 300-365 mg elemental magnesium total per day as magnesium oxide, magnesium citrate, or magnesium carbonate; minimum 1-12 months (16-18)

Magnesium Glycinate Complex contains highly absorbable magnesium with each capsule providing 150 mg of elemental magnesium.
This product should not cause any of the unfavorable gastrointestinal (GI) symptoms associated with magnesium supplementation due to the very stable chelate formed between two glycine molecules and each magnesium ion via a patented process.

Calcium-Bone Builder

Recommended Dose: 500-1,200 mg, as calcium carbonate, calcium citrate, or calcium microcrystalline hydroxyapatite, total per day, minimum 1 year 5, (19-25)

Bone Builder® supports bone health and bone mineral density with a comprehensive formula backed by more than 30 years of research.
Features microcrystalline hydroxyapatite (MCHC), a naturally occurring component of bone that contains naturally occurring calcium, phosphorus, and other minerals
Ideal for people who prefer tablets

References

1.Elliot-Gibson, V., Bogoch, E. R., Jamal, S. A., & Beaton, D. E. (2004). Practice patterns in the diagnosis and treatment of osteoporosis after a fragility fracture: a systematic review. Osteoporosis International: A Journal Established as Result of Cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 15(10), 767–778. https://pubmed.ncbi.nlm.nih.gov/15258724/ 2.Bischoff-Ferrari, H. A., Willett, W. C., Wong, J. B., Giovannucci, E., Dietrich, T., & Dawson-Hughes, B. (2005). Fracture prevention with vitamin D supplementation: a meta-analysis of randomized controlled trials. JAMA: The Journal of the American Medical Association, 293(18), 2257–2264. https://pubmed.ncbi.nlm.nih.gov/15886381/ 3.Zhou, Q., Zhu, L., Zhang, D., Li, N., Li, Q., Dai, P., Mao, Y., Li, X., Ma, J., & Huang, S. (2016). Oxidative Stress-Related Biomarkers in Postmenopausal Osteoporosis: A Systematic Review and Meta-Analyses. Disease Markers, 2016, 7067984. https://pubmed.ncbi.nlm.nih.gov/27594735/ 4.Zheng, X., Lee, S.-K., & Chun, O. K. (2016). Soy Isoflavones and Osteoporotic Bone Loss: A Review with an Emphasis on Modulation of Bone Remodeling. Journal of Medicinal Food, 19(1), 1–14. https://pubmed.ncbi.nlm.nih.gov/26670451/ 5.Weaver, C. M., Alexander, D. D., Boushey, C. J., Dawson-Hughes, B., Lappe, J. M., LeBoff, M. S., Liu, S., Looker, A. C., Wallace, T. C., & Wang, D. D. (2016). Calcium plus vitamin D supplementation and risk of fractures: an updated meta-analysis from the National Osteoporosis Foundation. Osteoporosis International: A Journal Established as Result of Cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 27(1), 367–376. https://pubmed.ncbi.nlm.nih.gov/26510847/ 6.Cesareo, R., Iozzino, M., D’onofrio, L., Terrinoni, I., Maddaloni, E., Casini, A., Campagna, G., Santonati, A., & Palermo, A. (2015). Effectiveness and safety of calcium and vitamin D treatment for postmenopausal osteoporosis. Minerva Endocrinologica, 40(3), 231–237. https://pubmed.ncbi.nlm.nih.gov/26205648/ 7.Bergman, G. J. D., Fan, T., McFetridge, J. T., & Sen, S. S. (2010). Efficacy of vitamin D3 supplementation in preventing fractures in elderly women: a meta-analysis. Current Medical Research and Opinion, 26(5), 1193–1201. https://pubmed.ncbi.nlm.nih.gov/20302551/ 8.Bischoff-Ferrari, H. A., Willett, W. C., Wong, J. B., Stuck, A. E., Staehelin, H. B., Orav, E. J., Thoma, A., Kiel, D. P., & Henschkowski, J. (2009). Prevention of nonvertebral fractures with oral vitamin D and dose dependency: a meta-analysis of randomized controlled trials. Archives of Internal Medicine, 169(6), 551–561. https://pubmed.ncbi.nlm.nih.gov/19307517/ 9.Boonen, S., Lips, P., Bouillon, R., Bischoff-Ferrari, H. A., Vanderschueren, D., & Haentjens, P. (2007). Need for additional calcium to reduce the risk of hip fracture with vitamin d supplementation: evidence from a comparative metaanalysis of randomized controlled trials. The Journal of Clinical Endocrinology and Metabolism, 92(4), 1415–1423. https://pubmed.ncbi.nlm.nih.gov/17264183/ 10.Izaks, G. J. (2007). Fracture prevention with vitamin D supplementation: considering the inconsistent results. BMC Musculoskeletal Disorders, 8, 26. https://pubmed.ncbi.nlm.nih.gov/17349055/ 11.Fang, Y., Hu, C., Tao, X., Wan, Y., & Tao, F. (2012). Effect of vitamin K on bone mineral density: a meta-analysis of randomized controlled trials. Journal of Bone and Mineral Metabolism, 30(1), 60–68. https://pubmed.ncbi.nlm.nih.gov/21674202/ 12.Huang, Z.-B., Wan, S.-L., Lu, Y.-J., Ning, L., Liu, C., & Fan, S.-W. (2015). Does vitamin K2 play a role in the prevention and treatment of osteoporosis for postmenopausal women: a meta-analysis of randomized controlled trials. Osteoporosis International: A Journal Established as Result of Cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 26(3), 1175–1186. https://pubmed.ncbi.nlm.nih.gov/25516361/ 13.Moseley, K. F., Weaver, C. M., Appel, L., Sebastian, A., & Sellmeyer, D. E. (2013). Potassium citrate supplementation results in sustained improvement in calcium balance in older men and women. Journal of Bone and Mineral Research: The Official Journal of the American Society for Bone and Mineral Research, 28(3), 497–504. https://pubmed.ncbi.nlm.nih.gov/22991267/ 14.Gregory, N. S., Kumar, R., Stein, E. M., Alexander, E., Christos, P., Bockman, R. S., & Rodman, J. S. (2015). POTASSIUM CITRATE DECREASES BONE RESORPTION IN POSTMENOPAUSAL WOMEN WITH OSTEOPENIA: A RANDOMIZED, DOUBLE-BLIND CLINICAL TRIAL. 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A randomized controlled study of effects of dietary magnesium oxide supplementation on bone mineral content in healthy girls. The Journal of Clinical Endocrinology and Metabolism, 91(12), 4866–4872. https://pubmed.ncbi.nlm.nih.gov/17018656/ 18.Dimai, H. P., Porta, S., Wirnsberger, G., Lindschinger, M., Pamperl, I., Dobnig, H., Wilders-Truschnig, M., & Lau, K. H. (1998). Daily oral magnesium supplementation suppresses bone turnover in young adult males. The Journal of Clinical Endocrinology and Metabolism, 83(8), 2742–2748. https://pubmed.ncbi.nlm.nih.gov/9709941/ 19.Bristow, S. M., Gamble, G. D., Stewart, A., Horne, L., House, M. E., Aati, O., Mihov, B., Horne, A. M., & Reid, I. R. (2014). Acute and 3-month effects of microcrystalline hydroxyapatite, calcium citrate and calcium carbonate on serum calcium and markers of bone turnover: a randomised controlled trial in postmenopausal women. 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