According to the U.S. Department of Agriculture
(USDA), Americans have failed to meet the RDA
for several key nutrients, including calcium,
magnesium, and zinc.1 Other research on both
athletes and sedentary individuals indicated that
their food intake was RDA-deficient in more than one-third of
the seven minerals analyzed.2 In addition, research done by
the USDA has shown that over a period of about 90 years,
a 3–7 percent decrease in magnesium, zinc and potassium
levels occurred in our food supply.3 Furthermore, studies from various sources demonstrated that growing conditions,
agricultural technologies and nutrient content of the soil
can reduce some minerals in some crops by as much as 300
This data clearly indicates that Americans are not getting
sufficient minerals in their diet, which can have a number
of health implications. One such implication is the loss of
bone mineral density, a common occurrence as we age,
and more prevalent in women than men.9 Consequently,
supplementation with mineral supplements can help to fill
the missing mineral gap and promote healthy bone density.
In doing so, it is important to note that calcium is not the
only nutrient necessary for helping to build bone density.
The following text will elucidate some of the key nutrients
necessary for healthy bone density, including calcium.
Potassium is necessary to help maintain normal osmotic
pressure of body fluids, the acid-base balance of the
body, and for transmission of nerve impulses and muscle
contraction. In addition, at least four cross-sectional studies
have reported significant positive associations between
dietary potassium intake and bone mineral density (BMD)
in populations of premenopausal, perimenopausal, and
postmenopausal women as well as elderly men.10,11,12 In
studies on postmenopausal women, supplementation with
potassium decreased urinary acid and calcium excretion,
resulting in increased biomarkers of bone formation and
decreased biomarkers of bone resorption.13 Other studies have
reported that supplementation with potassium decreased
urinary acid excretion and biomarkers of bone resorption in
Calcium is necessary for the formation of bones and teeth,
blood clotting, and for normal muscle and nerve activity.
Adequate calcium, along with regular exercise and a healthy
diet, helps maintain good bone health, and may help teen and
young adult women reduce their high risk for osteoporosis
later in life.15,16,17 Furthermore, daily calcium supplementation
has been shown to effectively slow bone loss.18,19,20,21 Calcium’s
role in the prevention and treatment of osteoporosis is also
well established.22 Research overwhelmingly supports the use
of calcium supplementation, alone or in combination with
other therapies, for slowing or stopping the progression of
osteoporosis.23 As a matter of fact, FDA-approved therapy
for the treatment of postmenopausal osteoporosis includes
calcium supplementation.24 In addition, osteoporosis can lead
to an increased incidence of fractures. Research has clearly
shown that calcium supplementation can help to reduce the
risk of, and even prevent fractures in osteoporosis.25,26,27,28
Regarding the types of calcium, hydroxyapatite, calcium
citrate, and calcium malate are good choices. Research
using calcium citrate/malate has demonstrated a high
level of absorption and an ability to effectively promote the
consolidation and maintenance of bone mass in adults.29
In addition, some research has shown that calcium
citrate has greater absorption than other forms such as
calcium gluconolactate and carbonate.30,31,32 Then, there is
hydroxyapatite (HA), a whole bone concentrate that provides
calcium, phosphorus and a variety of other naturally occurring
bone nutrients. Research indicates that women who use HA
gain significant cortical bone thickness as compared to women
who used calcium alone (as calcium gluconate).33
Iodine is an essential component of thyroid hormones, which
regulate metabolic rate and other functions. Thyroid hormones
have many interactions with the skeleton, and play a role in
bone growth and development in the fetal growth plate and
the normal mechanisms of mature bone remodeling.34
Magnesium is necessary for normal functioning of muscle
and nervous tissue and participates in the formation of bones
and teeth.35,36 Given its role in bone health, it is not surprising
that people with osteoporosis were reported to be at high
risk for magnesium malabsorption.37 Furthermore, bone38
and blood levels of magnesium have also been reported to
be low in people with osteoporosis.39 Research has shown
that supplementing with magnesium reduces indications of
bone loss.40 Other research has shown that supplementing
with magnesium daily also stopped bone loss, and even
increased bone mass in twenty-seven of thirty-one people with
osteoporosis in a two-year study.41
Zinc is a versatile trace mineral required as a cofactor by
more than 100 enzymes in every organ of the body. It is also
associated with the hormone insulin, involved in making
genetic material and proteins, immune reactions, transport
of vitamin A, taste perception, wound healing, the making of
sperm, and the normal development of the fetus. The highest
concentrations of zinc in the body are in bone, the prostate
gland, and the eyes.42
Low blood and bone levels of zinc have been reported
in people with osteoporosis.43 Also, research indicates that
urinary loss of zinc may be high in people with osteoporosis.44
Other research found that men consuming a good amount
of zinc in their diet had almost half the risk of osteoporosis-related
fractures compared with those consuming significantly
less dietary zinc.45 Furthermore, in one study the use of
supplemental zinc with calcium was more effective than
calcium supplementation by itself in protecting against the
loss of bone density.46
Selenium functions as a constituent of the antioxidant enzyme
glutathione peroxidase, which detoxifies products of oxidized
fats, and is found in the red blood cells. Selenium plays a
fundamental role in regulating thyroid and other functions
of the human body including reproduction, autoimmunity,
glucose metabolism and bone metabolism.47 Specifically, it is
the selenoproteins that are involved in bone metabolism.48
Copper is necessary with iron for the formation of red blood
cells and nerve fibers. It is also necessary in the formation
of the hair and skin pigment melanin. Furthermore, copper
is needed for normal bone synthesis, and one study reported that daily copper prevented bone loss.49 The potential
importance of copper for people with osteoporosis requires
further research, although consumption of some copper
can still be recommended at this time at least for general
Manganese is an activator of enzymes (cofactor), and is
involved in fatty acid metabolism and protein synthesis. It also
plays a role in bone health.50 Unpublished research indicated
that manganese deficiency occurred in a small group of
women with osteoporosis,51 and published research using a
combination of minerals including manganese was reported
to halt bone loss.52
Chromium participates in glucose metabolism by enhancing
the effects of insulin.53 Since some data suggest that insulin
is a potential anabolic agent in bone, this insulin-enhancing
effect of chromium may contribute to bone health.54
In humans, molybdenum is known to function as a cofactor
for three enzymes: sulfite oxidase, xanthine oxidase, and
aldehyde oxidase. Sulfite oxidase catalyzes the transformation
of sulfite to sulfate, a reaction that is necessary for the
metabolism of sulfur-containing amino acids (methionine
and cysteine). Xanthine oxidase catalyzes the breakdown
of nucleotides (precursors to DNA and RNA) to form uric
acid, which contributes to the plasma antioxidant capacity
of the blood. Aldehyde oxidase and xanthine oxidase catalyze
hydroxylation reactions that involve a number of different
molecules with similar chemical structures. Xanthine oxidase
and aldehyde oxidase also play a role in the metabolism of
drugs and toxins.55
Silica has been recognized as playing a significant role in bone
formation.56 Also, supplementation with silica has increased
bone formation in animal research.57 In human research,
supplementation with silica increased bone mineral density
in a group of eight women with osteoporosis.58 Bamboo stem
extract is a rich source of silica, and is used in this formulation.
Chronically low intakes of the trace mineral boron may predispose
people to osteoporosis.59 Changes caused by boron
deprivation include reduced blood levels of calcium, as
well as an increase in urinary excretion of calcium. Boron
deprivation causes changes similar to those seen in women
with postmenopausal osteoporosis, and this mineral is
needed to prevent the excessive bone loss, which often occurs
in postmenopausal women and older men.60 In addition,
studies have reported possible improvements in bone mineral
density in women who were supplemented with boron.61 For
example, research has found that supplementation with 3 mg
daily of the boron reduced urinary loss of both calcium and
Vanadium is a trace mineral that appears to be important in
normal bone growth and as a cofactor for various enzyme
reactions. The highest concentrations of vanadium are found
in the liver, kidney, and bone.63 Some evidence suggests
that vanadium can mimic the actions of insulin, possibly by
causing phosphorylation of insulin receptor proteins.64 Since
some data suggest that insulin is a potential anabolic agent in
bone, this insulin-mimicking action of vanadium may further
contribute to bone health.65
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- Sebastian A, Harris ST, Ottaway JH, Todd KM, Morris RC, Jr. Improved mineral balance and skeletal metabolism in postmenopausal women treated with potassium bicarbonate. N Engl J Med 1994;330(25):1776–81.
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