Our bones are made up of minerals bound to a protein matrix that creates a strong framework for our bodies. During childhood and adolescence, bones grow and increase in size (eg, length). Near age 20 bones reach their peak bone mass (PBM). Therefore, prior to age 20, it is especially important for youngsters and teens to eat a healthy and balanced diet and get regular exercise.
PBM is the point at which the body has the largest amount of bone it will ever carry. After PBM is achieved, bones undergo a process called modeling when they thicken, usually through the early 30s.
The next stage is remodeling (illustration below). Remodeling is the continuous orchestrated process whereby old bone breaks down, is resorbed and replaced by new bone. After about age 34, the body may resorb more bone than it replaces causing bone mass to diminish. Bone mineral density (BMD) is the term a doctor uses when explaining how strong a patient’s bones are. BMD refers to the density, strength, and often the resiliency of bone.
To boost bone health, your doctor may recommend both calcium and Vitamin D supplements. Calcium, along with phosphorous, is one of the main minerals the body needs to create bone cells. The body also depends on calcium for a number of bodily functions — supporting the nerves, heart and other muscles in addition to some organs. Most of the calcium stored in the body is used to make and bones and teeth.
Calcium is not created in the body. It must be consumed through food or supplements, and because of the number of bodily functions that require calcium, quite a bit is needed to maintain proper bodily functions.
Therefore, supplements may be doctor-recommended for people who have difficulty absorbing calcium; such as patients with pancreatitis or an inflammatory bowel disorder. Furthermore, some medications or foods can affect calcium absorption.
How much calcium?
According to the National Institute of Health, the average daily recommended amount of calcium for a healthy adult aged 19 to 50 years is 1,000 mg. After age 50, calcium requirements go up to 1,200 mg a day. Growing children and teens ages 9 to 18, however, require the most calcium to maintain adequate levels of the mineral: 1,300 mg per day.
Foods like milk, cheese, kale, yogurt, broccoli, and fish with soft bones (ie, salmon) are rich in calcium, but sometimes diet isn’t enough to meet daily calcium requirements. People who have trouble absorbing calcium or those who have demonstrated bone loss are likely to be encouraged to take both calcium and Vitamin D supplements in addition to following a calcium-rich diet.
About Vitamin D
Vitamin D may seem like an unlikely addition to a bone-healthy supplement regimen, but calcium is useless if the body canNOT process it. Vitamin D helps the body absorb calcium in the gut, aids bone growth and remodeling, and maintains correct calcium and phosphorus serum levels to sustain normal bone mineralization. As a bonus, Vitamin D is linked to proper immune function, reduction of inflammation, and better emotional health. Vitamin D supplementation may be encouraged in patients with anxiety and/or depression.
In a way, the body produces Vitamin D by synthesizing it from exposure to sunlight. Only a few foods naturally provide Vitamin D. Swordfish, salmon, cod liver oil, tuna, and egg yolks are natural sources of Vitamin D, and certain calcium-rich foods like milk and yogurt can be fortified with Vitamin D too.
Not only can proper levels of calcium and Vitamin D stave off osteoporosis; these supplements may help lower blood pressure, manage cholesterol, and reduce the effects of premenstrual syndrome. Talk with your doctor about calcium and Vitamin D supplementation to find out if it can improve your bone health.
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National Institutes of Health (NIH). Calcium. http://ods.od.nih.gov/factsheets/Calcium-QuickFacts/. Accessed September 15, 2014.
National Institutes of Health (NIH), Office of Dietary Supplements. Vitamin D. http://ods.od.nih.gov/factsheets/VitaminD-HealthProfessional/. Accessed September 15, 2014.
Penckofer S, Kouba, J, Byrn, M, Estwing Ferrans C. Vitamin D and Depression: Where is all the Sunshine? Issues Ment Health Nurs. 2010;31(6):385–393.
Oregon State University. Micronutrient Information Center. http://lpi.oregonstate.edu/infocenter/bonehealth.html#overview. Accessed September 15, 2014.