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Bone support

Calcium - Vitamine D
Expert opinion

Calcium - Vitamine D

  • Increase bone density
  • Strengthen the bone architecture
  • Significantly reduce the risk of osteoporosis
  • Are often insufficiently taken through the diet

Calcium and movement affect bone strength

Approximately 99% of the body's calcium is found in the skeleton. This calcium supply regulates the calciaemia (amount of calcium in the blood). Bone is a dynamic tissue. When the calcium intake is too small to meet the body's needs, calcium is extracted from the skeleton. This process weakens the bones, affects the bone structure and can lead to bone decalcification or osteoporosis.

Several factors influence the quality of the bone structure. These include hereditary factors, lifestyle and total dietary calcium intake or an easily absorbable dietary supplement. Numerous studies have shown that, in addition to sufficient calcium, regular mechanical stress on the bones through physical activity results in an increased bone mass and stronger bones.

References:
  • Behringer M, Gruetzner S, McCourt M, Mester J. Effects of weight-bearing activities on bone mineral content and density in children and adolescents: a meta-analysis. J Bone Miner Res 2014; 29(2):467-78.
  • Uusi-Rasi K, Karkkainen MU, Lamberg-Allardt CJ. Calcium intake in health maintenance – a systematic review. Food & nutrition research 2013; 57.

Negative calcium balance increases the risk of osteoporosis

In adults over the age of 45, bone breakdown takes precedence and the loss of bone mass causes a negative calcium balance (more bone breakdown than bone formation). The calcium deficiency from this age is more present in women than in men. This is due to reduced estrogen production as a result of the menopause. Therefore, it is important to take sufficient calcium throughout life as part of a balanced diet.

References:
  • Jackson et al. Calcium plus vitamin D supplementation and the risk of fractures. N Engl J Med. 2006 Feb 16;354(7):669-83.
  • Thulkar et al. Preventable risk factors for osteoporosis in postmenopausal women: Systematic review and meta-analysis. J Midlife Health. 2016 Jul-Sep;7(3):108-113.

Risk factors for osteoporosis or osteoporosis

It's hard to tell who gets osteoporosis and who doesn't. However, there are certain factors that play an important role in the development of osteoporosis:

  • Gender: women are more at risk than men
  • Osteoporosis in the family (mother or father with osteoporosis)
  • Long-term use of medicinal products (e.g. cortisone)
  • Insufficient exercise
  • Age (over 45 years)
  • Insufficient calcium intake
  • A deficiency of vitamin D
  • Smoke
  • Alcohol (more than 2 glasses daily)
  • Foods rich in oxalic acid and phytic acid; oxalic acid is present in, for example, spinach, rhubarb and sorrel; phytic acid is found in whole grains; eating too many of these foods can prevent the absorption of calcium
  • Excessive consumption of meat, salt, coffee and tea stimulates the removal of calcium via the urine.
References:
  • Body et al. Non-pharmacological management of osteoporosis: a consensus of the Belgian Bone Club. Osteoporos Int. 2011 Nov;22(11):2769-88.
  • Waugh et al. Risk factors for low bone mass in healthy 40-60 year old women: a systematic review of the literature. Osteoporos Int. 2009 Jan;20(1):1-21.

Without vitamin D no good calcium absorption

Vitamin D is needed to absorb calcium from the diet into the body. Therefore, vitamin D is for the growth and maintenance of firm bones and teeth. Sunlight is the main source of vitamin D. The body can produce vitamin D itself under the influence of sunlight in the skin. Vitamin D is also present in a limited way in food. Especially fatty fish is an important source of vitamin D.

References:
  • Sirichakwal et al. Vitamin D Status Is Positively Associated with Calcium Absorption among Postmenopausal Thai Women with Low Calcium Intakes. J Nutr. 2015 May;145(5):990-5.

Vitamin D3 or vitamin D2?

In food, we find vitamin D in two forms: ergocalciferol (vitamin D2) and cholecalciferol (vitamin D3). Vitamin D2 is found in mushrooms, vitamin D3 is of animal origin. Both forms of vitamin D are biologically active but the effect of vitamin D3 is strong than that of vitamin D2. Conclusion? When there is an extra need for vitamin D, vitamin D3 is preferred.

References:
  • Dereje et al. Cholecalciferol (D₃) Versus Ergocalciferol (D₂) in Older Adults. Consult Pharm. 2017 Jun 1;32(6):337-339.
  • Gottschlich et al. Clinical Trial of Vitamin D2 vs D3 Supplementation in Critically Ill Pediatric Burn Patients. JPEN J Parenter Enteral Nutr. 2017 Mar;41(3):412-421