Better Bones and Joints
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[Bone Health] Vol. 10 No. 11 October 2005 Better Bones and Joints By Steve Myers, Managing Editor Beyond injuries, bones and joints can be affected by numerous diseases and conditions, including inflammation, arthritis and osteoporosis. While bones can often regenerate and heal, age saps the ability to do so, and poor bone and joint health can devastate the body even further. However, bones are living tissue sensitive to diet and exercise; thus, certain vitamins, minerals and specialty supplement ingredients can be useful in both maintaining good general bone health and addressing specific aspects of bone and joint diseases. A human adult is comprised of 206 bones and more than 230 moveable and semi-movable joints, all of which are a part of a musculoskeletal system that keeps a person vertical and mobile, and protects softer inner body parts. However, bones are more than just structural. Inside bone is soft marrow, which is home to stem cells that produce the body's red blood cells and platelets. The periosteum, the outer membrane on bone, is dense with blood vessels and nerves that nourish and signal the bones for growth and repair. Three kinds of cells are special to bone. Osteocytes carry nutrients and waste to and from bone; osteoblasts help make new bone and repair damaged bone; and osteoclasts break down bone and reshape it. Lifestyle factors prominently in bone health. Muscles attached to and surrounding bones move limbs, fingers and other body parts. Therefore, strong, healthy muscles contribute to bone health. Experts have advised weight-bearing exercise not only improves muscle, but it also promotes bone formation. A In a 2005 Swiss study, one year of regular weight bearing exercise increased bone mineral density (BMD), a crucial marker in gauging bone strength and health.(1) Health officials also advise increased consumption of alcohol and caffeine can contribute to bone loss, as can long-term cigarette smoking. Beyond lifestyle factors, a 2005 study revealed chemotherapy treatments can cause decreased BMD.(2) Bone is made mostly of calcium and protein collagen, as well as phosphorus, magnesium and other trace minerals. In fact, 99 percent of the body's calcium is in the bones, which store the mineral and release it into the bloodstream as it is needed in other parts of the body. In fact, if the body's calcium levels are not sufficient, the mineral is pulled from the bones. For these reasons, adequate dietary calcium intake has forever been linked to healthy bones. A Cochrane Database System Review investigating data from 15 trials involving more than 1,800 people concluded calcium supplementation had a positive effect on bone density and reduced vertebral fractures.(3) Similarly, a controlled study of 200 Chinese postmenopausal women found consumption of high-calcium skim milk (providing 1,200 mg/d of calcium) led to reduced bone loss in the lumbar spine and hip.(4) According to a 2005 study conducted by Purdue University researchers, increased dietary calcium from dairy protected total hip BMD and spine BMD from loss in young healthy women who previously had low calcium intake and were taking oral contraceptives.(5) www.naturalproductsinsider.com Page 1 [Bone Health] Vol. 10 No. 11 October 2005 The Food and Drug Administration (FDA) recognized the importance of calcium intake and authorized a bone health claim for calcium-rich foods. The National Institutes of Health (NIH) reported high Bone or Fat: The Role of Bone Marrow in Bone Health and Disease Located in the cavities of bone is marrow, a soft tissue that is home to stem cells, which form a host of different blood cells, including white and red blood cells, and platelets. Over time, the blood cells in bone marrow, which starts as red marrow, turns into fat and is called yellow marrow. Bone marrow has very little fat content at birth, but it is half fat when a person is about 30 years old, and it is almost entirely fat by old age. Science has determined a stem cell present in bone marrow can turn into fat or bone, depending on the signals it receives. Furthermore, contrary to initial belief, bone cavities associated with osteoporosis are not empty, but are filled with this fatty yellow marrow. Studies have shown people with osteoporosis have more of this bone fat than do people of the same age without osteoporosis. Scientists studying bone marrow stem cells in vitro reported stem cells subjected to glucocorticoids, drugs that cause bone loss, overwhelmingly turned into fat; conversely, stem cells subjected to vitamin D3 turned into bone.(1) How this would translate in vivo and how vitamin D intake, plasma levels or supplementation would impact the conversion is still unknown. But it creates interesting possibilities. Recent research conducted at the Massachusetts Institute of Technology (MIT) has unveiled a gene called TAZ that is responsible for signaling adult bone marrow stem cells to turn into bone, fat or muscle.(2) Now the race is on to find substances that influence expression of the TAZ gene and, thus, could modulate bone formation and one aspect of osteoporosis. Science still has many questions to answer on bone formation, but it is clear bone marrow plays a role. Also, scientists from University of Vienna, Austria, studying animal models reported bone marrow actively participates in arthritis, particularly inflammatory arthritis.(3) They noted arthritis can destroy the cortical bone barrier, exposing bone marrow to synovial fluid and affecting the severity of rheumatoid arthritis. Therefore, in addition to its importance to blood cell production and the immune system, maintaining healthy bone marrow is vital to bone health. Healthy bone marrow requires adequate nutrient intakes, especially B vitamins such as B12, niacin, folic acid and biotin. Natural ingredients can aid bone health in other ways. Studies show yeast-derived beta-glucans (as WGP 3-6® from Biothera) is taken up by gastrointestinal macrophage cells and broken down in the bone marrow to smaller parts that can enhance granulocyte activity.(3) Further research found WGP 3-6 improved recovery following bone marrow injury.(4) References: 1. Gimble JM and Kelly KA. "1,25-Dihydroxy Vitamin D3 Inhibits Adipocyte Differentiation and Gene Expression in Murine Bone Marrow Stromal Cell Clones and Primary Cultures." Endocrinol. 139, 5:2622-8, 1998. 2. Yaffe MB et al. "TAZ, a transcriptional modulator of mesenchymal stem cell differentiation." Science 309, 5737:1074- 8, 2005. 3. Gortz B et al. "Arthritis induces lymphocytic bone marrow inflammation and endosteal bone formation." J Bone Mineral Res. 19, 6:990-8, 2004. 3.Hong F et al. "Mechanism by which orally administered beta-1,3-glucans enhance the tumoricidal activity of antitumor monoclonal antibodies in murine tumor models." J Immunol. 173:797-806, 2004. 4. Le Blanc, BW. "The effect of beta-glucan on cytokine transcription in the macrophages." Presented at Experimental Biology & the 35th International Congress of Physiological Sciences, April 2005. www.naturalproductsinsider.com Page 2 [Bone Health] Vol. 10 No. 11 October 2005 calcium intake reduces the risk of osteoporosis, a bone disease categorized by low bone mass and impaired bone structural integrity. About 10 million Americans suffer from osteoporosis, with another 34 million people at risk for the disease. A whopping 68 percent of those inflicted or at risk are women, according to NIH, which also reported osteoporosis-related costs exceed $14 billion annually. Addressing these costs, a study commissioned by the Dietary Supplement Education Alliance (DSEA) and conducted by respected Washington-based research firm the Lewin Group found calcium supplements (1,200 mg/d) could prevent 734,000 hip fractures in people over 65, producing a net savings of $13.9 billion in the next five years.(6) Echoing the importance of such savings, top cancer prevention expert Harold Newmark advised the government in 2004 that vitamin D and calcium food fortification would lead to a 20- percent reduction in colon cancer and osteoporosis fractures.(7) Calcium is often taken in combination with vitamin D, which promotes absorption in the gastrointestinal (GI) tract. While numerous studies have shown positive bone health benefits from this supplement combination, a recent study conducted in the United Kingdom and published in the Lancet and British Medical Journal questioned the efficacy of this vitamin-mineral tandem in preventing hip fractures in high-risk populations.(8) However, many experts noted a significantly low patient compliance issue threatened the accuracy of the studies results. Vitamin D has stood on its own in various bone health study, as daily intake between 500 IU and 800 IU (with or without calcium) has been shown to increase BMD.(9) The body can produce vitamin D from sunlight absorbed through the skin, but people with limited sun exposure might need the help of supplements. In addition, the body's ability to produce vitamin D from sun exposure declines with age, making vitamin D supplements increasingly important for the elderly. An Australian study demonstrated cyclic variations in serum vitamin D levels corresponded to changes in ultraviolet light exposure; they also found an increase in bone resorption (process by which bone is destroyed and absorbed into the body) and bone fractures as vitamin D levels declined.(10) Vitamin D deficiency has also been linked to women who spend most of their time in the home, especially those suffering bone fractures.(11) In a 2005 Japanese study, ED-71, a new active form of vitamin D with improved binding to vitamin D binding protein (DBP), effectively and safely increased lumbar and hip BMD in osteoporotic patients who were under vitamin D supplementation.(12) Calcium and vitamin D certainly dominate bone health nutrition, but other micronutrients can improve various aspects of bone density and disease.