Importance of calcium, vitamin D and vitamin K for osteoporosis prevention and treatment

Abstract

Throughout the life cycle the skeleton requires optimum development and maintenance of its integrity to prevent fracture. Bones break because the loads placed on them exceed the ability of the bone to absorb the energy involved. It is now estimated that one in three women and one in twelve men aged > 55 years will suffer from osteoporosis in their lifetime and at a cost in the UK of > £1 . 7 · 10 9 per year. The pathogenesis of osteoporosis is multifactorial. Both the development of peak bone mass and the rate of bone loss are determined by key endogenous and exogenous factors. Ca supplements appear to be effective in reducing bone loss in women late post menopause (> 5 years post menopause), particularly in those with low habitual Ca intake (< 400 mg/d). In women early post menopause (< 5 years post menopause) who are not vitamin D deficient, Ca supplementation has little effect on bone mineral density. However, supplementation with vitamin D and Ca has been shown to reduce fracture rates in the institutionalised elderly, but there remains controversy as to whether supplementation is effective in reducing fracture in free-living populations. Re-defining vitamin D requirements in the UK is needed since there is evidence of extensive hypovitaminosis D in the UK. Low vitamin D status is associated with an increased risk of falling and a variety of other health outcomes and is an area that requires urgent attention. The role of other micronutrients on bone remains to be fully defined, although there are promising data in the literature for a clear link between vitamin K nutrition and skeletal integrity, including fracture reduction.

Risk factors for metabolic bone disease in Crohnʼs disease patients

“…[2][3][4][5] In a previous case-control study that included 78 patients with CD 6 we observed that a large proportion of patients had a restrictive diet in terms of dairy products and well as of vegetables and fruits, which resulted in a significantly lower intake of calcium, vitamin D, and vitamin K, as compared to controls, all these nutrients being fundamental for bone metabolism. 7 In that same study we observed that patients with CD presented a significantly lower body mass index (BMI) as compared to controls and the prevalence of sedentarism was also higher in CD patients. 6 These latter are also risk factors for MBD.…”

Invited review: Dairy intake and bone health: A viewpoint from the state of the art

“…Less consensus exists on the proposal that plasma levels <30 ng/mL would indicate a vitamin D deficiency (Holick, 2007). The large number of people of any age in the world that are frankly vitamin D deficient or insufficient is a risk for several poor health outcomes and they need vitamin D supplementation (Lanham-New, 2008;Henry et al, 2010).…”

Interrelationships between Tooth Properties and Biochemical Bone Turnover Markers Investigated on Six-Month-Old Pig Model

“…As shown in previous studies, long-term treatment with glucocorticoids and dexamethasone inhibits bone formation and accelerates bone resorption [28]. Contrary to dexamethasone treatment, calcium administration in rational dosages in mammals improves bone formation processes leading to higher bone mass acquisition and improved bone mineral density [14,23].…”