Calcium accounts for 1–2 % of adult human body weight. Over 99 % of total body Ca is found in the teeth and bones. Therefore, in addition to the obvious structural role of the skeleton, it also serves as a reservoir for Ca. Dietary Ca intake has an important impact on bone metabolism and bone health. Chronic Ca deficiency resulting from inadequate intake or poor intestinal absorption is one of several important causes of reduced bone mass and osteoporosis. It is vital, therefore, that adequate dietary Ca is consumed at all stages of life — in early life so that the genetically programmed peak bone mass can be reached and in later adulthood so that the skeletal mass can be maintained and age-related bone loss minimised. Unfortunately, there is wide variation in the estimates of daily Ca requirements made by different expert authorities. Furthermore, there is evidence that many individuals are not consuming these recommended levels. The consequence of this for bone health will be discussed in the present review. Besides the amount of Ca in the diet, the absorption of dietary Ca in foods is also a critical factor in determining the availability of Ca for bone development and maintenance. Thus, there is a need to identify food components and/or functional food ingredients that may positively influence Ca absorption in order to ensure that Ca bioavailability from foods can be optimised. This approach may be of particular value in individuals who fail to achieve the dietary recommended level of Ca.
Osteoporosis is a debilitating disease that affects many older people. Fragility fractures are the hallmark of osteoporosis. Although nutrition is only 1 of many factors that influence bone mass and fragility fractures, there is an urgent need to develop and implement nutritional approaches and policies for the prevention and treatment of osteoporosis that could, with time, offer a foundation for population-based preventive strategies. However, to develop efficient and precocious strategies in the prevention of osteoporosis, it is important to determine which modifiable factors, especially nutritional factors, are able to improve bone health throughout life. There are potentially numerous nutrients and dietary components that can influence bone health, and these range from the macronutrients to micronutrients as well as bioactive food ingredients. The evidence-base to support the role of nutrients and food components in bone health ranges from very firm to scant, depending on the nutrient/component. This article initially overviews osteoporosis, including its definition, etiology, and incidence, and then provides some information on possible dietary strategies for optimizing bone health and preventing osteoporosis. The potential benefits of calcium, vitamin D, vitamin K1, phytoestrogens, and nondigestible oligosaccharides are briefly discussed, with particular emphasis on the evidence base for their benefits to bone. It also briefly considers some of the recent findings that highlight the importance of some dietary factors for bone health in childhood and adolescence.
1 December 2008 in The American Journal of Clinical Nutrition
Background: The relative potency of 25-hydroxyvitamin D3 to vitamin D3 needs to be better defined so that food-composition tables can better reflect the true vitamin D nutritive value of certain foods.