What is bone health?
Bones are dynamic, specialized connective tissue that play an integral role in maintaining the proper functioning of the body. Healthy bones are strong and dense, and play the following essential roles in the body:
- providing support for body structure and muscle attachment, allowing us to move and exercise freely
- protecting vital organs
- housing bone marrow, where blood and bone cells are formed
- participating in hormonal homeostasis
- serving as a storage depot for minerals like calcium and phosphorus
Given this remarkable range of responsibilities, bone health is multifaceted and inextricably linked to other organ systems (e.g., muscular, endocrine, and gastrointestinal).
How is bone health measured?
Bone health is first assessed by a medical provider through a detailed history and physical exam, which may include validated risk factor screening tools for bone-related issues. Findings from this assessment dictate whether and how bone health will be measured. Bone mineral density (BMD) is the most common way to measure someone’s bone health.
How does physical activity affect bone health?
An appropriate and well-designed exercise program is an excellent way to preserve and improve bone health. Not only does exercise increase BMD, but it also protects against falls/injuries through enhanced muscle strength, balance, and coordination. The exercises that are most beneficial for bone health vary somewhat depending on one’s age and comorbidities, but resistance training (like weight lifting),[1] plyometrics (like bodyweight jumps),[2] weight-bearing exercises (like running and stair climbing),[3] and activities that promote multidirectional loading of bone tissue (like playing sports)[4] are all effective for promoting bone health. Resistance training may be especially important for postmenopausal individuals and older adults who are at higher risk of osteoporosis.[1][5]
It is important to note that too much exercise may be detrimental to bone health. Excessive exercise without adequate recovery and nutrition may result in a condition known as relative energy deficiency in sport (RED-S), which is characterized by decreased bone mass.[6]
Have any supplements been studied for bone health?
Calcium and vitamin D have been extensively studied for their effect on bone health in a variety of populations. Although a diet that contains adequate calcium and vitamin D is important for bone health, there is little evidence that calcium supplements — administered with or without vitamin D — reduce the risk of fractures.[7] However, calcium and/or vitamin D supplementation may confer a small benefit to BMD and reduce fracture risk in two groups of people: those with extremely low baseline levels of calcium or vitamin D, and older adults who are at an increased risk of osteoporosis.[8]
Other supplements that may affect bone health can be found in the Examine Database for bone health, below.
How can diet affect bone health?
A well-balanced diet that matches a person’s energy needs is important for bone health. Three nutrients that are particularly vital for bones are calcium, vitamin D, and protein. These nutrients contribute to establishing peak bone mass in childhood, and, in adults, they maintain bone mass and prevent bone loss with age. Low-protein diets are associated with reduced bone mass and fracture risk in older adults.[9] A lack of vitamin D and calcium can cause soft, weak bones in children, a condition known as rickets. In adults, this condition is known as osteomalacia.[10]
Other beneficial nutrients for bone health include copper, zinc, fluoride, magnesium, phosphorus, vitamin C, vitamin K, and omega-3 fatty acids.[11][12] Diets that contain fruits and vegetables (e.g., the Mediterranean diet), dairy products, seafood, and a low intake of alcohol, caffeine, and sodium are all associated with better bone health.[11]
The best diet for bone health also depends on a person’s pre-existing medical conditions. For example, a gluten-free diet may improve bone mass in people with celiac disease.[13]
Which other factors can affect bone health?
Having underweight, smoking cigarettes, being a woman, being of white or Asian descent, having a family history of osteoporosis, and long-term use of certain medications (including corticosteroids, breast cancer treatments, selective serotonin reuptake inhibitors (SSRIs), and proton pump inhibitors) are risk factors for poor bone health.[14][15]
Certain diseases may elevate the risk for poor bone health. These include anorexia, cancer, type 2 diabetes, inflammatory bowel disease, liver or kidney disease, multiple sclerosis, thyroid disorders, lupus, alcohol use disorder, Cushing’s disease, and rheumatoid arthritis.[16]
Examine Database: Bone Health
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Frequently asked questions
Bones are dynamic, specialized connective tissue that play an integral role in maintaining the proper functioning of the body. Healthy bones are strong and dense, and play the following essential roles in the body:
- providing support for body structure and muscle attachment, allowing us to move and exercise freely
- protecting vital organs
- housing bone marrow, where blood and bone cells are formed
- participating in hormonal homeostasis
- serving as a storage depot for minerals like calcium and phosphorus
Given this remarkable range of responsibilities, bone health is multifaceted and inextricably linked to other organ systems (e.g., muscular, endocrine, and gastrointestinal).
Bone health is determined by genetics and the environment. Throughout life, both internal (e.g., genetics and hormones) and external (e.g., exercise and diet) factors are continually modeling and remodeling bones. The remodeling occurs via a complex and carefully orchestrated interplay between bone resorption (bone breakdown) and bone deposition (bone formation). Bone mass, i. e., the amount of minerals in the bone, reflects the interplay between these two processes.
Most bone mass is accrued early in life, with peak bone mass achieved by the age of 30. In later life, bone remodeling continues, but more bone is generally lost than gained. However, this doesn’t mean bone health can’t improve at any age. In fact, it is estimated that most of the adult skeleton is replaced every ten years, and lifestyle choices can modify the strength and health of these “new” bones.
Bone health is first assessed by a medical provider through a detailed history and physical exam, which may include validated risk factor screening tools for bone-related issues. Findings from this assessment dictate whether and how bone health will be measured. Bone mineral density (BMD) is the most common way to measure someone’s bone health.
One common measurement of bone health is a BMD test.[17] A BMD test measures bone density in the hip and lumbar spine. It is used to diagnose osteoporosis, predict fracture risk, and monitor therapeutic outcomes. The results of a BMD test are provided as a T-score, which compares your BMD to established norms for your sex, age, and other demographic information. Results of a BMD test are presented as “normal”, “low bone mass”, “osteoporosis”, and “severe or established osteoporosis”.
Other measures that may be used to assess bone health include imaging (e.g., X-rays), genetic testing, and blood tests for hormones (e.g., growth hormone, parathyroid hormone, calcitonin, cortisol, and sex hormones); markers of bone turnover (e.g., C-telopeptide crosslink, bone-specific alkaline phosphatase, and amino-terminal propeptide of type I procollagen); and certain nutrients (e.g., vitamin D and calcium).
An appropriate and well-designed exercise program is an excellent way to preserve and improve bone health. Not only does exercise increase BMD, but it also protects against falls/injuries through enhanced muscle strength, balance, and coordination. The exercises that are most beneficial for bone health vary somewhat depending on one’s age and comorbidities, but resistance training (like weight lifting),[1] plyometrics (like bodyweight jumps),[2] weight-bearing exercises (like running and stair climbing),[3] and activities that promote multidirectional loading of bone tissue (like playing sports)[4] are all effective for promoting bone health. Resistance training may be especially important for postmenopausal individuals and older adults who are at higher risk of osteoporosis.[1][5]
It is important to note that too much exercise may be detrimental to bone health. Excessive exercise without adequate recovery and nutrition may result in a condition known as relative energy deficiency in sport (RED-S), which is characterized by decreased bone mass.[6]
To improve bone strength, exercise should be dynamic, induce a high strain on the bone, and be applied rapidly in multiple directions. One way to achieve this is through progressive, high-load resistance training.[18] For the best effects, it’s important to utilize a heavy load (80%–85% of your maximal strength), perform training at least twice per week, and involve major muscle groups. High-impact, high-load exercises, such as jumping, bounding, skipping, drop jumps, and (to some extent) running, are also effective for stimulating bone. Incorporating these exercises 4–7 times per week at a dose of 10–50 “impacts” per day appears to be optimal.[19] Combining high-impact exercise with vitamin D and calcium or progressive resistance training can lead to further improvements in bone health.
Walking is often recommended as a way to maintain bone health. However, some meta-analyses suggest that walking has minimal to no effects on BMD, likely because the impact isn’t high enough.[20][21] In addition, prolonged endurance exercises like swimming, and cycling — while beneficial for cardiovascular health — provide very little osteogenic (bone-forming) activity.[22]
Calcium and vitamin D have been extensively studied for their effect on bone health in a variety of populations. Although a diet that contains adequate calcium and vitamin D is important for bone health, there is little evidence that calcium supplements — administered with or without vitamin D — reduce the risk of fractures.[7] However, calcium and/or vitamin D supplementation may confer a small benefit to BMD and reduce fracture risk in two groups of people: those with extremely low baseline levels of calcium or vitamin D, and older adults who are at an increased risk of osteoporosis.[8]
Other supplements that may affect bone health can be found in the Examine Database for bone health, below.
A well-balanced diet that matches a person’s energy needs is important for bone health. Three nutrients that are particularly vital for bones are calcium, vitamin D, and protein. These nutrients contribute to establishing peak bone mass in childhood, and, in adults, they maintain bone mass and prevent bone loss with age. Low-protein diets are associated with reduced bone mass and fracture risk in older adults.[9] A lack of vitamin D and calcium can cause soft, weak bones in children, a condition known as rickets. In adults, this condition is known as osteomalacia.[10]
Other beneficial nutrients for bone health include copper, zinc, fluoride, magnesium, phosphorus, vitamin C, vitamin K, and omega-3 fatty acids.[11][12] Diets that contain fruits and vegetables (e.g., the Mediterranean diet), dairy products, seafood, and a low intake of alcohol, caffeine, and sodium are all associated with better bone health.[11]
The best diet for bone health also depends on a person’s pre-existing medical conditions. For example, a gluten-free diet may improve bone mass in people with celiac disease.[13]
The relationship between gut health and bone health — known as the gut-bone axis — is an emerging area of research.[25] There are a number of potential ways in which the two may be connected. For one, gut dysbiosis impairs the absorption of calcium in the intestines. Additionally, several gut-derived metabolites exert control over cells that are responsible for bone turnover. Finally, gut-dysbiosis-induced intestinal permeability causes the release of inflammatory cytokines into the bloodstream, which can negatively affect BMD and other bone-health-related factors.
Prebiotics and probiotics have been investigated for their ability to improve bone health via their effects on the gut microbiome. While more research is needed, some evidence suggests that probiotic supplementation may protect against the loss of BMD and improve markers of bone turnover in postmenopausal women.[25]
Modulation of the gut microbiota through other means, such as diet, synbiotics, postbiotics, antibiotics, and fecal microbiota transplantation, is another avenue through which the gut-bone axis can be targeted to improve bone health. The Mediterranean diet may exert favorable effects on reducing fracture risk due to its high content of fiber, fermented dairy, and polyphenols, which favorably alter the composition of the gut microbiome.[26]
Having underweight, smoking cigarettes, being a woman, being of white or Asian descent, having a family history of osteoporosis, and long-term use of certain medications (including corticosteroids, breast cancer treatments, selective serotonin reuptake inhibitors (SSRIs), and proton pump inhibitors) are risk factors for poor bone health.[14][15]
Certain diseases may elevate the risk for poor bone health. These include anorexia, cancer, type 2 diabetes, inflammatory bowel disease, liver or kidney disease, multiple sclerosis, thyroid disorders, lupus, alcohol use disorder, Cushing’s disease, and rheumatoid arthritis.[16]
In most people, bone health declines in later life. This includes a decrease in BMD (usually beginning in the early 40s for men and late 30s for women); an increased risk of osteoporosis, bone fractures, and certain bone cancers; and a higher prevalence of degenerative bone/joint conditions (such as osteoarthritis). Among these age-related concerns, the increased risk of osteoporosis is the most common cause of bone disease in older adults.
This is because approximately 90% of our bone mass is acquired between birth and 20 years of age.[23] Peak bone mass is maintained in men until their early 40s, and in women until their late 30s, at which point BMD begins to decline. The decline begins earlier in women due to the hormonal changes that occur during perimenopause and menopause, especially the decline in estrogen.[24] After age 60, the rate of BMD loss in both men and women is around 1%–1.5% each year, and, by age 70, around 30%–40% of total bone mass is lost.[24] People who achieve a higher peak bone mass early in life are at a significantly reduced risk of osteoporosis. While bone mass is influenced by genetics, diet and physical activity can also help build more bone during childhood and attenuate the decline that begins around midlife.
References
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- ^Arntz F, Mkaouer B, Markov A, Schoenfeld BJ, Moran J, Ramirez-Campillo R, Behrens M, Baumert P, Erskine RM, Hauser L, Chaabene HEffect of Plyometric Jump Training on Skeletal Muscle Hypertrophy in Healthy Individuals: A Systematic Review With Multilevel Meta-Analysis.Front Physiol.(2022)
- ^Guadalupe-Grau A, Fuentes T, Guerra B, Calbet JAExercise and bone mass in adults.Sports Med.(2009)
- ^Leigey D, Irrgang J, Francis K, Cohen P, Wright VParticipation in high-impact sports predicts bone mineral density in senior olympic athletes.Sports Health.(2009-Nov)
- ^Exercise for Your Bone Health
- ^Dipla K, Kraemer RR, Constantini NW, Hackney ACRelative energy deficiency in sports (RED-S): elucidation of endocrine changes affecting the health of males and females.Hormones (Athens).(2021-Mar)
- ^Bolland MJ, Grey A, Reid IRShould we prescribe calcium or vitamin D supplements to treat or prevent osteoporosis?Climacteric.(2015)
- ^Ian R Reid, Mark J Bolland, Andrew GreyEffects of vitamin D supplements on bone mineral density: a systematic review and meta-analysisLancet.(2014 Jan 11)
- ^Spence et al.New Perspectives on Dietary Protein and Bone Health: PrefaceThe Journal of Nutrition.(2003-03-01)
- ^Rickets and osteomalacia(2018-06-06)
- ^Cashman KDDiet, nutrition, and bone health.J Nutr.(2007-11)
- ^Sahni S, Mangano KM, McLean RR, Hannan MT, Kiel DPDietary Approaches for Bone Health: Lessons from the Framingham Osteoporosis Study.Curr Osteoporos Rep.(2015-Aug)
- ^Mosca C, Thorsteinsdottir F, Abrahamsen B, Rumessen JJ, Händel MNNewly Diagnosed Celiac Disease and Bone Health in Young Adults: A Systematic Literature Review.Calcif Tissue Int.(2022-06)
- ^Bone Health for Life: Health Information Basics for You and Your Family
- ^How to keep your bones healthy
- ^Bone Health for Life: Health Information Basics for You and Your Family
- ^Bone Mass Measurement: What the Numbers Mean
- ^Beck BR, Daly RM, Singh MA, Taaffe DRExercise and Sports Science Australia (ESSA) position statement on exercise prescription for the prevention and management of osteoporosis.J Sci Med Sport.(2017-May)
- ^Bailey CA, Brooke-Wavell KOptimum frequency of exercise for bone health: randomised controlled trial of a high-impact unilateral intervention.Bone.(2010-Apr)
- ^Ma D, Wu L, He ZEffects of walking on the preservation of bone mineral density in perimenopausal and postmenopausal women: a systematic review and meta-analysis.Menopause.(2013-Nov)
- ^Martyn-St James M, Carroll SMeta-analysis of walking for preservation of bone mineral density in postmenopausal women.Bone.(2008-Sep)
- ^A Ram Hong, Sang Wan KimEffects of Resistance Exercise on Bone HealthEndocrinol Metab (Seoul).(2018 Dec)
- ^Santos L, Elliott-Sale KJ, Sale CExercise and bone health across the lifespan.Biogerontology.(2017-12)
- ^Azzolino D, Spolidoro GCI, Saporiti E, Luchetti C, Agostoni C, Cesari MMusculoskeletal Changes Across the Lifespan: Nutrition and the Life-Course Approach to Prevention.Front Med (Lausanne).(2021)
- ^de Sire A, de Sire R, Curci C, Castiglione F, Wahli WRole of Dietary Supplements and Probiotics in Modulating Microbiota and Bone Health: The Gut-Bone Axis.Cells.(2022-02-21)
- ^René Rizzoli, Emmanuel Biver, Tara C Brennan-SperanzaNutritional intake and bone healthLancet Diabetes Endocrinol.(2021 Sep)
Examine Database References
- Bone Mineral Density - Clifton-Bligh PB, Baber RJ, Fulcher GR, Nery ML, Moreton TThe effect of isoflavones extracted from red clover (Rimostil) on lipid and bone metabolismMenopause.(2001 Jul-Aug)
- Bone Mineral Density - Atkinson C, Compston JE, Day NE, Dowsett M, Bingham SAThe effects of phytoestrogen isoflavones on bone density in women: a double-blind, randomized, placebo-controlled trialAm J Clin Nutr.(2004 Feb)
- Bone Mineral Density - Powles TJ, Howell A, Evans DG, McCloskey EV, Ashley S, Greenhalgh R, Affen J, Flook LA, Tidy ARed clover isoflavones are safe and well tolerated in women with a family history of breast cancerMenopause Int.(2008 Mar)
- Osteocalcin - Schult TM, Ensrud KE, Blackwell T, Ettinger B, Wallace R, Tice JAEffect of isoflavones on lipids and bone turnover markers in menopausal womenMaturitas.(2004 Jul 15)
- Bone Mineral Density - Agustina Malpeli, María Apezteguia, José L Mansur, Alicia Armanini, Melisa Macías Couret, Rosa Villalobos, Marta Kuzminczuk, Horacio F GonzalezCalcium supplementation, bone mineral density and bone mineral content. Predictors of bone mass changes in adolescent mothers during the 6-month postpartum periodArch Latinoam Nutr.(2012 Mar)
- Bone Mineral Density - Marissa M Shams-White, Mei Chung, Zhuxuan Fu, Karl L Insogna, Micaela C Karlsen, Meryl S LeBoff, Sue A Shapses, Joachim Sackey, Jian Shi, Taylor C Wallace, Connie M WeaverAnimal Versus Plant Protein and Adult Bone Health: A Systematic Review and Meta-Analysis From the National Osteoporosis FoundationPLoS One.(2018 Feb 23)
- Bone Mineral Density - Tao Li, Yanhong Li, Shanshan WuComparison of human bone mineral densities in subjects on plant-based and omnivorous diets: a systematic review and meta-analysisArch Osteoporos.(2021 Jun 18)
- Bone Mineral Density - Isabel Iguacel, María L Miguel-Berges, Alejandro Gómez-Bruton, Luis A Moreno, Cristina JuliánVeganism, vegetarianism, bone mineral density, and fracture risk: a systematic review and meta-analysisNutr Rev.(2019 Jan 1)
- Bone Mineral Density - Zhang G, Qin L, Shi YEpimedium-derived phytoestrogen flavonoids exert beneficial effect on preventing bone loss in late postmenopausal women: a 24-month randomized, double-blind and placebo-controlled trialJ Bone Miner Res.(2007 Jul)
- Bone Mineral Density - Knapen MH, Drummen NE, Smit E, Vermeer C, Theuwissen EThree-year low-dose menaquinone-7 supplementation helps decrease bone loss in healthy postmenopausal womenOsteoporos Int.(2013 Sep)
- Bone Mineral Density - Binkley N, Harke J, Krueger D, Engelke J, Vallarta-Ast N, Gemar D, Checovich M, Chappell R, Suttie JVitamin K treatment reduces undercarboxylated osteocalcin but does not alter bone turnover, density, or geometry in healthy postmenopausal North American womenJ Bone Miner Res.(2009 Jun)
- Bone Mineral Density - Iwamoto I, Kosha S, Noguchi S, Murakami M, Fujino T, Douchi T, Nagata YA longitudinal study of the effect of vitamin K2 on bone mineral density in postmenopausal women a comparative study with vitamin D3 and estrogen-progestin therapyMaturitas.(1999 Jan 4)
- Bone Mineral Density - Nishiguchi S, Shimoi S, Kurooka H, Tamori A, Habu D, Takeda T, Kubo SRandomized pilot trial of vitamin K2 for bone loss in patients with primary biliary cirrhosisJ Hepatol.(2001 Oct)
- Bone Mineral Density - Braam LA, Knapen MH, Geusens P, Brouns F, Vermeer CFactors affecting bone loss in female endurance athletes: a two-year follow-up studyAm J Sports Med.(2003 Nov-Dec)
- Bone Mineral Density - Booth SL, Dallal G, Shea MK, Gundberg C, Peterson JW, Dawson-Hughes BEffect of vitamin K supplementation on bone loss in elderly men and womenJ Clin Endocrinol Metab.(2008 Apr)
- Bone Mineral Density - Fang Y, Hu C, Tao X, Wan Y, Tao FEffect of vitamin K on bone mineral density: a meta-analysis of randomized controlled trialsJ Bone Miner Metab.(2012 Jan)
- Bone Mineral Density - Knapen MH, Schurgers LJ, Vermeer CVitamin K2 supplementation improves hip bone geometry and bone strength indices in postmenopausal womenOsteoporos Int.(2007 Jul)
- Bone Mineral Density - Shea MK, Dallal GE, Dawson-Hughes B, Ordovas JM, O'Donnell CJ, Gundberg CM, Peterson JW, Booth SLVitamin K, circulating cytokines, and bone mineral density in older men and womenAm J Clin Nutr.(2008 Aug)
- Bone Mineral Density - Koitaya N, Sekiguchi M, Tousen Y, Nishide Y, Morita A, Yamauchi J, Gando Y, Miyachi M, Aoki M, Komatsu M, Watanabe F, Morishita K, Ishimi YLow-dose vitamin K2 (MK-4) supplementation for 12 months improves bone metabolism and prevents forearm bone loss in postmenopausal Japanese womenJ Bone Miner Metab.(2013 May 24)
- Bone Mineral Density - Ushiroyama T, Ikeda A, Ueki MEffect of continuous combined therapy with vitamin K(2) and vitamin D(3) on bone mineral density and coagulofibrinolysis function in postmenopausal womenMaturitas.(2002 Mar 25)
- Bone Mineral Density - Mott A, Bradley T, Wright K, Cockayne ES, Shearer MJ, Adamson J, Lanham-New SA, Torgerson DJEffect of vitamin K on bone mineral density and fractures in adults: an updated systematic review and meta-analysis of randomised controlled trials.Osteoporos Int.(2019-Aug)
- Bone Mineral Density - Salma, Ahmad SS, Karim S, Ibrahim IM, Alkreathy HM, Alsieni M, Khan MAEffect of Vitamin K on Bone Mineral Density and Fracture Risk in Adults: Systematic Review and Meta-Analysis.Biomedicines.(2022 May 1)
- Bone Mineral Density - Chuin A, Labonté M, Tessier D, Khalil A, Bobeuf F, Doyon CY, Rieth N, Dionne IJEffect of antioxidants combined to resistance training on BMD in elderly women: a pilot studyOsteoporos Int.(2009 Jul)
- Bone Mineral Density - Ruiz-Ramos M, Vargas LA, Fortoul Van der Goes TI, Cervantes-Sandoval A, Mendoza-Nunez VMSupplementation of ascorbic acid and alpha-tocopherol is useful to preventing bone loss linked to oxidative stress in elderlyJ Nutr Health Aging.(2010 Jun)
- Bone Mineral Density - Kahn AJ, Halloran B, Wolkowitz O, Brizendine LDehydroepiandrosterone supplementation and bone turnover in middle-aged to elderly menJ Clin Endocrinol Metab.(2002 Apr)
- Bone Mineral Density - Weiss EP, Shah K, Fontana L, Lambert CP, Holloszy JO, Villareal DTDehydroepiandrosterone replacement therapy in older adults: 1- and 2-y effects on boneAm J Clin Nutr.(2009 May)
- Bone Mineral Density - von Mühlen D, Laughlin GA, Kritz-Silverstein D, Bergstrom J, Bettencourt REffect of dehydroepiandrosterone supplementation on bone mineral density, bone markers, and body composition in older adults: the DAWN trialOsteoporos Int.(2008 May)
- Bone Mineral Density - Michael Bebenek, Wolfgang Kemmler, Simon von Stengel, Klaus Engelke, Willi A KalenderEffect of exercise and Cimicifuga racemosa (CR BNO 1055) on bone mineral density, 10-year coronary heart disease risk, and menopausal complaints: the randomized controlled Training and Cimicifuga racemosa Erlangen (TRACE) studyMenopause.(2010 Jul)
- Bone Mineral Density - Godard MP, Johnson BA, Richmond SRBody composition and hormonal adaptations associated with forskolin consumption in overweight and obese menObes Res.(2005 Aug)
- Bone Mineral Density - Carpenter TO, DeLucia MC, Zhang JH, Bejnerowicz G, Tartamella L, Dziura J, Petersen KF, Befroy D, Cohen DA randomized controlled study of effects of dietary magnesium oxide supplementation on bone mineral content in healthy girlsJ Clin Endocrinol Metab.(2006 Dec)
- Osteocalcin - Aydin H, Deyneli O, Yavuz D, Gözü H, Mutlu N, Kaygusuz I, Akalin SShort-term oral magnesium supplementation suppresses bone turnover in postmenopausal osteoporotic womenBiol Trace Elem Res.(2010 Feb)
- Osteocalcin - Doyle L, Flynn A, Cashman KThe effect of magnesium supplementation on biochemical markers of bone metabolism or blood pressure in healthy young adult femalesEur J Clin Nutr.(1999 Apr)
- Bone Mineral Density - Zhu K, Meng X, Kerr DA, Devine A, Solah V, Binns CW, Prince RLThe effects of a two-year randomized, controlled trial of whey protein supplementation on bone structure, IGF-1, and urinary calcium excretion in older postmenopausal womenJ Bone Miner Res.(2011 Sep)
- Bone Mineral Density - Conforti AS, Gallo ME, Saraví FDYerba Mate (Ilex paraguariensis) consumption is associated with higher bone mineral density in postmenopausal womenBone.(2012 Jan)
- Bone Mineral Density - Chilibeck PD, Chrusch MJ, Chad KE, Shawn Davison K, Burke DGCreatine monohydrate and resistance training increase bone mineral content and density in older menJ Nutr Health Aging.(2005 Sep-Oct)
- Bone Mineral Density - Scott C Forbes, Philip D Chilibeck, Darren G CandowCreatine Supplementation During Resistance Training Does Not Lead to Greater Bone Mineral Density in Older Humans: A Brief Meta-AnalysisFront Nutr.(2018 Apr 24)
- Bone Mineral Density - H Lambert, L Frassetto, J B Moore, D Torgerson, R Gannon, P Burckhardt, S Lanham-NewThe effect of supplementation with alkaline potassium salts on bone metabolism: a meta-analysisOsteoporos Int.(2015 Apr)
- CTX-II - Yoshimura M, Sakamoto K, Tsuruta A, Yamamoto T, Ishida K, Yamaguchi H, Nagaoka IEvaluation of the effect of glucosamine administration on biomarkers for cartilage and bone metabolism in soccer playersInt J Mol Med.(2009 Oct)
- Osteocalcin - Kheiridoost-Langaroodi H, Shakouri SK, Amirpour M, Iranshahi AM, Farshbaf-Khalili AThe Effect of Selected Herbal Medicines on Bone Turnover Markers: A Systematic Review and Meta-Analysis.J Family Reprod Health.(2022-Mar)
- Fracture Healing - Vibha Singh, Narendra Singh, U S Pal, Satish Dhasmana, Shadab Mohammad, Nimisha SinghClinical evaluation of cissus quadrangularis and moringa oleifera and osteoseal as osteogenic agents in mandibular fractureNatl J Maxillofac Surg.(2011 Jul)
- Fracture Risk - Bischoff-Ferrari HA, Willett WC, Wong JB, Stuck AE, Staehelin HB, Orav EJ, Thoma A, Kiel DP, Henschkowski JPrevention of nonvertebral fractures with oral vitamin D and dose dependency: a meta-analysis of randomized controlled trialsArch Intern Med.(2009 Mar 23)
- Calcium Absorption - Abrams SA, Hawthorne KM, Chen ZSupplementation with 1000 IU vitamin D/d leads to parathyroid hormone suppression, but not increased fractional calcium absorption, in 4-8-y-old children: a double-blind randomized controlled trialAm J Clin Nutr.(2013 Jan)
- Bone turnover markers - Wu M, Bhimavarapu A, Alvarez JA, Hunt WR, Tangpricha VChanges in bone turnover after high-dose vitamin D supplementation during acute pulmonary exacerbation in cystic fibrosis.Bone.(2023-Sep)
- Insulin - Racine NM, Watras AC, Carrel AL, Allen DB, McVean JJ, Clark RR, O'Brien AR, O'Shea M, Scott CE, Schoeller DAEffect of conjugated linoleic acid on body fat accretion in overweight or obese childrenAm J Clin Nutr.(2010 May)
- Serum Magnesium - Meacham SL, Taper LJ, Volpe SLEffect of boron supplementation on blood and urinary calcium, magnesium, and phosphorus, and urinary boron in athletic and sedentary womenAm J Clin Nutr.(1995 Feb)
- Hyperthyroidism Symptoms - Benvenga S, Ruggeri RM, Russo A, Lapa D, Campenni A, Trimarchi FUsefulness of L-carnitine, a naturally occurring peripheral antagonist of thyroid hormone action, in iatrogenic hyperthyroidism: a randomized, double-blind, placebo-controlled clinical trialJ Clin Endocrinol Metab.(2001 Aug)
- Bone-specific Alkaline Phosphatase - Manonai J, Chittacharoen A, Udomsubpayakul U, Theppisai H, Theppisai UEffects and safety of Pueraria mirifica on lipid profiles and biochemical markers of bone turnover rates in healthy postmenopausal womenMenopause.(2008 May-Jun)