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    Features

    Bone Health Update

    Ingredients backed by significant research are catching the interest of many consumers, particularly aging baby boomers.

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    Joe King11.01.07
    According to the National Osteoporosis Foundation (NOF), osteoporosis is a major health concern for an estimated 44 million Americans-especially for a majority of those over 50.

    In the U.S., 10 million people are estimated to already have the disease and almost 34 million more are estimated to be at an increased risk due to low bone mass. While most people primarily consider osteoporosis a women's disease, the Third National Health and Nutrition Examination Survey showed that in addition to eight million women, more than two million men also have the disease.

    The average woman acquires 98% of her skeletal mass by the age of 20. However, five to seven years after menopause, they can lose up to 20% of their bone mass, putting them at higher risk for osteoporosis.

    According to research cited by Gameil Fouad, PhD, president, Biotron Labs, Centerville, UT, osteoporosis exacts a heavy toll not only physically but also financially. "The costs are staggering," he said, noting that research has shown more than 400,000 hospitalizations and nearly four million outpatient visits were logged due to osteoporotic fractures in 1995 (the last year for which complete data were available). The direct economic consequences, according to the study, were estimated at nearly $14 billon.

    "The impact of the disease is considerably greater today as the population continues to age and cost of treatment skyrockets," Dr. Fouad said. "In addition, it is virtually impossible to quantify the intangible costs that affect quality of life in both the affected and their family.

    "These hidden costs include factors such as chronic pain, reduced mobility and depression in the patient, as well as the caretaking burden to spouses, children and extended family," he added. "The intangibles include added strain to an overburdened healthcare system. The economic and human costs are projected to continue increasing over the coming decades, so taking positive steps now can minimize the negative consequences later."

    Bone Builders



    Maintaining bone health throughout life depends on many factors. While proper calcium intake has long been known to play an important role, vitamin D is also critical to calcium absorption. Vitamin D allows calcium to leave the intestine and enter the bloodstream. It also helps kidneys reabsorb calcium that otherwise would be excreted.

    "With respect to bone health, it seems that vitamin D is not only essential in achieving peak bone density in young adulthood, but may also be useful in recovery after a fracture later in life," Biotron's Dr. Fouad said.

    A double-blind study conducted by Mette Hitz and colleagues researched the effects of vitamin D and calcium on bone mineral density (BMD) in older women who had suffered a fracture of either the hip or an upper extremity.

    "This study showed that 1400 IU of vitamin D (as cholecalciferol) in addition to sufficient calcium was more effective in improving BMD when compared to 200 IU of vitamin D alone," Dr. Fouad said. "Not only did bone mineral density increase, but analysis showed that those receiving the calcium and vitamin D had less bone turnover and better physical performance at the end of one year.

    "Again, the message is reinforced: these nutrients are important and the greatest benefits are realized when healthy patterns are established and maintained over a lifetime," he added.

    Some evidence suggests that magnesium deficiency poses an additional risk factor for postmenopausal osteoporosis, according to the Institute of Medicine's Office of Dietary Supplements report on magnesium. The re-port states that magnesium deficiency alters calcium metabolism and the hormones that regulate calcium.

    The report also cites several human studies suggesting magnesium supplementation may improve bone mineral density. Research published in 1999 in the American Journal of Clinical Nutrition showed that "greater magnesium intake among older adults maintained bone mineral density to a greater degree than a lower magnesium intake."

    A recent entry into the bone health supplement market is stable (non-radioactive) strontium, according to Ryan Davis, vice president of technical services for Kelatron Corporation, Ogden, UT. "New research continues to support strontium and its contribution to increased bone mineral density," he said. "It will be critical that we understand the proper dosage, how it should be supplemented, and how it can work synergistically with calcium and other essential bone health nutrients."

    Research from Ward Dean, MD, published in the Anti-Aging Library concluded that strontium appears to be an effective substance for the prevention and treatment of osteoporosis and other bone-related conditions.

    Boron and other trace minerals are also being added to the list of well-researched ingredients, which are critical for bone health, according to Dr. Chris Meletis, director of scientific affairs, Trace Minerals Research, Og-den, UT. Dr. Meletis cites research, which demonstrated that boron im-proves calcium absorption and re-duces the amount of calcium excreted in the urine.

    Vitamin K is also making headlines as a beneficial bone health ingredient. A paper published in Thrombosis and Haemostasis discusses the link be-tween vitamin K and the role it plays in supporting bone health. According to Leon Schurgers, PhD, one of the authors of the paper, "Since vitamin K was discovered, we have understood its role in providing the liver's needs for proper coagulation. It is only in the last 10 years or so that we have recognized K's role activating proteins responsible for calcium utilization in the bones."

    "There is a definite need for this product in the market," stated Cecilia McCollum, executive vice president, Blue California, Rancho Santa Margarita, CA, adding, "We expect the market to continue growing based on the needs of the aging consumer, the availability of science supporting this product, and the better understanding of the role of supplementation on the part of the medical community.

    "We are living longer, working past retirement age, and we are more active and want more out of life," she continued. "This is creating unique and special challenges for our industry, which is why we are responding by offering ingredients that will enable consumers to maintain greater physical activity, prevent diseases like osteoporosis, avoid fractures, stay healthy and enjoy more years of productivity and comfort."

    Prebiotics, noted Trina O'Brien, marketing manager for GTC Nutrition, Golden, CO, represent another ingredient group gaining recognition in the area of bone health. She said research has recognized prebiotic fibers' ability to improve calcium absorption to help build stronger bones.

    Additionally, Ms. O'Brien pointed out recent research behind one its bone health ingredients, Aquamin, which is a calcified mineral source. "Aquamin provides a unique combination of calcium, magnesium and trace minerals, which, when used in combination, may offer superior support for building healthy bones," she said.

    Most often people think of iron as essential to hemoglobin levels in red blood cells and for this reason the role of iron in bone health is underappreciated, according to Dr. Fouad. However, research conducted at the University of Arizona (Bone Estrogen and Strength Training or BEST Study) found that iron status was positively correlated with BMD in women who were also getting adequate calcium.

    "This is an important finding because it suggests these two nutrients working together may act synergistically to maximize bone mineral density," Dr. Fouad said. "While preliminary, this is an interesting line of investigation and more work needs to be done to pinpoint the way in which these minerals cooperate in maximal BMD."

    Aging Population + Consumer Awareness = A Solid Market



    An aging population and increased awareness among consumers has fueled the market for bone health supplements.

    "With the aging population in the U.S., sales continue to grow significantly," said Trace Minerals' Mr. Meletis. "In addition to the increased knowledge of the healthcare consumer, the old standbys of low quality calcium-only products are no longer the focus of the serious health savvy consumer. Now they (consumers) are looking for calcium blended with other minerals and nutrients essential for healthy bones."

    GTC's Ms. O'Brien believes bone health supplement sales are escalat-ing due to consumer concern over health issues such as osteoporosis. "The consumer base paying the most attention to bone health issues is the baby boomer generation, one of the largest and most proactive consumer groups," she said. "This group is sensitive to the aging process, and is taking action to maintain and improve bone health by incorporating better-for-you products into their diets."

    Women are also driving the sales of bone health supplements. "More and more women of the 'baby boom' generation are approaching and entering their post-menopausal years," said Dr. Fouad. "As this transition continues, osteoporosis and fracture present very real health concerns. "Further, more young women show greater understanding of the importance of establishing peak bone mass early in life and are coming to recognize how this can impact their bones in later years."

    Looking Ahead



    The introduction of bone health liquids and powders is an emerging trend in the bone health product category. As a result, Trace Minerals' Mr. Boyson said, "Consumers feel that when a supplement is in a liquid or powder form, it's more absorb-able and will help them feel relief quicker."

    Beverages such as smoothies, juices and other wellness drinks are already integrating prebiotic fibers and/or fortifying with calcium to provide more bone healthy, convenient products for today's active consumers. Another emerging market segment for bone health products is snacks, which is definitely on the horizon, according to GTC's Ms. O'Brien.

    Many industry executives are confident that this industry segment is well positioned for growth as consumers start to take a more proactive approach to managing health through the diet.

    New research, said Kelatron's Mr. Davis, will also be one of the drivers. "I believe sales will rise significantly as new research is published elucidating the role of strontium in overall bone health," he said.

    An aging baby boomer population will be another catalyst for this segment's growth. "The bone health segment is not going away," Mr. Boyson stated. "With the baby boomer generation continually getting older, they will need bone health supplements to help curtail the effects of getting older. Therefore, I believe sales will continue to rise."

    Marketing support and consumer education will also be key to the growth of this product category. "Many companies support this approach to wellness," Ms. O'Brien said, adding that GTC Nutrition recently launched a bone health education program featuring NutraFlora prebiotic fiber and its unique ability to significantly improve calcium absorption. "The investment in this program will likely grow along with the segment as consumer interest and awareness increase."

    Dr. Fouad sees continued opportunity in this area over the long term. "As the population continues to age and with increased interest in health maintenance and prevention (rather than treatment after the fact), supplementation and fortification will definitely play important roles going forward," he said.
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