The National Osteoporosis Foundation's position statement on peak bone mass development and lifestyle factors: a systematic review and implementation recommendations.
Osteoporos Int. 2016 Feb 8. [Epub ahead of print]
Weaver CM1, Gordon CM2,3, Janz KF4, Kalkwarf HJ5, Lappe JM6, Lewis R7, O'Karma M8, Wallace TC9,10,11, Zemel BS12,13.
Lifestyle choices influence 20-40 % of adult peak bone mass. Therefore, optimization of lifestyle factors known to influence peak bone mass and strength is an important strategy aimed at reducing risk of osteoporosis or low bone mass later in life. The National Osteoporosis Foundation has issued this scientific statement to provide evidence-based guidance and a national implementation strategy for the purpose of helping individuals achieve maximal peak bone mass early in life. In this scientific statement, we (1) report the results of an evidence-based review of the literature since 2000 on factors that influence achieving the full genetic potential for skeletal mass; (2) recommend lifestyle choices that promote maximal bone health throughout the lifespan; (3) outline a research agenda to address current gaps; and (4) identify implementation strategies. We conducted a systematic review of the role of individual nutrients, food patterns, special issues, contraceptives, and physical activity on bone mass and strength development in youth. An evidence grading system was applied to describe the strength of available evidence on these individual modifiable lifestyle factors that may (or may not) influence the development of peak bone mass (Table 1). A summary of the grades for each of these factors is given below. We describe the underpinning biology of these relationships as well as other factors for which a systematic review approach was not possible. Articles published since 2000, all of which followed the report by Heaney et al. [1] published in that year, were considered for this scientific statement. This current review is a systematic update of the previous review conducted by the National Osteoporosis Foundation [1]. Lifestyle Factor Grade Macronutrients Fat D Protein C Micronutrients Calcium A Vitamin D B Micronutrients other than calcium and vitamin D D Food Patterns Dairy B Fiber C Fruits and vegetables C Detriment of cola and caffeinated beverages C Infant Nutrition Duration of breastfeeding D Breastfeeding versus formula feeding D Enriched formula feeding D Adolescent Special Issues Detriment of oral contraceptives D Detriment of DMPA injections B Detriment of alcohol D Detriment of smoking C Physical Activity and Exercise Effect on bone mass and density A Effect on bone structural outcomes B Considering the evidence-based literature review, we recommend lifestyle choices that promote maximal bone health from childhood through young to late adolescence and outline a research agenda to address current gaps in knowledge. The best evidence (grade A) is available for positive effects of calcium intake and physical activity, especially during the late childhood and peripubertal years-a critical period for bone accretion. Good evidence is also available for a role of vitamin D and dairy consumption and a detriment of DMPA injections. However, more rigorous trial data on many other lifestyle choices are needed and this need is outlined in our research agenda. Implementation strategies for lifestyle modifications to promote development of peak bone mass and strength within one's genetic potential require a multisectored (i.e., family, schools, healthcare systems) approach.
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Typically they considered tfials using only 200 or 400 IU of vitamin D
Sometimes trials used Vitamin D2
Typically trials lasted less than 12 weeks
Continued to focus on Calcium - which actually CAUSES many health problems
Continued to focus on Bone DENSITY rather than bone STRENGTH
Did not consider Magnesium other than one trial using Magnesium Oxide (which has poor bioavailability)
Did not mention that excessive Vitamin A reduces bone strength
See also VitaminDWiki
- Calcium supplements proven to NOT reduce fractures, but are proven to INCREASE heart problems – July 2015
- 20X increase in vitamin D sold and 36 percent decrease in osteoporosis business in Australia – Nov 2013
The doctors ignore Vitamin D,but the patients do not - Yes, need more than 400 IU of vitamin D to strengthen bones
- 800 IU Vitamin D proven again to not be enough to stop bone loss - Aug 2015
Pages listed in BOTH the categories Bone and Magnesium
- Magnesium helps bones a bit – meta-analysis Jan 2022
- Magnesium increases Vitamin D, which increases Mg. Both increase bone – Oct 2019
- Vitamin D and Calcium do not increase bone density (also need exercise, Mg, K2, protein etc.) – RCT Aug 2019
- Many seniors do not get enough protein, Vitamin D, Mg, etc. needed for bones – Feb 2019
- More Magnesium makes more bone when there is enough Vitamin D (petri dish) – Jan 2019
- Diagnosis and treatment of osteopenia – Holick 2010
- Adding just vitamin D again failed to add bone density (also need Magnesium, Vitamin K, etc) – RCT Aug 2018
- MAGNESIUM IN MAN - IMPLICATIONS FOR HEALTH AND DISEASE – review 2015
- Stronger bones after 3 generations of tap water (more Ca and Mg) vs bottled water – March 2015
- Bones grow better with high level of magnesium: rat study – Dec 2013
- 20 percent fewer male hip fractures if more Magnesium in the water – July 2013
- Magnesium may be more important to kids’ bone health than calcium – May 2013
- Healthy bones need: Calcium, Vitamin D, Magnesium, Silicon, Vitamin K, and Boron – 2012
- Vitamin D, K2, Magnesium, etc increase bone density when taking together– Jan 2012
- 400 IU of vitamin D Magnesium and Calcium helped Twin bones – Feb 2011
Pages listed in BOTH the categories Bone and Vitamin K2
- Vitamin K2-7 helps bone, blood vessels, cancer, diabetes, etc. – June 2022
- Role of Vitamin K in Bones and Muscles - Feb 2022
- Bone loss results in blood vessel plaque if low Vitamin K2, less bone loss if high K2– April 2021
- Bone increased : Stiffness (Vitamin D), Flexibility (Vitamin K2) – Sept 2020
- Bone quality improved 2X by Vitamin D plus Vitamin K2 (trend) – meta-analysis March 2020
- Vitamin D and Calcium do not increase bone density (also need exercise, Mg, K2, protein etc.) – RCT Aug 2019
- Vitamin K (any amount and any kind) reduced bone fractures by 24 percent – meta-analysis – May 2019
- Calcium Supplementation is OK provided you also take Vitamin K – Feb 2019
- Hard bones, soft arteries, rather than vice versa (Vitamin D and Vitamin K) – March 2016
- Many seniors do not get enough protein, Vitamin D, Mg, etc. needed for bones – Feb 2019
- Adding just vitamin D again failed to add bone density (also need Magnesium, Vitamin K, etc) – RCT Aug 2018
- Osteocalcin – overview of the hormone needed to build bones, etc. Jan 2018
- Vitamin K and bone – review Oct 2017
- Bone formation in the lab is aided by Vitamin D, Vitamin K1, and Vitamin K2 – meta-analysis Nov 2017
- Better bones again associated with higher vitamin K intake – Nov 2015
- Vitamin K-2 – bone biomarkers indicate at least 600 ug of MK-4 are needed daily – Sept 2014
- Vitamin K2 (as MK-7) is needed for bone quality – Review Feb 2013
- Increased Vitamin K2 reduces the problems of excess Calcium – Nov 2013
- Vitamin K and bone health – need more research Oct 2013
- Vitamin K-2 (180 ug MK-7) helped both bone density and strength – RCT March 2013
- Healthy bones need Ca, Silicon, Vitamins B, C, D, and K – Dec 2012
- Increasing bone mineral density increases breast cancer by at least 2X – Aug 2012
- Healthy bones need: Calcium, Vitamin D, Magnesium, Silicon, Vitamin K, and Boron – 2012
- Vitamin D, K2, Magnesium, etc increase bone density when taking together– Jan 2012
- BONE SPURS not produced if have enough Vitamin D3, Vitamin K2, etc. – Nov 2011
- Vitamin K1 reduced hip fracture but Vitamin K2 did not – Aug 2011
- Women with hip fractures very low on vitamins D3 and K – Mar 2011
- Vitamin K2 from natto improved bone mineral density – March 2011
Overview Osteoporosis and vitamin D contains the following summary
- FACT: Bones need Calcium (this has been known for a very long time)
- FACT: Vitamin D improves Calcium bioavailability (3X ?)
- FACT: Should not take > 750 mg of Calcium if taking lots of vitamin D (Calcium becomes too bio-available)
- FACT: Adding vitamin D via Sun, UV, or supplements increased vitamin D in the blood
- FACT: Vitamin D supplements are very low cost
- FACT: Many trials, studies. reviews, and meta-analysis agree: adding vitamin D reduces osteoporosis
- FACT: Toxic level of vitamin D is about 4X higher than the amount needed to reduce osteoporosis
- FACT: Co-factors help build bones.
- FACT: Vitamin D Receptor can restrict Vitamin D from getting to many tissues, such as bones
- It appears that to TREAT Osteoporosis:
- Calcium OR vitamin D is ok
- Calcium + vitamin D is good
- Calcium + vitamin D + other co-factors is great
- Low-cost Vitamin D Receptor activators sometimes may be helpful
- CONCLUSION: To PREVENT many diseases, including Osteoporosis, as well as TREAT Osteoporosis
- Category Osteoporosis has
207 items - Category Bone Health has
299 items Note: Osteoporosis causes bones to become fragile and prone to fracture
Osteoarthritis is a disease where damage occurs to the joints at the end of the bones
Osteoporosis category includes the following207 items in category - see also Overview Osteoporosis and vitamin D - Overview Fractures and vitamin D
- Bone - Health
299 items - VitaminDWiki pages with BONE MINERAL DENSITY or BMD in title 29+ pages
- Search VitaminDWiki for OSTEOPENIA 1740 items as of July 2020
12 articles are in both Osteroporosis and Vitamin D Receptor categories 9 articles are in both Osteroporosis and Meta-analysis categories - 20X increase in vitamin D sold and 36 percent decrease in osteoporosis business in Australia – Nov 2013
Falls and Fractures category contains the following summary
238 items in FALLS and FRACTURES - Vitamin D and Calcium cost-effectively reduce falls and fractures – April 2019
- see also Overview Seniors and Vitamin D
Falls
- Deaths due to falls doubled in just a decade (age-adjusted, perhaps decreased vitamin D) – June 2019
- Preventing Falls in Older Adults – Vitamin D combination is the best - JAMA Meta-analysis Nov 2017
- Falls cut in half by 100,000 IU vitamin D monthly - RCT 2016
- Falls reduced by a third if achieved 40 ng level vitamin D– RCT Sept 2018
- Note: Took 6 months to get to that level. Most trials last only 3 months
- Vitamin D prevents falls – majority of meta-analyses conclude – meta-meta analysis Feb 2015
- Falls reduced by Vitamin D: 13 percent reduction if more than 700 IU – review of 38 trials – Aug 2022
Fracture
- Vitamin D and fractures – 24 meta-analyses and counting – Dec 2014
- Low trauma bone fractures in seniors – considering Vitamin D loading dose for all, without testing – Nov 2019
- Vitamin K (any amount and any kind) reduced bone fractures by 24 percent – meta-analysis – May 2019
- Hip fracture in VitaminDWiki title (73 as of April 2023) Click here for details
The Meta-analysis of Falls/Fractures
- Increased risk of fracture if high level of Vitamin D (if continue to take Calcium) – umbrella analysis of meta-analyses Nov 2020
- Hip fractures not prevented by Vitamin D (800 IU daily or large quarterly or annual doses) – meta-analysis – Dec 2019
- Vitamin K (any amount and any kind) reduced bone fractures by 24 percent – meta-analysis – May 2019
- Vitamin D not help fractures and falls if not vitamin D deficient – meta-analysis Oct 2018
- Fractures not reduced by small amounts of vitamin D - meta-analysis Dec 2017
- Preventing Falls in Older Adults – Vitamin D combination is the best - JAMA Meta-analysis Nov 2017
- Hip fracture 58 percent more likely if low vitamin D – meta-analysis March 2017
- Fracture risk reduced somewhat by 800 IU of vitamin D and Calcium – meta-analysis Oct 2015
- Acute fracture patients – 70 percent were vitamin D deficient – meta-analysis Sept 2015
- Falls not prevented by vitamin D given every 3 months or less often – meta-analysis Jan 2015
- Vitamin D prevents falls – majority of meta-analyses conclude – meta-meta analysis Feb 2015
- Vitamin D and fractures – 24 meta-analyses and counting – Dec 2014
- Bone fractures reduced by a minimum of 800 IU vitamin D and Calcium – meta-meta-analysis March 2014
- Fractures reduced with any amount of vitamin D and some Calcium - Cochraine April 2014
- Fallers often had less than 20 ng of vitamin D – meta-analysis April 2014
- Hip fractures greatly reduced by sunshine, vitamin D, and vitamin K – meta-analysis Sept 2012
- Vitamin D may prevent falls and fractures without Calcium – an overview of 9 meta-analysis – Oct 2012
- Hip fractures reduced 30 percent with 800 IU of vitamin D – meta-analysis July 2012
- Vitamin D reduces falls – meta-analysis Oct 2011
- Active form of vitamin D (calcitriol) cut in half the fractures following organ transplant – meta-analysis Aug 2011
- 1000 IU minimum to decrease falls and fractures Swiss - 2009
- Meta-analysis of falls and 800+ IU of vitamin D found good results – June 2010
- 800 IU vitamin D reduces falls - Dec 2009
Bones not helped much by vitamin D (low dose or short term) National Osteoporosis Foundation – Feb 2016Printer Friendly Follow this page for updates4867 visitors, last modified 10 Feb, 2016, This page is in the following categories (# of items in each category)
- Category Bone Health has