Beyond Calcium and Vitamin D—How to Really Build Strong Bones

By Dr. Mercola

One of the important strategies for healthy bones is to eat the right kind of foods. A diet full of processed foods will produce biochemical and metabolic conditions in your body that will decrease your bone density, so avoiding processed foods is definitely the first step in the right direction.

Eating high-quality, organic, biodynamic, locally-grown food will naturally increase your bone density and decrease your risk of developing osteoporosis. Along with your foods, your omega-3 fat content also has a major role in building healthy bone. I recommend krill oil, as I believe it’s a superior source of omega-3s.

Other nutrients, including calcium, vitamin D and K2, and magnesium, are also critical for strong bones—as is exercise, especially weight-bearing exercises.

Recent research presented at The Endocrine Society's 95th Annual Meeting in San Francisco suggests that the timing of calcium and vitamin D supplementation may actually influence how your bones adapt to exercise, and help decrease exercise-induced calcium loss.

As reported by Medical News Today:1

"The timing of calcium supplementation, and not just the amount of supplementation, may be an important factor in how your skeleton adapts to exercise training... Previous research has shown that a year of intense training is associated with substantial decreases in bone mineral density...

Experts believe that this kind of exercise-induced bone loss could be related to the loss of calcium during exercise. As blood calcium levels drop, the parathyroid gland produces excess parathyroid hormone, which can mobilize calcium from your skeleton."

How Bone Adapts to Exercise May Be Affected by Timing of Supplementation

The featured research study indicated that taking calcium prior to hitting the gym may help keep your blood levels of calcium more stable, compared to taking calcium after your workout. However, the study did not assess the long-term effects this might have on your bone density, and this, of course, is of utmost importance for anyone interested in building healthy bones.

According to the featured article:

“[E]xercise-induced decrease in blood calcium occurred whether calcium supplements were taken before or after exercising. Pre-exercise supplementation, however, resulted in less of a decrease.

Although not statistically significant, parathyroid hormone levels increased slightly less among cyclists who took calcium before exercising... The timing of calcium supplementation did not cause a difference in blood levels of a compound that is a biological indicator of bone loss. Both the before- and after-exercise groups exhibited 50 percent increases in the level of this compound, called CTX...”

The Critical Role of Vitamin K2 for Bone Health

There’s plenty of controversy on the issue of using calcium supplementation to ensure strong healthy bones. It’s important to realize that calcium works synergistically with vitamins D and K2, so taking calcium supplements alone may actually end up doing more harm than good. Dr. Kate Rheaume-Bleue has authored a comprehensive book on this topic titled: Vitamin K2 and the Calcium Paradox: How a Little Known Vitamin Could Save Your Life.

Dr. Robert Thompson M.D. also addressed this important issue in his book, The Calcium Lie. One of the tenets of his book is that bone is composed of at least a dozen minerals, and if you focus exclusively on calcium supplementation you are likely going to worsen your bone density.

Additionally you will actually increase your risk of osteoporosis. Interestingly, he proposes that one of the best practical alternatives is the use of natural, unprocessed salts, such as Himalayan salt, as they are one of the best sources of a wide variety of trace minerals.

So, while the featured research is interesting, I believe it falls far short in terms of making a health recommendation that will result in improved bone health. And while the researchers argue that timing, and not just dosage may play a significant role in bone adaptation to exercise, I would add that nutrient ratios and combinations may be even more important...

The researchers did combine calcium with vitamin D, which is important, but they did not address vitamin K2, which is critical. I say critical because the biological role of vitamin K2 is to help move calcium into the proper areas in your body, such as your bones and teeth. It also helps remove calcium from areas where it shouldn’t be, such as in your arteries and soft tissues.

Furthermore, if you take supplemental vitamin D, you also need to increase your intake of vitamin K2, because when you take vitamin D, your body creates more vitamin K2-dependent proteins—the proteins that help move the calcium around in your body. But you need vitamin K2 to activate those proteins. If they're not activated, the calcium in your body will not be properly distributed and can lead to weaker bones and hardened arteries. In fact, vitamin K2 deficiency is actually what produces the symptoms of vitamin D toxicity, which includes inappropriate calcification that can lead to hardening of your arteries.

In a nutshell, it’s important to maintain the proper balance between all three of these nutrients: calcium, vitamin D and K2, as well as magnesium. Lack of balance between these four nutrients is why calcium supplements have become associated with increased risk of heart attack and stroke...

The optimal amounts of vitamin K2 are still under investigation, but it seems likely that 180 to 200 micrograms of vitamin K2 daily should be enough to activate your body's K2-dependent proteins to shuttle the calcium to and from the appropriate areas. Most Americans get nowhere near this amount though. In fact, an estimated 80 percent of Americans do not get enough vitamin K2 in their diet to activate their K2 proteins, which is similar to the deficiency rate of vitamin D.

How Can You Tell if You're Lacking in Vitamin K2?

There is no test for vitamin K2 deficiency, but you can get an idea of whether or not you may be lacking in this critical nutrient simply by assessing your diet and lifestyle. If you have osteoporosis, heart disease or diabetes, then you're likely deficient in vitamin K2 as these conditions are all associated with K2 deficiency. If you do not have any of those health conditions, but do NOT regularly eat high amounts of the following foods, then your likelihood of being vitamin K2 deficient is still very high:

• Grass-fed organic animal products (i.e. eggs, butter, dairy)
• Certain fermented foods such as natto, or vegetables fermented using a starter culture of vitamin K2-producing bacteria. Please note that most fermented vegetables are not really high in vitamin K2 and come in at about 50 mcg per serving. However, if specific starter cultures are used they can have ten times as much, or 500 mcg per serving.
• Goose liver pâté
• Certain cheeses such as Brie and Gouda (these two are particularly high in K2, containing about 75 mcg per ounce). While cheese from grass-fed milk would be an added boon, it’s not necessary for the cheese to be grass-fed because the K2 is not derived from the milk itself; it’s derived from the bacteria in the cheese. So what’s important is how the cheese was made.

Fermented vegetables, which supply beneficial bacteria to your gut, can also be a great source of vitamin K if you ferment your own using the proper starter culture. We recently had samples of high-quality fermented organic vegetables made with our specific starter culture tested, and were shocked to discover that not only does a typical serving of about two to three ounces contain about 10 trillion beneficial bacteria, but it also contained 500 mcg of vitamin K2.

Note that not every strain of bacteria makes K2. For example, most yoghurt has almost no vitamin K2. Certain types of cheeses are very high in K2, and others are not. It really depends on the specific bacteria. You can't assume that any fermented food will be high in K2, but some fermented foods are very high in K2, such as natto. Others, such as miso and tempeh, are not.

Mind Your Sodium-Potassium Levels as Well

Two additional nutrients that play an important role are sodium and potassium—you want the optimal ratio between these two in order to maintain your bone mass. If you eat a diet loaded with processed foods, there's a good chance your potassium to sodium ratio is far from optimal, which is typically done by consuming a diet of processed foods, which are notoriously low in potassium while high in sodium.

An imbalanced sodium to potassium ratio can contribute to a number of diseases, including osteoporosis. To ensure you get these two important nutrients in more appropriate ratios, simply ditch processed foods, which are very high in processed salt and low in potassium and other essential nutrients. Instead, eat a diet of whole, unprocessed foods, ideally organically grown to ensure optimal nutrient content. This type of diet will naturally provide much larger amounts of potassium in relation to sodium, which is optimal for your bone health, and your overall health. If you find it difficult to eat the recommended amount of vegetables, give vegetable juicing a try.

Exercise Also Builds Strong Bones

The other component you can’t ignore if you want strong, healthy bones is weight bearing exercises like strength training. Bone-building is a dynamic process, so you want to make sure you exert enough force on your bones to stimulate the osteoblasts to build new bone. Further, bone is living tissue that requires regular physical activity in order to renew and rebuild itself, so you should make exercise a lifelong commitment.

Peak bone mass is achieved in adulthood and then begins a slow decline, but exercise can help you to maintain healthy bone mass as you get older, without having to resort to dangerous bisphosphonate drugs.

Weight-bearing exercise is actually one of the most effective remedies against osteoporosis, because as you put more tension on your muscles it puts more pressure on your bones, which then respond by continuously creating fresh, new bone. In addition, as you build more muscle, and make the muscle that you already have stronger, you also put more constant pressure on your bones. A good weight-bearing exercise to incorporate into your routine (depending on your current level of fitness, of course) is a walking lunge, as it helps build bone density in your hips, even without any additional weights.

Ideally, though, your fitness program should be comprehensive, providing the necessary weight-bearing activities for bone health while also improving your cardiovascular fitness and fat-burning capabilities with high-intensity exercises. For a more complete, in-depth explanation of my Peak Fitness regimen, please review my previous article, The Major Exercise Mistake I Made for Over 30 Years. Implementing Peak Fitness -- with its array of weight-bearing exercises for bone health and Peak Exercises for disease prevention, fat loss and more -- may be one of the best lifestyle changes you could ever make.

The Power Plate—A Valuable Exercise Tool for Prevention and Treatment of Brittle Bones

Acceleration Training, a.k.a. Whole Body Vibrational Training (WBVT) using a Power Plate has also been shown to be a safe, natural way to ward off osteoporosis, and it’s gentle enough even for the disabled and elderly. For example, in one six-month long study, WBVT was found to produce a significant increase in hip area bone density in postmenopausal women, while conventional training was only able to slow the rate of deterioration.2 A total of 90 women, aged 58 to 70 years old, were divided into three groups:

1. The first group did up to 30 minutes of WBVT three times a week. Static and dynamic exercises for the upper leg and hip area included squats and lunges.
2. The second group did 60 minutes of conventional weight training three times per week.
3. The control group did not exercise at all.

The researchers concluded that Acceleration Training might be a solution for reversing bone loss and eliminating osteoporosis, stating that:

"The whole body vibration group got positive results: strength increased as much as 16 percent in upper leg muscles, while bone density at the hip increased by 1.5 percent. In addition, the whole body vibration group showed an improvement in postural control and balance, increased muscle strength and lean mass while losing body fat and fat mass. The conventionally trained subjects were able to slow the rate of bone loss, which is consistent with previous published studies on weight training and bone loss. The control group subjects continued to lose bone mineral density at the average rate."

NASA has also tested vibration platforms to help prevent the bone loss that occurs during space travel. According to a 2001 article in NASA Science:3

"...NASA-funded scientists suggest that astronauts might prevent bone loss by standing on a lightly vibrating plate for 10 to 20 minutes each day... The same therapy, they say, might eventually be used to treat some of the millions of people who suffer from bone loss, called osteoporosis here on Earth.

...Although the vibrations are subtle they have had a profound effect on bone loss in laboratory animals such as turkeys, sheep, and rats. In one study (published in the October 2001 issue of The FASEB Journal), only 10 minutes per day of vibration therapy promoted near-normal rates of bone formation in rats that were prevented from bearing weight on their hind limbs during the rest of the day."

Build Strong, Healthy Bones the Natural Way

To recap, your bones are actually composed of several different minerals, and if you focus on calcium alone, you will likelyweaken your bones and increase your risk of osteoporosis as Dr. Robert Thompson explains in his book, The Calcium Lie. Remember, calcium, vitamins D and K2, and magnesium work synergistically together to promote strong, healthy bones, and your sodium to potassium ratio also play an important role in maintaining your bone mass. Ideally, you’d get all or most of these nutrients from your diet (with the exception of vitamin D). This includes:

• Plant-derived calcium: raw milk from pasture-raised cows (who eat the plants), leafy green vegetables, the pith of citrus fruits, carob, and sesame seeds
• Magnesium: raw organic cacao and supplemental magnesium threonate if need be
• Vitamin K2: Grass-fed organic animal products (i.e. eggs, butter, dairy), certain fermented foods such as natto, or vegetables fermented using a starter culture of vitamin K2-producing bacteria. Goose liver pâté, and certain cheeses such as Brie and Gouda
• Trace minerals: Himalayan Crystal Salt, which contains all 84 elements found in your body, or other natural, unprocessed salt (NOT regular table salt!)
• Vitamin D: Ideally from appropriate sun exposure (or a safe tanning bed), as it’s virtually impossible to get sufficient amounts from food. As a last resort, you could use a supplement, but if you do, you may also need to supplement with vitamin K2 to maintain ideal ratios

The bottom line?

One of the best ways to achieve healthy bones is a diet rich in fresh, raw whole foods that maximizes natural minerals so that your body has the raw materials it needs to do what it was designed to do. In addition, you need healthy sun exposure along with regular, weight-bearing exercise.

About Dr Kevin Lau

Dr Kevin Lau is a Singapore chiropractor and the founder of Health In Your Hands, a series of tools for Scoliosis prevention and treatment. The set includes his book Your Plan for Natural Scoliosis Prevention and Treatment, a companion Scoliosis Exercises for Prevention and Correction DVD and the innovative new iPhone application ScolioTrack. Dr Kevin Lau is a graduate in Doctor of Chiropractic from RMIT University in Melbourne Australia and Masters in Holistic Nutrition. He is a member of International Society On Scoliosis Orthopaedic and Rehabilitation Treatment (SOSORT), the leading international society on conservative treatment of spinal deformities. In 2006 I was awarded the "Best Health-care Provider Awards" by the largest Newspaper publication in Singapore on October 18 2006 as well as being interviewed on Primetime Channel News Asia as well as other TV and Radio. For more information on Dr Kevin Lau, watch his interviews or get a free sneak peek of his book, go to:

Website - http://www.hiyh.info.
ScolioTrack Website - http://www.ScolioTrack.com.
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Youtube - http://www.youtube.com/user/DrKevinLau.
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