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Back to Bone Health and Osteoporosis

Milk Products and Bone Health: Potential Mechanisms

Milk products contain many nutrients, such as calcium, vitamin D, protein and phosphorus, which play a key role in the formation and maintenance of optimal bone health.

Calcium and phosphorus account for 80% to 90% of hydroxyapatite crystals, which make up bone mineral and play important roles for both bone rigidity and mobility. Protein, found in the bone matrix, also contributes to bone strength.1

A review of the potential mechanisms of nutrients found in milk products that play a role in bone health is presented below:

Calcium and vitamin D

  • Offsetting obligatory losses
    • Calcium and vitamin D are both needed to offset obligatory losses of calcium from the human skeleton. Vitamin D is necessary for efficient absorption of calcium from the diet, which in turn helps maintain blood calcium levels;1,2  
    • Calcium is recognized as a critical nutritional factor in achieving optimal peak bone mass.3
  • Reducing excessive bone remodelling (turnover)
    • Both calcium and vitamin D, particularly together, reduce excessive bone remodelling or turnover;2
    • Both increased calcium intake and increased vitamin D status reduce bone remodelling because they reduce parathyroid hormone secretion.1,2
  • Antifracture efficacy
    • Calcium, as well as vitamin D which is needed for its absorption, helps maintain the structural strength of bones. Together, calcium and vitamin D contribute to increased bone mineral density, a key factor in reducing fracture risk.4
  • Vitamin D and neuromuscular function
    • Vitamin D has also been shown to improve lower-extremity neuromuscular function, increase muscle strength and reduce fall frequency.2,5

Protein

  • Dietary protein plays many roles that may contribute to improving bone mineral density:1,6
    • Increasing calcium absorption from the intestine;
    • Decreasing bone resorption;
    • Improving lean muscle mass and strength;
    • Stimulating production of insulin-like growth factor 1 (IGF-1), a bone anabolic factor.
  • The effect of increasing dietary protein on bone mineral density or bone mineral content is even more favourable when the level of both calcium and vitamin D is adequate.7

Phosphorus

  • Increasing phosphorus intake helps in the absorption and overall retention of calcium;7
  • The calcium-phosphorus (Ca-Pi) ratio of dairy products appears to be optimal in supporting bone health during growth and adulthood. In particular, the Ca-Pi ratio in milk appears to favour a positive Ca-Pi balance that leads to bone matrix formation and mineral deposition.8

Interactions between calcium, vitamin D, phosphorus and protein

  • Calcium, phosphorus, protein and vitamin D interact to reduce bone resorption and stimulate bone formation, which diminishes bone loss related to aging.7

In summary, milk products are one of the best available food sources that provide a combination of nutrients (calcium, vitamin D, protein and phosphorus) which contribute to bone health.

References

  1. Heaney RP. Dairy and bone healthJ Am Coll Nutr 2009;28:82S-90S.
  2. Heaney RP. Bone healthAm J Clin Nutr 2007;85:300S-303S.
  3. Caroli A et al. Invited review: dairy intake and bone health: a viewpoint from the state of the artJ Dairy Sci 2011;94:5249-5262.
  4. Moore LL et al. Effects of average childhood dairy intake on adolescent bone healthJ Pediatr 2008;153:667-673.
  5. Laird E et al. Vitamin D and bone health: potential mechanismsNutrients 2010;2:693-724.
  6. Mangano KM et al. Dietary protein is beneficial to bone health under conditions of adequate calcium intake: an update on clinical researchCurr Opin Clin Nutr Metab Care 2014;17:69-74.
  7. Bonjour JP et al. Dairy in adulthood: from foods to nutrient interactions on bone and skeletal muscle healthJ Am Coll Nutr 2013;32:251-263.
  8. Bonjour JP. Calcium and phosphate: a duet of ions playing for bone healthJ Am Coll Nutr 2011;30:438S-448S.

Keywords: health studies , bone health


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