Nutrition

Bone is a living tissue that requires all essential nutrients. Nutrients likely to be at risk of being deficient are calcium, the major mineral in hard tissue, and vitamin D, whose active metabolite facilitates calcium absorption. Magnesium is another mineral in bone that is at risk of suboptimal intake and contributes to bone quality. Protein is the dominant nutrient in connective tissue and is necessary, along with calcium, to reduce risk of fracture. Several micronutrients facilitate cross-linking of connective tissue. Bioactive compounds are being explored for their unique benefits to bone. The diet as a whole is important for bone health as it not only contributes essential nutrients but also determines many things that influence bone balance and quality, such as energy balance, acid-base balance, and salt intake. Sodium is the largest predictor of urinary calcium excretion. Because diets are complex and have long latency effects on bone, it is not easy to study the role of individual constituents on bone health. Deficiencies are more apparent during periods of rapid bone turnover such as growth or menopause. Dietary patterns that include milk and dairy products are associated with bone health and reduced risk of fracture.