As people age, loss of bone health can greatly decrease the quality of life. Because bones are constantly breaking down and rebuilding themselves, the body needs a continuous supply of all the nutrients required for bone regeneration.

Most people do not take their bone health seriously until it is lost. Many of these individuals require bone medications to slow or stop bone loss and possibly rebuild bone structure gradually.

Many people turn to calcium supplements. Those needing medication sometimes opt for strontium supplements as an alternative to prescription medications. In the United States, both calcium and strontium are available in dietary supplement form. In Europe, however, strontium has been available for almost 10 years only as a well-studied prescription drug.

Too frequently, individuals who get a diagnosis of excessive bone loss start taking high doses of calcium supplements in an attempt to make up for years of bone loss. But this may not be a good idea: Proving the old adage that more is not always better, recent research in Sweden linked high calcium intake with an increased risk of death, especially from heart disease. Following on the heels of this calcium research, ongoing European studies recently identified similar risks associated with strontium use.

Certainly, adequate calcium and strontium can play key roles in bone health. But it is important to remember that all essential nutrients are needed in adequate amounts for bone health. And although strontium is available in supplement form, it should be considered to be a medication.

QUESTION: Are there any problems with taking calcium supplements for bone health?

ANSWER: Depending on your diet, a calcium supplement may be helpful or potentially harmful. A supplement should make up for inadequate calcium in the diet, but not be taken on top of an already adequate supply in the diet. The recent Swedish study on calcium found an increased risk of heart disease both for people who consume high and low calcium. Based on this study, the safest range of calcium intake is between 800 and 1200 milligrams per day.

Q: What are the European guidelines for strontium?

A: The latest research found that 1.7 percent of those taking strontium experienced heart attacks compared to 1.1 percent of those taking a placebo. Consequently, it is currently recommended that strontium not be used by people with any form of heart or blood vessel disease.

Q: What are the key nutrients for bone health?

A: First, it is important to remember that bone is a protein matrix structure within which minerals such as calcium and phosphorus are deposited — sort of like concrete around steel rebar. Phosphorus is rarely in short supply. In addition to calcium, other key nutrients include vitamin D, magnesium and vitamin K.

Q: What are the best sources of these bone nutrients?

A: Without a doubt, the foundation for meeting critical nutrient needs is established by eating a variety of foods from all the key food groups in adequate amounts. This includes high-protein foods (meat, fish, poultry, soy foods and beans), calcium sources (including dairy or calcium-fortified soy milks), vegetables, fruits and grains. How much you select from each of these food groups depends on your calorie needs. However, without adequate protein and calcium sources, the other groups can’t promote bone health.

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Alan Titchenal, Ph.D., C.N.S., and Joannie Dobbs, Ph.D., C.N.S., are nutritionists in the Department of Human Nutrition, Food and Animal Sciences, College of Tropical Agriculture and Human Resources, University of Hawaii-Manoa. Dobbs also works with University Health Services.