Bone health: the role of micronutrients.

Development and maintenance of skeletal health is essential since the resultant effect of poor bone health is an increased risk of osteoporotic fracture. Osteoporosis is currently a major public health problem and with predicted demographic changes, its future health and economic impact is likely to be phenomenal. Adult bone health is predominantly governed by two factors: (i) maximum attainment of peak bone mass; and (ii) rate of bone loss which occurs with ageing. Both aspects are determined by a combination of endogenous and exogenous factors and, although genetic influences are believed to account for up to three-quarters of the variation in bone mass, there is still room for the modifiable factors (including nutrition) to play an important role. There is now good evidence to show that calcium is important not only to peak bone mass development but also in reducing bone loss in women who are greater than 5 year postmenopause. Vitamin D and calcium (and possibly vitamin K) are vital to fracture prevention in the elderly. Our knowledge of the influence of other micronutrients on bone health remains limited and further research is required to establish the essential ingredients for optimum bone health.