The Role of Nutrients and Non-nutrients in Bone and Muscle Health: A Bone and Nutrients Perspective

Bone is formed as a result of calcium phosphate deposition onto a collagenous matrix. Calcium is an important constituent of bone, exert various important biological functions, and therefore its serum concentration is strictly regulated by factors such as parathyroid hormone, active vitamin D, and FGF23. Vitamin D insufficiency, which is milder than deficiency, is a risk factor for osteoporotic fracture and a number of other diseases. Vitamin K is an essential cofactor for both blood coagulation factors and bone matrix proteins. Osteoporosis is defined as a state of increased fracture risk, and is influenced by both bone mineral density and bone quality. Hyperhomocysteinemia, caused by insufficiency of folate, vitamin B12, or vitamin B6, impairs bone quality and is a fracture risk factor. In the Dietary Reference Intakes for Japanese 2020 (DRIs 2020), DG (tentative dietary goal for prevention of lifestyle-related diseases) is not defined for calcium or vitamins, since it has not received attention in the context of osteoporotic fracture prevention. For this reason, the requirements for these nutrients differ between the DRIs 2020 and the Guideline for the Prevention and Treatment of Osteoporosis.