In the realm of bone health assessment, Bone Mineral Density (BMD) has long been regarded as the gold standard. While an increase in bone density often indicates improved bone strength, it doesn't necessarily guarantee enhanced bone quality and strength. Let’s explore this concept and shed light on the complexities of bone health assessment beyond traditional measures like BMD.
What Is Bone Density, Bone Quality & Bone Strength?
What Is Bone Density, Bone Quality & Bone Strength?
Bone density is the concentration of minerals, including calcium, within the bone. Higher mineral content indicates denser bones, which are typically stronger and more resistant to fractures. However, bone density can decrease with age or due to specific medical conditions.
 
Bone quality refers to various characteristics of bone composition and structure that influence bone strength regardless of bone mineral density. These factors encompass bone turnover, microarchitecture, mineralization, microdamage, and the composition of both bone matrix and mineral.
 
Bone strength refers to the ability of bone to withstand fracture, such as the maximum load it can bear before breaking, under specific conditions like the impact experienced during a fall.
Bone Density Doesn’t Necessarily Guarantee Good Bone Quality & Strength
Research conducted by Seeman (2008) and Boskey and Coleman (2010) highlights the multifaceted nature of bone health assessment. Bone density, typically measured through techniques like dual-energy X-ray absorptiometry (DXA), reflects the amount of mineralized bone tissue per unit volume. An increase in bone density suggests greater bone mass, which can contribute to improved bone strength and reduced fracture risk.
 
However, it's essential to recognize that bone strength is influenced by multiple factors beyond just mineral density. While BMD provides valuable information about bone mass, it fails to account for other crucial determinants of bone strength, such as bone microarchitecture, mineralization, collagen composition, and turnover rate. For instance, two individuals may have similar BMD values, but differences in bone microarchitecture could lead to significant variations in bone strength and fracture risk. These factors collectively influence the mechanical properties of bone, such as its flexibility, resilience, and resistance to fractures.
 
It's well-established that individuals with osteoporosis are at increased risk of fractures, yet a significant proportion of these fractures occur in individuals with BMD values above the osteoporotic threshold. This paradox underscores the inadequacy of BMD as a sole predictor of fracture risk and emphasizes the importance of assessing bone quality comprehensively.
Traditional Methods For Poor Bone Health Have Many Holes
Most traditional methods for improving osteoporosis deactivate osteoclasts, preventing them from breaking down and shedding dead bone cells. In other words, when osteoclasts are inactivated, bone cells that have reached the end of their life are destroyed and cannot escape, accumulating in the bone.
 
When bone density is scanned with DEXA, bone density appears to stagnate or slightly increase (1-5%/5 years). This is a completely different story from bone quality. When traditional treatments are discontinued, bone density often declines rapidly (after 1-2 months), indicating that the structural integrity of the bone has not necessarily improved.
 
In addition to this, the underlying issues such as abnormalities in bone microarchitecture or collagen quality may remain unaddressed. Similarly, supplements containing calcium, vitamin D, and other nutrients may support bone density maintenance, but their influence on bone quality may be limited without addressing other factors like collagen cross-linking and turnover rates.
SAC®  FORMULATION TECHNOLOGY
SAC® Nature’s Best Solution
Marah Natural’s SAC® naturally enhances bone density by supporting the process of bone remodeling, which involves the continuous removal of old bone tissue by osteoclasts and the formation of new bone tissue by osteoblasts.
 
By providing readily absorbable calcium, SAC® helps facilitate this remodeling process, leading to the formation of healthier and stronger bone tissue that can lead to better bone quality.
SAC®  FORMULATION TECHNOLOGY
SAC® Nature’s
Best Solution
Marah Natural’s SAC® naturally enhances bone density by supporting the process of bone remodeling, which involves the continuous removal of old bone tissue by osteoclasts and the formation of new bone tissue by osteoblasts.
 
By providing readily absorbable calcium, SAC® helps facilitate this remodeling process, leading to the formation of healthier and stronger bone tissue that can lead to better bone quality.
BONE HEALTH
Advancements In Technologies
Can Help In The Future

Recent advancements in imaging technologies have enabled the evaluation of bone microarchitecture and composition, providing insights into bone quality beyond BMD.

Techniques such as High-Resolution Peripheral Quantitative Computed Tomography (HR-pQCT) and Quantitative Ultrasonography (QUS) offer valuable information about bone structure, density distribution, and mechanical properties.

By integrating these novel modalities into clinical practice, we can obtain a more comprehensive understanding of bone health and improve risk stratification for fractures.

BONE HEALTH
Advancements In Technologies
Can Help In The Future
 

Recent advancements in imaging technologies have enabled the evaluation of bone microarchitecture and composition, providing insights into bone quality beyond BMD.

Techniques such as High-Resolution Peripheral Quantitative Computed Tomography (HR-pQCT) and Quantitative Ultrasonography (QUS) offer valuable information about bone structure, density distribution, and mechanical properties.

By integrating these novel modalities into clinical practice, we can obtain a more comprehensive understanding of bone health and improve risk stratification for fractures.

SAC®  FORMULATION TECHNOLOGY
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THE SECRETS OF STRONG BONES
Conclusion

In summary, while an increase in bone density often suggests improved bone strength, it's essential to consider other aspects of bone quality for a comprehensive assessment of bone health.

By addressing both density and quality through holistic interventions, individuals can enhance their overall bone health and reduce the risk of fractures.

THE SECRETS OF STRONG BONES
Conclusion
In summary, while an increase in bone density often suggests improved bone strength, it's essential to consider other aspects of bone quality for a comprehensive assessment of bone health.
By addressing both density and quality through holistic interventions, individuals can enhance their overall bone health and reduce the risk of fractures.

REFERENCES

  1. Boskey AL, Coleman R. Aging and Bone. Journal of Dental Research. 2010;89(12):1333-1348. doi:10.1177/0022034510377791

  2. Seeman, Ego. "Bone quality: the material and structural basis of bone strength." Journal of bone and mineral metabolism 26, no. 1 (2008): 1-8.

  3. Siris, Ethel S., Ronald Emkey, Steve P. Harden, David M. Minshall, Conrad C. Miller, Reiner Barringer, and Steven K. Abbott. "Predictive value of low BMD for 1-year fracture outcomes is similar for postmenopausal women ages 50–64 and 65 and older: results from the National Osteoporosis Risk Assessment (NORA)." Journal of Bone and Mineral Research 22, no. 9 (2007): 1445-1450.

  4. Burghardt, Andrew J., Punam K. Saha, Thomas M. Link, and Sharmila Majumdar. "High-resolution peripheral quantitative computed tomographic imaging of cortical and trabecular bone microarchitecture in patients with type 2 diabetes mellitus." Journal of Clinical Endocrinology & Metabolism 93, no. 6 (2008): 2102-2108.

  5. Bauer, Douglas C., Jane A. Cauley, Steven R. Cummings, Kristine E. Ensrud, Dennis M. Black, Marc C. Hochberg, and Michael C. Nevitt. "Monitoring osteoporosis therapy with bone densitometry: misleading changes and regression to the mean." Journal of the American Medical Association 291, no. 1 (2004): 131-138.

  6. Seeman, Ego, and Richard S. Weinstein. "The new bone biology: pathologic, molecular, and clinical correlates." Journal of Clinical Investigation 104, no. 12 (1999): 1689-1696.