Many factors are known or suspected to accelerate the rate of bone loss. These include smoking, alcohol, low calcium intake, lack of exercise, various medications, and several medical illnesses. Excessive consumption of vitamin A may also increase risk of osteoporosis,1,109 and rapid weight loss may increase the risk in postmenopausal women.2 Raw food vegetarians are also likely to have significant bone thinning.129
In general, women are far more prone to osteoporosis than men. For this reason, the following discussion focuses almost entirely on women.
Hormone replacement therapy prevents or reverses osteoporosis in women. However, now that long-term use of hormone replacement therapy has been found to be unsafe, conventional medical treatment for osteoporosis in women centers mainly on drugs in the bisphosphonate family, such as Fosamax (taken along with calcium and vitamin D— see below).
Exercise, especially weight-bearing exercise, almost certainly helps strengthen bone (although the evidence for this apparently obvious statement is weaker than one might expect).167-170 Minimal evidence suggests that the Chinese form of exercise called Tai Chi may also provide some benefit.177,180 However, in a randomized trial of 86 postmenopausal women with osteopenia (low bone density), tai chi plus usual care did not appear to improve bone mineral density of proximal femur or lumbar spine compared to usual care alone.195
Principal Proposed Natural Treatments
There is good evidence that people with osteoporosis, or who are at risk for it, should take calcium and vitamin D supplements regardless of what other treatments they may be using.
Substances called isoflavones found in soy and other plants may be helpful for osteoporosis (as well as general menopausal symptoms). Vitamin K and a new supplement called strontium ranelate have also shown promise. A semisynthetic isoflavone called ipriflavone has shown considerable promise for osteoporosis, but safety concerns have decreased its popularity.
Calcium and Vitamin D
Calcium is necessary to build and maintain bone. You need vitamin D, too, as the body cannot absorb calcium without it. Many people do not get enough calcium in their daily diet. Although your body can manufacture vitamin D when exposed to the sun, supplemental vitamin D may be necessary in this age of sunblock.
According to most, but not all studies, calcium supplements (especially as calcium citrate, and taken with vitamin D) appear to be modestly helpful in slowing down bone loss in postmenopausal women.3-7,121,130-131,140,165,171 Contrary to some reports, milk does appear to be a useful source of calcium for this purpose.175-176 Any improvements in bone density rapidly disappear once the supplements are stopped.10 People who religiously continue calcium use may do better than those who forget from time to time.140 Vitamin D without calcium, however, does not appear to offer more than minimal bone-protective benefits for seniors.110,181,182
The effect of calcium and vitamin D supplementation in any form is relatively minor and may not be strong enough to reduce the rate of osteoporotic fractures. A large randomized trial of over 3,000 postmenopausal women aged 65-71 years found that three years of daily supplementation with calcium and vitamin D was not associated with a significant reduction in the incidence of fractures.193
In a much larger observational study (not a randomized trial) involving 61,433 women aged 39-73, researchers investigated the effects of dietary calcium (as opposed to supplements) on the risk of osteoporosis and fracture over a 19-year period.194 They found that women who consumed less than 750 mg/day of calcium had a higher rate of osteoporotic fractures in any location. Unexpectedly, however, the study also found that those who consumed the highest amounts of calcium (over 1,137 mg/day) did not have a comparatively reduced rate of fractures or osteoporosis. Indeed, this high dietary intake was associated with an increase in the number of hip fractures for reasons the authors could not completely explain.
Use of calcium supplements early in life might put calcium "in the bank" and prevent problems later, especially when children also engage in physical exercise; however, study results are somewhat contradictory.132-136,142-145
One study found benefits for male seniors using a calcium and vitamin D-fortified milk product.141 However, there are some concerns that excessive calcium intake could raise the risk of prostate cancer in men. See the Calcium article for more information.
Certain other supplements may enhance the effects of calcium and vitamin D. One study found that adding various trace minerals ( zinc at 15 mg, copper at 2.5 mg, and manganese at 5 mg) produced further improvement.11,12 However, copper by itself may not be helpful.99
There is some evidence that essential fatty acids may also enhance the effectiveness of calcium. In one study, 65 postmenopausal women were given calcium along with either placebo or a combination of omega-6 fatty acids (from evening primrose oil) and omega-3 fatty acids (from fish oil) for a period of 18 months. At the end of the study period, the group receiving essential fatty acids had higher bone density and fewer fractures than the placebo group.13 In contrast to this, however, a similar 12-month, double-blind trial of 42 postmenopausal women found no benefit from essential fatty acids.14 The explanation for the discrepancy may lie in the differences between the women studied. The first study involved women living in nursing homes, while the second studied healthier women living on their own. The second group of women may have been better nourished and already receiving sufficient essential fatty acids in their diet.
Interestingly, vitamin D may offer another benefit for osteoporosis in seniors: most, though not all, studies have found that vitamin D supplementation improves balance in seniors (especially female seniors) and reduces risk of falling.103,104,112,113,120,122.123,146-149,163 However, this was not the case in a randomized trial of 409 women who lived at home with a history of one or more falls in the past year. Vitamin D without exercise was not associated with a reduced risk of falls when compared to placebo combined with exercise. In this case, strength and balance exercises was only intervention that improved physical functioning.197
There is weak, preliminary evidence that calcium supplementation in healthy, postmenopausal women may slightly increase the risk of cardiovascular events, such as myocardial infarction.190
Genistein and Other Isoflavones
Soy contains substances called isoflavones that produce effects in the body somewhat similar to the effects of estrogen. (For this reason, they are called “phytoestrogens.”) Although study results are not entirely consistent, growing evidence suggests that genistein and other isoflavones can (like estrogen) help prevent bone loss.37-48,105,106,114,124-126,150-151,185
For example, in a 1-year, double-blind, placebo-controlled study, 90 women aged 47 to 57 were given genistein at a dose of 54 mg/day, standard hormone replacement therapy (HRT), or placebo.106 The results showed that genistein prevented bone loss in the back and hip to approximately the same extent as HRT. No adverse effects on the uterus or breast were seen. A subsequent 2-year, double-blind study of 389 postmenopausal women with mild bone loss found that 54 mg of genistein plus calcium and vitamin D improved bone density to a greater extent than calcium and vitamin D alone.185 However, a fairly high percentage of participants given genistein experienced substantial digestive distress.
In a 1-year, double-blind, placebo-controlled study of 203 postmenopausal Chinese women, use of soy isoflavones at a dose of 80 mg daily had mildly positive protective effects on bone mass in the hip.125 This supplement contained 46.4% daidzein, 38.8% glycetein, and 14.7% genistein.
Another study evaluated an isoflavone supplement made from red clover (containing 6 mg biochanin A, 16 mg formononetin, 1 mg genistein, and 0.5 mg daidzein daily).126 In this 1-year, double-blind, placebo-controlled study of 205 people, use of red clover isoflavones significantly reduced loss of bone in the lumbar spine. Benefits were also seen in a 1-year, double-blind, placebo-controlled study using an extract made from the soy product tofu.127
However, it is not clear that the consumption of foods rich in isoflavones offers the same benefits. For example, in placebo-controlled study involving 237 healthy women in the early stages of menopause, the consumption of isoflavone-enriched foods (providing an average of 110 mg isoflavone daily) for one year had no affect on bone density or metabolism.192
Interestingly, the effect of isoflavones on bone may be more complex than that of estrogen. Bone is always undergoing two opposite processes at once: bone breakdown and bone formation. Estrogen acts on the first of these processes: it inhibits bone breakdown. Isoflavones may affect both sides of the equation at once: inhibiting bone breakdown while at the same time enhancing new bone formation.49,50,106,126,178
In about one out of three people, intestinal bacteria convert some soy isoflavones into a substance called "equol." Isoflavones may have a greater bone-protecting effect in such "equol producers."152,183
For more information, including dosage and safety issues, see the full Soy article.
Growing evidence indicates that the mineral strontium (as strontium ranelate) is effective as an aid in the treatment of osteoporosis.115-117,137,138
The best and largest study on strontium was a double-blind, placebo-controlled study of 1,649 postmenopausal women with osteoporosis.128 In this 3-year study, a dose of strontium ranelate at 2 g daily significantly increased bone density in the spine and hip, and significantly decreased the rate of vertebral fractures.
While some treatments for osteoporosis act to increase bone formation, and others decrease bone breakdown, some evidence suggests that strontium ranelate has a dual effect, providing both these benefits at once.153
There is one major caveat, however. At present, all major controlled clinical trials of strontium ranelate have involved some of the same researchers. Entirely independent confirmation is needed. It is not clear to what extent the “ranelate” portion of strontium ranelate is necessary for this benefit, or whether other strontium salts would work as well.
Note : The strontium used in these studies is not the same as the radioactive strontium that was such a concern during the decades of above-ground atomic testing.
For more information, including dosage and safety issues, see the full Strontium article.
Vitamin K TOP
Increasing, but inconsistent, evidence indicates that vitamin K may help prevent osteoporosis.51-60,111,154, 173-174 It may work by reducing bone breakdown, rather than by enhancing bone formation.155
Perhaps the best evidence for a beneficial effect comes from a 3-year, double-blind, placebo-controlled trial of 181 women.111 Participants, postmenopausal women between the ages of 50 and 60, were divided into three groups: placebo, calcium plus vitamin D plus magnesium, or calcium plus vitamin D plus magnesium plus vitamin K (at a dose of 1 g daily). Researchers monitored bone loss by using a standard DEXA bone density scan. The results showed that the study participants using vitamin K along with the other nutrients lost less bone than those in the other two groups.
However, another placebo-controlled trial involving 452 older men and woman with normal levels of calcium and vitamin D failed to demonstrate any beneficial effects of 500 mcg per day of vitamin K supplementation on bone health over a 3-year period.191
For more information, see the full Vitamin K article.
Ipriflavone is a semisynthetic variation of soy isoflavones. Ipriflavone appears to help prevent osteoporosis by interfering with bone breakdown. Estrogen works in much the same way, but ipriflavone does not appear to produce estrogenic effects anywhere else in the body other than in bone. For this reason, it probably does not increase the risk of breast or uterine cancer. However, it also does not reduce the hot flashes, night sweats, mood changes, or vaginal dryness of menopause. In addition, it may cause health risks of its own.
Numerous double-blind, placebo-controlled studies involving a total of more than 1,700 participants have examined the effects of ipriflavone on various forms of osteoporosis.15-26 Overall, it appears that ipriflavone can stop the progression of osteoporosis and perhaps reverse it to some extent.
For example, a 2-year, double-blind study followed 198 postmenopausal women who had evidence of bone loss.27 At the end of the study, there was a gain in bone density of 1% in the ipriflavone group compared to a loss of 0.7% in the placebo group.
Conversely, the largest and longest study of ipriflavone found no benefit.28 In this 3-year trial of 474 postmenopausal women, no differences in extent of osteoporosis were seen between ipriflavone and placebo groups. However, for reasons that are not clear, the researchers in this study gave women only 500 mg of calcium daily. All other major studies of ipriflavone gave participants 1,000 mg of calcium daily. It is possible that ipriflavone requires the higher dose of calcium to work properly.
Ipriflavone may also be helpful for preventing osteoporosis in women who are taking Lupron or corticosteroids, medications that accelerate bone loss.29-31 (However, the combined use of ipriflavone and drugs that suppress the immune system, such as corticosteroids, presents risks.)
There is some evidence that combining ipriflavone with estrogen may improve anti-osteoporosis benefits.32,33 However, we do not know whether such combinations increase or decrease the other benefits and adverse effects of estrogen-replacement therapy.
Finally, for reasons that are not at all clear, ipriflavone appears to be able to reduce pain in osteoporosis-related fractures that have already occurred.34-36
For more information, including dosage and safety issues, see the full Ipriflavone article.
Other Proposed Natural Treatments TOP
It has been suggested (though with little meaningful supporting evidence), that the typical American diet causes the body to become acidic, and that this in turn leads to bone loss. One study tested potassium citrate as a treatment for bone loss, in the belief that this supplement would counteract this hypothesized diet-related acidity.183 The results in this 1-year study of 161 postmenopausal women indicated that potassium citrate reduced bone loss to a greater extent than the placebo used (potassium chloride). This study suffered from numerous problems in design, analysis, and reporting, and does not necessarily show anything about dietary “acidity.” It may, however, indicate that the citrate part of potassium citrate has some bone-protective effects. If this is in fact true, it could in turn explain why calcium citrate has, in some studies, proven more effective for treating or preventing osteoporosis than other forms of calcium.
Observational studies hint that higher levels of high homocysteine might increase risk of osteoporosis.157-159 Vitamins B12, B6, and folate are known to reduce homocysteine levels. On this basis, supplementation with these vitamins has been proposed for preventing or mitigating the effects of osteoporosis. One double-blind study found weak evidence that supplemental folate and vitamin B12 (known to reduce homocysteine) might reduce risk of osteoporotic fractures in people who had suffered a stroke.160 However, two other studies failed to find that use of mixed B-vitamins had any positive effect on bone density or chemical markers of bone turnover.172,188
Some evidence suggests that the hormone DHEA may be helpful for preventing or treating osteoporosis, especially in postmenopausal women over 70.61-64,101,161,189 One study found weak evidence that DHEA might be helpful for preventing the osteoporosis that sometimes develops in women with anorexia nervosa.107
Chinese studies suggest that the herb Epimedium brevicornum has phytoestrogenic effects and, on this basis, may be helpful for preventing bone loss.179 ( Epimedium brevicornum is related, but not identical, to Epimedium sagittatum, otherwise known as horny goat weed.)
Although it has long been stated that high phosphorus intake due to consumption of soft drinks might lead to osteoporosis, there is no solid evidence for this claim; in fact, elevated intake of phosphorus may help prevent osteoporosis.164 The reason is that bone contains both calcium and phosphate.
According to one very preliminary study, but not another, boron may be helpful for preventing osteoporosis.66,108 However, there are some concerns that boron supplements may raise levels of the body's own estrogen, especially in women on estrogen-replacement therapy, and therefore might present an increased risk of cancer.67,68 If you want to increase your boron intake, the best way might be to eat more fruits and vegetables.
Extremely weak evidence hints at possible benefit for osteoporosis through use of royal jelly.186
Although it has long been believed that consuming too much protein (especially animal-based protein) increases the risk of osteoporosis, the balance of available evidence suggests the reverse: if anything, high intake of protein appears to help strengthen bone.69,70,118,119 One study found that calcium supplements may do a better job of strengthening bones in people with relatively high protein intake than those with lower intake.100
The Progesterone Story
Many books promote the idea that natural progesterone prevents or even reduces osteoporosis. In this case, the term natural indicates that we are using the same progesterone found in the body. It is still made synthetically, but it is called "natural progesterone" to distinguish it from its chemical cousins known as progestins. Generally, prescription "progesterone" is actually a progestin.
The progesterone/osteoporosis story began with test tube and other preliminary studies suggesting that progesterone or progestins can stimulate the activity of cells that build bone.71,72 Subsequently, a poorly designed and uncontrolled study (really a series of case histories from one physician's practice) purportedly demonstrated that progesterone cream can slow or even reverse osteoporosis.73-75
However, a 1-year, double-blind trial of 102 women given either progesterone cream (providing 20 mg progesterone daily) or placebo cream, along with calcium and multivitamins, found no evidence of any improvements in bone density attributable to progesterone.76
Furthermore, in a 3-year study of 875 women, combination treatment with estrogen and oral progesterone was no more effective for osteoporosis than estrogen alone.77
The Estriol Story
For over a decade, some alternative medicine practitioners have popularized the use of a special form of estrogen called estriol, claiming that, unlike standard estrogen, it does not increase the risk of cancer. However, this claim is unfounded.
However, like other forms of estrogen, oral estriol stimulates the growth of uterine tissue. This leads to a risk of uterine cancer.
In a placebo-controlled study of 1,110 women, uterine tissue stimulation was seen among women given estriol orally (1 mg to 2 mg daily) as compared to those given placebo.84 Another large study found that oral estriol increased the risk of uterine cancer.85 In another study of 48 women given estriol at a dose of 1 mg twice daily, uterine tissue stimulation was seen in the majority of cases.86
In contrast, a 12-month, double-blind trial of oral estriol (2 mg daily) in 68 Japanese women found no effect on the uterus.87 It may be that the high levels of soy in the Japanese diet altered the results. Additionally, test tube studies suggest that estriol is just as likely to cause breast cancer as any other form of estrogen.98
The bottom line: If you use estriol, you should consider it like any other form of estrogen.
Traditional Chinese Herbal Medicine TOP
Traditional Chinese herbal medicine (TCHM) has a long historical tradition, although it is not quite as ancient as popularly believed. In China today, TCHM is used alongside conventional pharmaceutical treatment. Considerable attempts have been made to subject TCHM to scientific evaluation however, most of the published Chinese studies on the subject fall far short of current scientific standard, making it impossible to determine true benefits. The exact amounts and types of herbs used in each mix can also vary from person to person, making its effects less reliable.
In a review of 108 randomized trials with 10,655 people with osteoporosis, TCHM showed some promise at increasing bone mass density (BMD). Ninety nine mixtures of TCHMs were compared to traditional Western medications, placebo, or no intervention. TCHM was associated with increased BMD in 3 trials when TCHM was compared to placebo, in 2 of 5 trials when compared to no intervention, and in 23 of 61 trials when compared to Western medications. TCHM also increased BMD in 26 of 48 trials when TCHM was added to Western medications compared to Western medication alone. All the trials in this review had several biases and design flaws, which affect the reliability of the results and make it difficult to draw specific conclusions.196.
Herbs and Supplements to Use Only With Caution TOP
Various herbs and supplements may interact adversely with drugs used to treat osteoporosis. For more information on this potential risk, see the individual drug article in the Drug Interactions section of this database.
References[ + ]
1. Melhus H, Michaelsson K, Kindmark A, et al. Excessive dietary intake of vitamin A is associated with reduced bone mineral density and increased risk for hip fracture. Ann Intern Med. 1998;129:770-778.
2. Chao D, Espeland MA, Farmer D, et al. Effect of voluntary weight loss on bone mineral density in older overweight women. J Am Geriatr Soc. 2000;48:753-759.
3. Reid IR. The roles of calcium and vitamin D in the prevention of osteoporosis. Endocrinol Metab Clin North Am. 1998;27:389-398.
4. Cumming RG. Calcium intake and bone mass: a quantitative review of the evidence. Calcif Tissue Int. 1990;47:194-201.
5. Dawson-Hughes B, Dallal GE, Krall EA, et al. A controlled trial of the effect of calcium supplementation on bone density in postmenopausal women. N Engl J Med. 1990;323:878-883.
6. Peacock M, Liu G, Carey M, et al. Effect of calcium or 25OH vitamin D 3 dietary supplementation on bone loss at the hip in men and women over the age of 60. J Clin Endocrinol Metab. 2000;85:3011-3019.
7. Prince RL. Diet and the prevention of osteoporotic fractures. N Engl J Med. 1997;337:701-702.
8. Buckley LM, Leib ES, Cartularo KS, et al. Calcium and vitamin D 3 supplementation prevents bone loss in the spine secondary to low-dose corticosteroids in patients with rheumatoid arthritis. A randomized, double-blind, placebo-controlled trial. Ann Intern Med. 1996;125:961-968.
9. Homik J, Suarez-Almazor ME, Shea B, et al. Calcium and vitamin D for corticosteroid-induced osteoporosis. Cochrane Database Syst Rev. 2000;:CD000952.
10. Dawson-Hughes B, Harris SS, Krall EA, et al. Effect of withdrawal of calcium and vitamin D supplements on bone mass in elderly men and women. Am J Clin Nutr. 2000;72:745-750.
11. Saltman PD, Strause LG. The role of trace minerals in osteoporosis. J Am Coll Nutr. 1993;12:384-389.
12. Strause L, Saltman P, Smith KT, et al. Spinal bone loss in postmenopausal women supplemented with calcium and trace minerals. J Nutr. 1994;124:1060-1064.
13. Kruger MC, Coetzer H, de Winter R, et al. Calcium, gamma-linolenic acid and eicosapentaenoic acid supplementation in senile osteoporosis. Aging (Milano). 1998;10:385-394.
14. Bassey EJ, Littlewood JJ, Rothwell MC, et al. Lack of effect of supplementation with essential fatty acids on bone mineral density in healthy pre- and postmenopausal women: two randomized controlled trials of Efacal® v. calcium alone. Br J Nutr. 2000;83:629-635.
15. Agnusdei D, Crepaldi G, Isaia G, et al. A double blind, placebo-controlled trial of ipriflavone for prevention of postmenopausal spinal bone loss. Calcif Tissue Int. 1997;61:142-147.
16. Gennari C, Adami S, Agnusdei D, et al. Effect of chronic treatment with ipriflavone in postmenopausal women with low bone mass. Calcif Tissue Int. 1997;61(suppl 1):S19-S22.
17. Valente M, Bufalino L, Castiglione GN, et al. Effects of 1-year treatment with ipriflavone on bone in postmenopausal women with low bone mass. Calcif Tissue Int. 1994;54:377-380.
18. Kovacs AB. Efficacy of ipriflavone in the prevention and treatment of postmenopausal osteoporosis. Agents Actions. 1994;41:86-87.
19. Adami S, Bufalino L, Cervetti R, et al. Ipriflavone prevents radial bone loss in postmenopausal women with low bone mass over 2 years. Osteoporos Int. 1997;7:119-125.
20. Agnusdei D, Bufalino L, et al. Efficacy of ipriflavone in established osteoporosis and long-term safety. Calcif Tissue Int. 1997;61(suppl 1):S23-S27.
21. Agnusdei D, Zacchei F, Bigazzi S, et al. Metabolic and clinical effects of ipriflavone in established post-menopausal osteoporosis. Drugs Exp Clin Res. 1989;15:97-104.
22. Maugeri D, Panebianco P, Russo MS, et al. Ipriflavone-treatment of senile osteoporosis: results of a multicenter, double-blind clinical trial of 2 years. Arch Gerontol Geriatr. 1994;19:253-263.
23. Passeri M, Biondi M, Costi D, et al. Effects of 2-year therapy with ipriflavone in elderly women with established osteoporosis. Ital J Mineral Electrolyte Metab. 1995;9:137-144.
24. Agnusdei D, Adami S, Cervetti R, et al. Effects of ipriflavone on bone mass and calcium metabolism in postmenopausal osteoporosis. Bone Miner. 1992;19(suppl 1):S43-S48.
25. Alexandersen P, Toussaint A, Christiansen C, et al. Ipriflavone in the treatment of postmenopausal osteoporosis: a randomized controlled trial. JAMA. 2001;285:1482-1488.
26. Melis GB, Paoletti AM, Cagnacci A. Ipriflavone prevents bone loss in postmenopausal women. Menopause. 1996;3:27-32.
27. Agnusdei D, Crepaldi G, Isaia G, et al. A double blind, placebo-controlled trial of ipriflavone for prevention of postmenopausal spinal bone loss. Calcif Tissue Int. 1997;61:142-147.
28. Alexandersen P, Toussaint A, Christiansen C, et al. Ipriflavone in the treatment of postmenopausal osteoporosis: a randomized controlled trial. JAMA. 2001;285:1482-1488.
29. Gambacciani M, Cappagli B, Piaggesi L, et al. Ipriflavone prevents the loss of bone mass in pharmacological menopause produced by GnRH-agonists. Calcif Tissue Int. 1997;61(suppl 1):S15-S18.
30. Yamazaki I, Shino A, Shimizu Y, et al. Effect of ipriflavone on glucocorticoid-induced osteoporosis in rats. Life Sci. 1986;38:951-958.
31. Gambacciani M, Spinetti A, Piaggesi L, et al. Ipriflavone prevents the bone mass reduction in premenopausal women treated with gonadotropin hormone-releasing hormone agonists. Bone Miner. 1994;26:19-26.
32. Melis GB, Paoletti AM, Bartolini R, et al. Ipriflavone and low doses of estrogens in the prevention of bone mineral loss in climacterium. Bone Miner. 1992;19(suppl 1):S49-S56.
33. Nozaki M, Hashimoto K, Inoue Y, et al. Treatment of bone loss in oophorectomized women with a combination of ipriflavone and conjugated equine estrogen. Int J Gynaecol Obstet. 1998;62:69-75.
34. Maugeri D, Panebianco P, Russo MS, et al. Ipriflavone-treatment of senile osteoporosis: results of a multicenter double-blind clinical trial of 2 years. Arch Gerontol Geriatr. 1994;19:253-263.
35. Moscarini M, Patacchiola F, Spacca G, et al. New perspectives in the treatment of postmenopausal osteoporosis: ipriflavone. Gynecol Endocrinol. 1994;8:203-207.
36. Scali G, Mansanti P, Zurlo A, et al. Analgesic effect of ipriflavone versus sCalcitonin in the treatment of osteoporotic vertebral pain. Curr Ther Res. 1991;49:1004-1010.
37. Potter SM, Baum JA, Teng H, et al. Soy protein and isoflavones: their effects on blood lipids and bone density in postmenopausal women. Am J Clin Nutr. 1998;68(6 suppl):1375S-1379S.
38. Alekel DL, St. Germain A, Peterson CT, et al. Isoflavone-rich soy protein isolate attenuates bone loss in the lumbar spine of perimenopausal women. Am J Clin Nutr. 2000;72:844-852.
39. Harrison E, Adjei A, Ameho C, et al. The effect of soybean protein on bone loss in a rat model of postmenopausal osteoporosis. J Nutr Sci Vitaminol (Tokyo). 1998;44:257-268.
40. Fanti O, Faugere MC, Gang Z, et al. Systematic administration of genistein partially prevents bone loss in ovariectomized rats in a nonestrogen-like mechanism [abstract]. Am J Clin Nutr. 1998;68(suppl):1517S-1518S.
41. Arjmandi BH, Alekel L, Hollis BW, et al. Dietary soybean protein prevents bone loss in an ovariectomized rat model of osteoporosis. J Nutr. 1996;126:161-167.
42. Fanti P, Monier-Faugere MC, Geng Z, et al. The phytoestrogen genistein reduces bone loss in short-term ovariectomized rats. Osteoporos Int. 1998;8:274-281.
43. Anderson JJ, Ambrose WW, Garner SC. Biphasic effects of genistein on bone tissue in the ovariectomized, lactating rat model. Proc Soc Exp Biol Med. 1998;217:345-350.
44. Malochet S, Picherit C, Horcajada-Molteni MN, et al. Do endurance training and soy isoflavones exhibit additive effects on ovariectomy-induced osteopenia in the rat? [abstract]. J Bone Miner Res. 1999;14(suppl 1):S536.
45. Arjmandi BH, Birnbaum R, Goyal NV, et al. Bone-sparing effect of soy protein in ovarian hormone-deficient rats is related to its isoflavone content. Am J Clin Nutr. 1998;68(suppl):1364S-1368S.
46. Lees CJ, Ginn TA. Soy protein isolate diet does not prevent increased cortical bone turnover in ovariectomized macaques. Calcif Tissue Int. 1998;62:557-558.
47. Jayo MJ. Dietary soy isoflavones and bone loss: a study in ovariectomized monkeys [abstract]. J Bone Miner Res. 1996;11(suppl 1):S228.
48. Gallagher JC, Rafferty K, Haynatzka V, et al. The effect of soy protein on bone metabolism [abstract]. J Nutr. 2000;130:666S-669S.
49. Fanti O, Faugere MC, Gang Z, et al. Systematic administration of genistein partially prevents bone loss in ovariectomized rats in a nonestrogen-like mechanism [abstract]. Am J Clin Nutr. 1998;68(suppl):1517S-1518S.
50. Fanti P, Monier-Faugere MC, Geng Z, et al. The phytoestrogen genistein reduces bone loss in short-term ovariectomized rats. Osteoporos Int. 1998;8:274-281.
51. Feskanich D, Weber P, Willett WC, et al. Vitamin K intake and hip fractures in women: a prospective study. Am J Clin Nutr. 1999;69:74-79.
52. Kanai T, Takagi T, Masuhiro K, et al. Serum vitamin K level and bone mineral density in post-menopausal women. Int J Gynaecol Obstet. 1997;56:25-30.
53. Hart JP, Shearer MJ, Klenerman L, et al. Electrochemical detection of depressed circulating levels of vitamin K1 in osteoporosis. J Clin Endocrinol Metab. 1985;60:1268-1269.
54. Bitensky L, Hart JP, Catterall A, et al. Circulating vitamin K levels in patients with fractures. J Bone Joint Surg. 1988;70-B:663-664.
55. Hodges SJ, Pilkington MJ, Stamp TC, et al. Depressed levels of circulating menaquinones in patients with osteoporotic fractures of the spine and femoral neck. Bone. 1991;12:387-389.
56. Jie KS, Gijsbers BL, Knapen MH, et al. Effects of vitamin K and oral anticoagulants on urinary calcium excretion. Br J Haematol. 1993;83:100-104.
57. Knapen MH, Hamulyak K, Vermeer C. The effect of vitamin K supplementation on circulating osteocalcin (bone Gla protein) and urinary calcium excretion. Ann Intern Med. 1989;111:1001-1005.
58. Tomita A, Fujita T, Takatsuki K, et al. 47 Ca kinetic study and vitamin K 2 in postmenopausal osteoporosis [in Japanese]. Horumon To Rinsho. 1971;19:731-736.
59. Orimo H, Shiraki M, Fujita T, et al. Clinical evaluation of menatetrenone in the treatment of involutional osteoporosis—a double-blind multicenter comparative study with 1 alpha-hydroxy vitamin D3 [abstract]. J Bone Miner Res. 1992;7(suppl 1):S122.
60. Booth SL, Tucker KL, Chen H, et al. Dietary vitamin K intakes are associated with hip fracture but not with bone mineral density in elderly men and women. Am J Clin Nutr. 2000;71:1201-1208.
61. Baulieu EE, Thomas G, Legrain S, et al. Dehydroepiandrosterone (DHEA), DHEA sulfate, and aging: contribution of the DHEAge Study to a sociobiomedical issue. Proc Natl Acad Sci USA. 2000;97:4279-4284.
62. Labrie F, Diamond P, Cusan L, et al. Effect of 12-month dehydroepiandrosterone replacement therapy on bone, vagina and endometrium in postmenopausal women. J Clin Endocrinol Metab. 1997;82:3498-3505.
63. van Vollenhoven RF, Park JL, Genovese MC, et al. A double-blind, placebo-controlled, clinical trial of dehydroepiandrosterone in severe systemic lupus erythematosus. Lupus. 1999;8:181-187.
64. Greendale GA, Edelstein S, Barrett-Connor E. Endogenous sex steroids and bone mineral density in older women and men: the Rancho Bernardo Study. J Bone Miner Res. 1997;12:1833-1843.
65. Hegarty V, May H, Khaw K. Tea drinking and bone mineral density in older women. Am J Clin Nutr. 2000;71:1003-1007.
66. Nielsen FH, Hunt CD, Mullen LM, et al. Effect of dietary boron on mineral, estrogen and testosterone metabolism in postmenopausal women. FASEB J. 1987;1:394-397.
67. Naghii MR, Samman S. The effect of boron supplementation on its urinary excretion and selected cardiovascular risk factors in healthy male subjects. Biol Trace Elem Res. 1997;56:273-286.
68. Nielsen FH, Hunt CD, Mullen LM, et al. Effect of dietary boron on mineral, estrogen and testosterone metabolism in postmenopausal women. FASEB J. 1987;1:394-397.
69. Munger RG, Cerhan JR, Chiu BC. Prospective study of dietary protein intake and risk of hip fracture in postmenopausal women. Am J Clin Nutr. 1999;69:147-152.
70. Schurch MA, Rizzoli R, Slosman D, et al. Protein supplements increase serum insulin-like growth factor-I levels and attenuate proximal femur bone loss in patients with recent hip fracture. A randomized, double-blind, placebo-controlled trial. Ann Intern Med. 1998;128:801-809.
71. Prior JC. Progesterone as a bone-trophic hormone. Endocr Rev. 1990;11:386-398.
72. Verhaar HJ, Damen CA, Duursma SA, et al. A comparison of the action of progestins and estrogen on the growth and differentiation of normal adult human osteoblast-like cells in vitro. Bone. 1994;15:307-311.
73. Lee JR. Is natural progesterone the missing link in osteoporosis prevention and treatment? Med Hypotheses. 1991;35:316-318.
74. Lee JR. Osteoporosis reversal with transdermal progesterone. Lancet. 1990;336:1327.
75. Lee JR. Osteoporosis reversal, the role of progesterone. Int Clin Nutr Rev. 1990;10:384-391.
76. Leonetti HB, Longo S, Anasti JN. Transdermal progesterone cream for vasomotor symptoms and postmenopausal bone loss. Obstet Gynecol. 1999;94:225-228.
77. Writing Group for the PEPI Trial. Effects of hormone replacement therapy on endometrial histology in postmenopausal women: the postmenopausal estrogen/progestin interventions (PEPI) trial. JAMA. 1996;275:370-375.
78. Minaguchi H, Uemura T, Shirasu K, et al. Effect of estriol on bone loss in postmenopausal Japanese women: a multicenter prospective open study. J Obstet Gynaecol Res. 1996;22:259-265.
79. Itoi H, Minakami H, Sato I. Comparison of the long-term effects of oral estriol with the effects of conjugated estrogen, 1-alpha-hydroxyvitamin D3 and calcium lactate on vertebral bone loss in early menopausal women. Maturitas. 1997;28:11-17.
80. Hayashi T, Ito I, Kano H, et al. Estriol (E3) replacement improves endothelial function and bone mineral density in very elderly women. J Gerontol A Biol Sci Med Sci. 2000;55:B183-B190.
81. Holland EF, Leather AT, Studd JW. Increase in bone mass of older postmenopausal women with low mineral bone density after one year of percutaneous oestradiol implants. Br J Obstet Gynaecol. 1995;102:238-242.
82. Nozaki M, Hashimoto K, Inoue Y, et al. Usefulness of estriol for the treatment of bone loss in postmenopausal women [in Japanese; English abstract]. Nippon Sanka Fujinka Gakkai Zasshi. 1996;48:83-88.
83. Lindsay R, Hart DM, Maclean A, et al. Bone loss during oestriol therapy in postmenopausal women. Maturitas. 1979;1:279-285.
84. Granberg S, Ylostalo P, Wikland M, et al. Endometrial sonographic and histologic findings in women with and without hormonal replacement therapy suffering from postmenopausal bleeding. Maturitas. 1997;27:35-40.
85. Weiderpass E, Baron JA, Adami HO, et al. Low-potency oestrogen and risk of endometrial cancer: a case-control study. Lancet. 1999;353:1824-1828.
86. Montoneri C, Zarbo G, Garofalo A, et al. Effects of estriol administration on human postmenopausal endometrium. Clin Exp Obstet Gynecol. 1987;14:178-181.
87. Takahashi K, Manabe A, Okada M, et al. Efficacy and safety of oral estriol for managing postmenopausal symptoms. Maturitas. 2000;34:169-177.
98. Lippman M, Monaco ME, Bolan G. Effects of estrone, estradiol and estriol on hormone-responsive human breast cancer in long-term tissue culture. Cancer Res. 1977;37:1901-1907.
99. Cashman KD, Baker A, Ginty F, et al. No effect of copper supplementation on biochemical markers of bone metabolism in healthy young adult females despite apparently improved copper status. Eur J Clin Nutr. 2001;55:525-531.
100. Dawson-Hughes B, Harris S. Calcium intake influences the association of protein intake with rates of bone loss in elderly men and women. Am J Clin Nutr. 2002;75:773-779.
101. Kahn AJ, Haloran B. Dehydroepiandrosterone supplementation and bone turnover in middle-aged to elderly men. J Clin Endocrinol Metab. 2002;87:1544-1549.
102. Wuttke W. Abstracts P3-333, P3-317. 84th annual meeting of The Endocrine Society; June 21, 2002.
103. Pfeifer M, Begerow B, Minne H, et al. Effects of a short-term vitamin D and calcium supplementation on body sway and secondary hyperparathyroidism in elderly women. J Bone Miner Res. 2000;15:1113-1118.
104. Janssen HC, Samson MM, Verhaar HJ. Vitamin D deficiency, muscle function, and falls in elderly people. Am J Clin Nutr. 2002;75:611-615.
105. Messina M, Gardner C, Barnes S. Gaining insight into the health effects of soy but a long way still to go: commentary on the fourth International Symposium on the Role of Soy in Preventing and Treating Chronic Disease. J Nutr. 2002;132:547S.
106. Morabito N, Crisafulli A, Vergara C, et al. Effects of genistein and hormone-replacement therapy on bone loss in early postmenopausal women: a randomized double-blind, placebo-controlled study. J Bone Miner Res. 2002;17:1904-1912.
107. Gordon CM, Grace E, Emans SJ. Effects of oral dehydroepiandrosterone on bone density in young women with anorexia nervosa: a randomized trial. J Clin Endocrinol Metab. 2002;87:4935-4941.
108. Beattie JH, Peace HS. The influence of a low boron-diet and boron supplementation on bone, major mineral and sex steroid metabolism in postmenopausal women. Br J Nutr. 1993;69:871-884.
109. Michaelsson K, Lithell H, Vessby B, et al. Serum retinol levels and the risk of fracture. N Engl J Med. 2003;348:287-294.
110. Trivedi DP, Doll R, Khaw KT. Effect of four monthly oral vitamin D3 (cholecalciferol) supplementation on fractures and mortality in men and women living in the community: randomised double blind controlled trial. BMJ. 2003;326:469.
111. Braam LA, Knapen MH, Geusens P, et al. Vitamin K1 supplementation retards bone loss in postmenopausal women between 50 and 60 years of age. Calcif Tissue Int. 2003;73:21-26.
112. Bischoff HA, Stahelin HB, Dick W, et al. Effects of vitamin D and calcium supplementation on falls: a randomized controlled trial. J Bone Miner Res. 2003;18:343-351.
113. Latham NK, Anderson CS, Lee A, et al. A randomized, controlled trial of quadriceps resistance exercise and vitamin D in frail older people: the frailty interventions trial in elderly subjects (FITNESS). J Am Geriatr Soc. 2003;51:291-299.
114. Jones G, Dwyer T, Hynes K, et al. A randomized controlled trial of phytoestrogen supplementation, growth and bone turnover in adolescent males. Eur J Clin Nutr. 2003;57:324-327.
115. Reginster JY, Meunier PJ. Strontium ranelate phase 2 dose-ranging studies: PREVOS and STRATOS studies. Osteoporos Int. 2003;14(suppl 3):S56-65. Epub 2003 Mar 12.
116. Marie PJ. Optimizing bone metabolism in osteoporosis: insight into the pharmacologic profile of strontium ranelate. Osteoporos Int. 2003;14:9-12.
117. Boivin G, Meunier PJ. The mineralization of bone tissue: a forgotten dimension in osteoporosis research. Osteoporos Int. 2003;14(suppl 3):19-24.
118. Skov A, Haulrik N, Toubro S, et al. Effect of protein intake on bone mineralization during weight loss: a 6-month trial. Obes Res. 2002;10:432-438.
119. Promislow J, Goodman-Gruen D, Slymen D, et al., Protein consumption and bone mineral density in the elderly: the Rancho Bernardo study. Am J Epidemiol. 2002;155:636-644.
120. Latham NK, Anderson CS, Reid IR. Effects of vitamin D supplementation on strength, physical performance, and falls in older persons: a systematic review. J Am Geriatr Soc. 2003;51:1219-1226.
121. Shea B, Wells G, Cranney A, et al. Calcium supplementation on bone loss in postmenopausal women. Cochrane Database Syst Rev. 2003;4:CD004526.
122. Harwood RH, Sahota O, Gaynor K, et al. A randomised, controlled comparison of different calcium and vitamin D supplementation regimens in elderly women after hip fracture: The Nottingham Neck of Femur (NONOF) Study. Age Ageing. 2004;33:45-51.
123. Kenny AM, Biskup B, Robbins B, et al. Effects of vitamin D supplementation on strength, physical function, and health perception in older, community-dwelling men. J Am Geriatr Soc. 2003;51:1762-1767.
124. Cotter A, Cashman KD. Genistein appears to prevent early postmenopausal bone loss as effectively as hormone replacement therapy. Nutr Rev. 2003;61:346-351.
125. Chen YM, Ho SC, Lam SS, et al. Soy isoflavones have a favorable effect on bone loss in Chinese postmenopausal women with lower bone mass: a double-blind, randomized, controlled trial. J Clin Endocrinol Metab. 2003;88:4740-4747.
126. Atkinson C, Compston JE, Day NE, et al. The effects of phytoestrogen isoflavones on bone density in women: a double-blind, randomized, placebo-controlled trial. Am J Clin Nutr. 2004;79:326-333.
127. Yoles I, Yogev Y, Frenkel Y, et al. Tofupill/Femarelle (DT56a): a new phyto-selective estrogen receptor modulator-like substance for the treatment of postmenopausal bone loss. Menopause. 2003;10:522-525.
128. Meunier PJ, Roux C, Seeman E, et al. The effects of strontium ranelate on the risk of vertebral fracture in women with postmenopausal osteoporosis. N Engl J Med. 2004;350:459-468.
129. Fontana L, Shew JL, Holloszy JO, Villareal DT. Low bone mass in subjects on a long-term raw vegetarian diet. Arch Intern Med. 2005;165:684-689.
130. Porthouse J, Cockayne S, King C, et al. Randomised controlled trial of calcium and supplementation with cholecalciferol (vitamin D3) for prevention of fractures in primary care. BMJ. 2005;330:1003.
131. Avenell A, Campbell MK, et al. Oral vitamin D3 and calcium for secondary prevention of low-trauma fractures in elderly people: a randomised placebo-controlled trial. Lancet. 2005;365:1621-1628.
132. Matkovic V, Goel PK, Badenhop-Stevens NE, et al. Calcium supplementation and bone mineral density in females from childhood to young adulthood: a randomized controlled trial. Am J Clin Nutr. 2005;81:175-188.
133. Dodiuk-Gad RP, Rozen GS, Rennert G, et al. Sustained effect of short-term calcium supplementation on bone mass in adolescent girls with low calcium intake. Am J Clin Nutr. 2005;81:168-174.
134. Lloyd T, Andon MB, Rollings N, et al. Calcium supplementation and bone mineral density in adolescent girls. JAMA. 1993;270:841-844.
135. Barr SI, Petit MA, Vigna YM, et al. Eating attitudes and habitual calcium intake in peripubertal girls are associated with initial bone mineral content and its change over 2 years. J Bone Miner Res. 2001;16:940-947.
136. Lanou AJ, Berkow SE, Barnard ND, et al. Calcium, dairy products, and bone health in children and young adults: a reevaluation of the evidence. Pediatrics. 2005;115:736-743.
137. Delmas PD. Clinical effects of strontium ranelate in women with postmenopausal osteoporosis. Osteoporos Int. 2004 Dec 2. [Epub ahead of print]
138. Reginster JY, Seeman E, DE Vernejoul MC, et al. Strontium ranelate reduces the risk of nonvertabral fractures in post-menopausal women with osteoporosis: tropos study. J Clin Endocrinol Metab. 2005 Feb 22. [Epub ahead of print]
139. Baecker N, Boese A, Schoenau E, et al. L-Arginine, the natural precursor of NO, is not effective for preventing bone Loss in postmenopausal women. J Bone Miner Res. 2005;20:471-479.
140. Prince RL, Devine A, Dhaliwal SS, et al. Effects of calcium supplementation on clinical fracture and bone structure: results of a 5-year, double-blind, placebo-controlled trial in elderly women. Arch Intern Med. 2006;166:869-875.
141. Daly RM, Bass S, Nowson C. Long-term effects of calcium-vitamin-D(3)-fortified milk on bone geometry and strength in older men. Bone. 2006 May 23. [Epub ahead of print].
142. Barger-Lux MJ, Davies KM, Heaney RP, et al. Calcium supplementation does not augment bone gain in young women consuming diets moderately low in calcium. J Nutr. 2005;135:2362-2366.
143. French SA, Story M, Fulkerson JA, et al. Increasing weight-bearing physical activity and calcium-rich foods to promote bone mass gains among 9-11 year old girls: outcomes of the Cal-Girls study. Int J Behav Nutr Phys Act. 2005 Jul 19. [Epub ahead of print].
144. Cheng S, Lyytikainen A, Kroger H, et al. Effects of calcium, dairy product, and vitamin D supplementation on bone mass accrual and body composition in 10-12-y-old girls: a 2-y randomized trial. Am J Clin Nutr. 2005;82:1115-1126.
145. Courteix D, Jaffre C, Lespessailles E, et al. Cumulative effects of calcium supplementation and physical activity on bone accretion in premenarchal children: a double-blind randomised placebo-controlled trial. Int J Sports Med. 2005;26:332-338.
146. Bischoff-Ferrari HA, Conzelmann M, Stahelin HB, et al. Is fall prevention by vitamin D mediated by a change in postural or dynamic balance? Osteoporos Int. 2006 Mar 1. [Epub ahead of print]
147. Bischoff-Ferrari HA, Orav EJ, Dawson-Hughes B, et al. Effect of cholecalciferol plus calcium on falling in ambulatory older men and women: a 3-year randomized controlled trial. Arch Intern Med. 2006;166:424-430.
148. Sato Y, Iwamoto J, Kanoko T, et al. Low-dose vitamin D prevents muscular atrophy and reduces falls and hip fractures in women after stroke: a randomized controlled trial. Cerebrovasc Dis. 2005 Jul 27. [Epub ahead of print]
149. Law M, Withers H, Morris J, et al. Vitamin D supplementation and the prevention of fractures and falls: results of a randomised trial in elderly people in residential accommodation. Age Ageing. 2006 Apr 26. [Epub ahead of print]
150. Huang HY, Yang HP, Yang HT, et al. One-year soy isoflavone supplementation prevents early postmenopausal bone loss but without a dose-dependent effect. J Nutr Biochem. 2006 Feb 3. [Epub ahead of print].
151. Ye YB, Tang XY, Verbruggen MA, et al. Soy isoflavones attenuate bone loss in early postmenopausal Chinese women: A single-blind randomized, placebo-controlled trial. Eur J Nutr. 2006 Jun 8. [Epub ahead of print]
152. Wu J, Oka J, Higuchi M, et al. Cooperative effects of isoflavones and exercise on bone and lipid metabolism in postmenopausal Japanese women: a randomized placebo-controlled trial. Metabolism. 2006;55:423-433.
153. Marie PJ. Strontium ranelate: a dual mode of action rebalancing bone turnover in favour of bone formation. Curr Opin Rheumatol. 2006;18(suppl 1):S11-S15.
154. Purwosunu Y, Rachman IA, Reksoprodjo S, et al. Vitamin K treatment for postmenopausal osteoporosis in Indonesia. J Obstet Gynaecol Res. 2006;32:230-234.
155. Martini LA, Booth SL, Saltzman E, et al. Dietary phylloquinone depletion and repletion in postmenopausal women: effects on bone and mineral metabolism. Osteoporos Int. 2006 Mar 18. [Epub ahead of print]
156. Purwosunu Y, Rachman IA, Reksoprodjo S, et al. Vitamin K treatment for postmenopausal osteoporosis in Indonesia. J Obstet Gynaecol Res. 2006;32:230-234.
157. Sato Y, Honda Y, Iwamoto J, et al. Homocysteine as a predictive factor for hip fracture in stroke patients. Bone. 2005;36:721-726.
158. Sato Y, Iwamoto J, Kanoko T, et al. Homocysteine as a predictive factor for hip fracture in elderly women with Parkinson's disease. Am J Med. 2005;118:1250-1255.
159. McLean RR, Jacques PF, Selhub J, et al. Homocysteine as a predictive factor for hip fracture in older persons. N Engl J Med. 2004;350:2042-2049.
160. Sato Y, Honda Y, Iwamoto J, et al. Effect of folate and mecobalamin on hip fractures in patients with stroke: a randomized controlled trial. JAMA. 2005;293:1082-1088.
161. Jankowski CM, Gozansky WS, Schwartz RS, et al. Effects of DHEA replacement therapy on bone mineral density in older adults: a randomized, controlled trial. J Clin Endocrinol Metab. 2006 May 30. [Epub ahead of print]
162. Spector T, Calomme M, Anderson S, et al. Effect on bone turnover and BMD of low dose oral silicon as an adjunct to calcium/vitamin D3 in a randomized, placebo-controlled trial. Poster presented at: ASBMR 27th Annual Meeting; September 2005; Nashville, TN.
163. Bunout D, Barrera G, Leiva , et al. Effects of vitamin D supplementation and exercise training on physical performance in Chilean vitamin D deficient elderly subjects. Exp Gerontol. 2006 Jun 21. [Epub ahead of print]
164. Heaney RP. Advances in therapy for osteoporosis. Clin Med Res. 2003;1:93-99.
165. Reid IR, Mason B, Horne A, et al. Randomized controlled trial of calcium in healthy older women. Am J Med. 2006;119:777-785.
166. Carpenter TO, Delucia MC, Zhang JH, et al. A randomized controlled study of effects of dietary magnesium oxide supplementation on bone mineral content in healthy girls. J Clin Endocrinol Metab. 2006 Oct 3. [Epub ahead of print]
167. Kelley GA, Kelley KS. Exercise and bone mineral density at the femoral neck in postmenopausal women: a meta-analysis of controlled clinical trials with individual patient data. Am J Obstet Gynecol. 2006;194:760-767.
168. Martyn-St James M, Carroll S. High-intensity resistance training and postmenopausal bone loss: a meta-analysis. Osteoporos Int. 2006;17:1225-1240.
169. Kelley GA, Kelley KS, Tran ZV. Exercise and bone mineral density in men: a meta-analysis. J Appl Physiol. 2000;88:1730-1736.
170. Bonaiuti D, Shea B, Iovine R, et al. Exercise for preventing and treating osteoporosis in postmenopausal women. Cochrane Database Syst Rev. 2002;(3):CD000333.
171. Bolton-Smith C, McMurdo ME, Paterson CR, et al. A two-year randomized controlled trial of vitamin K(1) (phylloquinone) and vitamin D(3) Plus calcium on the bone health of older women. J Bone Miner Res. 2007 Jan 23. [Epub ahead of print]
172. Green TJ, McMahon JA, Skeaff CM, et al. Lowering homocysteine with B vitamins has no effect on biomarkers of bone turnover in older persons: a 2-y randomized controlled trial. Am J Clin Nutr. 2007;85:460-464.
173. Knapen MH, Schurgers LJ, Vermeer C. Vitamin K(2) supplementation improves hip bone geometry and bone strength indices in postmenopausal women. Osteoporos Int. 2007 Feb 8. [Epub ahead of print]
174. Cockayne S, Adamson J, Lanham-New S, et al. Vitamin K and the prevention of fractures: systematic review and meta-analysis of randomized controlled trials. Arch Intern Med. 2006;166:1256-1261.
175. Ting GP, Tan SY, Chan SP, et al. A follow-up study on the effects of a milk supplement on bone mineral density of postmenopausal Chinese women in Malaysia. J Nutr Health Aging. 2007;11:69-73.
176. Chee WS, Suriah AR, Chan SP. The effect of milk supplementation on bone mineral density in postmenopausal Chinese women in Malaysia. Osteoporos Int. 2003;14:828-34. [Epub 2003 Aug 12]
177. Woo J, Hong A, Lau E, et al. A randomised controlled trial of Tai Chi and resistance exercise on bone health, muscle strength, and balance in community-living elderly people. Age Ageing. 2007 Mar 13. [Epub ahead of print]
178. Ma DF, Qin LQ, Wang PY, et al. Soy isoflavone intake inhibits bone resorption and stimulates bone formation in menopausal women: meta-analysis of randomized controlled trials. Eur J Clin Nutr. 2007 Mar 28. [Epub ahead of print]
179. Zhang G, Qin L, Shi Y. Epimedium-derived phytoestrogen flavonoids exert beneficial effect on preventing bone loss in late postmenopausal women: a 24-month randomized, double-blind and placebo-controlled trial. J Bone Miner Res. 2007 Apr 9. [Epub ahead of print]
180. Wayne PM, Kiel DP, Krebs DE, et al. The effects of tai chi on bone mineral density in postmenopausal women: a systematic review. Arch Phys Med Rehabil. 2007;88:673-680.
181. Bischoff-Ferrari HA, Dawson-Hughes B. Where do we stand on vitamin D? Bone. 2007 Mar 24. [Epub ahead of print]
182. Lyons RA, Johansen A, Brophy S, et al. Preventing fractures among older people living in institutional care: a pragmatic randomised double blind placebo controlled trial of vitamin D supplementation. Osteoporos Int. 2007;18:811-818.
183. Wu J, Oka J, Ezaki J, et al. Possible role of equol status in the effects of isoflavone on bone and fat mass in postmenopausal Japanese women: a double-blind, randomized, controlled trial. Menopause. 2007 Apr 25. [Epub ahead of print]
184. Krapf R. Partial neutralization of the acidogenic Western diet with potassium citrate increases bone mass in postmenopausal women with osteopenia. Int J Prosthodont. 2007;20:113-114.
185. Marini H, Minutoli L, Polito F, et al. Effects of the phytoestrogen genistein on bone metabolism in osteopenic postmenopausal women. Ann Intern Med. 2007;146:839-847.
186. Narita Y, Nomura J, Ohta S, et al. Royal jelly stimulates bone formation: physiologic and nutrigenomic studies with mice and cell lines. Biosci Biotechnol Biochem. 2006;70:2508-2514.
187. Demos LL, Kazda H, Cicuttini FM, et al. Water fluoridation, osteoporosis, fractures—recent developments. Aust Dent J. 2001;46:80-87.
188. Herrmann M, Umanskaya N, Traber L, et al. The effect of B-vitamins on biochemical bone turnover markers and bone mineral density in osteoporotic patients: a 1-year double blind placebo controlled trial. Clin Chem Lab Med. 2007 Nov 18. [Epub ahead of print]
189. von Muhlen D, Laughlin GA, Kritz-Silverstein D, et al. Effect of dehydroepiandrosterone supplementation on bone mineral density, bone markers, and body composition in older adults: the DAWN trial. Osteoporos Int. 2007 Dec 15.
190. Bolland MJ, Barber PA, Doughty RN, et al. Vascular events in healthy older women receiving calcium supplementation: randomised controlled trial. BMJ. 2008 Jan 15.
191. Booth SL, Dallal G, Shea MK, et al. Effect of vitamin K Supplementation on bone loss in elderly men and women. J Clin Endocrinol Metab. 2008 Feb 5.
192. Brink E, Coxam V, Robins S, et al. Long-term consumption of isoflavone-enriched foods does not affect bone mineral density, bone metabolism, or hormonal status in early postmenopausal women: a randomized, double-blind, placebo controlled study. Am J Clin Nutr. 2008;87:761-770.
193. Salovaara K, Tuppurainen M, Kärkkäinen M, et al. Effect of vitamin D3 and calcium on fracture risk in 65- to 71-year old women - a population-based 3-year randomized controlled trial: OSTPRE-FPS study. J Bone Miner Res. 2010 Jan 29 early online.
194. Warensjö E, Byberg L, Melhus H, et al. Dietary calcium intake and risk of fracture and osteoporosis: prospective longitudinal cohort study. BMJ. 2011;342:d1473.
195. Wayne PM, Kiel DP, Buring JE, et al. Impact of Tai Chi exercise on multiple fracture-related risk factors in post-menopausal osteopenic women: a pilot pragmatic, randomized trial. BMC Complement Altern Med. 2012;12:7.
196. Liu Y, Liu JP, et al. Chinese herbal medicines for treating osteoporosis. Cochrane Database Syst Rev. 2014;3:CD005467.
197. Uusi-Rasi K, Patil R, Karinkanta S, et al. Exercise and vitamin D in fall prevention among older women: A randomized clinical trial. JAMA Intern Med. 2015;175(5):703-711.
Last reviewed December 2015 by EBSCO CAM Review Board
Last Updated: 12/15/2015
EBSCO Information Services is fully accredited by URAC. URAC is an independent, nonprofit health care accrediting organization dedicated to promoting health care quality through accreditation, certification and commendation.
This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.
To send comments or feedback to our Editorial Team regarding the content please email us at email@example.com. Our Health Library Support team will respond to your email request within 2 business days.