Vitamin D combos revitalize bone health relevance: Vitamin K2, calcium and probiotics spotlighted

17 Mar 2021 --- While vitamin D has enjoyed heightened consumer consideration due to its connection with COVID-19, it remains a key strategy to preventing bone health damage, such as osteoporosis.

NutritionInsight discusses how vitamin D combined with vitamin K2 is gaining industry attention with NattoPharma and Kappa Bioscience. Also, experts from IFF Health and BioGaia reveal how soy isoflavones and probiotics, respectively, grant the bone health sector a new lease on life. 

“At an older age, a stumble in the bathroom can already cause a femoral neck or pelvic fracture,” says Jörg Büttinghaus, vice president of sales at Kappa Bioscience.

“Long stays in hospital and rehabilitation centers are closely associated with limited mobility, social isolation, reduced enjoyment of life, and the risk of secondary diseases and infections.”

No question about bone health importance
For the elderly, mobility is a requirement for active aging, says Dr. Laetitia Petrussa, product manager at IFF Health. “Osteoporosis and bone fragility often go unnoticed until they break, at which point it is too late.”

“[Mobility is] essential for independence, autonomy, overall life satisfaction and general quality of life. Besides regular exercise, preserving bone strength is an important factor in preventing fractures and the sudden loss of mobility,” Petrussa affirms.

While an aging population focuses more on self-care and prevention, younger supplement users are also looking to prevent bone problems in the future. The mobility sector is therefore shifting its priorities to ensure its target consumers are not limited to just seniors.

Supplements combining vitamins K2 and D3 to support calcium is crucial for those seeking optimal bone and cardiovascular health, says Quackenbusch.Balancing vitamin synergies
Combination products featuring Vitamins D3 and K2 to support bone health have been on the market for some time, says Kate Quackenbush, communications director for NattoPharma.

“From an industry perspective, brand owners are aware that certain nutrients work synergistically, which is why there are so many stellar combination formulas on the market. For consumers, that understanding is not so robust, but it is growing.”

When it comes to working together as complementary nutrients, Quackenbush maintains “no two are better paired” than K2 and D3, especially in bone health.

Like vitamin D3, vitamin K2 is a fat-soluble vitamin. Vitamin K2 can improve the functional balance of key systems – namely the skeletal and cardiovascular systems – that ensure robust and active health.

“While K2 is required to activate K-dependent proteins, such as osteocalcin for bone health and matrix Gla protein (MGP) to inhibit soft tissue calcification, vitamin D3 is needed to create these proteins,” says Quackenbush.

“But if we are not balancing our D3 intakes with K2, we simply have an excess of inactive proteins not performing their function.” 

Completing the trifecta with calcium
Calcium remains a key ingredient for maintaining bone health. Innova Market Insight data reveals that calcium was the top ingredient used in 36 percent of F&B and supplement launches tracked with a bone and joint health claim (Global, 2020).

Soy germ, rather than the whole soybean, contains the highest natural level of isoflavones, rich in vitamin K2.However, the combination of only calcium and vitamin D provides “an incomplete solution,” flags Büttinghaus. “Only vitamin K2 activates the proteins provided by vitamin D.”

NattoPharma’s Quackenbush adds that calcium on its own can create “an undesirable seesaw effect.”

On one side, incoming calcium helps build bone. In the opposite direction, calcium tends to settle inside arteries and soft tissues, causing them to stiffen like concrete and impede blood flow.

“Vitamin K2 activates proteins already present in the body that help the body to utilize calcium properly,” she explains. MGP inhibits calcium from depositing in arteries and soft tissues, while osteocalcin binds calcium to the bone mineral matrix for stronger bones and teeth.

Cost considerations
Büttinghaus recalls how, in the past, ingredient providers were reluctant to use K2 because they “mistakenly assumed” vitamin K2 was an expensive raw material. 

“This is not the case. The price per kilogram of vitamin K2 may be startling at first,” he states.

“However, when you consider that vitamin K2 is already fully effective in the range of a few micrograms, it quickly becomes clear that a daily dose costs less than 2 cents, but offers significant improvements for consumers.” 

Clean label solutions: Soy germ and post-biotics
Only products containing calcium, magnesium, manganese, phosphor, vitamin C, D or K can claim bone health benefits on their label, highlights Petrussa.

“Therefore, consumers often resort to products that have been used in traditional medicine for specific benefits like bone health.” Soybeans are a rich source of vitamin K, and Petrussa adds isoflavones from soy, for example, have been used in supportive products for women for millennia.

IFF Health’s SoyLife is manufactured exclusively from soy germ, which provides natural support for bone health, says the company. 

BioGaia Osfortis with vitamin D for bone health. (Credit BioGaia)More promise for probiotics?
Also tapping into the vitamin D frenzy is Sweden-based BioGaia, which launched BioGaia Osfortis for bone health on the domestic market in January.

According to Jakob Axelsson, research manager at BioGaia, the probiotic strain Limosilactobacillus reuteri ATCC PTA 6475 has been shown to change the relationship between different types of T-cells in preclinical trials.

“This change results in a decreased formation and activation of osteoclasts, tilting the balance in favor of the osteoblasts, subsequently increasing bone density,” he explains.

The positive effects of L. reuteri 6475 on bone health were further confirmed in a randomized, double-blind, placebo-controlled study in 90 women with incipient osteoporosis. 

The results showed that daily supplementation of L. reuteri 6475, combined with 5 µg (200 IU) of vitamin D3 for 12 months reduced bone loss with almost half, compared to placebo.

“The pharmaceuticals of today, bisphosphonates for example, are effective but often cause several side effects,” says Axelsson, noting a spiked demand for osteoporosis prevention alternatives.

“As an increasing bulk of research on probiotics indicates positive effects on bone health, there is a potential for specific probiotics to become a valuable alternative and an additional tool in the care of patients with osteopenia/osteoporosis.”

Axelsson concludes approximately a third of women and a fifth of men over the age of 50 are at risk of suffering a fracture caused by osteoporosis. “Thus, the medical need is large and will increase further.”

By Anni Schleicher