Consumers in the US are leading globally when it comes to vitamin D and calcium supplements—two of the most popular associated with bone health. But as calcium traditionally led the category, recent bad press has dragged sales for the entire bone health category of supplements in the US.
Euromonitor data identified the US as the largest market for vitamin D supplements (around $900 million), far outpacing runner-ups Australia and Canada, both under $200 million. Meanwhile, the US places second for sales of calcium supplements after China, but sales are declining, from passing the billion mark in 2010 to going just under $1 billion in 2015.
“[Its] projected to continue to decline through 2020,” said Katherine Leaderbrand, Consumer Health Analyst, during NutraIngredients-USA’s Bone & Joint Health Online Event yesterday. ”If we look at [all] bone health supplements, they’re also in decline. This is just a plot of year-over-year growth—it’s been in the negative for the past five years.”
A public image issue
The decline of interest in bone health supplements doesn’t reflect the US vitamins and dietary supplements market at large, as it has generally been steadily growing.
Additionally, Euromonitor data didn’t show any significant increases in consumption of food sources positioned for bone health (vegetables, dairy, or fortified functional foods), crossing out the possibility that consumers are looking to food instead of supplements.
But the data did reveal that the decline of calcium sales was approximately the same size as the increase of sales for multivitamins, including vitamins D and K2, noted for their bone health benefits.
“It might be that the public perception of calcium and bone supplements are poor,” Leaderbrand said. In fact, the top results in a quick Google News search for “Calcium Supplement” shows a multitude of negative headlines.
Time to go beyond calcium
But CDC data showed that 55% of people aged 50 and older in the US have either osteoporosis or low bone mass, and by 2020, an estimated 61 million Americans will have these bone problems.
The essential nutrients for bone health aren’t just calcium and vitamin D—there’s protein, magnesium, and vitamin K2. Indirectly affecting bone health but crucial nonetheless are vitamin C, copper, manganese, zinc, iron. “These help certain enzymes and regulators function properly so that we can form optimal bone matrix and structure for strength,” said Jennifer Murphy, manager of research and development at GNC, about the last five nutrients.
According Murphy, the average American diet isn’t fulfilling all the essential nutrients for healthy bones. “For vitamin D, very few individuals are meeting the recommended allowances. Magnesium is another one that’s quite short,” she said. Same goes to Vitamin K2, abundant in goose liver pâté, Japanese natto, cheeses brie and gouda, and grass-fed animal products—food items not common in the average American diet.
Research on the horizon
There’s a multitude of research out there discovering potential biomarkers for bone resorption (dissolution of old bone) and bone formation (building new bone), Murphy said. For example, hydroxyproline, pyridinoline, and deoxypyridinoline degrade collagen. For bone formation, there are byproducts of collagen synthesis, such as procollagen type I C-terminal propeptide, and the matrix protein osteocalcin.
Murphy also presented a list of emerging actives, ones that are currently being investigated for their potential in benefiting bone health: collagen (bioactive peptides), polyphenols such as naringin, probiotics and prebiotics, botanicals, from traditional Chinese medicines, and creatine.
According to Murphy, there’s further research on how bone health relates to obesity, the microbiome, and the body’s acid-base balance. These studies, Murphy said, might impact future formulas in bone health by providing adequate intake of essential nutrients, finding the right actives to target bone resorption and bone formation (either limiting or supporting), personalizing actives to target estrogen and androgen, studying inflammation, and supporting muscle health.
“You can’t just pick one part of the skeletal muscle system to stay healthy, it’s like buying gas and never changing the oil in your car,” Murphy said. As the pilot studies develop, Murphy hopes that more holistic dietary supplements addressing the whole skeletal muscle system will emerge, improving the segment declines.