Traditional physicians are becoming more and more aware of the benefits of nutrition as a way to improve patient care. Charles T. Price, MD, founder of the Institute for Better Bone Health and a noted academic orthopaedic surgeon, said: 'In the past, we just told our patients to eat healthy foods, but there’s an increasing recognition that most of our patients have dietary insufficiencies that cannot be met by the typical American diet.'
This growing awareness led Dr Price and his colleagues — faculty orthopaedic surgeons at the Florida State University College of Medicine and the University of Central Florida College of Medicine — to form the Institute for Better Bone Health. Their objectives were to promote nutritional education, research and product development to improve musculoskeletal health. Most of Dr Price’s research had involved bone formation, bone healing and bone remodelling. When his mother struggled with osteoporosis and then never recovered from a broken hip, he decided it was time to put his knowledge to work on the fundamental building blocks of bone health. This eventually led to the development of the Silical System for nutritional bone support.
The major difference between the Silical System and many bone supplements is that the Silical System supports both aspects of bone quality — not just the mineral content that is visible on X-rays and DXA scans. As orthopaedic surgeons, they were well aware that bone is a living organ, replete with proteins and collagen that allow the bone to bend (a little) and provide the flexibility to resist breaking. This collagen fabric is then mineralised with calcium and magnesium for hardness to provide muscle support.
As stated by R.J. Munger in 1999: 'The preoccupation to date with calcium has resulted in less emphasis being placed on the role of other nutrients in bone quality and osteoporosis.' This focus on calcium has been confirmed by several recent publications in the British Medical Journal. These studies and others have shown that 1200mg of daily calcium is idea for many biological needs, but 750mg is all that’s required for bone strength, and too much calcium actually increases the risk of fractures.
Dr Price and his colleagues were aware of the need for improved supplements that combined several nutrients for bone health. They were also aware of a new synthetic bone graft material that contained tiny amounts of silicon and stimulated bone formation to a greater degree than materials without silicon.
Their first research objective was to identify all the nutrients that influence bone health. In addition to their own research, they reviewed the 2004 US Surgeon General’s report on bone health and osteoporosis, in which a list of nutrients with beneficial or adverse effects had been identified. Additional resources revealed more nutrients that influence bone health. Then, a search of the scientific literature and government reports determined the amounts of these nutrients consumed in the typical American diet.
Managing manganese
After that, it was a simple matter to compare the beneficial nutrients with the typical intake to determine which ones might benefit from supplementation. For example, manganese was excluded from the Silical System even though it is needed for bone formation. The US Surgeon General’s report states: 'Manganese supplements may not be a good choice for everyone.' This is partly because an adequate intake of manganese for women is 2.3mg per day, but the average daily intake from foods is 2.8mg per day. Manganese blood levels have been found to be normal in women with osteoporosis and there are no scientific studies supporting manganese supplementation for osteoporosis.
Also, many Americans approach 7mg per day in their regular foodstuffs, and the upper safe level is only 9mg per day. Excess manganese consumption has been associated with an increased risk of cognitive and neurological disorders, including Parkinson’s disease. And, although some people may need manganese supplementation, there did not seem to be a need to augment intake levels for the majority of Americans, especially considering the narrow margin between the adequate level and the upper safe level of manganese.
In contrast, several nutrients were determined to be inadequate for bone health in the typical American diet. These were chosen, in moderate amounts, for supplementation in the Silical System to compensate for dietary insufficiencies rather than providing mega-doses. Scientific evidence was identified to support the inclusion of each ingredient to benefit bone health. Dr Price and his colleagues published their findings in a peer-reviewed scientific study after completing their research, which is available to the general public.
Silicon supplementation
One specific ingredient deserves special attention. That ingredient is silicon; it’s essential for bone formation but is not found in high quantities in bone residues. The limited amount of silicon in bone residues may be one reason why silicon has not received more attention as an important bone health nutrient. Although research regarding silicon has clearly established its importance for bone health, the physicians at the Institute for Better Bone Health emphasise that any single nutrient is not as important as a combination of nutrients. Scientific research, by design, identifies one variable and then studies the effect of that single variable, but this does not mean that other variables are unimportant. There are numerous studies that show that combinations of certain nutrients are more effective than single nutrients, and this is true for bone health. However, silicon may be a very important factor that has been somewhat overlooked as a nutritional supplement.
Although research regarding silicon has clearly established its importance for bone health, the physicians at the Institute for Better Bone Health emphasise that any single nutrient is not as important as a combination of nutrients
Silicon is an element that is neither a metal nor a non-metal. It’s a metalloid and has unique electrical properties that make it useful for computer chips, solar panels and micro-pressure gauges. When pressure is applied to silicon, it releases electrons. Collagen protein also releases electrons when pressure is applied. These electrons attract calcium to the collagen to form mature bone. Calcification does not occur when silicon is removed from the process. Early research has shown that silicon is twenty five times more concentrated in bone that is forming compared with mature bone. Thus, silicon seems to attract calcium to bone and then leave the collagen after it becomes bone.
Other research studies show that silicon increases the production and cross-linking of collagen, which forms the very fabric of bone. Bones with more silicon have shown more resistance to breaking. Men and premenopausal women with higher intakes of silicon have increased bone mineral density, and areas of the world with high dietary silicon intakes have very low rates of hip fractures. As silicon improves collagen’s properties, it has also been shown to improve hair thickness, decrease nail brittleness and reduce the depth of skin wrinkles because collagen is important to hair, skin and nails, in addition to being important for bone.
Food sources of silicon are limited and mostly comprise whole grains, green beans and a few other foods. Bioavailability is also limited for most foods that contain silicon. Mineral waters that filter through volcanic soils are often rich in silicon, but the water softening process removes useful silicon from the water supply. Another source of silicon is beer, derived from the fermentation of barley and hops. Bamboo contains approximately ten times the amount of silicon found in horsetail (Equisetum spp.) and water extraction provides a reliable source of organic silicon, so this was selected as the source of silicon for the Silical System.
Other ingredients
Other ingredients in the Silical System were selected because of their synergistic effects and because they support collagen formation (in addition to bone mineralisation). Boron is insufficient in the diet of most Americans, but boron supplementation has been shown to increase the bending strength of bone. Vitamin K2 activates a protein that binds calcium to collagen. Decreased fracture rates have been observed after supplementation with vitamin K, even when bone mineral density has not increased. Other studies have shown that vitamin K and vitamin D supplementation together have improved effects compared with supplementation with either alone. This is another example of how ingredients can have synergistic effects.
These were some of the considerations when the Institute for Better Bone Health created the Silical System. This 'system' consists of Silical 1, which provides calcium, magnesium and vitamin D for bone hardness, and Silical 2, with additional nutrients that support collagen and bone formation. Since launching the product 4 years ago, sales have steadily increased as more and more people realize that calcium and vitamin D are not enough alone to provide the foundation for optimum bone health.