Healthy bones have tensile and compressional strengths, similar to that of reinforced concrete. Besides providing structural support for the muscles and internal organs, bones also act as a reservoir for important minerals and elements such as calcium, magnesium, phosphorus, fluoride and sodium. Of these minerals, calcium is the most important for providing the essential bone infrastructure. In addition, bones play an integral role in the overall homeostatic control of calcium in the body (1). Approximately 97 to 99 percent of the body¡s calcium stores are found in bone.
Bones, being dynamic tissues, are constantly changing their structure as a result of the result of the opposing processes of deposition and resorption. This process is called remodeling (2). Osteoblasts are responsible for the deposition, or growth, of bones, and osteoclasts account for resorption, or breakdown. When bones start to resorb, the osteoclasts secrete proteolytic enzymes and acids that create small tunnels in the bone¡s internal structure. If the tissue is healthy and capable of growth, eventually osteoblasts will fill in these tunnels. Osteoblasts that are trapped in the tunnels and become permanent are called osteocytes. According to some estimates, more than 100 osteoblasts are required to reverse the resorption caused by a single osteoclast. The complex process of bone remodeling is dependent on several factors including androgens, calcitonin, corticosteroids, estrogen, exercise, insulin, insulinlike growth factor, interleukins, parathyroid hormone, po!
staglandins, thyroid hormone and vitamin D (2). Bone remodeling occurs constantly. The average bone turnover rate is 10 percent annually- the entire skeleton is regenerated every 10 years.
As an individual grows, their bone mass increases. Maximum bone mass is attained between age 25 and 30. Beyond 30, especially in women, and also as a result of other factors such as drugs and d...