Depending on how we count them, there are at least 20 bone-building nutrients essential for optimal bone health — “essential” in that our bodies cannot manufacture them, so we must get them from our food and drink. Let’s take a quick look at them, one by one, so you can get a better idea of their roles in bone health and how much of each you should be getting. Remember, none of these nutrients does its work in isolation — you need balanced amounts of each and every one, so they can all work together to keep your bones standing strong all your life long.

For most women (including myself!), it’s just not possible to get enough of all these vitamins and minerals through diet alone. I recommend nutritional supplements in addition to a healthy diet, to ensure your bones get the nutrients they need. When choosing your supplements, go with a medical-grade multivitamin/mineral formulated specifically for bone health, containing balanced, therapeutic levels of these nutrients in their most bioavailable forms — and don’t forget to include essential fatty acids.

(Click through on individual nutrients to learn more...)

Table of 20 essential bone-building nutrients
NutrientAdult RDA or AICommon therapeutic range for bone health (daily intake)Dietary considerations concerning adequacy of average daily intake
Key minerals
1000–1200 mg800–1200 mgTypical diet is inadequate, averaging 500–850 mg.
1250 mg, 9–18 yrs

700 mg, adults
800–1200 mgInadequate intake is rare except in the elderly and malnourished. Excess intake common with use of processed foods and soft drinks — ~ 1500 mg/day in men and ~1025 mg/day in women.
420 mg, adult males

320 mg, adult females
400–800 mgIntake generally inadequate among all ages, sexes, and classes except children under the age of 5; 40% of total population and 50% of adolescents consume 66% of RDA; and 56% of all Americans have intakes below Estimated Average Requirement (EAR).
30–35 mcg, adult males

20–25 mcg, adult females
200–1000 mcgCommon intake in the US is 50 mcg or lower.
(Silicon – Si)
No values set to dateAs yet undeterminedIntake significantly higher in men (30–33 mg/day) than in women (~25 mg/day), yet generally suboptimal. Silica is the first element to go in food processing.
11 mg, adult males

8 mg, adult females
12–30 mgAverage intake is 46–63% of RDA. Marginal zinc deficiency is common, especially among children.
2.3 mg (AI), adult males

1.8 mg (AI), adult females
2–10 mgIntake generally inadequate, at 1.76 mg adolescent girls; 2.05 mg adult females; and 2.5 mg adult men.
900 mcg, adults
(0.90 mg)
1–3 mg75% of diets fail to contain RDA. Average daily intake is below the RDA.
No RDA established3–5 mgCommon daily intake is only 0.25 mg, to possible optimum of 3.0 mg.
4700 mg, adults4000–6000 mgAdult intake averages 2300 mg for women and 3100 mg for men.
StrontiumNo RDA established3–30 mg (supplements)

Up to 680 mg (in medications)
Daily dietary intake thought to vary from 1 mg to more than 10 mg.
Key vitamins
Vitamin D400 IU, infancy–59 yr

400 IU, 51–70 yr

600 IU, >70 yr
800–2000 IU and up, as neededThe overwhelming news from numerous experts is that a billion people worldwide are deficient today. Deficiency is especially common among people who are elderly, dark skinned, and those with little UV sunlight exposure. A simple, inexpensive blood test for 25(OH)D is the best way to determine vitamin D status and need.
Vitamin C90 mg, adult males

75 mg, adult females
Oral 500–3000 mg (and upward to bowel tolerance), as needed.Average daily intake is about 95 mg for women and 107 mg for men. Based on US survey of nearly 9000 people, intake for 31% of population is below Estimated Average Requirement (EAR).
Vitamin A2997 IU, adult males

2331 IU, adult females
5000 IU or less44% of US population has intake below EAR.
Vitamin B61.3–1.7 mg, adult males

1.3–1.5 mg, adult females
25–50 mgStudies indicate widespread inadequate vitamin B6 consumption among all sectors of the population; >50% of population consume <70% RDA.
Folic acid / folate
(vitamin B9)
400 mcg, adults
(0.4 mg)
400–1000 mcg
(0.4–1 mg)
Inadequate intake common among all age groups; although improving with food fortification, 49% of participants in NHANES survey had intakes below estimated average requirement (EAR). Anywhere from 5–50% of population (varying by geographic region and ethnicity) have genetic variants that impact the ability to optimally metabolize folate.
Vitamin B122.4 mcg, adults150–1000 mcgUp to 40% of US population have marginal B12 status. Older people and vegans are especially at risk.
Vitamins K1 and K2K1:
120 mcg, adult males
90 mcg, adult females

No recommended intake
250–1000 mcg

45–180 mcg MK-7 (menaquinone-7)
Averages 45–150 mcg, which is well below the recommended AI.

Average US intake 9–12 mcg (if any)
Other nutrients
FatsShould comprise minimum of 7% total calories. General recommendation is not to exceed 30% of caloric intake.20–30% of total calories is perhaps more ideal.Average American consumes ~33% of his/her calories in fat. Consumption of essential fatty acids (EFA’s), however, is frequently inadequate.
Protein0.8 g/kg per day, adult males and females

125–lb person = 45 g
175–lb person = 63 g

56 g, adult males
46 g, adult females
1.0–1.5 g/kgDaily intake commonly exceeds 100 g, but the elderly and some women often have very deficient intake. Higher protein intake should be balanced with higher RDA level potassium intake from food sources.

About... Dietary Reference Intakes (DRI),
Adult Recommended Dietary Allowances (RDA),
Adequate Intakes (AI), and
Estimated Average Requirements (EAR)

  • The Dietary Reference Intake (DRI) is a system of nutritional guidelines developed by the Institute of Medicine (IoM) of the US National Academy of Sciences. It was first introduced in 1997 to broaden the set of existing Recommended Daily Allowance, which is the system currently still in use in food nutrition labeling. The DRI includes two sets of values that serve as goals for nutrient intake (from the National Academy of Science). These are the RDA and Adequate Intake (AI).

  • Recommended Dietary Allowance (RDA) represents the daily dietary intake of a nutrient regarded to be sufficient for meeting the requirements of nearly all (97–98%) healthy individuals in each age and gender group. The RDA reflects the average daily amount of a nutrient considered adequate to meet the needs of most healthy people. If there is insufficient evidence to determine an RDA, an AI is set.

    Adult RDA figures come from: National Academy of Sciences, Institute of Medicine, and the Food and Nutrition Board, through the United States Department of Agriculture Food and Nutrition Information Center website. (Dietary Reference Intakes for individuals.)

  • Adequate Intake (AI) values are more tentative than RDA, but both may be used as goals for nutrient intake.

  • In addition to the values that serve as goals for nutrient intakes, the DRI includes a set of values called Tolerable Upper Intake Levels (UL). The UL represent the maximum amount of a nutrient that appears safe for most healthy people to consume on a regular basis.

  • The Estimated Average Requirement (EAR) calculations are the average daily nutrient intake level estimated to meet the requirement of half of the healthy individuals in a particular life stage and gender group. They are established by the Institute of Medicine (IoM).

Keep in mind that these are values that are meant to cover nutritional adequacy for most folks — which is not the same as optimizing health! The common therapeutic dose for bone health may be much higher in “special need” cases.



1 US DHHS. 2004. Bone health and osteoporosis: A report of the Surgeon General. Chapter 1: A public health approach to promote bone health. URL: (accessed 05.28.2008).

  Wright, J., et al. 2003. Dietary intakes of ten key nutrients for public health, United States: 1999–2000. Adv. Data, (334), 1–4. URL (PDF): (accessed 05.28.2008).

  Morgan, K., et al. 1985. Magnesium and calcium dietary intakes of the US population. J. Am. Coll. Nutr., 4 (2), 195–206. URL (abstract): (accessed 05.28.2008).

2 Brown, J. 2005. Nutrition Now. Belmont, CA: Wadsworth Publishing.

  Pennington, J., et al. 1986. Mineral content of foods and total diets: The Selected Minerals in Foods Survey, 1982 to 1984. J. Am. Diet. Assoc., 86 (7), 876–891. URL: (accessed 05.28.2008).

  Morgan, K., et al. 1985. Magnesium and calcium dietary intakes of the US population. J. Am. Coll. Nutr., 4 (2), 195–206. URL (abstract): (accessed 05.28.2008).

  Lakshmanan, F., et al. 1984. Magnesium intakes, balances, and blood levels of adults consuming self-selected diets. Am. J. Clin. Nutr., 40 (6 Suppl.), 1380–1389. URL (abstract): (accessed 05.28.2008).

3 Moshfegh, A., et al. 2005. What we eat in America, NHANES 2001–2002: Usual nutrient intakes from food compared to Dietary Reference Intakes. USDA, Agricultural Research Service. URL: (accessed 06.17.2008).

4 Kumpulainen, J. 1992. Chromium content of foods and diets. Biol. Trace Elem. Res., 32 (1–3), 9–18. URL (abstract): (accessed 10.19.2009).

5 Jugdaohsingh, R., et al. 2002. Dietary silicon and absorption. Am. J. Clin. Nutr., 75 (5), 887–893. URL: (accessed 05.28.2008).

6 Pennington, J., et al. 1986.

7 Brown, J. 2005.

8 Freeland–Graves, J., et al. 1988. Metabolic balance of manganese in young men consuming diets containing five levels of dietary manganese. J. Nutr., 118 (6), 764–773. URL: (accessed 05.28.2008).

9 Pennington, J., et al. 1986.

  Klevay, L. 1979. Evidence of dietary copper and zinc deficiencies. JAMA, 241, 1917–1918. URL (abstract): (accessed 01.28.2010).

10 Brown, J. 2005.

11 Nielsen, F., et al. 1987. Effect of dietary boron on mineral, estrogen, and testosterone metabolism in postmenopausal women. FASEB J., 1 (5), 394–397. URL: (accessed 05.13.2008).

12 Hajjar, et al. 2001. Impact of diet on blood pressure and age-related changes in blood pressure in the US population: Analysis of HNANES III. Arch. Intern. Med., 161 (4), 589–593. URL: (accessed 05.28.2008).

13 Holick, M. 2007. Vitamin D deficiency. New Eng. J. Med., 357 (3), 266–281. URL: (accessed 05.28.2008).

  Kimlin, M., et al. 2007. Location and vitamin D synthesis: Is the hypothesis validated by geophysical data? J. Photochem. Photobiol., 86 (3), 234–249. URL: (accessed 05.20.2008).

14 PDRHealth. [No date listed]. Vitamin C | Herbal remedies, supplements | PDRHealth. URL: (accessed 05.13.2008).

15 Moshfegh, A., et al. 2005.

16 Serfontein, W., et al. 1984. Vitamin B6 revisited. Evidence of subclinical deficiencies in various segments of the population and possible consequences thereof. S. Afr. Med. J., 66 (12), 437–440. URL (abstract): (accessed 05.13.2008).

17 Brown, J. 2005.

18 Song, W., et al. 2005. Serum homocysteine concentration of US adults associated with fortified cereal consumption. J. Am. Coll. Nutr., 24 (6), 503–509. URL: (accessed 06.17.2008).

19 Botto, L., & Yang, Q. 2000. 5,10-Methylenetetrahydrofolate reductase gene variants and congenital anomalies: A HuGE review. Am. J. Epidem., 151 (6), 862. URL: (accessed 07.21.2008).

20 McBride, J. 2000. B12 Deficiency may be more widespread than thought — August 1, 2000 — News from the USDA Agricultural Research Service. URL: (accessed 06.17.2008).

21 Brown, J. 2005.

22 Booth, S., & Suttie, J. 1998. Dietary intake and adequacy of vitamin K. J. Nutr., 128 (5), 785–788. Review. URL: (accessed 05.28.2008).

23 Brown, 2005.

24 National Academy of Sciences. Institute of Medicine. Food and Nutrition Board. 2002. Through the United States Department of Agriculture Food and Nutrition Information Center website. Dietary Reference Intakes for individuals. PDF: (accessed 02.02.2010).

25 Brown, J. 2005.

26 Larsen, T., et al. 2000. Whole small fish as a rich calcium source. Br. J. Nutr., 83 (2), 191–196. URL (abstract): (accessed 05.06.2008).

  Hansen, M., et al. 1998. Calcium absorption from small, soft-boned fish. J. Trace Elem. Med. Biol., 12 (3), 148–154. URL (abstract): (accessed 05.06.2008).

  Heaney, R., & Weaver, C. 1990. Calcium absorption from kale. Am. J. Clin. Nutr., 51, 656–657. URL: (accessed 05.06.2008).

27 Weaver, C., et al. 1999. Choices for achieving adequate dietary calcium with a vegetarian diet. Am. J. Clin. Nutr., 70 (Suppl.), 543S–548S. URL: (accessed 01.28.2010).

28 Heaney, R., & Weaver, C. 2003. Calcium and vitamin D. Endocrinol. Metab. Clin. N. Am., 32 (1), 181–194, vii–viii. URL (abstract): (accessed 05.20.2008).

29 Murray, M., & Pizzorno, J. 1998. Encyclopedia of Natural Medicine, 459. Roseville, CA: Prima Publishing.

30 Brown, S. 2008. Vitamin D and fracture reduction: An evaluation of the existing research. Alt. Med. Rev., 13 (1), 21–33. URL (PDF): (accessed 05.22.2008).

31 Heaney, R., & Weaver, C. 2003. Calcium and vitamin D. Endocrinol. Metab. Clin. N. Am., 32 (1), 181–194, vii–viii. URL (abstract): (accessed 05.20.2008).

  Heaney, R., et al. 2003. Calcium absorption varies within the reference range for serum 25–hydroxyvitamin D. J. Am. Coll. Nutr., 22 (2) 142–146. URL: (accessed 05.22.2008).

32 Randall, T. 1992. Longitudinal study pursues questions of calcium, hormones, and metabolism in life of skeleton. JAMA, 268 (17), 2357–2358.

33 Sakhaee, K., et al. 2004. Stone forming risk of calcium citrate supplementation in healthy postmenopausal women. J. Urol., 172 (3), 958–961. URL (abstract): (accessed 05.06.2008).

  [No author listed.] 1986. Citrate for calcium nephrolithiasis. Lancet, 1 (8487), 955.

  Wabner, C., & Pak, C. 1992. Modification by food of the calcium absorbability and physiochemical effects of calcium citrate. J. Am. Coll. Nutr., 11, 548–552. URL: (abstract): (accessed 05.06.2008).

34 Heller, H., et al. 2000. Pharmacokinetic and pharmacodynamics comparison of two calcium supplements in postmenopausal women. J. Clin. Pharmacol., 40 (11), 1237–1244. URL (abstract): (accessed 05.28.2008).

35 Peck W., et al. 1991. Physician’s Resource Manual on Osteoporosis. Washington, DC: National Osteoporosis Foundation.

36 Food and Nutrition Board, Institute of Medicine. 1997. Phosphorus. In Dietary Reference Intakes: Calcium, Phosphorus, Magnesium, Vitamin D, and Fluoride, 146–189. Washington, DC: National Academy Press. URL: (accessed 05.20.2008).

37 Moshfegh, A., et al. 2005.

38 Worthington–Roberts, B. 1981. Contemporary Developments in Nutrition, 240–253. St. Louis, MO: Mosby Co.

  Linkswiler, H., et al. 1981. Protein-induced hypercalciuria. Fed. Proc., 40 (9), 2429–2433. URL: (accessed 05.06.2008).

39 Medalle, R., et al. 1976. Vitamin D resistance in magnesium deficiency. Am. J. Clin. Nutr., 29, 854–858. URL: (accessed 05.12.2008).

40 Rude, R., et al. 2006. Reduction of dietary magnesium by only 50% in the rat disrupts bone and mineral metabolism. Osteoporos. Int., 17 (7), 1022–1032. URL (abstract) (accessed 05.12.2008).

  Rude, R., et al. 2005. Dietary magnesium reduction to 25% of nutrient requirement disrupts bone and mineral metabolism in the rat. Bone, 37 (2), 211–219. URL (abstract): (accessed 05.12.2008).

  Rude, R., et al. 1999. Magnesium deficiency-induced osteoporosis in the rat: Uncoupling of bone formation and bone resorption. Magnes. Res., 14 (4), 257–267. URL: (abstract): (accessed 05.12.2008).

  Iseri, L., & French, J. 1984. Magnesium: Nature’s physiologic calcium blocker. Am. Heart J., 108, 188–193.

41 Cohen, L., & Kitzes, R. 1981. Infrared spectroscopy and magnesium content of bone mineral in osteoporotic women. Israel J. Med. Sci., 17, 1123–1125. URL:

  Seelig, M. 1980. Magnesium Deficiency in the Pathogenesis of Disease. New York: Plenum Press. URL: (accessed 05.12.2008).

  Gaby, A., & Wright, J. 1988. Nutrients and bone health. Health World, 29–31.

  Hegsted, D. 1967. Mineral intake and bone loss. Fed. Proceedings, 26 (6), 1747–1763.

42 Shils, M. 1973. “Magnesium.” In Modern Nutrition in Health and Disease, ed. R. Goodhart & M. Shils. Philadelphia: Lea & Febiger.

43 Pennington, J. 1996. Intakes of minerals from diets and foods: Is there a need for concern? J. Nutr., 126 (9 Suppl.), 2304S–2308S. URL: (accessed 05.13.2008).

44 Hunt, C., & Johnson, L. 2006. Magnesium requirements: New estimations for men and women by cross-sectional statistical analyses of metabolic magnesium balance data. Am. J. Clin. Nutr., 84 (4), 843–852. URL: (accessed 05.13.2008).

  Moshfegh, A., et al. 2005.

  Food & Nutrition Board, Institute of Medicine. 1997. Dietary reference intakes for calcium, phosphorus, magnesium, vitamin D, and fluoride. Washington, DC: National Academy Press.

45 Moshfegh, A., et al. 2005.

46 Martin, J., et al. 2006. Chromium picolinate supplementation attenuates body weight gain and increases insulin sensitivity in subjects with type 2 diabetes. Diabetes Care, 29 (8), 1826–1832. URL: (accessed 10.20.2009).

  Frauchiger, M., et al. 2004. Effects of acute chromium supplementation on postprandial metabolism in healthy young men. J. Am. Coll. Nutr., 23 (4), 351–357. URL: (accessed 10.20.2009).

47 McCarty, M. 1995. Anabolic effects of insulin on bone suggest a role for chromium picolinate in preservation of bone density. Med. Hypotheses, 45 (3), 241–246. URL: (accessed 10.20.2009).

48 Evans, G., et al. 1995. Chromium picolinate decreases calcium excretion and increases dehydroepiandrosterone (DHEA) in postmenopausal women. FASEB J., 9, A449. [As quoted in Lamson, D., & Plaza, S. 2002. The safety and efficacy of high-dose chromium. Altern. Med. Rev., 7 (3), 218–235. URL (abstract): (accessed 10.20.2009).]

49 Anderson, R. “Chromium in Health and Disease.” Council for the Advancement of Diabetes Research and Education (CADRE) Chromium Summit. April 2003. Boston, Massachusetts.

50 Bae, Y., et al. 2008. Short-term administration of water-soluble silicon improves mineral density of the femur and tibia in ovariectomized rats. Biol. Trace Elem. Res.,124 (2), 157–163. URL (abstract): (accessed 05.13.2008).

  Gaby, A., & Wright, J. 1988.

  Davies, S. & Stewart, A. 1987. Nutritional Medicine: The Drug-free Guide to Better Family Health. London/Sydney: Pan Books.

  Carlisle, E. 1975. Silicon with the osteoblast, the bond-forming cell. Fed. Proc., 34, 927.

  Carlisle, E. 1970. A relationship between silicon and calcium in bone formation. Fed. Proc., 29, 265.

51 Anderson, J. 1999. Plant-based diets and bone health: Nutritional implications. Am. J. Clin. Nutr., 70 (3) (Suppl,), 539S–542S. URL: (accessed 05.28.2008).

  Chen, F., et al. 1994. Estimates of trace element intakes in Chinese farmers. J. Nutr., 124, 196–201.

  Anasuya, A., et al. 1996. Fluoride and silicon intake in normal and endemic fluorotic areas. J. Trace Elem. Med. Biol., 10 (3), 149–155. URL (abstract): (accessed 05.28.2008).

52 Gullberg, B., et al. 1997. World-wide projections for hip fracture. Osteoporos. Int., 7, 407–413. URL (abstract): (accessed 05.28.2008).

53 Kamen, B., et al. 1984. Osteoporosis: What It Is, How to Prevent It, How to Stop It, 222. NY: Pinnacle Books.

54 Jugdaohsingh, R., et al. 2002. Dietary silicon and absorption. Am. J. Clin. Nutr., 75 (5), 887–893. URL: (accessed 05.28.2008).

55 Kimmel, P., et al. 1992. Zinc nutritional status modulates the response of 1,25-dihydroxycholecalciferol to calcium depletion in rats. J. Nutr., 122 (7), 1576–1581. URL: (accessed 05.13.2008).

  Teller, E., et al. 1987. Zinc (Z) nutritional status modulates the 1,25(OH)2D(125) response to low calcium (LC) diet (D). Kidney Int., 31, 358.

56 Hambidge, M. 2000. Human zinc deficiency. J. Nutr., 130 (5), 1344S–1349S. URL: (accessed 07.21.2008).

57 Johtatsu, T., et al. 2007. Serum concentrations of trace elements in patients with Crohn’s disease receiving enteral nutrition. J. Clin. Biochem. Nutr., 41 (3), 197–201. URL: (accessed 05.13.2008).

  Hendricks, K. 1990. Zinc and inflammatory bowel disease. Nutr. Report, 66.

  Atik, S. 1983. Zinc and senile osteoporosis. J. Am. Ger. Soc., 31 (12), 790–791. URL (abstract): (accessed 05.13.2008).

58 Greger, J. 1998. Dietary standards for manganese: Overlap between nutritional and toxicological studies. J. Nutr., 128 (2), 368S–371S. URL: (accessed 05.13.2008).

59 Raloff, J. 1986. Reasons for boning up on manganese. [Review.] Science News, 130, 199.

  Schwartz, R., et al. 1986. Apparent absorption and retention of Ca, Cu, Mg, Mn, Zn from a diet containing bran. Am. J. Clin. Nutr., 43 (3), 444–445. URL: (accessed 05.13.2008).

60 Pennington, J., & Young, B. 1991. Total Diet Study nutritional elements 1982–1989. J. Am. Diet. Assoc., 91 (2), 179–183. URL (abstract): (accessed 05.13.2008).

61 Freeland–Graves, J., et al. 1987. “Manganese requirements of humans.” In Nutritional Bioavailability of Manganese, ed. C. Keys. Washington, DC: Am. Chem. Soc.

  Hallfrisch, J., et al. 1987. Mineral balances of men and women consuming high-fiber diets with complex or simple carbohydrate. J. Nutr., 117 (1), 48–55. URL: (accessed 05.13.2008).

  Ricketts, C., et al. 1985. Manganese and magnesium utilization of humans as affected by level and kind of dietary fat. Fed. Proc., 44, 1850.

62 Strause, L., & Saltman, P. 1987. “Role of manganese in bone metabolism.” In Nutritional Bioavailability of Manganese, ed. C. Keys. Washington, DC: Am. Chem. Soc.

63 Slemenda, C., et al. 1990. Predictors of bone mass in perimenopausal women. A prospective study of clinical data using photon absorptiometry. Ann. Intern. Med., 112 (2), 96-101. URL (abstract): (accessed 05.13.2008).

64 Reginster, J.Y., et al. 1988. Trace elements and postmenopausal osteoporosis: A preliminary study of decreased serum manganese. Med. Sci. Res., 16, 337–338.

65 Strain, J. 1988. A reassessment of diet and osteoporosis — possible role for copper. Med. Hypotheses, 27 (4), 333–338. URL (abstract): (accessed 05.13.2008).

  Strause, L., et al. 1986. Effects of long-term dietary manganese and copper deficiency on rat skeleton. J. Nutr., 116 (1), 135-41. URL: (accessed 05.13.2008).

  Raloff, J. 1986.

66 Turnlund, J. 1999. “Copper,” in Modern Nutrition in Health and Disease, ed. M.E. Shils et al., pp. 241–252. Baltimore: Lippincott Williams & Wilkins.

67 Hallfrisch, J., et al. 1987.

68 Strain, J. 1988.

69 Pennington, J. 1996.

  Pennington, J. & Young, B. 1991.

  Pennington, J., et al. 1986. Mineral content of food and total diet: The Selected Minerals in Foods Survey, 1982 to 1984. J. Am. Diet. Assoc., 86 (7), 876–891. URL (abstract): (accessed 05.13.2008).

  Klevay, L. 1979.

70 Samann, S., et al. 1998. The nutritional and metabolic effects of boron in humans and animals. Biol. Trace Elem. Res., 66 (1–3), 227–235. URL (abstract): (accessed 05.13.2008).

  Nielsen, F., et al. 1987. Effect of dietary boron on mineral, estrogen, and testosterone metabolism in postmenopausal women. FASEB J., 1 (5), 394–397. URL: (accessed 05.13.2008).

71 Neilsen, F. 1995. Personal communication with Dr. Susan Brown.

72 Gaby, A. 1994. Preventing and Reversing Osteoporosis: What You Can Do About Bone Loss — A Leading Expert’s Natural Approach to Increasing Bone Mass, 304. Roseville, CA: Prima Publishing.

73 Sebastian, A., et al. 1994. Improved mineral balance and skeletal metabolism in postmenopausal women treated with potassium bicarbonate. NEJM, 130 (125), 1776–1781. URL (abstract): (accessed 06.04.2008).

74 Nieves, J. 2005. Osteoporosis: the role of micronutrients. Am. J. Clin. Nutr., 81 (5), 1232S–1239S. URL: (accessed 05.13.2008).

75 Davies, K., et al. 2002. Dietary potassium conserves calcium after menopause. J. Bone Miner. Res., 17 (Suppl. 1), S476. Abstract M362.

76 Tucker, K., et al. 2001. The acid–base hypothesis: Diet and bone in the Framingham Osteoporosis Study. Eur. J. Nutr., 40 (5), 231–237. URL (abstract): (accessed 05.13.2008).

77 Demigné, C., et al. 2004. Protective effects of high dietary potassium: Nutritional and metabolic aspects. J. Nutr., 134 (11), 2903–2906. URL: (accessed 05.13.2008).

78 Gaby, A. 1994.

79 Reginster, J., et al. 2004. Strontium ranelate: A new paradigm in the treatment of osteoporosis. Expert Opin. Investig. Drugs, 13 (7), 857-864. Review. URL (abstract): (accessed 05.20.2008).

80 Holick, M. 2006. High prevalence of vitamin D inadequacy and implications for health. Mayo Clin. Proc., 81 (3), 353–373. URL: (accessed 05.13.2008).

  Hanley, D., & Davison, K. 2005. Vitamin D insufficiency in North America. Symposium: Vitamin D Insufficiency: A Significant Risk Factor in Chronic Diseases and Potential Disease-Specific Biomarkers of Vitamin D Sufficiency. J. Nutr., 135 (2), 332-337. URL: (accessed 05.13.2008).

  Holick, M. 2005. The vitamin D epidemic and its health consequences. J. Nutr., 135 (11),2739S–2748S. URL: (accessed 05.13.2008).

81 Cannell, J., et al. 2008. Uses of vitamin D in clinical practice. Alt. Med. Rev., 13 (1). URL (PDF): (accessed 06.02.2008).

82 [No author listed.] 2008. Healthday. MedlinePlus: Low levels of vitamin D spell trouble for breast cancer patients. URL: (accessed 05.28.2008).

  Grayson, A. 2008. ABC News: Low vitamin D may mean worse breast cancer. More aggressive breast cancer linked to vitamin D deficiency. URL: (accessed 05.28.2008).

83 Bischoff–Ferrari, H., et al. 2007. Calcium intake and hip fracture risk in men and women: A meta-analysis of prospective cohort studies and randomized controlled trials. Am. J. Clin. Nutr., 86 (6), 1780–1790. URL (abstract): (accessed 06.17.2008).

  Steingrimsdottir, L., et al. 2005. Relationship between serum parathyroid hormone levels, vitamin D sufficiency, and calcium intake. JAMA, 294 (18), 2336-2341. URL: (accessed 06.17.2008).

  Dawson–Hughes, B., et al. 1997. Effect of calcium and vitamin D supplementation on bone density in men and women 65 years of age or older. NEJM, 337 (10), 670-676. URL: (accessed 06.17.2008).

  Dawson–Hughes, B., et al. 1990. A controlled trial of the effect of calcium supplementation on bone density in postmenopausal women. NEJM, 323 (13), 878–883. URL: (accessed 05.13.2008).

84 Dawson–Hughes, B., et al. 1990.

85 Grant, W., et al. 2005. Comparisons of estimated economic burden due to insufficient solar ultraviolet irradiance for the United States. Photochem. Photobiol., 81 (6), 1276–1286. URL (abstract): (accessed 06.04.2008).

86 Brown, S. 2008. Vitamin D and fracture reduction: An evaluation of the existing research. Alt. Med. Rev., 13 (1). URL: ( (accessed 06.04.2008).

87 Prince, R., et al. 2008. Effects of ergocalciferol added to calcium on the risk of falls in elderly high-risk women. Arch. Int. Med., 168 (1), 103–108. URL (accessed 05.13.2008).

  Bischoff-Ferrari, H., et al. 2006. Effect of cholecalciferol plus calcium on falling in ambulatory older men and women: A 3-year randomized controlled trial. URL: (accessed 05.13.2008).

  Flicker, L., et al. 2005. Should older people in residential care receive vitamin D to prevent falls? Results of a randomized trial. J. Am. Geriatrics Soc., 53 (11), 1881. URL (abstract): (accessed 05.13.2008).

  Freudenheim, J., et al. 1986. Relationships between usual nutrient intake and bone mineral content of women 35–65 years of age: Longitudinal and cross-sectional analysis. Am. J. Clin. Nutr., 44 (6), 863–876. URL: (accessed 05.13.2008).

88 Broe, K., et al. 2007. A higher dose of vitamin D reduces the risk of falls in nursing home residents: A randomized, multiple-dose study. J. Am. Geriatr. Soc., 55 (2), 234–239. URL: (accessed 06.04.2008).

  Bischoff, H., et al. 2003. Effects of vitamin D and calcium supplementation on falls: A randomized controlled trial. J. Bone Miner. Res., 18 (2), 343–351. URL: (accessed 06.04.2008).

89 NIH. 1994. Consensus statement. Washington, DC: National Institute on Aging.

90 Eufemio, M. 1990. Advances in the therapy of osteoporosis. Part VIII. Ger. Med. Today, 9 (11), 37–49.

  Gallagher, J., et al. 1979. Intestinal calcium absorption and serum vitamin D metabolites in normal subjects and osteoporotic patients. J. Clin. Invest., 64 (3), 729–736. URL: (accessed 05.13.2008).

91 Heaney, R., et al. 2003. Calcium absorption varies within the reference range for serum 25–hydroxyvitamin D. J. Am. Coll. Nutr., 22 (2), 42–146. URL: (accessed 06.04.2008).

92 Cannell, J., et al. 2008. Diagnosis and treatment of vitamin D deficiency. Review. Expert Opin. Pharmacother., 9 (1), 1–12. URL (summary): (accessed 05.22.2008).

93 Vieth, R., et al. 2001. Efficacy and safety of vitamin D intake exceeding the lowest observed adverse effect level. Am. J. Clin. Nutr., 73 (2), 288–294. URL: (accessed 06.04.2008).

94 Goralczyk, R., et al. 1992. Regulation of steroid hormone metabolism requires l–ascorbic acid. Ann. NY Acad. Sci., 669, 349–351.

  Freudenheim, J., et al. 1986.

95 Pauling, L. 1986. How to Live Longer and Feel Better. Corvallis, OR: Oregon State University Press.

96 Kawaguchi, J. 2006. Generation of osteoblasts and chondrocytes from embryonic stem cells. Methods Mol. Biol., 330, 135–148. (accessed 05.13.2008).

97 Newton, H., et al. 1985. The cause and correction of low blood vitamin C concentrations in the elderly.

98 Maggio, D., et al. 2006. Low levels of carotenoids and retinol in involutional osteoporosis. Bone, 38 (2), 244–248. URL (abstract): (accessed 03.02.2009).

99 Ribaya–Mercado, J., & Blumberg, J. 2007. Vitamin A: Is it a risk factor for osteoporosis and bone fracture? Nutr. Rev., 65 (10), 425–438. URL (abstract): (accessed 05.22.2008).

  Macdonald, H., et al. 2004. Nutritional associations with bone loss during the menopausal transition: Evidence of a beneficial effect of calcium, alcohol, and fruit and vegetable nutrients and of a detrimental effect of fatty acids. Am. J. Clin. Nutr., 79, 155–165.

  Barker, M., & Blumsohn, A. 2003. Is vitamin A consumption a risk factor for osteoporotic fracture? Proc. Nutr. Soc., 62 (4), 845–850. URL (abstract): (accessed 05.22.2008).

  Symanski, E., & Hertz–Picciotto, I. 1995. Blood lead levels in relation to menopause, smoking, and pregnancy history. Am. J. Epidemiol., 141, 1047–1058.

  Melhus, H., et al. 1998. Excessive dietary intake of vitamin A is associated with reduced bone mineral density and increased risk for hip fracture. Ann. Intern. Med., 129, 770–778.

100 Ribaya–Mercado, J., & Blumberg, J. 2007.

   Macdonald, H., et al. 2004.

   Barker, M., & Blumsohn, A. 2003.

   Symanski, E., & Hertz–Picciotto, I. 1995.

   Melhus, H., et al. 1998.

101 Mercadante, A. “New carotenoids: Recent progress.” Invited Lecture 2. Abstracts of the 12th International Carotenoid Symposium, 07/18–23/1999, Cairns, Australia.

   Ong, A., & Tee, E. 1992. Natural sources of carotenoids from plants and oils. Meth. Enzymol., 213, 142–167.

102 Tanvetyanon, T., & Bepler, G. 2008. Beta-carotene in multivitamins and the possible risk of lung cancer among smokers versus former smokers: A meta-analysis and evaluation of national brands. Cancer, 113 (1), 150–157. URL (abstract): (accessed 02.25.2009).

   Touvier, M., et al. 2005. Dual association of beta-carotene with risk of tobacco-related cancers in a cohort of French women. J. Natl. Cancer Inst., 97 (18), 1338–1344. URL: (accessed 02.25.2009).

103 Serfontein, W., et al. 1984.

104 Azuma, J., et al. 1976. Apparent deficiency of vitamin B6 in typical individuals who commonly serve as normal controls. Res. Commun. Chem. Pathol. Pharmacol., 14 (2), 343–348. URL (abstract) (accessed 05.13.2008).

105 Kishi, H., et al. 1977. Deficiency of vitamin B6 in women taking contraceptive formulations. Res. Commun. Chem. Pathol. Pharmacol., 17 (2), 283–293. URL (abstract): (accessed 05.13.2008).

  Brown, J. 1990. The Science of Human Nutrition. NY: Harcourt Brace Jovanovich.

  Azuma, J., et al. 1976.

106 Botto & Yang. 2000.

107 Brown, S. 2006. “Bone nutrition.” In Scientific Evidence for Musculoskeletal, Bariatric, and Sports Nutrition, ed. I. Kohlstadt, p. 458. Boca Raton, FL: CRC Press.

108 Carmel, R. et al. 1988. Cobalamin and osteoblast–specific proteins. NEJM, 319 (2), 70–75. URL (abstract): (accessed 05.13.2008).

109 Matteini, A., et al. 2008. Markers of B-vitamin deficiency and frailty in older women. J. Nutr. Health Aging, 12 (5), 303–308. URL (abstract): (accessed 05.06.2008).

110 McBride, J. 2000. B12 Deficiency may be more widespread than thought — August 1, 2000 — News from the USDA Agricultural Research Service. URL: (accessed 06.17.2008).

111 McBride, J. 2000. Are you vitamin B12 deficient? Ag. Res. Mag., 48 (8). URL (PDF): (accessed 06.17.2008).

112 Santos, F., et al. 2008. The complete coenzyme B12 biosynthesis gene cluster of Lactobacillus reuteri CRL1098. Microbiology, 154 (Pt 1), 81–93. URL (abstract): (accessed 05.22.2008).

113 Gaby, A. 1994.

114 Wright, J. 1989. Testing for vitamin K1: An osteoporosis “risk factor.” Int. Clin. Nutr. Rev., 9 (1), 14–15.

   Feldman, E. 1988. Essentials of Clinical Nutrition. Philadelphia: F. A. Davis Co.

   Tomita, A. 1971. Postmenopausal osteoporosis CA-47 study with vitamin K2. Clin. Endocrinol. (Jpn.), 19, 731.

115 Hart, J., et al. 1985. Electrochemical detection of depressed circulating levels of vitamin K1 in osteoporosis. J. Clin. Endocrinol. Metab., 60 (6), 1268–1269. URL (abstract): (accessed 05.13.2008).

116 Knapen, M., et al. 2007. Vitamin K2 supplementation improves hip bone geometry and bone strength indices in postmenopausal women. Osteoporos. Int., 18 (78), 963–972. URL: (accessed 05.14.2008).

   Braam, L., et al. 2003. Vitamin K1 supplementation retards bone loss in postmenopausal women between 50 and 60 years of age. Calcif. Tissue Int., 73 (1), 21–26. URL (abstract): (accessed 05.14.2008).

117 Schurgers, L., et al. 2007. Vitamin K-containing dietary supplements: Comparison of synthetic vitamin K1 and natto-derived menaquinone-7. Blood, 108 (8), 3279–3283. URL (abstract): (accessed 05.22.2008).

   Takemura, H. 2006. [Prevention of osteoporosis by foods and dietary supplements. “Kinnotsubu honegenki”: A fermented soybean (natto) with reinforced vitamin K2 (menaquinone-7)] [In Japanese.] Clin. Calcium, 16 (10), 171–172. URL (abstract): (accessed 05.22.2008).

  Yamaguchi, M., & Ma, Z. 2001. Inhibitory effect of menaquinone–7 (vitamin K2) on osteoclast–like cell formation and osteoclastic bone resorption in rat bone tissues in vitro. Molecul. Cellul. Biochem., 228 (1–2), 39–49 (9). URL (abstract): (accessed 05.22.2008).

   Tsukamoto, Y., et al. 2000. Intake of fermented soybean (natto) increases circulating vitamin K2 (menaquinone–7) and gamma-carboxylated osteocalcin concentration in normal individuals. J. Bone Miner. Metab., 18 (4), 216–222. URL (abstract): (accessed 05.22.2008).

  Yamaguchi, M., et al. 1998. Effect of vitamin K2 (menaquinone–7) in fermented soybean (natto) on bone loss in ovariectomized rats. J. Bone Min. Metab., 17 (1), 23–29. URL (abstract): (accessed 05.22.2008).

118 Cranenburg, E., et al. 2007. Vitamin K: The coagulation vitamin that became omnipotent. Thrombos. Haemostasis, 98 (1), 120–125. URL (PDF): (accessed 06.17.2008).

119 Krasinski, S., et al. 1985. The prevalence of vitamin K deficiency in chronic gastrointestinal disorders. Am. J. Clin. Nutr., 41 (3), 70–75. URL: (accessed 05.13.2008).

120 Kruger, M., & Horrobin, D. 1997. Calcium metabolism, osteoporosis, and essential fatty acids: A review. Prog. Lipid Res., 36 (2–3), 131–151. URL (abstract): (accessed 05.13.2008).

121 Dawson–Hughes, B., & Harris, S. 2002. Calcium intake influences the association of protein intake with rates of bone loss in elderly men and women. Am. J. Clin. Nutr., 75 (4), 773–779. URL: (accessed 05.22.2008).


References on the terms DRI, RDA, AI, and EAR

a Dietary Reference Intake. URL: (accessed 05.06.2008).

b Ibid.

c Moshfegh, A., et al. 2005. What we eat in America, NHANES 2001–2002: Usual nutrient intakes from food compared to Dietary Reference Intakes. US Department of Agriculture, Agricultural Research Service. URL: (accessed 06.17.2008).

d Palacios, C. 2006. The role of nutrients in bone health, from A to Z. Crit. Rev. Food Sci. Nutr., 46 (8), 621–628. URL (abstract): (accessed 05.13.2008).