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
Nutrient Adult RDA or AI Common therapeutic range for bone health (daily intake) Dietary considerations concerning adequacy of average daily intake
Key minerals
Calcium
(Ca) 		1000–1200 mg 800–1200 mg Typical diet is inadequate, averaging 500–850 mg.
Phosphorus
(P) 		1250 mg, 9–18 yrs

700 mg, adults 		800–1200 mg Inadequate 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.
Magnesium
(Mg) 		420 mg, adult males

320 mg, adult females 		400–800 mg Intake 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).
Chromium
(Cr) 		30–35 mcg, adult males

20–25 mcg, adult females 		200–1000 mcg Common intake in the US is 50 mcg or lower.
Silica
(Silicon – Si) 		No values set to date As yet undetermined Intake 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.
Zinc
(Zn) 		11 mg, adult males

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

1.8 mg (AI), adult females 		2–10 mg Intake generally inadequate, at 1.76 mg adolescent girls; 2.05 mg adult females; and 2.5 mg adult men.
Copper
(Cu) 		900 mcg, adults
(0.90 mg) 		1–3 mg 75% of diets fail to contain RDA. Average daily intake is below the RDA.
Boron
(B) 		No RDA established 3–5 mg Common daily intake is only 0.25 mg, to possible optimum of 3.0 mg.
Potassium
(K) 		4700 mg, adults 4000–6000 mg Adult intake averages 2300 mg for women and 3100 mg for men.
Strontium No RDA established 3–30 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 D 400 IU, infancy–59 yr

400 IU, 51–70 yr

600 IU, >70 yr 		800–2000 IU and up, as needed The 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 C 90 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 A 2997 IU, adult males

2331 IU, adult females 		5000 IU or less 44% of US population has intake below EAR.
Vitamin B6 1.3–1.7 mg, adult males

1.3–1.5 mg, adult females 		25–50 mg Studies 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 B12 2.4 mcg, adults 150–1000 mcg Up to 40% of US population have marginal B12 status. Older people and vegans are especially at risk.
Vitamins K1 and K2 K1:
120 mcg, adult males
90 mcg, adult females

K2:
No recommended intake 		K1:
250–1000 mcg

K2:
45–180 mcg MK-7 (menaquinone-7) 		K1:
Averages 45–150 mcg, which is well below the recommended AI.

K2:
Average US intake 9–12 mcg (if any)
Other nutrients
Fats Should 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.
Protein 0.8 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/kg Daily 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.

References

References

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;

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

a Wikipedia.org. Dietary Reference Intake. URL: http://en.wikipedia.org/wiki/Dietary_Reference_Intake (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: http://www.ars.usda.gov/SP2UserFiles/Place/12355000/pdf/usualintaketables2001-02.pdf (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): http://www.ncbi.nlm.nih.gov/pubmed/17092827 (accessed 05.13.2008).

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