Authored by Dr. Susan E. Brown, PhD
Science has learned some amazing things about nutrients for bone health and osteoporosis in recent years. The outmoded thinking that says bone nutrition is all about calcium has been shown by research to be an oversimplification at best. Yes, calcium is critical for bone health — but our bones are so much more complex than we ever imagined!
Bones play a number of surprising roles in the body, from regulating blood calcium and blood sugar to storing needed minerals to supporting and protecting the body’s organs and tissues.
Getting the full complement of nutrients for bone health is essential for overall health. But it’s especially important for women in midlife to recognize the value of bone-building nutrients, because that’s when women start to lose bone mass. Perhaps you’ve been diagnosed with osteoporosis or told you have osteopenia and are wondering if there are nutrients for osteoporosis that can help you fend off a fracture. Or perhaps you’ve broken a bone and want to know what nutrients for bone healing can also speed your recovery. We’ll look beyond the “usual suspects” and highlight nutrients that support bone health so that whatever you’re looking for — whether it’s nutrition for osteopenia or bone-healing nutrients for osteoporotic fractures — you’ll know what to look for and where to find it.
Table Of Contents:
Calcium
Magnesium
Vitamin D3
Vitamin K
Zinc
Manganese
Boron
Chromium
Silica
Copper
Potassium
Vitamin C
Vitamin A
Vitamin B6
Folate/folic Acid (Vitamin B9)
Vitamin B12
Fats
Protein
Bottom line for bone health and osteoporosis
Calcium
Your body contains more calcium than any other mineral, making up about 2% of your total adult body weight. It’s stored in your bones and teeth, and the skeleton itself is also a reserve of calcium. Calcium is vital to maintaining heart rhythm, muscle function, blood clotting and many enzymes, so it’s crucial that you have what you need — and if your body doesn’t get the calcium it needs from food or supplementation, it takes it from your skeleton, which weakens your bones.
But getting enough calcium isn’t as simple as adding more to your diet by eating cheese or yogurt.
Whether you can absorb the calcium in your diet is just as important, if not more important, than eating enough of it. And there are a lot of nutritional factors influencing absorption: for instance, calcium absorption is highly dependent on other nutrients for bone health such as Vitamin D, magnesium and zinc, among others. So having too little of such companion nutrients can affect how much calcium you absorb. As an example, a person with inadequate Vitamin D absorbs 65% less calcium than someone who has adequate Vitamin D (at least 32 ng/ml). Not to mention the fact that without nutrients for bone health like phosphorus, magnesium and Vitamin K, bones are not as strong and flexible.
Magnesium
Magnesium assures the strength and firmness of bones and also makes teeth harder. It’s one of the key nutrients needed to ensure calcium is both optimally absorbed and best utilized by the body. It’s also necessary for converting Vitamin D into its active form. What’s more, magnesium is required for over 300 biochemical reactions in the body. You can find it in foods such as nuts, leafy greens, beans and, best of all, dark chocolate.
The majority of the body’s reserves (60%) of magnesium are held in the bone, then the bones act as a storage reservoir, transferring magnesium to the blood in times of need.
Vitamin D3
Ranking high on the list of nutrients for bone health, Vitamin D — and specifically the hormone our body produces from Vitamin D — is the most important regulator of calcium absorption. People with low Vitamin D absorb 65% less calcium than those with adequate levels of this vitamin. Vitamin D is one of the few nutrients we make ourselves, surprisingly by exposing skin to sunlight for 10 to 30 minutes a day. It’s an easy vitamin to get if you live in a sunny location — not so easy if you live in a northern state where it’s wintry half the year, which is why people who are housebound or who live in colder climates are encouraged to take supplements. Osteoporotic fractures are much more common in folks with low levels of Vitamin D, though fracture incidence can be dramatically reduced with Vitamin D supplementation.
Low levels of Vitamin D are also linked to the development of numerous diseases, including:
- Cancer
- Heart disease
- Diabetes
- Hypertension
- Depression
- Muscle weakness
- Dementia
- Autoimmune disease (such as MS)
Vitamin K
Emerging research is showing Vitamin K2 as MK-7 (menaquinone-7) to be one of the key nutrients for bone health, specifically for building bone strength and helping to prevent osteoporosis, protecting the heart and even reducing mortality. For example, K2 is involved in preventing fractures in postmenopausal women with osteoporosis. An analysis of the results of 19 different studies focusing on postmenopausal women with osteoporosis showed that Vitamin K2 plays a role in improvement of the vertebral bone mineral density and also the prevention of fractures.
Vitamin K2 as MK-7 has also been shown to improve cardiovascular health in healthy postmenopausal women. Finally, in one recent study, participants who increased their Vitamin K1 and K2 dietary intakes over the nearly five-year follow-up period had a 43% and 45% reduced risk of overall mortality respectively compared to those whose intakes were unchanged or reduced. Those with increased Vitamin K2 intakes during follow-up had a 59% lower risk of death from cancer. Vitamin K is most often associated with leafy greens (kale is particularly high in this vitamin) but it’s also found in hard cheeses like manchego or Romano.
Zinc
Zinc helps produce the matrix of collagen protein threads upon which the all-important bone-forming calcium–phosphorus compound is deposited. It’s also necessary for the production of enzymes that degrade and recycle worn-out bits of bone protein. Zinc deficiency is problematic because it prevents full absorption of calcium. Low levels have been closely linked with the development of osteoporosis. Zinc can be found in foods such as beans, nuts, shellfish and whole grains.
Manganese
Manganese is often overlooked among important nutrients for bone health — there’s not even an RDA for the trace element! However, research shows clearly that manganese is a co-factor in the formation of bone cartilage and bone collagen, as well as in bone mineralization.
Manganese deficiency can have serious consequences — it appears to increase bone breakdown while decreasing new bone mineralization — that can lead to osteoporosis. For example, in one study, blood levels of manganese in severely osteoporotic women were found to be just 1/4 those of non-osteoporotic women their same age — and it was the only significantly different variable out of 25 studied. Manganese is found in a lot of different foods such as beans, nuts, rice, leafy vegetables, even coffee and tea.
Boron
The benefits of boron for bone health have only recently been discovered. Your body requires boron for proper metabolism and utilization of various bone-building factors, such as calcium, magnesium, Vitamin D, estrogen and perhaps testosterone. Overall studies show boron has a mineral-conserving and estrogen-enhancing effect, especially among women with low magnesium intake. Boron is generally found in non-citrus fruits, nuts, grains and leafy greens.
Chromium
As well as keeping insulin activity in the body efficient, chromium may protect bone by promoting the production of collagen by osteoblasts (our bone-building cells) and by moderating bone breakdown (resorption). Chromium may also improve bone health by raising blood levels of the hormone DHEA, which is thought to be important to the preservation of bone density among postmenopausal women. Good sources of chromium are foods such as grapes and grape juice, apples, beef, poultry and broccoli.
Silica
High amounts of silica are found in the strongest body tissues, such as the arteries, tendons, ligaments, connective tissue, collagen, skin, nails, hair and teeth. In terms of its ranking among nutrients for bone health, it was found that bone collagen increases with silica supplementation and also that the mineral is involved in strengthening the connective tissue matrix by cross-linking collagen strands. Furthermore, dietary silicon increases the rate of mineralization and high concentrations of silica are found in areas of active bone mineralization. Silica also combines with calcium in bone-building cells. There are many foods rich in silica such as green beans, bananas, leafy greens and brown rice.
Copper
Copper is a trace mineral essential to bone health maintenance. Although its role is not fully understood, a copper-containing enzyme called lysyl oxidase is known to help form collagen for bone and connective tissue and contributes to the strength of bone collagen fibrils. Also, copper is an important element of an antioxidant called superoxide dismutase that helps limit bone resorption — perhaps one reason why low levels of copper are associated with the development of osteoporosis. Copper is not common in a lot of foods, but leafy greens, dark chocolate and seafood are good sources.
Potassium
Potassium, along with sodium, helps to maintain critical fluid balance in the body. It also helps bone in the form of alkalizing compounds that neutralize bone-depleting acids — which prevents too much calcium from being excreted in the urine. The prevention of excess calcium loss in the urine can be done through dietary potassium (think bananas, melons, citrus fruits, spinach, broccoli and cucumbers) or supplemental potassium, such as potassium bicarbonate and potassium citrate.
Vitamin C
This antioxidant protects bone cells from oxidative damage. Most people know that it’s present in citrus fruits, but you can also get it from tomatoes and tomato juice, peppers, strawberries, brussels sprouts and potatoes. It is essential for bone health in multiple ways:
- It helps form collagen. Bone mineral is laid over a protein matrix, collagen, which is the connective tissue of cartilage and bone. It makes up 30% of our bones.
- It may stimulate bone-building cells, enhance calcium absorption and promote Vitamin D’s effect on bone metabolism.
- Vitamin C is responsible for the synthesis and optimal function of adrenal steroid hormones, which are vital in bone health. These hormones are especially important during perimenopause and menopause.
- It is the most abundant water-soluble antioxidant in the body.
- A potent anti-inflammatory, Vitamin C decreases bone-damaging immune system pro-inflammatory compounds.
- It chaperones toxins stored in bone out of the body.
Vitamin A
This vitamin plays a significant role in developing osteoblasts, the bone-building cells that lay down new bone. It’s available through a wide range of dietary sources, both animal and vegetable. A deficiency inhibits calcium absorption and metabolism, thus increasing the risk of poor bone growth. In general, low Vitamin A levels are associated with osteoporosis and increased fracture risk. We recommend the retinoid forms.
Vitamin B6
Vitamin B6 plays an important yet indirect role in bone metabolism in the following ways:
- It is needed for hydrochloric acid (HCI) production by the stomach which is necessary for calcium absorption.
- Adrenal functioning needs Vitamin B6. Several hormones are then released by the adrenal glands, some of which aid in maintaining proper mineral balance.
- This vitamin is a cofactor in the enzymatic cross-linking of collagen strands. That means that it increases the strength of connective tissue.
- It plays a role in the breakdown of homocysteine, a metabolite of an amino acid that interferes with collagen cross-linking and can cause defective bone matrix and osteoporosis. It also contributes to the development of heart disease. Vitamin B6 and folic acid work together to prevent a build-up of homocysteine. You can find Vitamin B6 in foods such as fish, chicken, beans, bananas and oats.
Folic acid/folate (Vitamin B9)
Folate is necessary for the proper processing of homocysteine. Its role is specifically in the detoxification of the metabolite. Vitamin B9’s role in homocysteine regulation is essential for osteoporosis and atherosclerosis prevention. The best sources of folate are leafy green vegetables, broccoli and beans.
Vitamin B12
Another B vitamin that plays a role in the detoxification of homocysteine is Vitamin B12, which is essential for red blood cell production. Osteoblasts need B12 to function. This vitamin is often found in fish or meat products, which makes it problematic for vegans and vegetarians unless they supplement — and because low B12 levels can cause pernicious anemia (low red blood cell count), it’s generally recommended that people who don’t eat meat take supplements.
Research has found that overall deficiency in B12 is linked with osteoporosis.
Fats
Although we Americans are consuming too much fat in our diets, there are certain fats that are important for our health called essential fatty acids. In fact, our bodies require these fats. Essential fatty acids are not produced by the body but are obtained through diet or supplementation. They are important for reasons such as nerve functioning, hormone production, maintenance and function of the brain, and everyday energy production. Essential fatty acids also play a role in bone health. These fats are needed for calcium metabolism and are essential components of all membranes, such as cartilage and bone. EFAs increase calcium absorption from the intestines, regulate and reduce calcium excretion in the urine, and also increase calcium deposition in bone. Omega-3 specifically serves as a potent anti-inflammatory to protect bones from cytokine damage.
Protein
Protein promotes intestinal absorption of calcium and serves as a major building block for bone. It even makes up about one-third to one-half of our bone. Additionally, it has been found that protein malnutrition weakens bone. The most obvious sources of protein are meat, eggs and dairy, but whole grains, nuts and beans offer vegetable proteins as well.
Bottom line on nutrients for bone health and osteoporosis
Ideally, we would get the optimal supply of supplemental nutrients from the food we eat. But for most of us, that’s just not possible — even when we’re doing our very best to eat well. Also, most people don’t realize how critical specific nutrients are for the absorption and utilization of other nutrients. Without this synergistic effect, your body can’t absorb certain nutrients and won’t get the benefits.
To get the right amounts of the top nutrients for bone health every day, you may want to use a nutritional supplement in addition to enjoying a healthy diet. When choosing your supplements, go with a medical-grade multivitamin/mineral formulated specifically for bone health, and make sure it contains balanced, therapeutic levels of these nutrients in their most bioavailable forms.
Our exclusive Better Bones Builder is formulated with ideal amounts of Vitamin D, calcium and magnesium and all other essential bone-building vitamins and minerals at therapeutic levels, as well as nutrients to optimize absorption and bone-building support.
References and further reading
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