Bone Health
While bones are often thought to be passive structures in the body, they are actually on a constant basis, breaking down old bone, then reabsorbing and removing it (osteoclasts) to make room for new bone (osteoblasts) to keep itself strong. This process is actually what allows children to grow taller — their new bone grows at a much faster rate than old bone is removed.
at about age 25 — this is the point at which the body removes old bone and creates new bone at the same speed. In our mid-to-late 20s, bone loss begins as the body removes bone faster than it produces it. This isn’t something most people notice because it occurs at such a slow rate and people are less likely to focus on health issues that aren’t immediately apparent.
In the years just after women reach menopause, they experience rapid bone loss. This has much to do with the changing sex hormones in their bodies — specifically, lower estrogen. Lower estrogen levels are directly correlated to bone loss, and the longer a woman goes with low estrogen levels (say, from early menopause) the more likely they are to experience serious bone health issues.
While men are less likely to be diagnosed with osteoporosis than women (given that estrogen is a major factor), men will still experience age-related bone loss and should make bone health a priority.
Here are supplement ingredients and good bone health practices for everyone, regardless of age.
6 Vitamins and Minerals for Strong Bones
Calcium
Calcium is the mineral most commonly associated with bone health. This is also the reason that pediatricians and parents are always pushing children to drink milk above anything else — the calcium they get helps them develop healthy osteoblasts that help them grow (even soy, almond and other nut milks are calcium fortified). Calcium helps build new bone — regardless of age — in addition to slowing the pace of age-related bone loss.
Remember that it’s important to even out the breakdown of old bone and replacement with new bone as much as possible, for as long as possible. This is what will help maintain dense bones throughout life.
Some people may get the necessary daily calcium requirement from the foods they eat. However, the current acknowledge that calcium is generally underconsumed in the United States. Furthermore, there are age-related reasons that can contribute to a calcium deficiency.
As the body ages, it may have a harder time absorbing this nutrient. If the body can’t find the calcium it needs to perform essential functions, it will essentially steal it from bones which is why calcium supplements are usually recommended for older adults.
If calcium supplements are recommended, it’s important to “the percentage of calcium absorbed [by the body] depends on the total amount of elemental calcium consumed at one time; as the amount increases, the percentage of absorption decreases.” The body of current evidence supports taking more frequent, but lower doses of calcium (with meals if using calcium carbonate), and avoiding high doses above 500 mg at a time. Most nutritionists recommend taking 250-350 mg with each meal and at bedtime or similarly spaced out during the day.
This is because the body absorbs more calcium in doses under 500 mg, which suggests that if someone plans to supplement 1,000 mg per day, it’s best to break it up into two, three or more doses. Taking your daily dose of 1000 mg all at once means your body won’t absorb it all and most will be wasted.
Vitamin D
is crucial to bone health because it . Adequate calcium and vitamin D throughout life, as part of a well-balanced diet, may .
Unfortunately, the prevalence of around the world has become a public health crisis. In the U.S. alone, it’s estimated that about are vitamin D deficient. There are multiple reasons for this, including climate (lack of sun), lack of vitamin D available in foods, and the public health push to wear sunscreen (sunscreen blocks vitamin D production in the body).
Because vitamin D is so crucial for bone health and growth (particularly during the early years of life), infants are often prescribed a liquid vitamin D supplement. Formula typically has added vitamin D, but exclusively breastfed infants often need a supplement because breastmilk isn’t rich in vitamin D.
In the U.S. milk products are often fortified with vitamin D, as well as some juices (orange juice in particular can be fortified with vitamin D and calcium) and some yogurt. Pediatricians typically recommend at least two cups of milk or other vitamin D fortified beverage per day for children to facilitate osteoblast production, but many experts recommend supplementation for kids as well.
Magnesium
is just as important as calcium when it comes to bone health because more than 60% of the magnesium in the body is stored in the bone structure. The balance of calcium and magnesium in the body is very important and so is a balanced intake, which is why most bone support supplements contain calcium and magnesium in a 2:1 ratio.
Clinical research has demonstrated time and time again that this 2:1 ratio of daily calcium to magnesium intake provides the best physiological balance and benefit. If you take calcium, you should need about half as much magnesium to balance it, which can come from both food and supplements.
indicates that magnesium plays a particularly crucial role in the activation of vitamin D. Therefore, magnesium indirectly assists in calcium absorption and utilization, and magnesium supplementation may also help avoid vitamin D deficiency.
in the European Journal of Epidemiology concluded that “low serum magnesium concentrations are independently associated with an increased risk of future total and femoral fractures.”
Magnesium is a cofactor in over 300 essential functions in the body, so it shouldn’t come as a surprise that it plays such a significant role in bone health. According to , about 56% of Americans (more than half of the US population) are consuming inadequate amounts of this vital mineral. Magnesium is widely present in both animal and plant foods, but the standard American diet typically contains about half of the recommended daily allowance for magnesium.
The Recommended Dietary Allowance (RDA) of magnesium for adults is 400 mg/day for men and 310-320 mg/day for women. The National Food and Nutrition Board has established a safe upper limit (UL) for magnesium of 350 mg/day that applies only to supplemental magnesium (not dietary magnesium from food) for healthy infants, children, and adults.
This means that — in addition to the magnesium you’re getting in your diet — you may safely supplement up to 350 mg/day with magnesium. If you’re taking a calcium/magnesium or bone support supplement that contains magnesium, you will likely meet that daily limit. You should not exceed that amount unless instructed by your healthcare provider.
Vitamin C
Vitamin C is imperative for collagen synthesis in the body, and collagen is crucial for bone mineralization. A conducted by Cambridge University found that “greater dietary vitamin C intake” was associated with stronger bones and better bone health overall.
Furthermore, that ascorbic acid is a “vital modulator of osteogenic and chondrogenic differentiation. Vertebrate organisms deficient in normal physiological levels of [ascorbic acid] develop bone disorders such as spontaneous fracturing, impaired bone growth and impaired bone healing.”
While researchers have noted that there are “inconsistencies” in human studies, the scientific community largely agrees that vitamin C is a vital nutrient for bone health. Given that about are vitamin C deficient, this is rather concerning.
Vitamin K
is often associated with the agent that assists in healthy blood coagulation. Most newborns are given a before they’re released from the hospital for this very reason. Some research has suggested that vitamin K plays a role in bone mineralization.
Lack of vitamin K has been linked to osteoporosis by many studies, as determined by a . The function of osteocalcin is dependent on the interplay of vitamin D and K. The synthesis of osteocalcin by osteoblasts is regulated by vitamin D3, but the calcium-binding capacity of osteocalcin requires vitamin K to be activated. According to a , “vitamin K is in fact required for osteocalcin carboxylation that in turn regulates bone mineral accretion; it seems to promote the transition of osteoblasts to osteocytes and also limits the process of osteoclastogenesis.”
We do know two functions of vitamin K in the body that are crucial for bone health:
- Stimulates calcium reabsorption from the kidneys, and
- Helps hold calcium in bones so it can build osteoblasts.
When it comes to bone building and remodeling, simplistically, vitamin D and vitamin K have opposite functions. Vitamin D mobilizes calcium out of the bones if there is not enough calcium in the bloodstream, and vitamin K pulls it back into the bones.
When we refer to vitamin K, we’re actually referring to different variations of fat soluble molecules, the most common of which are K1 and K2. K1 is found in leafy greens and some plant oils, and is our primary source of vitamin K. Vitamin K2 includes a variety of forms primarily bacterial in origin and accounts for about 10% of vitamin K consumption. Vitamin K2 is found in meats and fermented foods including cheeses, but are also synthesized in the gut by human intestinal bacteria.
According to , the vitamin K deficiency prevalence in the U.S. could be as much as 97%.
In order to get more vitamin K in your diet, Amanda A. Kostro Miller, RD, LDN, and advisory board member at recommends that you “drop a bunch of greens in your breakfast smoothie.” It’s a great way to sneak in a serving of vegetables, while nourishing your body first thing in the morning.
While it is clear that we still don’t know everything about vitamin K, we do know that it works in tandem with vitamin D to help maintain proper calcium balance in the body, and to help maintain strong bones. That’s why it’s included in most bone support supplements, and widely prescribed in other parts of the world to menopausal women specifically for helping to maintain bone mass.
Vitamin A
Research on vitamin A tends to be mixed. Many researchers agree that vitamin A is helpful in maintaining strong bones because it influences osteoblast production and osteoclast removal, but that too much vitamin A can have the reverse effect, .
As with most other things in life, moderation appears to be the key to vitamin A. Most people should be able to get enough vitamin A in their diets to negate the need for a supplement. Orange foods, such as carrots, sweet potatoes and salmon, are excellent sources of vitamin A. In fact vitamin A is one of the few areas that isn’t a major concern in the standard American diet — (NHANES) data puts the vitamin A deficiency rate at .
However, people with absorption disorders or specific medical conditions may require a supplement. It’s prudent — especially for older women at risk for bone loss — to limit vitamin A supplementation to 5000 IU (1500 mcg)/day.
Other Helpful Ways to Support Bone Health
Exercise
Weight bearing exercise is the primary way to build and maintain bone density throughout life. Walking, jogging, hiking, racquet sports (like badminton or tennis), dancing, gardening, yard work and even house cleaning are great exercises to promote bone health. Essentially, anything that requires you to move against gravity is going to work toward this goal.
“I recommend walking up and down hills if possible. Walking uphill is a good cardiovascular workout, and walking downhill is great weight bearing movement for bone building,” says Emerson Ecologics Medical Advisory Board Member . Getting regular exercise can help prevent falling, which is a contributing factor to elderly mobility.
But, as Paul Claybrook, MS, MBA, CN warns, exercise is just one piece of the puzzle. “Exercise without the nutrients or the nutrients without exercise is not a complete solution,” he says. “You need both.”
Eat Plenty of Vegetables
As if practitioners need another reason to tell their patients to eat more vegetables, bone health is yet another one. “Beans and greens,” as they’re sometimes referred to, and orange vegetables are packed with the nutrients on this list and can help support strong, healthy bones.
Be sure to pack plenty of these veggies into your daily diet:
- Broccoli
- Brussels sprouts
- Spinach
- Kale
- Mustard or collard greens
- Swiss chard
- Bell peppers
Beans and almonds are also wonderful sources of calcium.
Focus on Anti-Inflammatory Foods
“I recommend a diet that keeps inflammation at bay — one that minimizes gluten, dairy, sugar, alcohol, caffeine, corn, and nightshades like peppers, tomatoes and eggplants,” says Bader. “Additionally, a high-quality probiotic is important for maintaining gut integrity, which can impact bone health in the long-term. And finally, hormonal health is key to bone health. It’s important to test and treat appropriately.”
is also a major proponent of . In fact, he created the Zone Diet largely based on these principles. He says that “bone loss is highly correlated with inflammation.” Specifically, he recommends a diet with plenty of omega-3 fatty acids and because both have anti-inflammatory properties.
At Emerson Ecologics, we’re big fans of the , which is an excellent choice if you’re looking for an anti-inflammatory food plan.
Focus on Gut Health
“Bone health starts in the stomach, so proper digestion is key,” says Bader. “I recommend digestive bitters or a half-teaspoon of apple cider vinegar in some water before meals, especially if someone is prone to GERD (gastroesophageal reflux disease) or has high levels of stress.”
If you can’t properly absorb the nutrients your body needs to support bone health, you won’t reap the benefits of the anti-inflammatory diet, supplements you may be taking, or healthy lifestyle changes you’re making.
Reduce Stress
By now, most people know that stress has toxic effects on our physical and mental health. For Sears, this cannot be ignored with bone health because of its link to inflammation. “Stress reduction is also known to reduce inflammation,” he says. But more importantly, Sears says that anything you can do to reduce inflammation and stress in your life is critical as the body ages.
Proactive Support for Bones
Like most other aspects of overall health, being proactive can support the body’s natural ability to take care of itself. If we make sure kids get the recommended amount of calcium and vitamin D, and make healthy meals for our families, we’ll all be in a better position to stay strong throughout childhood, young adulthood, and old age.
Are you interested in learning more about bone health? Check out these articles with additional pro tips: