Best Nutrition to Strengthen Bones
Following is the recommendations for diet, physical activity, and other lifestyle practices that can help to achieve good bone health:
Nutrition
Since many nutrients are important for bone health, it is important to eat a well-balanced diet containing a variety of foods. Eating Plan emphasizes fruits, vegetables, low-fat or fat-free dairy foods, whole grains, fish, poultry, and nuts, making it rich in calcium, magnesium, protein, and potassium while also being low in fat, cholesterol, and sodium.
Calcium
The Food and Nutrition Board (FNB) of the Institute of Medicine updated recommended intakes for several nutrients important to the skeleton including calcium
Selected Food Sources of Calcium
Food | Calcium (mg) | % DV* |
Sardines, canned in oil, with bones, 3 oz. | 324 | 32% |
Cheddar cheese, 1½ oz. shredded | 306 | 31% |
Milk, nonfat, 8 fl oz. | 302 | 30% |
Yogurt, plain, low fat, 8 oz | 300 | 30% |
Milk, reduced fat (2% milk fat), no solids, 8 fl oz. | 297 | 30% |
Milk, whole (3.25% milk fat), 8 fl oz. | 291 | 29% |
Milk, buttermilk, 8 fl oz. | 285 | 29% |
Milk, lactose reduced, 8fl oz. (content varies slightly according to fat content; average = 300 mg) | 285–302 | 29–30% |
Cottage cheese, 1% milk fat, 2 cups unpacked | 276 | 28% |
Mozzarella, part skim 1½ oz. | Mozzarella, part skim 1½ oz. | 28% |
Tofu, firm, w/calcium, ½ cup† | 204 | 20% |
Orange juice, calcium fortified, 6 fl oz. | 200–260 | 20–26% |
Salmon, pink, canned, solids with bone, 3 oz. | 181 | 18% |
Pudding, chocolate, instant, made with w/2% milk, ½ cup | 153 | 15% |
Tofu, soft, w/calcium, ½ cup† | 138 | 14% |
Breakfast drink, orange flavor, powder prepared with water, 8 fl oz. | 133 | 13% |
Frozen yogurt, vanilla, soft serve, ½ cup | 103 | 10% |
Ready to eat cereal, calcium fortified, 1 cup | 100–1000 | 10%–100% |
Turnip greens, boiled, ½ cup | 99 | 10% |
Kale, raw, 1 cup | 90 | 9% |
Kale, cooked, 1 cup | 94 | 9% |
Ice Cream, vanilla, ½ cup | 85 | 8.5% |
Soy beverage, calcium fortified, 8 fl oz. | 80–500 | 8–50% |
Chinese cabbage, raw, 1 cup | 74 | 7% |
Tortilla, corn, ready to bake/fry, 1 medium | 42 | 4% |
Tortilla, flour, ready to bake/fry, one 6″ diameter | 37 | 4% |
Sour cream, reduced fat, cultured, 2 tbsp | 32 | 3% |
Bread, white, 1 oz. | 31 | 3% |
Broccoli, raw, ½ cup | 21 | 2% |
Bread, whole wheat, 1 slice | 20 | 2% |
Cheese, cream, regular, 1 Tbsp | 12 | 1% |
.*DV=Daily Value
†Calcium values are only for tofu processed with a calcium salt. Tofu processed with a non-calcium salt will not contain significant amounts of calcium.
Note. Daily Values (DV) were developed to help consumers determine if a typical serving of a food contains a lot or a little of a specific nutrient. The DV for calcium is based on 1000 mg. The percent DV (% DV) listed on the nutrition facts panel of food labels tells you what percentages of the DV are provided in one serving. For instance, if we consumed a food that contained 300 mg of calcium, die DV would be 30% for calcium on die food label.
A food providing 5% of the DV or less is a low source while a food that provides 10–19% of the DV is a good source and a food that provides 20% of the DV or more is an excellent source for a nutrient.
Vitamin D
Vitamin D can be made in the skin by being exposed to sunlight. For some individuals who get enough exposure during warmer months, the sun can provide adequate levels of vitamin D. For many, however, it is not practical to get adequate levels of vitamin D from exposure to sun should boost their vitamin D levels through diet.
Especially for elderly individuals who have higher vitamin D needs may have difficulty getting the same from outside.
Dietary Sources of Vitamin D:
Serving Size | Vitamin D (IU) | |
Milk | 1 cup | 98 |
Baked herring | 3 oz. | 1,775 |
Baked salmon | 3 oz. | 238 |
Canned tuna | 3 oz. | 136 |
Sardines | 1 oz. | 77 |
Raisin bran cereal | ¾cup | 42 |
Pork sausage | 1 oz | 31 |
Egg yolk | 1 | 25 |
Other Nutrients Important to Bone
Other Nutrients Affecting Bone | What Is the Effect on Bone? | How Much Is Needed?* | What Are the Dietary Sources? | Special Considerations |
Potentially Beneficial Effects on Bone | ||||
Copper | Copper helps certain enzymes and local regulators function properly so that we can form the optimal bone matrix or structure for bone strength. | RDA is 900 μg for men and women over age 30. Daily intakes over 10,000 μg are not recommended. | Organ meats, seafood, nuts, seeds, wheat bran, cereals, whole grain products, cocoa products. | Calcium supplementation may result in lower levels of copper. |
Fluoride | Fluoride stimulates the formation of new bone. Necessary for skeletal and dental development. | RDA is 4 mg for men over age 30 and 3 mg for women over age 30. Daily intakes over 10 mg are not recommended. | Fluoridated water, teas, marine fish, fluoridated dental products. | |
Iron | Iron helps certain enzymes and local regulators function properly so that we can form the optimal bone matrix or structure for bone strength. | RDA is 8 mg for men over the age of 19. The RDA for women is 18 mg between the ages of 19 and 50 and 8 mg over age 50. Daily intakes over 45 mg are not recommended. | Non-heme sources include fruits, vegetables and fortified bread and grain products such as cereal. | |
Magnesium | 60% of magnesium in our bodies is found in our bones in combination with calcium and phosphorus. Magnesium appears to enhance our bone quality. Magnesium can improve bone mineral density, and not getting enough may interfere with our ability to process calcium. | RDA is 420 mg for men over 30 and 320 mg for women over 30. Daily intakes over 350 mg are not recommended | Good sources include green leafy vegetables such as spinach, potatoes, nuts, seeds, whole grains including bran, wheat, oats & chocolate. Smaller amounts are found in many foods including bananas, broccoli, raisins and shrimp. Also found in magnesium-containing laxatives and antacids. | Magnesium deficiency is rare in US adults. Magnesium supplements are not recommended for most people. |
Manganese | Manganese helps certain enzymes and local regulators function properly so that we can form the optimal bone matrix or structure for bone strength. | RDA is 2.3 mg for men over age 30 and 1.8 mg for women over age 30. Daily intakes over 11 mg are not recommended. | Nuts, legumes, tea, whole grains and drinking water. | Manganese supplements may not be a good choice for everyone, including people already consuming high levels of manganese from diets high in plant foods and people with liver disease who are especially susceptible to the adverse effects of excess manganese intake. |
Phosphorus | Phosphorus is a component of every cell in our bodies and supports building bone and other tissue during growth. About 85% of the phosphorus in our bodies is found in our bones. In fact, phosphate, a form of phosphorus, makes up more than half of our bone mineral mass. | RDA is 700 mg for men and women over age 30. Daily intakes over 4,000 mg for adults up to age 70 and over 3,000 mg after age 70 are not recommended. | Milk, yogurt, ice cream, cheese, peas, meat, eggs, some cereals, breads, cola soft drinks and many processed foods. | |
Potassium | There is no RDA established for potassium. Scientists recommend a daily intake between 1,600 mg and 3,500 mg. | Milk, yogurt, chicken, turkey, fish, many fruits such as bananas, raisins and cantaloupe, and many vegetables such as celery, carrots, potatoes and tomatoes. | ||
Protein | Proteins are our bodies’ building blocks. We use protein to build tissue during growth and to repair and replace tissue throughout life. We also need protein to help heal fractures and to make sure our immune system is functioning properly. | RDA is 56 g for adult men and 46 g for adult women. Nutritionists recommend that 10% to 35% of our calories come from protein. (The rest come primarily from carbohydrates and fats.) | Complete protein comes from animal sources including meat, poultry, fish, eggs, milk, cheese, yogurt. | Getting enough protein is particularly important for elderly people. Studies show that elderly people who have not been getting enough protein and who break their hip are more likely to suffer poor medical outcomes. |
Vitamin C | Vitamin C helps certain enzymes and local regulators function properly so that we can form the optimal bone matrix or structure for bone strength. | RDA is 90 mg for men over age 30 and 75 mg for women over age 30. Daily intakes over 2,000 mg are not recommended. | Citrus fruits, tomatoes and tomato juice, potatoes, Brussels sprouts, cauliflower, broccoli, strawberries, cabbage and spinach. | People who smoke need 35 mg more vitamin C than the RDA. People who are regularly exposed to second-hand smoke also may need extra vitamin C. |
Vitamin K | Vitamin K helps certain enzymes and local regulators function properly so that we can form the optimal bone matrix or structure for bone strength. | RDA is 120 units for men over age 30 and 90 units for women over age 30. No maximum safe intake has been established for vitamin K. | Green vegetables including collards, spinach, salad greens and broccoli, Brussels sprouts, cabbage, plant oils and margarine. | Patients on anticoagulant medication should monitor their vitamin K intake. |
Zinc | Zinc helps certain enzymes and local regulators function properly which in turn helps our bodies form the optimal bone matrix or structure for bone strength. | RDA is 11 mg for boys and men over age19 and 8 mg for girls and women over age 19. Daily intakes over 40 mg are not recommended. | Fortified breakfast cereal, some seafood, whole grains, dry beans and nuts. | |
Caffeine | Studies suggest that caffeine may interfere with calcium absorption. However, this effect can be neutralized in the presence of adequate dietary calcium. | Not applicable | Coffee, tea, some soft drinks, some over the counter medications. | |
Fiber | Fiber has a minor negative impact on calcium absorption. | Men ages 31 to 50 need 38 grams per day and after 50 need 30 grams per day. Women ages 31–50 need 25 gm per day and after 50 need 21 gm per day. | Includes dietary fiber naturally present in grains (oats, wheat or unmilled rice) and functional fiber from plants and animals shown to be of benefit to health. | |
Oxalates | When oxalates and calcium are found in the same food, oxalates combine with the calcium, preventing us from absorbing the calcium. | Not applicable | Spinach. Other oxalate-rich foods include rhubarb and sweet potatoes, but since these foods do not contain calcium, the oxalates have no effect on calcium absorption. | Oxalates do not interfere with the absorption of calcium in other foods eaten with the oxalate-containing foods. |
Phosphorus | Phosphorus is necessary for healthy bones (see above), but some people are concerned that there may be too much in our diet, especially since phosphorus is a component of cola beverages and many processed foods. Some studies suggest that excess amounts of phosphorus may interfere with calcium absorption. The good news is that we can offset the loss by getting adequate amounts of calcium in our diet. | RDA is 700 m for men and women over age 30. Daily intakes over 4,000 mg for adults up to age 70 and over 3,000 mg after age 70 are not recommended. | Milk, yogurt, ice cream, cheese, peas, meat, eggs, some cereals, breads, cola soft drinks and many processed foods. | Possible negative effects of soft drinks on bone may be due primarily to the replacement of calcium-rich milk with soft drinks, especially by children and teenagers at a time when they need extra calcium to optimize their peak bone mass. |
Sodium | Sodium affects the balance of calcium in our bodies by increasing the amount we excrete in urine and perspiration. The loss of calcium can be significant, but we can replace the lost calcium by making sure we get adequate amounts of calcium in our diet. | The NIH (National Institute of Health) recommends restricting daily sodium intake to less than 2,400 milligrams (equal to about 1 teaspoon of table salt). | Sodium combined with chloride is common table salt. Many processed foods are high in salt. | |
Vitamin A | Vitamin A plays an important role in bone growth but excessive amounts of the retinal form of vitamin A may increase the breakdown of our bones and interfere with vitamin D, which we need to help us absorb calcium. The beta carotene form of vitamin A does not appear to cause these problems. | RDAs are 3000 IU for men and 2330 IU for women. Daily intakes over 10,000 IU of the retinol form of vitamin A are not recommended. | Retinol sources include animal-source foods such as liver, egg yolks, cheese, milk. Dietary supplements and some acne preparations also contain retinol. |
References:
- *Recommended Dietary Allowance (RDA)
- Lifestyle Approaches to Promote Bone Health. Available at: https://www.ncbi.nlm.nih.gov/books/NBK45523/ Accessed on 30th April 2021
- Calcium – Health Professional Fact Sheet Available at https://ods.od.nih.gov/factsheets/Calcium-HealthProfessional/ Accessed on 30th April 2021
- Table 7-4, Dietary Sources of Vitamin D – Bone Health and Osteoporosis – NCBI Bookshelf Available at https://www.ncbi.nlm.nih.gov/books/NBK45523/table/ch7.t4/ Accessed on 30th April 2021
- Table 7-5, Other Nutrients and Bone Health at a Glance – Bone Health and Osteoporosis – NCBI Bookshelf Available at https://www.ncbi.nlm.nih.gov/books/NBK45523/table/ch7.t5/?report=objectonly Accessed on 30th April 2021