See also our FAQs section
The essential nutrients for strong bones:
Most of us are aware of the importance of the mineral calcium when it comes to building strong bones. More than 99% of calcium in the body is stored in bones and teeth. Despite knowing that it’s critical to health, many people still do not get enough. The demographics who are most at risk of not meeting their daily calcium requirements are adolescents, menopausal/post-menopausal women, men over 70 and people who don’t eat dairy.
Calcium is found in dairy products such as cheese, yoghurt and milk and non-dairy food such as sardines, almonds, houmous (specifically tahini), dark-leafy green vegetables like kale, spinach and collard greens (spring greens/cabbage), okra, and dried fruit such as figs, currants and apricots.
Bread (except for wholemeal) is fortified with calcium by law in the UK.
Calcium-rich meal and snack suggestions:
If you’re concerned you’re not getting your daily calcium requirements you might want to consider supplementing. Adults should have 700 milligrams of calcium a day – possibly more if deficient but usually not more than 1,500mg.
Be sure not to exceed the stated dose - too much calcium from supplements could put a strain on kidneys and can cause hypercalcemia (a build-up of calcium in the blood). Hypercalcemia can cause weakened bones (amongst other health problems).
It should also be noted that when it comes to calcium food sources it is not necessarily the case of the more the better. One Swedish study found that there did not appear to be a decrease in fracture risk with a higher intake of milk (drinking three or more glasses of milk per day compared with drinking one glass per day), with high milk consumption being associated with more bone and hip fractures. More research is needed on this.
It has been hypothesised that too much protein, especially animal protein, can cause acidity in the body, which causes bones to excrete calcium in order to neutralise the acidity.
However, whilst it is well established that high protein intake does lead to an increase in calcium secretion via urine, there is no evidence to suggest that it is because it changes the pH balance of the body or, indeed, that people who eat a lot of protein have a higher fracture risk. There is some thinking that the body releases a hormone to mitigate the calcium loss, but there is no conclusive evidence that high protein intake leads to decreased bone density.
For a relatively active adult a daily protein intake RDA is 10% of total daily calories.
Signs of possible calcium deficiency include:
Finally, whilst there isn't conclusive evidence about why this is the case, studies have shown there is a link between high fizzy drink consumption and increased risk of bone fractures. It is clear that carbonated drinks are not good for bone health, so put an end to that fizzy pop habit.
Note: It is important to ensure that along with calcium you are getting enough vitamin D, as without this important vitamin your body will not absorb calcium efficiently.
Vitamin D is a fat-soluble vitamin essential for calcium absorption and bone mineralisation. The two forms important in humans are ergocalciferol (vitamin D2) and cholecalciferol (vitamin D3). When taken in supplement form, Vitamin D3 is generally considered to be better absorbed by the human body.
Our bodies synthesise our own vitamin D3 when exposed to sunlight outdoors, but, depending on where you live, it may not produce satisfactory amounts to fulfil recommended requirements and therefore vitamin D will need to be obtained from the diet and/or supplementation. It is interesting to note that you cannot overdose from vitamin D3 from the sun (although you can, of course, get skin damage from too much sun and increase skin cancer risk if you overdo it - see NHS seasonal health - sun safety for sun safety advice).
Good sources of vitamin D include fatty fish such as trout, salmon, tuna and mackerel, as well as egg yolk, butter and liver. Vitamin D is also added to certain food products like breakfast cereals and margarines. Mushrooms produce vitamin D when exposed to sunlight.
Vitamin D is not overly abundant in many foods, but here are some meal and snack suggestions:
The official recommended daily dietary amount of vitamin D for adults is 10µg (aka mcg or micrograms) - this is equivalent to 400 international units (IU) of vitamin D - but we recommend 50µg (2000 IU) a day in the darker months, between October and April, when there is not enough sunlight to synthesize enough vitamin D naturally.
Do not supplement more than 100µg a day, equivalent to 4,000 IU, as, while you can’t overdose from sunlight exposure, too much vitamin D from supplementation can have the same effects of calcium toxicity and cause hypercalcemia (a build-up of calcium in the blood).
Vitamin D insufficiency affects almost 50% of the population worldwide.
Signs of possible vitamin D deficiency include:
Note: Dairy milk is not considered a good source of vitamin D in the UK as, unlike in some other countries, it is not fortified.
Vitamin K is another important vitamin when it comes to bone health, ensuring calcium is directed where it is needed. Research suggests that low levels of this vitamin in the blood is associated with poor bone density in adults.
However, there are two types of vitamin K: K1 and K2. K1 has had the most attention paid to it and is usually the form found in supplements, but there has been some research on K2 that suggests this might be more helpful in transporting calcium to the places we need it. Unlike K1, vitamin K2 is synthesized by bacteria not in our bodies and is found in high-fat meat, cheese, egg yolk and fermented foods such as unpasteurized sauerkraut and natto (the latter two being suitable for vegans).
K2 is further divided into MK4 (synthetic) and MK7 (natural) and you can supplement with K2-MK7 as these are now easily available and are often paired with vitamin D3.
Vitamin K1 is found most abundantly in dark-green leafy vegetables and K2 is found in mostly animal-derived foods such as meat and cheese, except for natto which is a fermented soybean food very high in K2.
Vitamin K meals and snacks suggestions:
As well as being found in plant foods such as dark-green leafy vegetables, our bodies – like with vitamin D – can produce vitamin K1 by itself (using bacteria in our digestive system), so supplementing shouldn’t be necessary, unless there is a prolonged or frequent use of antibiotics. More research is needed regarding vitamin K2.
Deficiency is uncommon but signs of possible vitamin K deficiency include:
Magnesium is another important mineral for bone health, with an adult storing 50-60% of their body’s magnesium content in the skeletal system. Magnesium is also a team player with calcium and Vitamin D, working synergistically in the maintenance of normal bones.
Magnesium is found in foods such as nuts (ie. Brazil, almond, pecan and cashew), beans and legumes (ie. soybeans, peanuts, baked beans), pumpkin seeds, wholegrains and dark-green leafy vegetables.
Magnesium meal and snack suggestions:
More research is needed on the optimal dose of magnesium supplementation when it comes to the risk of osteoporosis and bone fracture. Overdosing on magnesium has been found to have the opposite effect, weakening bones instead of fortifying them. Therefore, it makes sense to try and get your magnesium requirements from magnesium-rich foods. Only a few servings a day are needed to reach your daily RDA.
Recommended daily amounts of magnesium are 270mg for adult females and 300mg for adult males, although there is some thinking that this recommendation should be increased. Having up to 400mg a day is unlikely to cause harm.
If you are unsure if you might still need to supplement, consult your doctor for advice.
Low levels of magnesium don’t tend to have symptoms unless severe, but some signs of possible magnesium deficiency include:
As well as being an important nutrient for all-round immune system health, zinc has an essential role in bone health, with zinc deficiencies having been associated with decreased bone density. Luckily zinc is very easy to get in your diet, being in many fortified breakfast cereals and in staples such as baked beans, oats, nuts, seeds, chickpeas, lentils, rice, red meat and poultry. Oysters are high in zinc but are a bit of an acquired taste some would say.
Zinc meal and snack suggestions:
You should be able to get all the zinc you need from eating a balanced diet, but if you do feel you might benefit from zinc supplementation remember not to exceed the stated dosage.
Zinc supplementation is often combined with copper, as zinc can suppress copper absorption.
Zinc deficiency is not common, but when a person is zinc deficient their body can’t produce healthy new cells.
Possible signs of zinc deficiency include:
Some prescribed medications can interfere with the absorption of certain vitamins, so be sure to check with your GP if you are on any treatment. Acid blocking drugs are sometimes used for longer than they should be, and this can increase the risk of osteoporosis.
A daily A-Z multivitamin and mineral tablet might be a good way to ensure you are keeping up with your nutritional requirements, especially if you eat a vegan diet or need to restrict your diet in some way.
Vitamin pills are in no way a replacement for a good, varied diet as food contains so much more needed for a body to maintain itself, but, rather, supplementation is a safety net for days when you don’t have time to think too much about your nutritional needs or if your body has additional needs due to other factors (discussed with your doctor). You don’t have to worry about overdosing on vitamins and minerals if you take a daily supplement and eat a varied diet, but do not exceed the stated dose. It’s often best to take vitamin supplements with food as this can stop feelings of nausea and help boost absorption of some vitamins.
One of the keys to maintaining vibrant health is, along with taking plenty of exercise, to eat a ‘rainbow’ diet of fruits and vegetables and to ensure you include a variety of healthy foods from across all the food groups: fruits and vegetables, starches/grains, dairy or non-dairy alternatives, protein and fat.
Why not take our test and see which areas you can take action in to improve your bone health?
Have some questions about bone health and osteoporosis? Check out our FAQs section.