However, it is also true that you can’t just rely on calcium to support the health and maintenance of strong bones! You need vitamin D and magnesium too Magnesium also contributes to a reduction of tiredness and fatigue). Couple this with some vitamin K and you have a powerful bone support formula.
NICE (The National Institute for Health and Care Excellence) in the UK, have emphasised the need for calcium to build strong bones for decades. However, this preoccupation with calcium has resulted in less emphasis on other equally important nutrients for bone quality, which if not acknowledged could have serious implications for your long-term bone health.
What is osteoporosis?
Osteoporosis is a fragile bone disease that results from an imbalance between bone deposition and resorption. It can cause painful and debilitating fractures, most often in the hip and spine. The consequences of a fracture for many people means living with long-term pain and suffering, which can lead to social isolation. Serious breaks may even result in premature death.
Some reasons why bones become fragile
Bones are metabolically very active, which means they undergo a constant cycle of wearing down and being rebuilt. An entire skeleton is totally replaced around once every 10 years. Tiny stress fractures caused by walking, running and jumping are continuously repaired by the body to avoid serious long-term damage.
If you’ve reached the age of 50, it’s likely your bones are starting to get thinner and weaker as regeneration slows and bone loss tends to increase from this age onwards. This is particularly so for menopausal women who lose more calcium during this life stage, as well as the added disadvantage of having smaller bones than men in the first place.
Risk factors for bone loss
Because of natural ageing, everybody is at risk but some more than others. Dietary deficiencies and missed periods are common amongst anorexics, bulimics, ballet dancers and endurance athletes, making them a high-risk group for osteoporosis. Early menopause predisposes you to an increased risk of fractures. This is exacerbated if you smoke, which accelerates the onset of menopause by up to five years. Smoking may also deplete vitamin C and other antioxidants essential for bone health. Additionally, lack of exercise raises your risk for osteoporosis as does stress, depression, too much dietary salt, alcohol, steroid abuse and soft drinks that contain phosphoric acid.
Nutrition support for bone health
The following nutrients are vital if you want to maintain the strength and quality of your bones.
During the early years of life, when bones are growing, calcium intake is important for contributing to peak bone mass, this doesn’t necessarily apply later in life though. Dietary calcium cannot be utilised in the bones unless other necessary bone-building factors are also present. Adequate levels of other nutrients are vital to support and maintain bone health through the different stages of life.
Studies fail to show that a calcium rich diet on its own may help to support bone strength. Interestingly, countries like Norway and Sweden have the greatest incidence of osteoporosis despite a high intake of dairy products.
Food sources of calcium
- Tinned salmon
- Milk products
Vitamin D is important for ensuring the normal absorption of calcium in the gut and promoting its uptake into new bone. Dietary sources of vitamin D are limited so the majority of vitamin D comes from exposure to the sun – hence its name ‘the sunshine vitamin’. It is estimated that as much as 50% of the population may have a vitamin D deficiency. In severe prolonged cases this can cause rickets in children and painful bone disease in adults.
The following factors could potentially lead to vitamin D deficiency:
- Gastric bypass surgery
- Eating disorders
- Malabsorption conditions (ulcerative colitis, crohn’s)
- Pregnancy and lactation
- The menopause
- Living in northerly regions with fewer hours of sunshine
- Remaining indoors during daylight hours.
The major cause of vitamin D deficiency is inadequate exposure to sunlight. Individuals at higher risk of osteoporosis are advised to expose their skin to the sun for at least 5-10 minutes a day 2 - 3 times a week and increase their dietary and supplemental intakes of vitamin D.
Sources of vitamin D
- Oily fish
- Cod liver oil
- Egg yolks
- Beef liver
The correct balance of magnesium is becoming increasingly recognised as a crucial factor in bone density. Magnesium is not only an important structural element in bone, but it also has a role in the active transport and metabolism of calcium. Supplementing your diet with magnesium may make a real difference. Early research by Leichter L et al in 1993 reported that after taking 250mg a day of magnesium, a group of Israeli women displayed a significant increase in bone strength.
When it comes to taking magnesium supplementation, it is important to find a good quality well absorbed source.
Food sources of magnesium
Although vitamin K is not as significant to bone health as vitamin D and calcium, studies show it may play a pivotal role in the maintenance of normal bone strength. One of its functions is to support the activation of key proteins which help bind calcium to form new bone. Research has found that women with low dietary intakes of vitamin K are associated with poor bone density and potential increased risk of hip fractures.
Food sources of vitamin K
- olive oil
Supplementing with bone supportive nutrients, coupled with regular exercise, plenty of sunshine and a healthy diet and lifestyle could make all the difference when trying to support bone health through different life stages.
By Jacqueline Newson BSc (Hons) Nutritional Therapy
- Akbari S and Rasouli-Ghahroudi AA. Review Article. Vitamin K and Bone Metabolism: A Review of the Latest Evidence in Preclinical Studies. BioMed Research International 2018; 4629383: 1-8.
- Askim M. Vitamin K in the Norwegian diet and osteoporosis. Tidsskr Nor Laegeforen 2001; 121 (22): 2614-6.
- Booth SL, Broe KE Cupples A et al. Vitamin K intake and bone mineral density in women and men, The American Journal of Clinical Nutrition 2003; 77(I2): 512–516.
- Castiglioni S, Cazzaniga A, Albisetti W, Maier JA. Magnesium and osteoporosis: current state of knowledge and future research directions. Nutrients. 2013;5(8):3022-33.
- Holick MF. Sunlight and vitamin D for bone health and prevention of autoimmune diseases, cancers, and cardiovascular disease. The American Journal of Clinical Nutrition, 2004; (80), 6 :1678S–1688.
- Nair R, Maseeh A. Vitamin D: The "sunshine" vitamin. J Pharmacol Pharmacother. 2012;3(2):118-26.
- National Osteoporosis Society. The Osteoporosis Agenda England. https://nos.org.uk/media/1959/agenda-for-osteoporosis-england-final.pdf [Accessed 8.2.19.]
- Price CT, Langford JR, Liporace FA. Essential Nutrients for Bone Health and a Review of their Availability in the Average North American Diet. Open Orthop J. 2012; 6:143-9.
- ScienceNordic. Milk is a poor preventer of osteoporosis. http://sciencenordic.com/milk-poor-preventer-osteoporosis. [Accessed 8.2.19.]