For Strong Bones You Need More Than Calcium

When most people think of bone health, calcium is the first thing that comes to mind.

But even though this mineral is a vital part of our skeleton, on its own it won’t be enough to keep the body’s 206 bones in good shape.

Vitamins, other minerals and fats play key roles. For optimum health you need a good supply of all of them.

Let’s look at some of the most important nutrients. . .

Three Bone-Healthy Vitamins

Calcium needs vitamin D, sometimes called cholecalciferol, to allow absorption in the intestines. Since there is a limited supply of vitamin D from food sources, 90% of our requirements must come from the sun – or from supplements.

With the modern tendency to avoid the sun because of skin cancer fears, and because the ability to make vitamin D from sunlight goes down rapidly with age, this vitamin is deficient in well over half of Americans above the age of 65.

This could be one of the reasons why 300,000 hip fractures will occur this year.

This vitamin helps synthesize collagen, which is needed to form and strengthen the bone matrix and maintain bone mineral density (BMD), a marker of bone strength.

Studies show hip fracture risk could be reduced between 44% and 69% in those with intakes of 260 – 313 mg/day compared to those with the average adult intake of 94 mg/day.

For optimal bone protection, we need a much greater intake of fruits and vegetables than most people eat these days. Vitamin C supplements are a big help, but don’t assume they replace C-rich foods.

Osteocalcin, a bone-specific protein, cannot be formed without vitamin K. Deficiencies lead to bone loss and fractures.

One study found those in the highest quarter of intake – they averaged 254 mcg a day — had a reduced hip fracture risk of 65% compared to those in the lowest quarter, who averaged 56 mcg. The 254 mcg is double the current average adult intake. Clearly, most of us need to be ingesting a lot more K.

Regular consumption of spinach, kale or broccoli would provide bone healthy amounts of this vitamin. Supplements give you valuable extra insurance.

The Essential Macrominerals

Potassium promotes the retention of calcium in the kidneys and magnesium is needed for proper calcium metabolism, bone integrity and synthesis of vitamin D. Some scientists believe dietary magnesium is more important for bone health than calcium.

One study found that higher intakes of these minerals were associated with greater BMD at the hip and lower arm.

Surveys show that three out of four Americans are deficient in magnesium, with intakes well below the recommended daily allowances (RDAs) of 320mg and 420mg for women and men respectively.

The picture is even worse for potassium, where less than 2% of US adults meet the RDA. This is surprising since so many popular foods are rich in potassium: orange juice, potatoes, bananas, to name a few. Sweet potatoes, beans, broccoli and beets also have quite a bit.

Our lack of magnesium and potassium reflects the lack of leafy green vegetables, legumes, whole grains, nuts and seeds in the average American diet.

Two Ignored Elements

These two minerals do not have RDAs, but there is little doubt they play essential roles in bone health.

Boron and silicon are biochemically similar and have related effects on bone. Boron is essential for bone growth and maintenance and is involved with the absorption and utilization of vitamin D, calcium and magnesium.

Silicon is believed to aid in new bone growth, inhibit its breakdown, and stimulate calcium metabolism. It’s also involved with the synthesis of collagen.

Studies found men with higher intakes of silicon had greater hip BMD, and premenopausal women had greater hip, spine and femur BMD. A recent review of 38 studies found a positive relationship between intake of silicon and bone regeneration.

Fruits, leafy vegetables, legumes and nuts are good sources of boron. Meat, fish and dairy foods are poor sources. Similarly, silicon is much higher in plant foods than in meat or dairy.

Fats are Important Too

Laboratory studies suggest that increasing the ratio of omega-3 to omega-6 fatty acids will have beneficial effects on bone health. Since most of us consume a lot of omega-6 oils, it’s the omega-3 side of the ratio we need to increase.

Studies in humans are limited, but the ones we have indicate that higher intakes of the omega-3 fats EPA and DHA from fatty fish, fish oils, and grass-fed meat are good for your bones. Another thing about fat-- but not the good kind of fat-- is the new research that shows how the amount of fat on your arms can indicate the health of your bones.

Eat More Bone-Healthy Foods

This list of nutrients isn’t the last word, but If Americans were to increase safe sun exposure and consume more omega-3 fats, fruits, vegetables, nuts, and whole foods, they’d be far more likely to get a good supply of all the essential bone-supporting nutrients.

And they’d be far less likely to be one of the 3½ million visitors to emergency rooms for fractures every year.