What foods promote bone health?

What are the best foods to promote bone health?

A healthy balanced diet, combined with proper exercise, is recommended to promote bone health from childhood to old age.¹ Maintaining a healthy body weight is recommended to avoid being exposed to higher risk of bone fractures.¹

In particular, the NHS recommends calcium, vitamin D to promote bone health.¹

1. Daily consumption of calcium is recommended to promote bone health.

Calcium is an essential nutrient to promote bone formation and maintenance from early childhood to old age.²

Good sources of calcium include: ¹

• Dairy products
• Green leafy vegetables except spinach; spinaches are not a good calcium source because they contain oxalate, a substance that reduces calcium absorption
• Soya beans
• Tofu
• Nuts
• Dried fruits (raisins, prunes, figs, dried apricots)
• Sesame seeds and tahini
• Fortified flours and milks
• Sardined and pilchards

2. Vitamin D is an important nutrient to promote optimal calcium metabolism and absorption into bones.²

Good sources of vitamin D include: ¹

• Oily fish (salmon, sardines, mackerel)
• Egg yolks
• Fortified fat spreads and breakfast cereals
• Vitamin D supplements

3. Vitamin K is an important nutrient to protect bone mineral density and prevent the loss of calcium from bones.^3,4

Vitamin K intake has been associated with increased osteocalcin synthesis.⁵ Osteocalcin is a calcium-binding protein hormone that prevents the loss of calcium from bones.

Good sources of vitamin K include:⁶

• Green leafy vegetables
• Vegetable oils ( soybean oil, rapeseed oil, olive oil)
• Fermented vegetables such as sauerkraut
• Beef and pork liver

Vitamin C through its antioxidant properties has been suggested to have the potential to contribute to optimal bone health against osteoporosis.⁴ More studies are necessary to support implementation in current guidelines.⁷

4. Potassium and magnesium are important minerals to prevent fracture risk.

It has been suggested that potassium intake may reduce calcium depletion.⁴

Potassium supplementation in diets in people with a low calcium intake has been associated with increased bone density and bone health.⁴

Magnesium is an important nutrient for bone formation and vitamin D metabolism.⁴ Several studies have found an association between bone mineral density, decreased fracture risk, and magnesium intake.⁸

Good sources of magnesium include whole foods, in particular: ⁹

• Legumes
• Nuts
• Seeds
• Whole grains and cereals

5. Protein consumption is important for bone health maintenance

Dietary proteins improve bone formation and calcium absorption.⁴

Adequate protein intake has been associated with greater bone density, and strength, lowered risk of bone fractures, and slower bone loss especially when associated with appropriate calcium intake and exercise.⁴

Both animal and vegetable proteins have been associated with promoting bone health.⁴

6. Vitamin A excess might increase the risk of bone fractures.

Vitamin A-rich diets are not advised for people at risk of osteoporosis.¹

In these populations, following the NIH recommended dietary allowances for vitamin A-rich foods such as animal liver and liver products and retinol supplements is extremely important.¹⁰

7. The olive oil-rich Mediterranean diet has been suggested as beneficial for bone health.

It has been suggested dietary patterns are more beneficial in promoting bone health than single nutrients.⁴

A healthy balanced diet rich in fruit and vegetables, low-fat dairy products, whole grains, nuts, legumes, fish, and poultry has been associated with reduced risk of osteoporosis.⁴

Instead, diets rich in processed foods, fat products, sodium, and additives have been indicated as detrimental.⁴

References

1. https://www.nhs.uk/live-well/bone-health/food-for-strong-bones/
2. Beto JA. The role of calcium in human aging. Clin Nutr Res. 2015 Jan;4(1):1-8. doi: 10.7762/cnr.2015.4.1.1. Epub 2015 Jan 16. PMID: 25713787; PMCID: PMC4337919.
3. Koitaya, N., Sekiguchi, M., Tousen, Y., Nishide, Y., Morita, A., Yamauchi, J., Gando, Y., Miyachi, M., Aoki, M., Komatsu, M., Watanabe, F., Morishita, K., & Ishimi, Y. (2014). Low-dose vitamin K2 (MK-4) supplementation for 12 months improves bone metabolism and prevents forearm bone loss in postmenopausal Japanese women. Journal of bone and mineral metabolism, 32(2), 142–150. https://doi.org/10.1007/s00774-013-0472-7
4. Muñoz-Garach, A., García-Fontana, B., & Muñoz-Torres, M. (2020). Nutrients and Dietary Patterns Related to Osteoporosis. Nutrients, 12(7), 1986. https://doi.org/10.3390/nu12071986
5. van Summeren, M. J., Braam, L. A., Lilien, M. R., Schurgers, L. J., Kuis, W., & Vermeer, C. (2009). The effect of menaquinone-7 (vitamin K2) supplementation on osteocalcin carboxylation in healthy prepubertal children. The British journal of nutrition, 102(8), 1171–1178. https://doi.org/10.1017/S0007114509382100
6. Mladěnka, P., Macáková, K., Kujovská Krčmová, L., Javorská, L., Mrštná, K., Carazo, A., Protti, M., Remião, F., Nováková, L., & OEMONOM researchers and collaborators (2022). Vitamin K – sources, physiological role, kinetics, deficiency, detection, therapeutic use, and toxicity. Nutrition reviews, 80(4), 677–698. https://doi.org/10.1093/nutrit/nuab061
7. Brzezińska, O., Łukasik, Z., Makowska, J., & Walczak, K. (2020). Role of Vitamin C in Osteoporosis Development and Treatment-A Literature Review. Nutrients, 12(8), 2394. https://doi.org/10.3390/nu12082394
8. Rondanelli, M., Faliva, M. A., Tartara, A., Gasparri, C., Perna, S., Infantino, V., Riva, A., Petrangolini, G., & Peroni, G. (2021). An update on magnesium and bone health. Biometals : an international journal on the role of metal ions in biology, biochemistry, and medicine, 34(4), 715–736. https://doi.org/10.1007/s10534-021-00305-0
9. Fiorentini, D., Cappadone, C., Farruggia, G., & Prata, C. (2021). Magnesium: Biochemistry, Nutrition, Detection, and Social Impact of Diseases Linked to Its Deficiency. Nutrients, 13(4), 1136. https://doi.org/10.3390/nu13041136
10. https://ods.od.nih.gov/factsheets/VitaminA-HealthProfessional/

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