Bone Health 101: A Simple Guide

Healthy bones – you’ve heard all the advice, and probably conflicting advice – and it can be pretty overwhelming. And that’s because, like everything in our bodies, it’s more complex than “just take a calcium supplement” (by the way, don’t) or, “drink lots of milk for healthy bones!” Bone health is dependent on many vitamins and minerals, achieving the correct balance, and being able to absorb and utilize them properly. The vitamins and minerals I’ll touch on in this article are: calcium, magnesium, vitamin K-2, phosphorus, and vitamin D, but there are many others that aid in healthy, strong bones.

Calcium is the most abundant mineral found in the human body, making up between 1.5-2% of our body weight. 98% of calcium is found in our bones, including teeth, while the remainder is found in our circulation and tissues. Bones are hard, calcified connective tissue that rebuild and repair continuously through our lives, a process called bone remodeling, and this process is the key to maintaining bone health. Here’s how it works:

Our bodies are constantly fine-tuning to maintain homeostasis. One of these balances it prioritizes is our blood calcium level, as it’s essential to maintaining cardiac health. When we don’t ingest or absorb enough calcium in our food, our blood calcium level drops. When our parathyroid glands sense this drop in blood calcium levels they release parathyroid hormone, which releases calcium from our bones, and deposits it into our blood stream. This brings our blood calcium levels back up to normal. So, maybe we start eating more foods like cheese, sardines, and a bunch of collard greens and we are flush with calcium (yay!). Our blood calcium level goes up, and our body reacts by depositing calcium into our bones. This constant breaking down and building up, or remodeling, of our bones is what keeps them dense and strong.

Now, this is an example of our body working correctly to maintain homeostasis. What happens if we are constantly depriving our bodies of calcium?

If we never have an overabundance of calcium in our blood (say we’re eating bananas and graham crackers all day), calcium never gets deposited in our bones. This breaks the normal bone remodeling cycle; it means our bones constantly have to release calcium into our blood stream to maintain our blood-calcium levels and, over time, our bone density will decrease. This leads to osteopenia, and later, osteoporosis.

Are you at-risk for bone-loss?

Who is most at risk?

  • Pregnant and nursing mothers. Calcium is drawn from the bones during the pregnant and nursing years, so if you don’t get enough calcium, and because it becomes harder to replace as we age, adequate calcium during this stage is more crucial.
  • Post-menopausal women and the elderly. As we age, our ability to absorb and utilize calcium is reduced, and an estimated 70-90% of bone fractures in elderly people are due to osteoporosis.
  • People with high-protein, high-phosphorus, or high-fat diets need even more calcium that those with a more balanced diet.

10 ways you can improve your bone health

So, what can we do about this? Here are some things you can incorporate into your life to ensure your body is getting and absorbing all the calcium, and other beneficial nutrients, it needs. And a note on getting your nutrients from food rather than through supplements: Rather than taking a multivitamin created in a lab, nutrients we get in our diets are packaged by nature, combined in a way that allows our bodies to use them optimally, ways we don’t even understand yet! It’s not a coincidence that many of the natural food sources for the vitamins and minerals listed below have crossover.

  1. Eat calcium-rich foods: I know this one sounds obvious, but with vegan diets gaining in popularity and more awareness of dairy sensitivity/intolerance, we really need to know what sources of calcium, other than milk, are available to us. The recommendations for calcium vary, but 500-700 mg of calcium per day is now commonly recommended, which is easily attainable through diet alone. Here’s a list of calcium-rich foods:
    • Cow’s milk cheeses: 300-500 mg per 2 oz. portion
    • Cow’s milk yogurt: 300 mg per 6 oz.
    • Broccoli, cauliflower cooked: 250 mg per 2 stalks
    • Sardines with bones: 240 mg per 2 oz.
    • Collard greens: 225 mg per 6 oz.
    • Turnip greens: 200 mg per 6 oz.
    • Almonds: 210 mg per 3 oz.
    • Brazil nuts: 160 mg per 3 oz.
    • Hazelnuts: 96 mg per 3 oz.
    • Soybeans, pinto, and adzuki beans, cooked: roughly 150 mg per 6 oz.
    • Blackstrap molasses: 130 mg per 1 tbsp.
    • Tofu: 110 mg per 3 oz.
    • Dried figs: 100 mg per 3 oz.
    • Dried apricots: 80 mg per 3 oz.
    • Parsley: 80 mg per 1.5 oz.
    • Kelp: 80 mg per .25 oz.
    • Sunflower and sesame seeds: 75-80 mg per 2 oz.
  2. Exercise: Exercising has been shown to improve absorption of calcium, and relatively heavy weight-bearing exercises and aerobic activities, like running, encourage the bone-remodeling process.
  3. Reduce stress: Cortisol can diminish calcium absorption, as can the inhibited digestive function often caused by stress. This goes hand-in-hand with exercise, as exercise is the easiest way to complete the stress cycle (releasing your stress).
  4. Avoid soft drinks and processed foods: Hopefully this goes without saying, but soft drinks and processed foods such as lunch meats or spreadable cheeses have added phosphoric acid – in high amounts – and almost certainly will lead to a phosphorus-calcium imbalance in our bodies. This can cause kidney stones and atherosclerotic plaque.
  5. Stay hydrated: It’s really important! Getting enough water ensures our blood is fluid enough to transport calcium to tissues.
  6. Eat enough healthy fats: Think olive oil, avocados, butter, ghee, coconut oil, and grass-fed/pastured animal fats. Fat transports calcium across the cell membranes into the cell.
  7. Get off those acid-blockers: Antacids and proton pump inhibitors for acid reflux may alleviate our symptoms, but they leave our stomach pH too alkaline for optimal digestion. Our stomachs must have an acidic enough environment to properly absorb many nutrients, one being calcium.
  8. Get plenty of vitamin D: Run around in the sunshine, eat vitamin D rich foods such as oily fish, cheese, and egg yolks, and/or supplement with your doctor’s guidance. Vitamin D increases the absorption of calcium in our digestive tract, so it’s as if you’re getting an extra dose of calcium when you get vitamin D. Shoot for 1000 mg of vitamin D each day.
  9. Get enough vitamin K2: Recent studies have shown that vitamin K2 not only helps bind calcium to strengthen our bones, but it prevents calcification of our arteries, a more recent discovery with calcium supplementation. Plus, it appears promising in terms of cancer, diabetes, and osteoarthritis research. While supplementation is possible, we should always look to our food first! Here are the foods highest in vitamin K2:
    • Natto (fermented soy)
    • Cheeses, hard and soft
    • Fermented foods, such as sauerkraut
    • Butter, egg yolks, lard, other animal products, grass-fed/pastured is higher
  10. Get enough magnesium: Magnesium and calcium are needed in the correct balance to perform their tasks correctly. And magnesium is also needed to properly use vitamin D. Some foods rich in magnesium are:
    • Nuts
    • Seeds
    • Avocados
    • Dark chocolate
    • Oily fish
    • Dark leafy greens
    • Tofu
    • Legumes

I hope you found some of this information helpful. As always, I am not a doctor and cannot diagnose or treat disease. What I can do is support optimal health through nutrient-dense foods and positive lifestyle changes. Please work with your provider if you suspect deficiency and would like to put together a comprehensive plan that includes supplementation.

Sources:

Vitamins K1 and K2: The Emerging Group of Vitamins Required for Human Health

Proper Calcium Use: Vitamin K2 as a Promoter of Bone and Cardiovascular Health

Staying Healthy with Nutrition

Vitamin K2 and the Calcium Paradox

Introduction to the Human Body

Vitamin K2: The Missing Nutrient

How Much Calcium Do You Really Need?

Calcium, Vitamin D, and Fractures (Oh My!)

The Role of Magnesium in Vitamin D Activation and Function

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