Osteoporosis Diet & Nutrition

Here are the top foods you should include in your diet based on research of dietary approaches for bone health.¹

Higher fruit and vegetable intake is associated with less bone mineral density (BMD) loss and a resulting higher BMD. You see, fruits and vegetables provide a whole host of key nutrients like folate, and bone-supporting magnesium, potassium, and vitamin K1. Plus antioxidants like carotenoids and vitamin C. And let’s not forget calcium! Dark leafy greens like kale, collard greens, bok choy and broccoli rabe are all calcium-rich foods. And it couldn’t be easier to add them to your diet. They can all be incorporated into salads, soups, smoothies and even juices. If you want to change things up, try the lesser-known mustard and turnip greens, which have a bit of a spicier note. Don’t overlook the sea veggies either. Along with kelp, other sea veggies like nori, wakame, and kombu are packed with calcium, phosphorus, magnesium, iron and other trace minerals that contribute to strong bones. Just make sure your sea veggies are responsibly sourced to ensure sustainability and purity. When it comes to fruit, acerola cherries, guava, strawberries, and blueberries are all rich in antioxidants. Antioxidants (like vitamin C, beta-carotene, vitamin E and lutein) play a crucial role in bone health because they combat oxidative stress. And oxidative stress has been linked to many diseases, including osteoporosis. Antioxidants activate osteoblasts (bone-building cells), play a role in the mineralization process, and help reduce the activity of osteoclasts (bone-resorption cells).² If you have low bone density or worry about your bone health, there’s another wonder-fruit you’ll want to know about. You may know it as the main ingredient in your parents or grandparents favorite juice, but it’s got a lot more going for it than you may think! Yes, we’re talking about prunes (dried plums)!

Prunes have been shown to positively affect bone mineral density in a number of studies. In fact, their anti-inflammatory and antioxidant properties are just one aspect of their bone-building benefit. Prunes also contain boron, which is a trace mineral that’s been linked with reducing osteoarthritis symptoms and promoting stronger bone health. The most recent research shows that just 4-5 prunes per day is effective in protecting bone mineral density in postmenopausal women! To discover more, check out our post on Prunes and Osteoporosis.

If you’re a seafood fan, you’re in luck! You already know seafood tastes great, but research shows it protects your bones too. The Framingham Osteoporosis study looked at associations between polyunsaturated fatty acid and fish intake and hip bone mineral density.³ The levels were measured at baseline, and then four years later. Results showed that both women and men with who ate more than 3 servings of fish per week gained hip bone mineral density. And individuals with low to moderate fish intake ended up losing bone mineral density. The researchers concluded that fish consumption may protect against bone loss. They also noted that these protective effects on bone may be dependent on the omega 3 fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), specifically. EPA and DHA have been linked with positive bone health, improved eye health⁴, cardiovascular health⁵, and combatting depression⁶ and anxiety due to their anti-inflammatory properties.⁷ Additional cross-sectional studies have also associated habitual fish intake with greater BMD.⁸ Salmon, mackerel, sardines, and anchovies are among the oily fish packed with bone-healthy nutrients- especially those omega 3 fatty acids. In fact, canned sardines and sockeye salmon also pack a calcium-punch, boasting 383 mg of calcium and 239 mg of calcium in one serving! Finally, fish are an excellent source of protein and are typically lower in calories than meat or dairy.

There’s no doubt dairy is a great source of complex essential nutrients like calcium, magnesium, protein, vitamin D, vitamin B12, zinc and riboflavin. (To discover exactly how much calcium is in dairy milk– and non-dairy alternatives– check out our “How Much Calcium is in Milk?” page). Given that dairy foods are considered an essential source of bone-building nutrients, plenty of studies have been conducted to discover their protection against osteoporosis. Some cross-sectional studies have reported positive links between milk consumption and bone density in later life⁹, while others showing the benefits of milk on osteoporotic fractures is less convincing.¹⁰ The reason for all the mixed results? Lactose, a sugar found in cow’s milk. When it’s broken down in your body it produces two sugars: glucose and D-galactose. D-galactose promotes inflammation and chronic inflammation activates osteoclasts (cells that break down bones). We do acknowledge that dairy foods have been controversial and have been accused of leaching calcium from our bones, increasing the risk of fractures, osteoporosis and even cancer. However, when Bone Health Expert Lara Pizzorno sat down to sift through the research and evaluate the studies, she found some surprising results. Read more about the dairy, milk and osteoporosis controversy — including what lactose and D-galactose have to do with it — in our post: Milk and Osteoporosis.

However, the good news is the majority of the research indicates dairy products help support healthy bones. So if you’re not allergic or sensitive to dairy products, keep enjoying them! Also, be sure to enjoy fermented dairy foods, like yogurt and cheeses, especially aged cheeses as these are completely lactose-free. In particular, organic plain, full-fat yogurt delivers the widest range of beneficial nutrients for bones. Not only does plain yogurt contain calcium, but magnesium, zinc, plus small amounts of vitamin K2 (in the form of MK-4), vitamin A, and vitamin D (if it is fortified) and a hefty dose of protein. Research also shows prebiotic and probiotic properties in fermented dairy, like yogurt, may help your gut absorb nutrients from the food you eat, benefiting your bones.¹¹ Pre- and probiotics are in products like kefir, natural yogurt and raw cheeses. Discover more about prebiotics and probiotics in our ultimate guide.

Protein makes up about 50% of your bone volume and about one-third of its mass!¹² Bone health isn’t just a skeletal issue, rather, it’s a musculoskeletal issue. You see, bone loss and muscle loss that occur with aging are closely related. And factors that affect bone mass, like your protein intake, also affect muscle anabolism (growth). So keeping your entire musculoskeletal system happy and healthy is the goal – and adequate protein intake is crucial. 

Protein affects your bones in the following ways:

You may be surprised to see this on the Foods for Osteoporosis section, however, alcohol in moderation has been shown to benefit overall health – and now bones! There are two types of alcohol that have been shown to have a positive effect on bone health.

Silicon plays a key role in bone formation by stimulating our production of osteoblasts (bone-building cells), our synthesis of type 1 collagen, and by boosting calcium’s incorporation into bone. It’s also been shown in human studies to improve bone mineral density. Most notably is the large, U.S. population-based Framingham Offspring Study, which reported that higher dietary silicon intake in both men and younger women was associated with improved bone mineral density and skeletal health – especially cortical bone strength (the denser outer part of your bone).¹⁵ Consumption of at least 40 milligrams of silicon daily was the amount associated with increased bone mineral density. In fact, it accounted for up to 10% more bone mineral density between those individuals with the highest (> 40 mg/day) and lowest (< 14 mg day) intakes of silicon. Mineral waters and beer are by far the richest dietary sources of bioavailable silicon.¹⁶ To get the most silicon from beer, drink Indian Pale Ales (IPAs).¹⁷ The silicon all beers contain is highly soluble, but IPAs retain more because they are exposed to less heat during the malting process. The darker ales, such as the chocolate, roasted barley and black malt, all undergo substantial roasting and thus have far lower silicon content. Also look for beers with the highest amounts of hops. Hops contain surprisingly high levels of silicon — as much as four times more silicon than is found in malt. However, hops are used in much smaller quantities than grains in beer production. In Western countries, dietary intake of silicon ranges from 13-62 mg per day. Bone Health Expert, Lara Pizzorno recommends at least 40 mg per day. In addition to being clinically supported to increase bone density safely and naturally ─ Algaecal Plus contains 26 mg of silicon in every daily dose (4 capsules), plus the other 12 essential minerals required for strong bones.

Red wine, in particular, has also been identified from the Framingham Osteoporosis Study to be beneficial to bone health in women.¹⁸ The potential contributor to this association is resveratrol. Resveratrol is a polyphenol that is abundant in red wine, grapes — and even nuts! It’s gained interested and attention for its heart-protecting and cancer-preventing benefits.¹⁹ Resveratrol also possesses anti-inflammatory properties, which are beneficial for bone health.

Moderate alcohol consumption may offer protection for health and bones, but a review of the studies on alcohol and bone health found that intakes beyond a certain level may show negative effects as well.²⁰ They suggested what is known as the “J”-shaped curve. If you enjoy your glass of red wine or beer at dinner, continue to enjoy yourself! Just keep in mind that excess alcohol consumption has been shown to be detrimental to overall health and bones.

Your bones do best when they receive the full combination of all the micronutrients necessary to build new bone – a fact amply demonstrated by the Combination of Micronutrients for Bone (COMB) Study.²¹ The study was published in the Journal of Environmental and Public Health in February 2012. Right after the annual meeting of the American Academy of Orthopedic Surgeons first officially warned doctors that certain osteoporosis drugs increase the risk for “atypical femur fractures.”²² The COMB study firmly demonstrated that providing our bones with the nutrients they need along with regular weight-bearing exercise is as, or more, effective than any of them or strontium ranelate*, produces no adverse side effects and is a lot less expensive! (*Strontium ranelate is the unnatural patent medicine version of natural strontium. The many reasons you do not want to take strontium ranelate, but should consider including a natural form of strontium (e.g., strontium citrate) in your bone-building program, are discussed in our post on the truth about strontium.)

Each day, the participants of the COMB Study took vitamin D3 (2,000 IU), DHA (250 mg), K2 (in the form of MK-7,100 mcg), strontium citrate (680 mg), magnesium (25 mg), and dietary calcium. On top of that, they were advised to engage in daily weight-bearing exercise – that’s it! After the completion of the 12-month COMB Study, results revealed an increase of bone mineral density of more than 3% for a major proportion of participants. “This combined micronutrient supplementation regimen appears to be at least as effective as certain osteoporosis drugs or strontium ranelate in raising bone mineral density (BMD) levels in hip, spine, and femoral neck sites,” according to researcher Dr. Stephen Genius. In other words, you can maintain and restore your bone health the natural way with results that mirror or best prescription drugs. Not only did the results show an increase in bone mineral density, but there were no fractures in the group taking the micronutrient protocol, in the entire 12-month time period. If you have been on a bone drug in the past and did not receive the results you expected, this may work for you, too. “Micronutrient combination alone can improve BMD in many patients who failed to achieve success with medications.”

The silver bullet approach (usually a prescription drug, but sometimes one or maybe two nutrients, typically calcium plus vitamin D) is likely to be ineffective. Or even in a “best case scenario,” will be nowhere near as effective at restoring the health of our disintegrating bones as a comprehensive approach that utilizes optimal doses of all the key nutrients our bones require along with regular weight-bearing exercise. Make sure to include all of the minerals, vitamins, and fats outlined in the section below and you’ll have strong, healthy bones for life—naturally.

Each of the following nutrients plays a vital role in combating bone loss and building new bone. And ideally, you need to be consuming them all. Click on the name of a nutrient to find out why it’s important.

the FDA states that “Adequate calcium and vitamin D throughout life, as part of a well-balanced diet, may reduce the risk of osteoporosis.”

In the space of 70 years, our diets have gone from nutrient-dense to nutrient-depleted. It’s been caused by a variety of reasons:

Here’s the reality. The produce our parents and grandparents ate had significantly more vitamins and minerals than today’s food supplies. A study in the Journal of the American College of Nutrition compared the nutritional data of 43 fruits and vegetables from both 1950 and 1996.⁹⁵ The study found that the crops suffered “statistically reliable declines” in protein, calcium, phosphorus, iron, riboflavin, and vitamin C within that time frame. So even if you are one of the few eating well to support overall and bone health – it still may not be enough. The need for supplementation is ever increasing. Taking supplements is the easiest way to ensure your body is getting enough of the vitamins and minerals that it needs to promote bone health. And as we’ve discussed, it’s not all about calcium. Bone building and maintenance rely on many other minerals and vitamins too: magnesium, boron, copper, manganese, silicon, nickel, selenium, strontium, phosphorus, potassium, vanadium, zinc and vitamins C, D3, and K2. Plus omega 3 fatty acids like EPA and DHA. Now, you might be thinking that that’s a lot of supplements to be taking every day. But what if you could get all of those bone supporting elements in one convenient package? 

Well, you can. With our AlgaeCal products: