Healthy Bones

The bones that make up your skeleton undergo constant changes in shape and size throughout your lifetime. Bones that become damaged are replaced with new bone through a remodeling process that is largely dependent on dietary intake and lifestyle factors. Any imbalance to this remodeling process can lead to the development of bones that are thin, brittle, and susceptible to fracture, a condition known as osteoporosis. In U.S. populations of adults who are 50 years of age and older, approximately 10.2 million are affected by osteoporosis, and 43.4 million have low bone mass.¹ In order to prevent and reverse osteoporosis, it is important to acquire the nutrients necessary for bone growth and maintenance, such as calcium and magnesium, in addition to practicing healthy lifestyle modifications that preserve bone integrity.

Research published in 2024 found that when plant-based diets are compared with omnivorous diets, there was no significant difference in bone mineral density.² The quality of our food choices also appears to be important. Research done on over 10,000 adults found that when people focus on healthful plant-based whole foods, and limit animal products and ultra-processed foods, their bone mineral density improves.³ And the more healthful plant-based foods people ate, the more protected they were against osteoporosis.

Key Nutrients

Calcium

Leafy green vegetables, like broccoli, Brussels sprouts, kale, and collards, are loaded with calcium. Beans, fortified juices, and plant milks are also great sources of calcium. And calcium absorption of leafy green vegetables is actually higher than cow’s milk.

While dairy products do contain calcium, they also contain animal proteins and growth factors, lactose sugar, occasional contaminants, and a substantial amount of fat and cholesterol, making them an unfavorable source of calcium. Research shows that dairy products have little or no benefit for bones. A 2005 review published in Pediatrics showed that drinking milk does not improve bone strength in children.⁴ In another study, researchers tracked the diets, exercise, and stress fracture rates of adolescent girls and concluded that dairy products and calcium do not prevent stress fractures.⁵ Visit our page on Nutrition for Kids to learn more.

Vitamin D

Vitamin D is another important component for strong bones because it controls your body’s absorption of calcium.⁶ Therefore, for calcium to be utilized properly, vitamin D intake must be sufficient.

Our skin makes vitamin D when exposed to sun. Five to 15 minutes of midday sun exposure can be enough to meet many people’s vitamin D needs. However, having darker skin, living in the north, and the winter season can all make it hard to get enough vitamin D from the sun alone. Therefore, fortified cereals, grains, bread, orange juice, and nondairy milks exist as options for providing vitamin D through the diet. Dairy milk does not naturally contain vitamin D but is typically fortified. However, as noted previously, dairy is not a favorable source of calcium or vitamin D.

Vitamin D requirements also increase for individuals over the age of 70. Talk with your doctor about your vitamin D levels and need for supplementation.

Magnesium

Magnesium, like calcium, is an important bone mineral that helps the body transport calcium. Studies have shown higher magnesium intakes to be associated with stronger bones.^7,8 “Beans and greens”—legumes and leafy green vegetables—are excellent sources of magnesium.

Vitamin C

Vitamin C from citrus fruits, tomatoes, peppers, and other fruits and vegetables is essential for making collagen, the connective tissue that minerals cling to when bone is formed. Vitamin C is also an antioxidant, which helps protect against free radicals and improve inflammation. The more anti-inflammatory and vitamin C rich foods in your diet, the lower the risk for bone loss and fractures.⁹

Vitamin K

Vitamin K is thought to stimulate bone formation. It is found most abundantly in dark leafy greens like kale and spinach, but is also readily available in beans, soy products, and some fruits and vegetables. In a study that assessed diet of the Nurses’ Health Study cohort, it was found that low intakes of vitamin K may increase the risk of hip fracture in women.¹⁰

Potassium

Potassium decreases the loss of calcium from the body and increases the rate of bone building. Oranges, bananas, potatoes, and many other fruits, vegetables, and beans are all rich sources of potassium. In a study measuring the prevalence of osteoporosis among older Korean adults, it was found that higher dietary potassium levels were associated with decreased risk of osteoporosis. ¹¹

Other Factors to Consider

Exercise is one of the most effective ways to increase bone density and decrease the risk of osteoporosis.¹² In a year-long study of 320 postmenopausal women, those who completed aerobic,
weight-bearing activity combined with weightlifting three times a week had a significant increase in regional bone density, compared with those who did not exercise.¹³ Physical activities help to stimulate increases in bone diameter, which can counteract the thinning of bones, and in turn, lessen the risk of fractures.¹⁴

Sodium in the foods you eat can greatly increase calcium loss through the kidneys.¹⁵ If you reduce your sodium intake to 1,000 to 2,000 milligrams/ day, you will hold on to calcium better. To do this, avoid the top sources of sodium in the diet including processed foods such as cured meats, cold cuts, chicken, frozen or premade meals, pizza, and cheese.

Avoid smoking, as it can lead to reduced bone mass by acting directly on bone tissue, increasing inflammation in bone tissue through free radicals, and negatively affecting hormones and mineral levels responsible for healthy bones.¹⁶

American recommendations for calcium intake are higher than in other countries, partly to compensate for our poor dietary habits, tobacco use, and physical inactivity of American life; all of these choices may lead to overly rapid and unnatural loss of calcium through the kidneys. By controlling these basic factors, you can have an enormous influence on whether calcium stays in your bones or drains out of your body.