Bones play a crucial role in many functions throughout the body. From providing structural support to protecting vital organs to supporting movement, strong bones are an integral part of a healthy foundation. However, bones lose minerals and density with age, causing them to become brittle and leading to osteoporosis and/or other age-related bone conditions.
Fortunately, proper nutrition can help ensure bones receive necessary vitamins and minerals for strength. Eating a diet rich in these nutrients or using supplements when necessary can be instrumental in maintaining bone health over time.
Read on to learn more about how vitamins and supplements affect bone health and which ones help promote bone health overall.
How Do Vitamins and Supplements Affect Bone Health?
Vitamins and supplements play an important role in bone formation, preservation and maintenance, says Meghan Pendleton, a registered dietician based in Detroit, Michigan and owner of Meghan Pendleton Nutrition, an in-person and telehealth nutrition counseling provider. “Our bones are constantly changing, and bone-related conditions, such as osteopenia, osteoporosis and related fractures, breaks and injuries [resulting from falls] can lead to pain, limited mobility or disability,” she adds.
For many healthy individuals, dietary sources of vitamins and minerals are adequate to promote and maintain bone health, but people with limited diets, certain health conditions and/or increased need due to age may benefit from supplementation. Notably, some vitamins and supplements stand out for their bone-boosting benefits, including calcium, vitamin D and vitamin K, says Jennifer Hankenson, M.D., an assistant professor of orthopedics and rehabilitation at Yale School of Medicine.
Vitamins and Supplements That Support Bone Health
Although a balanced diet provides most of the essential vitamins and minerals necessary for bone and overall health, certain vitamins play a key role in bone health and help support the bones specifically.
Calcium is the most abundant mineral found in the body. However, it’s not a mineral the body is able to make on its own. Instead, calcium must be obtained through food or supplements. Calcium helps build, harden and strengthen the bones and teeth and plays a role in the functioning of the muscles, heart and nerves.
“If your diet is low in varieties of food that contain higher levels of calcium, such as leafy greens, legumes and fortified foods, then supplementation may be helpful in improving bone health,” says Dr. Hankenson. “However, some research shows an increased risk of heart attack with calcium supplementation, so use caution if you’re healthy and just looking to prevent bone loss,” says Dr. Hankenson.
People with a history of heart or kidney disease, as well as other conditions that affect the body’s calcium levels, should consult a health care provider prior to calcium supplementation.
The best dietary sources of calcium include dairy products, such as milk, cheese and yogurt, fish like salmon, tuna and sardines, leafy green vegetables and tofu.
Calcium supplements, which are commonly available in the form of calcium carbonate or calcium citrate, are also available if additional calcium is needed. The forms of calcium supplements vary in the amount of elemental calcium they contain, which is the amount of calcium actually used by the body, explains Pendleton. Calcium carbonate supplements generally contain more elemental calcium (40% by weight), which is the calcium measured on the supplemental facts panel of a product, compared to calcium citrate (21% calcium by weight.)
Vitamin D helps the body absorb calcium and prevent osteoporosis, a bone disease resulting from decreased bone mineral density and bone mass. Although some vitamin D can be made by the body via sun exposure, many people are still deficient in the vitamin. Low vitamin D levels can cause rickets (a painful condition where the bones are soft, weak and abnormally shaped), osteomalacia (a condition that causes bone and muscle weakness) and osteoporosis.
“Combining calcium and a vitamin D supplement may reduce the risk of bone fracture and can be an effective treatment for low bone mineral density,” says Dr. Hankenson. “For many people, approximately 15 minutes of sunlight on exposed skin [with most skin exposed] every day may be enough to produce all the vitamin D needed. However, Vitamin D supplementation can often be necessary, especially in areas where sunlight exposure may be lower like the Northern U.S.,” she adds.
“Take care when consuming fat-soluble vitamins like vitamin D, as you can reach toxic levels if your dosing is too high,” cautions Dr. Hankenson. She recommends individuals consult with their doctors to check vitamin D levels via a blood test and determine if supplementation is right for their needs.
Foods that naturally contain vitamin D include certain types of fish like trout, salmon, tuna and mackerel. Milk, yogurt, breakfast cereal and orange juice are also often fortified with vitamin D.
“Vitamin K is a coenzyme required for making the proteins involved in bone metabolism [or bone remodeling],” explains Dr. Hankenson, meaning it helps facilitate the resorption of old or damaged bone, followed by the formation of new bone tissue. Some research suggests that adequate vitamin K consumption can improve bone mineral density, slow bone deterioration and reduce one’s risk of bone fracture. However, additional research is needed to verify these benefits.
Vitamin K is available in two main forms: vitamin K1 and vitamin K2. Low dietary intake of either vitamin K1 or vitamin K2 have both been associated with lower bone mineral density and higher risk of bone fracture. However, some types of vitamin K2 (MK-7) have higher bioavailability and are more commonly used for bone health, whereas vitamin K1 supplements are more frequently used to treat coagulation concerns.
Certain individuals, such as those with cystic fibrosis, celiac disease or ulcerative colitis, are at an increased risk of not getting enough vitamin K, which may cause reduced bone strength and an increased risk of osteoporosis, as well as bruising and bleeding issues. However, certain medications, such as blood thinners, antibiotics, bile acid sequestrants and weight loss medications may interact with vitamin K. Individuals using these or related medications should consult with their health care providers prior to considering a vitamin K supplement.
Dietary sources of vitamin K include leafy greens like collards, turnip greens, spinach and kale, as well as broccoli and soybeans. Vitamin K is also available as a dietary supplement and commonly sold as vitamin K only or vitamin K combined with other nutrients, such as calcium, magnesium and/or vitamin D.
Who Might Benefit From Vitamins and Supplements for Bone Health?
People across all age groups may consider using vitamins and supplements to support their bone health. Growing adolescents often need ample nutrients for their developing skeletal structure, some adults are particularly focused on maintaining their bone health and older adults (especially postmenopausal people) are often at higher risk of osteoporosis, says Pendleton. Individuals with certain health conditions like celiac disease, hyperparathyroidism or type 1 diabetes may also benefit from supplementation due to increased risk of deficiencies, she adds.
However, the use of vitamins and supplements should be approached with caution and under the supervision of a health care provider. For instance, individuals with cardiovascular concerns should consult their doctor before taking calcium supplements due to potential increased risk for cardiovascular disease, including coronary heart disease plus stroke, mainly in postmenopausal women. Although additional research is needed to confirm the mechanisms and implications, researchers believe these risks may be due to increased calcium levels in the blood and increased vascular calcification, which are both associated with increased risk for cardiovascular diseases.
While vitamins and supplements can be a valuable tool in maintaining and improving bone health, Pendleton cautions they’re not a one-size-fits-all solution. Needs differ based on an individual’s age, diet, lifestyle and overall health. “It’s always important to consult with your physician or dietitian before starting a new supplement,” adds Pendleton.
Additional Ways to Support Bone Health
“A very important factor for bone health is regular exercise, specifically strength training,” says Pendleton. “Bone density increases in response to stress on the bones from weight-bearing and impact activities. Regular exercise can help increase and maintain bone mass, even in older adults who are generally sedentary,” she adds.
Other lifestyle changes, such as reducing sodium intake, quitting smoking and consuming a variety of bone health-promoting foods including leafy greens, fortified orange juice, figs, tofu and legumes can help improve bone health as well, adds Dr. Hankenson.