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Dr. Susan E. Brown

20 key bone building nutrients — an overview

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Depending on how we count them, there are at least 20 bone building nutrients which are essential for optimal bone health — “essential” in that our bodies cannot manufacture them, so we must get them from our food and drink. Let’s take a quick look at them, one by one, so you can get a better idea of their roles in bone health and how much of each you should be getting.

Remember, none of these nutrients does its work in isolation — you need some of each and every one, so they can all work together to keep your bones standing strong all your life long. Taking a top-grade multivitamin–mineral complex and essential fatty acids will ensure that your cells have adequate levels of these nutrients ready at hand from minute to minute, day after day, to prevent bone loss leading to osteoporosis, other degenerative diseases, and accelerated aging.

Printable copy of the 20 Key Bone-Building Nutrients as researched by Dr.Brown for 35+ years

(Click on individual nutrients to learn more about these bone building nutrients and find a full chart at the bottom…)

20 Essential Bone Building Nutrients

Calcium (Ca):

  • Adult RDA or AI*:
    1000 – 1200 mg
  • Common therapeutic range for bone health (daily intake):
    800 – 1200 mg
  • Dietary considerations concerning adequacy of average daily intake:
    Typical diet is inadequate, averaging 500 – 850 mg
  • Add up your intake from diet and supplementation:__________________

Phosphorus (P):

  • Adult RDA or AI*:
    1250 mg 9 – 18 years old
    700 mg adults
  • Common therapeutic range for bone health (daily intake):
    800 – 1200 mg
  • Dietary considerations concerning adequacy of average daily intake:
    Inadequate intake is rare except in elderly and malnourished. Excess intake common with use of processed foods and soft drinks —
    1500 mg/day in men
    1025 mg/day in women
  • Add up your intake from diet and supplementation:__________________

Magnesium (Mg):

  • Adult RDA or AI*:
    420 mg adult men
    320 mg adult women
  • Common therapeutic range for bone health (daily intake):
    500 – 1,000 mg
  • Dietary considerations concerning adequacy of average daily intake:
    Intake generally inadequate among all ages, sexes, and classes except children under the age of 5; 40% of total population and 50% of adolescents consume 66% of RDA; and 56% of all Americans have intakes below Estimated Average Requirement (EAR)
  • Add up your intake from diet and supplementation:__________________

Chromuim (Cr):

  • Adult RDA or AI*:
    30 – 35 mcg adult men
    20 – 25 mcg adult women
  • Common therapeutic range for bone health (daily intake):
    200 – 1000 mcg
  • Dietary considerations concerning adequacy of average daily intake:
    Common intake in the US is 50 mcg or lower
  • Add up your intake from diet and supplementation:__________________

Silica (Silicon – Si):

  • Adult RDA or AI*:
    No values set to date
  • Common therapeutic range for bone health (daily intake):
    5 – 20 mg
  • Dietary considerations concerning adequacy of average daily intake:
    Intake significantly higher in men (30–33 mg/day) than in women (~25 mg/day), yet generally suboptimal Silica is the first element to go in food processing
  • Add up your intake from diet and supplementation:__________________

Zinc (Zn):

  • Adult RDA or AI*:
    11 mg adult men
    8 mg adult women
  • Common therapeutic range for bone health (daily intake):
    12 – 30 mg
  • Dietary considerations concerning adequacy of average daily intake:
    Average intake is 46–63% of RDA. Marginal zinc deficiency is common, especially among children
  • Add up your intake from diet and supplementation:__________________

Manganese (Mn):

  • Adult RDA or AI*:
    2.3 mg (AI) adult males
    1.8 mg (AI) adult females
  • Common therapeutic range for bone health (daily intake):
    2 – 10 mg
  • Dietary considerations concerning adequacy of average daily intake:
    Intake generally inadequate, at 1.76 mg adolescent girls; 2.5 mg adult men and 2.05 mg adult women
  • Add up your intake from diet and supplementation:__________________

Copper (Cu):

  • Adult RDA or AI*:
    900 mcg (0.90) adults
  • Common therapeutic range for bone health (daily intake):
    1 – 3 mg
  • Dietary considerations concerning adequacy of average daily intake:
    75% of diets fail to contain RDA. Average daily intake is below the RDA
  • Add up your intake from diet and supplementation:__________________

Boron (B):

  • Adult RDA or AI*:
    No RDA established
  • Common therapeutic range for bone health (daily intake):
    3 – 5 mg
  • Dietary considerations concerning adequacy of average daily intake:
    Common daily intake is only 0.25 mg, to possible optimum of 3.0 mg
  • Add up your intake from diet and supplementation:__________________

Potassium (K):

  • Adult RDA or AI*:
    4700 mg adults
  • Common therapeutic range for bone health (daily intake):
    4000 -6000 mg
  • Dietary considerations concerning adequacy of average daily intake:
    Adult intake averages 2300 mg for women and 3100 mg for men
  • Add up your intake from diet and supplementation:__________________

Key Vitamins

Vitamin D

  • Adult RDA or AI*:
    600 IU 1-70 yr
    800 IU >70 yr
  • Common therapeutic range for bone health (daily intake):
    800–4000 IU and up, as needed
  • Dietary considerations concerning adequacy of average daily intake:
    Numerous experts say that a billion people worldwide are deficient today. Deficiency is especially common among people who are elderly, dark skinned, and those with little UV sunlight exposure. A simple, inexpensive blood test for 25(OH)D is the best way to determine vitamin D status and need
  • Add up your intake from diet and supplementation:__________________

Vitamin C

  • Adult RDA or AI*:
    90 mg adult men
    75 mg adult women
  • Common therapeutic range for bone health (daily intake):
    Oral 500–3000 mg (and upward to bowel tolerance), as needed
  • Dietary considerations concerning adequacy of average daily intake:
    Average daily intake is about 95 mg for women and 107 mg for men. Based on US survey of nearly 9000 people, intake for 31% of population is below Estimated Average Requirement (EAR)
  • Add up your intake from diet and supplementation:__________________

Vitamin A

  • Adult RDA or AI*:
    2997 IU adult men
    2331 IU adult women
  • Common therapeutic range for bone health (daily intake):
    5000 IU or less
  • Dietary considerations concerning adequacy of average daily intake:
    44% of US population has intake below EAR
  • Add up your intake from diet and supplementation:__________________

Vitamin B6

  • Adult RDA or AI*:
    1.3–1.7 mg adult men
    1.3–1.5 mg adult women
  • Common therapeutic range for bone health (daily intake):
    25 – 50 mg
  • Dietary considerations concerning adequacy of average daily intake:
    Studies indicate widespread inadequate vitamin B6 consumption among all sectors of the population; >50% of population consume 70% RDA
  • Add up your intake from diet and supplementation:__________________

Folic acid/folate
(vitamin B9)

  • Adult RDA or AI*:
    400 mcg (0.4 mg) adults 
  • Common therapeutic range for bone health (daily intake):
    400–1000 mcg   (0.4–1 mg)
  • Dietary considerations concerning adequacy of average daily intake:
    Inadequate intake common among all age groups; although improving with food fortification, 49% of participants in NHANES survey had intakes below Estimated Average Requirement (EAR)
  • Add up your intake from diet and supplementation:__________________

Vitamin B12

  • Adult RDA or AI*:
    2.4 mcg adults
  • Common therapeutic range for bone health (daily intake):
    150–1000 mcg
  • Dietary considerations concerning adequacy of average daily intake:
    Up to 40% of US population have marginal B12 status. Older people and vegans are especially at risk
  • Add up your intake from diet and supplementation:__________________

Vitamins K1 and K2

  • Adult RDA or AI*:
    K1: 120 mcg adult men
    90 mcg adult women
    K2: No recommended intake but among  the essential bone building nutrients
  • Common therapeutic range for bone health (daily intake):
    K1: 150–1000 mcg, K2 as MK-7: 45–360 mcg
  • Dietary considerations concerning adequacy of average daily intake:
    Up to 40% of US population have marginal B12 status. Older people and vegans are especially at risk
  • Add up your intake from diet and supplementation:__________________

Other Nutrients

Fats

  • Adult RDA or AI*:
    Should comprise minimum of 7% total calories. General recommendation is not to exceed 30% of caloric intake
  • Common therapeutic range for bone health (daily intake):
    20–30% of total calories is perhaps more ideal
  • Dietary considerations concerning adequacy of average daily intake:
    Average American consumes ~33% of his/her calories in fat. Consumption of essential fatty acids (EFA’s), however, is frequently inadequate
  • Add up your intake from diet and supplementation:__________________

Protein

  • Adult RDA or AI*:
    0.8 g/kg per day adult males and females
    125-lb person = 45 g
    175-lb person = 63 g
    56 g adult males
    46 g adult females
  • Common therapeutic range for bone health (daily intake):
    1.0–1.5 g/kg
  • Dietary considerations concerning adequacy of average daily intake:
    Daily intake commonly exceeds 100 g, but the elderly and some women often have very deficient intake. Higher protein intake should be balanced with higher RDA level potassium intake from food sources
  • Add up your intake from diet and supplementation:__________________

About… Dietary Reference Intakes (DRI),
Adolescent Recommended Dietary Allowances (RDA),
Adult Recommended Dietary Allowances (RDA),
Adequate Intakes (AI), and
Estimated Average Requirements (EAR)

    • The Dietary Reference Intake (DRI) is a system of nutritional guidelines developed by the Institute of Medicine (IoM) of the US National Academy of Sciences. It was first introduced in 1997 to broaden the set of existing Recommended Daily Allowance (RDA), which is the system currently still in use in food nutrition labeling. The DRI includes two sets of values that serve as goals for nutrient intake (from the National Academy of Sciences). These are the RDA andAdequate Intake (AI).
    • Table of RDAs for Adolescents and Teenagers.

    • Recommended Dietary Allowances (RDA) represents the daily dietary intake of a nutrient regarded to be sufficient for meeting the requirements of nearly all (97–98%) healthy individuals in each age and gender group. The RDA reflects the average daily amount of a nutrient considered adequate to meet the needs of most healthy people. If there is insufficient evidence to determine an RDA, an AI is set.Adult RDA figures come from: National Academy of Sciences, Institute of Medicine, and the Food and Nutrition Board, through the United States Department of Agriculture Food and Nutrition Information Center website.

    • Adequate Intake (AI) values are more tentative than RDA, but both may be used as goals for nutrient intake.

  • In addition to the values that serve as goals for nutrient intakes, the DRI includes a set of values called Tolerable Upper Intake Levels (UL). The UL represent the maximum amount of a nutrient that appears safe for most healthy people to consume on a regular basis.
  • The Estimated Average Requirement (ERA) calculations are the average daily nutrient intake level estimated to meet the requirement of half of the healthy individuals in a particular life stage and gender group. They are established by the Institute of Medicine (IoM).

Keep in mind that these are values that are meant to cover adequacy for most folks, not for optimizing health! The common therapeutic dose for bone health may be significantly higher in “special need” cases.

Herbal boost for bone health
Dr. Susan E. Brown

Stinging Nettle Offers an Herbal Boost for Bone Health

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There are so many foods that boost nutrient intake and improve bone health, but one food that’s captured my interest lately is actually an herb — stinging nettle. Though many of us in North America tend to regard stinging nettle as an irksome lawn weed, the plant has a long history of use as a multi-purpose medicinal herb. Dried or wilted, and prepared in a simple infusion, stinging nettle is a fascinating option for women with osteoporosis.

Stinging nettle is a nutritional powerhouse for bones 

One of the important facets of this plant is its amazing nutrient content — including many key nutrients for bone health. Herbalist Susan Weed says that “[there] is no denser nutrition found in any plant, not even bluegreen algae” and after looking at the nutritional studies of this herb, I believe it!


Stinging nettle is rich in a multitude of amino acids, carbohydrates, proteins, flavonoids, and is a terrific source of many bone-building minerals (iron, calcium, magnesium, silicon, potassium, manganese zinc, copper, and chromium) and vitamins, including vitamin K (an important bone builder), vitamin C (a key antioxidant shown to reduce fracture risk) and most of the B vitamins (Ait Haj Said et al., 2015; Segneanu et al., 2017).

Scientists have started to take a closer look at this nutritional powerhouse, and the number of potential medicinal benefits range from anti-tumor and anti-inflammatory action to immune boosting, blood pressure reduction, relief of rhinitis, arthritis and rheumatism, and diabetes and cardiovascular disease prevention (Di Virgilio et al., 2015; Ait Haj Said et al., 2015; Segneanu et al., 2017). And, of course, its many nutrients have value for osteoporosis and bone health — but unfortunately, there’s very limited research in this area. What little there is does suggest that nettles might help maintain bone density during menopause (Gupta et al., 2014), so hopefully more studies will be undertaken.

Easy ways to give nettles a try

So how do we unlock the benefits of this multi-faceted herb? Susun Weed recommends making an herbal infusion using about 1 ounce of dried nettles (about 1 cup of dried nettles) added to 1 quart of boiling water and allowed to brew for at least four hours (or overnight) to extract the bone-supporting nutrients from the herb. Once it’s done steeping, you’d strain it, making sure to squeeze the soaked herbs to get every bit of goodness out of them, and then refrigerate it to use over the next few days. 

Simply drink the nettle infusion cold or warm (reheat infusion to temperature of your liking) all on its own, or, as Susun Weed suggests, mix the infusion with a little fruit juice for sweetness.

There are abundant recipes online for using nettle or nettle infusion in soups, stir fry, or pasta dishes — cooked, the nettle compares in flavor to spinach. Here are some nettle-infused dishes one of our clients shared to give us all some inspiration:

Arugula salad with 1 cup kidney beans, avocado, hemp seeds, olive oil, lemon juice and ground red pepper; nettle infusion; watermelon.

Kale salad with apples, almonds, olive oil and apple cider vinegar; watermelon; nettle infusion

Tossed salad with blackened catfish, hard boiled egg and balsamic vinaigrette; nettle infusion.

Bone-Appetit!

Better Bones Blog
Dr. Susan E. Brown

Nutrition for bone health — how to gain weight if you’re too thin

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In a couple of my blog posts, I’ve talked about how inadequate or imbalanced nutrition affects bone health, putting thin persons — particularly thin women — at greater risk for bone fractures. The most recent post, Beauty is Bone Deep, focused on women who try to force a thin physique on their (usually unwilling) bodies for the sake of an unrealistic beauty ideal. But there are those women, and men too, who try and try togain weight rather than lose it, often to no avail. These aren’t people who have an eating disorder or anorexia — they’re otherwise healthy-seeming people who simply can’t gain a single pound.

The problem everyone wants — unless they have it

Now, many folks out there will read this and think, “Gee, that’s a problem I wish I had.” But as people who do have this problem will tell them, the struggle to gain weight is actually harder than the struggle to lose it.

Think about it: there are dozens, if not hundreds, of weight loss solutions out there (some better than others), but there aren’t many workable solutions to gain weight in a healthy manner. If you search the internet, you’ll find most information on weight gain is for bodybuilders and focuses on building bulky muscle, but that’s not something most women (and many men, too) really want. And contrary to the suggestions some of my underweight clients hear, eating cheeseburgers, ice cream and cookies 24/7 does not help, and it’s a highly acidifying, bone-damaging way of life as well.

So what should an underweight woman or man do to gain weight in a healthy manner?

Root causes of being unable to gain weight

Just as with any health issue, solving underweight requires examining root causes. I’ve noticed that people who are underweight fall into several camps:

  • There are those who tell me, “I eat just fine, but I just never seem to put on any weight.”
  • Others say they simply don’t get hungry or don’t feel like eating, so they skip meals. Sometimes, these people say that eating makes them feel sick, so they eat less (or less often) as a result.
  • Some say they eat well some of the time, but that they eat less when they’re under stress — and they’re under stress often.

For people who stay thin despite eating well, I look at three factors. First, are theyreally eating enough food on a regular basis, or is that simply their perception? Is a meal something they sit down to at a table, with 2 or 3 different dishes, and spend time enjoying — or do they consider an apple and a small tub of yogurt consumed between meetings at work to be “lunch”? While the average adult needs 2000-2500 calories, that’s an average; some people require more, but may not realize it — and gaining weight might simply be a matter of eating more nutrient-dense foods. Moreover, if you’re underweight because of a nutritional deficit, you may need to supplement with the 20 key nutrients required for bone health because if your muscles, skin, organs and tissues aren’t getting what they need, they’ll take it from your bones!

Second, I consider whether a metabolic or endocrine issue could be at work. Hyperthyroidism, latent autoimmune diabetes in adults, and various other chronic disorders can prevent people from gaining weight, even when they eat well — and sometimes, these disorders are “silent,” meaning they have no clear-cut symptoms. I often recommend a medical workup for osteoporosis for this very reason. Simple blood tests can generally uncover the presence of autoantibodies or hormone imbalances, however. Such disorders represent significant health issues that need to be addressed by a specialist.

Finally, I’d look at the possibility that they might not be absorbing the food they eat. A great many malabsorption syndromes and digestive issues can prevent a person who eats reasonably well from reaping the benefits of the food they take in. Some of these, like IBS or Crohn’s disease, have obvious symptoms attached — diarrhea, gas, bloating, pain — but others, such as celiac disease, can damage the GI tract and impair nutrient absorption capabilities, sometimes without causing any distinct symptoms related to the digestion. Poor nutrient absorption frequently occurs in older people simply as a byproduct of aging. So if I saw indications of poor nutrient absorption (dry, brittle hair and nails, for instance), I might suggest that a client ask her physician for testing for celiac or other GI issues, and we’d look very closely at how to boost the nutritional and caloric content of her food so she gets more of what she needs. And I’d offer them suggestions for how to strengthen their digestion.

Suggestions for those who aren’t hungry

Those who don’t feel hungry or who don’t feel like eating usually have one of two problems. Either they have an imbalance in the “hunger hormones” that stimulate appetite (often associated with zinc inadequacy), or they simply don’t prioritize meals sufficiently. The second problem is likely more common than the first — many folks are so rushed or busy that they habitually ignore their body’s signals that it needs food, to the point that they genuinely believe they’re not hungry even when they are! These folks benefit by taking time to acknowledge and understand their physiologic needs. I would do the following:

  1. Review their diets to make sure they are getting a full balance of fats, carbohydrates, and proteins
  2. Help them schedule their mealtimes, including time for pre-meal “appetizer” foods such as broth (warm liquids stimulate the appetite).
  3. Suggest an elimination diet or allergy testing for those who say they feel ill or uncomfortable after eating.

If anxiety or worry is prohibiting weight gain

For those who stop eating or eat less due to anxiety or stress, part of the problem is their response to anxiety and worry. For clients whose thinness is related to an anxious mind, I’d help them to learn stress-reduction techniques, and also have them focus on their intentions around eating — that is, to find ways to celebrate their meals as an affirmation of their worth. It doesn’t need to be complicated — simply saying grace before each meal, for example, can send a strong signal from the mind and spirit to the body that the food in front of you is a blessing meant to nourish you. The power of the mind should not be underestimated, and focusing it on nourishment (instead of on anxieties and worries) may be an important component of promoting healthy weight gain.

If you’re underweight, taking steps to build strong muscles, eat a nutritious diet, and reduce stress and anxiety can help you gain weight, meanwhile reducing your fracture risk. Even if the tips outlined above don’t help you to add a single pound of weight, the bone-strengthening benefits of my Better Bones approach may make the difference in staying healthy and avoiding fractures — and isn’t that what matters in the long run?

Better Bones Blog
Dr. Susan E. Brown

Onions nothing to cry about for bone health

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How often do you eat onions?

a) Less than once a month

b) Twice a month to twice a week

c) Three to six times a week

d) Once a day or more

OnionsIf you answered “d” — once a day or more — your bones may be thanking you. Several recent studies have shown onions are a top crop when it comes to supporting bone density.

For example, we’ve seen that white women 50 years or older who ate onions every day had a 5% greater overall bone density than those who ate onions once a month or less. And — older women who consume onions most frequently may decrease their risk of hip fracture by more than 20% versus those who never consume onions.

Those are pretty impressive results for preventing bone loss! Another study compared the effects of eating onions to those of Fosamax in rats that had their ovaries removed (surgical menopause) — and found that onions stack up very well. The basic findings were:

• All the rats that had their ovaries removed lost bone (there was a control group that had a fake operation that did not lose bone).

• The rats that had their ovaries removed and were fed onions lost the least amount of bone – and the more onion they were given, the less bone they lost.

• Both the onion-fed rats and the rats who were given Fosamax had bone that was in better shape in terms of its structural components than the rats that had their ovaries removed but weren’t fed either onions or Fosamax — and the former had fewer bone-breakdown cells, so they would continue to lose less bone than their counterparts.

What it boils down to is you can get good results at preserving bone during menopause by regular consumption of onions – without the side effects that may happen with drugs. And onions are high in quercetin, which appears to have antioxidant and anti-inflammatory properties.

Here’s one tip to get the most out of your onions: Many of the phytonutrients in onions are found in the outer layers, so try not to peel off extra layers when you remove the outer, dry layer.

Happy and healthy cooking.

 

References:

Matheson, E.M. The association between onion consumption and bone density in perimenopausal and postmenopausal non-Hispanic white women 50 years and older (2009) Menopause, 16(4):756-9.

Huang T.-H., Muhlbauer R.C., Tang C.-H., Chen H.-I., Chang G.-L., Huang Y.-W., Lai Y.-T., Yang R.-S. Onion decreases the ovariectomy-induced osteopenia in young adult rats (2008) Bone, 42 (6), pp. 1154-1163.

 

dried plums
Dr. Susan E. Brown

Dried plums bear fruit yet again for bone health

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For a few years now I have been reporting the studies from Dr. Arjmandi and colleagues suggesting that dried plums have a special bone building effect. And, with the results of a new study, Dr. Arjmandi says, “Over my career, I have tested numerous fruits, including figs, dates, strawberries, and raisins, and none of them come anywhere close to having the effect on bone density that dried plums, or prunes, have.”

In the latest work, Dr. Arjmandi and his research group published data from a year-long trial with 100 post-menopausal women comparing the effect of 100 grams of dried apple with 100 grams of dried plums (that’s 10-12 prunes, if you’re counting!). While both fruits had bone-protective effects, the plums had significantly more pronounced effects on bone density of the spine and forearm. And, as would be expected, the markers of bone breakdown decreased most significantly and consistently in the dried plum group.

And do we know anything new about why dried plums maintain and build bone? Well, it is probably at least partially due to the fact that dried plums are high in bone-building vitamins C and K, boron, potassium and potent antioxidant compounds.

Prunes

This study also notes a new finding showing that prune consumption leads to a reduction in C-reactive protein (CRP), which is a marker of inflammation. Lower CRP is a good thing as this means there is less inflammation in the body as a whole. High C-reactive protein, on the other hand, is linked to a number of chronic diseases, including osteoporosis. In fact, a growing body of literature suggests osteoporosis involves an inflammatory response where the body is tearing down old tissue at a much higher rate than it is building new tissue. High antioxidant intake, including the powerful antioxidants from prunes, reduces inflammation.

For those considering adding prunes to their diet, the consumption of 10-12 prunes a day did not lead to any significant weight gain. Also, if you’re following an alkaline diet, you may wonder how prunes fit into the mix. It’s true, prunes are slightly acid-forming, but remember that an alkaline diet is about balancing acid-forming foods with alkaline-forming foods. It’s okay to eat some acid-forming foods as long as the majority of your diet is alkalizing foods. And when the bone-building benefits of the food are as great as they are with prunes, it’s clearly worth the trade-off!

So, if you like prunes, work them into your healthy diet. Wonderful organic prunes are available from California. I like them soaked or stewed a bit, and for the sociability factor, it is always wise to spread them out over a day, taking a few each meal rather than eating them all at once.

 

Reference:
Hooshmand, et al, “Comparative effects of dried plum and dried apples on bone in postmenopausal women”. British Jr. of Nutrition (2011) pages 1-8