Super Nutrients That Keep Bones Strong

By: Harris H. McIlwain, M.D., and Debra Fulghum Bruce, Ph.D.

Not only is weight loss vital for resolving back pain, but eating specific foods and nutrients can keep your bones strong and prevent osteoporosis. Review the following vitamins and minerals and make sure you get the recommended dietary allowance (RDA).


Osteoporosis (loss of bone density) is a common cause of back pain and results in fractures of the vertebrae (and other bones). Most men and women aren't even aware that they have osteoporosis until they break a bone and live with the excruciating pain. Calcium, the most abundant mineral in the body, plays a vital role in preventing osteoporosis since it helps to keep bones and teeth strong. But calcium must be replenished daily through dietary measures or supplementation, otherwise your body will be deficient.

Although the daily calcium recommendation for adults is approximately 1,000 to 1,200 milligrams (higher for pregnant and lactating women, postmenopausal women, and elderly men and women), the average adult gets only two-thirds to three-quarters of that amount. Some studies reveal that 80 percent of American women do not get adequate amounts of this bone-strengthening mineral. For example, extreme dieting can result in loss of bone density if you aren't ingesting adequate calcium. A low calcium intake during adolescence also affects bone density, as can certain medications and other risk factors. But getting adequate calcium through foods or supplements is something you can do each day to prevent back pain from fractures.

Although the risk of bone fractures increases with age, new findings presented at the 51st annual meeting of the American College of Obstetricians and Gynecologists in May 2003 suggest that many women develop dangerously low bone mass and fractures even during the first years after menopause. Researchers said that in examinations of almost 90,000 women between the ages of 50 and 64, almost one-third had bone mass low enough to put them at a higher risk of fracture. They concluded that doctors need to focus on the problem of low bone mass and fracture in their younger postmenopausal patients, as well as in older women. In the studies, younger women had an increased risk of fracture if they had low bone mass, had experienced a fracture after age 45, had generally poor health, and if their mothers had also experienced bone fractures in old age.

Usually, dietary calcium can reach the recommended amounts simply by including three or four servings of calcium-rich foods each day. Milk, cheese, and yogurt are easy sources and have an added benefit in that they contain lactose, which enhances calcium absorption. If you are watching your weight, select low-fat milk and by-products. Other sources of calcium include salmon with bones, sardines, calcium-enriched juices and other food products, soy foods, and green leafy vegetables. Nevertheless, keep in mind that you have eat a lot of non-dairy foods to get your calcium because it's not as easily absorbed by your body, as it is in dairy food. For instance, you'd need to consume 8 cups of spinach, nearly 5 cups of red beans, or 2 cups of broccoli to get the same amount of calcium absorbed from one cup of milk.

While getting calcium from food is preferable because of the other vitamins and minerals present, you can also get your daily calcium requirement from supplements, particularly those made from calcium carbonate or citrate.

Vitamin D

Although vitamin D is usually categorized as a fat-soluble vitamin, it actually functions as a hormone in the body. Vitamin D helps to activate calcium and phosphorus (another key mineral for keeping bones strong) in the bloodstream. When the body is depleted of vitamin D or has an insufficient supply, the blood levels of calcium and phosphorus plummet as well. Your body turns to the bones for replenishing this mineral. Loss of the minerals calcium and phosphorus is directly correlated to osteoporosis and a host of other bone-weakening problems that increases your risk of back injury and pain. New findings from Boston University show that vitamin D is an important nutrient for multiple facets of health -- including insulin function, cancer prevention (especially of the breast/colon/prostate), and cardiovascular health.

Although younger adults get plenty of sunlight throughout the day to keep this vitamin in check, many middle-aged and older adults may have a problem. In comprehensive studies at the New England Medical Center, researchers concluded that aging reduces the skin's capability to make use of sunlight to manufacture vitamin D. Consequently, daily vitamin D supplements of 800 IU (International Units) per day at age sixty-five to seventy are suggested. Some experts suggest that men and women over fifty take 800 IU of vitamin D year-round.

The usual recommended dietary allowance (RDA) for vitamin D is 400 IU. Along with sunlight, you can also obtain this bone-strengthening vitamin from food sources, such as halibut-liver oil, herring, cod-liver oil, mackerel, salmon, tuna, fortified milk, and fortified cereals. If you are not getting adequate amounts, vitamin D supplements should seriously be considered.

Vitamin K

Vitamin K is still another vitamin that plays a vital role in calcium absorption and an indirect role in preventing bone loss with osteoporosis. The RDA for this vitamin is 65 to 80 micrograms. The best food sources include green leafy vegetables, soybean oil, broccoli, alfalfa, cooked spinach, and fish oil.


Magnesium has a key function in numerous biochemical reactions that are necessary for bone strength and metabolism. This mineral regulates active calcium transport and might play a role in stopping bone fractures. Some findings reveal that many older women with osteoporosis are lacking in magnesium, even when their calcium levels are adequate.

About 60 percent of dietary magnesium is stored in the bones, while muscle and other tissues use the rest. The recommended dosages of magnesium range from 280 milligrams for women and 350 milligrams for men. A good rule of thumb is to take one milligram of magnesium for every two milligrams of calcium.

Food sources of magnesium include cereals, nuts, sunflower seeds, tofu, and dairy products; bananas, pineapples, plantains, raisins, artichokes, avocados, lima beans, spinach, okra, beet greens; oysters, halibut, mackerel, grouper, cod, and sole.


Boron, another mineral plentiful in fruits and vegetables, appears to play an active role in the metabolism of calcium and bone development. Although still controversial, research by the U.S. Department of Agriculture indicates that boron increases estrogen levels in the blood. As such, some researchers believe that this mineral might enhance estrogen's effects in women using estrogen replacement therapy (ERT), and it may be helpful to retain calcium and magnesium.

Although there is no established recommendation for boron, you can get this mineral in plentiful amounts in vegetables, legumes (dried beans and peas), dried fruits, seeds, and nuts. Avoid taking mega-doses with supplements since there can be side effects such as headaches.


Phosphorus is a key mineral in almost all chemical reactions in the body, and it also works side by side with calcium to build strong bones and teeth. The RDA for phosphorus is 800 milligrams for adults (1,200 milligrams for pregnant and lactating women). You can find phosphorus in fish, poultry, meats, grains, eggs, seeds, and nuts.


Manganese, an antioxidant, may also be important in preventing osteoporosis because it offers a possible tie-in with bone and connective tissue development. The recommended intake of this trace element is 2.5 to 5 milligrams daily. Food sources rich in manganese include grains and grain products, nuts, legumes, seeds, and green leafy vegetables.

Copyright (c) 2004 Harris H. McIlwain and Debra Fulghum Bruce

Excerpted from the book The Pain-Free Back: 6 Simple Steps to End Pain and Reclaim Your Active Life by Harris H. McIlwain and Debra Fulghum Bruce.

For more information, please visit

Article Comments: Leave Comment

Other Articles In: Nutrition for Adults