Ask most people which nutrient they need for strong bones and they’ll probably say calcium. And they’re right—calcium is essential for bone health. But it’s only one piece of a much bigger puzzle.
Your bones are living, constantly changing tissue that needs a steady supply of protein, vitamins, minerals and energy to maintain and rebuild itself. And there’s another part of the equation we often forget: it’s not simply about what you eat, but whether your digestive system can break those foods down and absorb the nutrients they contain.
So, if your strategy for protecting your bones is simply to drink more milk or take a calcium supplement, it may be time to look at the bigger picture.
Your bones need more than calcium
We tend to think of bone as a hard structure made primarily from calcium, but approximately half of bone by volume is protein, predominantly collagen. This protein framework provides the structure onto which minerals are deposited.
Protein: the overlooked bone nutrient
Protein is sometimes overlooked in conversations about osteoporosis because we tend to associate it with muscle rather than bone. But bone itself has a substantial protein matrix, predominantly collagen. Adequate protein therefore supports both sides of the bone–muscle relationship.
Food sources I’d recommend:
- Fish, poultry, lean meat,
- Eggs,
- Greek yoghurt, cottage cheese,
- Tofu, tempeh,
- Legumes, nuts and seeds
Protein requirements vary according to age, body weight, activity levels and health status. In midlife and beyond, many women benefit from consuming more than the minimum recommended dietary intake, particularly if they are strength training. Make sure that you spread your protein intake over the day. Rather than having most of your protein at dinner, aim to include a meaningful source of protein at each meal, including snacks. Here is an example:
Breakfast → pancakes made with eggs and cottage cheese
Lunch → legumes, tuna
Snack → Greek yoghurt
Dinner → chicken, steak or fish
Calcium: essential, but not the whole story
Bone contains a collagen protein matrix that is mineralised largely with calcium and phosphate, giving bone much of its strength and rigidity. In fact, around 99% of the body’s calcium is stored in bones and teeth.
But calcium is also needed for vital functions including muscle contraction, nerve signalling and blood clotting, so the body keeps blood calcium within a very narrow range. When calcium intake is inadequate, the body can draw on calcium stored in bone to help maintain those levels. Over time, chronically inadequate calcium intake can therefore contribute to poorer bone health — without causing obvious symptoms.
This is why getting enough calcium matters. But rather than automatically reaching for a supplement, I generally prefer to help people obtain as much as they reasonably can from food.
I believe that we should try to get as much calcium from our diet as possible. Dairy foods are well-known calcium sources, but they’re certainly not the only ones. Here are some good calcium food sources:
- Sardines/salmon/mackerel with edible bones (tinned)
- Dairy: parmesan cheese, milk, yoghurt, cottage cheese
- Green, leafy vegetables: bok choy, kale, collard greens
- Sesame seeds (tahini), chia seeds, almonds, flaxseeds
- Tofu, tempeh, edamame
- Dried figs, fortified plant milks
As with protein, you don’t need to get your entire required calcium from one meal. It can be spread across the day:
Breakfast → yoghurt
Lunch → tofu or tinned sardines/mackerel
Snack → cheese, dried figs
Dinner → leafy greens and salmon
Vitamin D: helping you use the calcium you eat
Vitamin D, in its activated form, calcitriol, increases calcium absorption from the gut, supporting overall calcium availability. This ensures that there is going to be adequate calcium for both bone mineralisation and general muscle function.
Sun exposure is our major natural source of vitamin D, as UVB radiation triggers vitamin D production in the skin. However, how much we produce varies considerably depending on factors such as season, latitude, skin pigmentation, age, clothing and sun-protection practices.
Whilst there are some food sources of vitamin D, like oily fish, egg yolks, dried mushrooms, they don’t provide a sufficient amount of vitamin D and therefore can’t be relied upon for meeting requirements. Unlike many nutrients, it can be useful to know your vitamin D status rather than simply guessing. A blood test can help determine whether your level is adequate and whether supplementation may be appropriate.
What about all the other nutrients?
Calcium, protein and vitamin D aren’t working alone. Vitamin K, magnesium, phosphorus, zinc and other micronutrients are also involved in maintaining healthy bone. This is why I prefer to think about a bone-supportive diet rather than individual “bone nutrients”. A varied, wholefood dietary pattern, such as a Mediterranean-style diet, can provide many of the nutrients needed to support bone health — provided you’re eating enough of the right foods for your individual needs.
Food first — but individual needs matter
I generally prefer food sources where practical, but requirements differ from person to person, and sometimes food along just won’t be enough.
Should you take supplements?
Supplements can be useful where there is an identified deficiency, inadequate dietary intake, increased requirements or other clinical indication—but supplementation should complement rather than automatically replace food.
The right supplement depends on the person.
Dietary intake, medications, pathology results, medical history and existing supplements all need to be considered.
Eating the Nutrients Is Only Half the Story
The food we eat needs to be digested and absorbed properly for the body to be able to use it. Digestive disorders and other factors can sometimes compromise the digestion or absorption of particular nutrients.
Medications can also influence nutrient status. Proton pump inhibitors (PPIs), which are commonly used for reflux, reduce stomach acid. Long-term use has been associated with altered absorption or status of nutrients including vitamin B12, iron, magnesium and calcium, although the clinical significance varies according to the nutrient and the individual.
This is why digestive health forms an important part of my bone health assessment. It isn’t enough to consider what someone is eating; we also need to consider whether digestion and absorption may be affecting their nutrient status.
Also, digestion is only part of the story. Emerging research suggests that the trillions of microorganisms living in our gut may also influence bone health through nutrient metabolism, immune regulation and inflammation.
This will be the fascinating gut-bone connection that I will explore in my next article.
Do you actually know whether you’re eating enough to support your bones?
In my Bone Health Program, I assess your current diet, nutrient intake, pathology results, medications, digestive health and individual risk factors to identify where additional support may be needed.
Learn more about my Bone Health Program or book a free discovery call.
