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Healthy Bones: Beyond Calcium

Updated: Oct 4, 2021

Bones are not static, they are living systems that are constantly being broken down and rebuilt. Although bone health is often synonymous with calcium there are other key vitamins, hormones, minerals and trace minerals that are needed to keep this living system strong.

Obviously, we would want to have strong bones. They carry us through life and protect our internal organs. Osteoporosis is a bone disease, where the bones become porous due to more bone being broken down than being formed, increasing the risk of fracture and chronic pain. Below are key factors that contribute to strong bones.

Essential Bone Builders:


Vitamin D

Vitamin K1

Vitamin C



Physical Activity


The most abundant mineral in the body, 99% of which is in bones and teeth. Although only 1% is in the blood, the body must keep blood calcium levels stable. Your body will pull calcium out of your bones if blood levels fall. Blood levels change due to either low intake or foods that change the blood-calcium balance.

Foods High in Calcium

Calcium is a structural component in the cell walls of leaves. Because of this, green leafy vegetables are a great source of absorbable calcium. Eat regularly:

  • green leafy vegetalbes including: collards, kale, mustard and turnip greens

  • broccoli

  • okra

  • brussels sprouts

  • sea vegetables

  • beans, especially white and black beans

  • figs and apricots

  • almonds, sesame seeds and tahini

  • blackstrap molasses

  • green tea

RDA: Recommended daily intake: children 1-3 years: 500mg, 4-8 years: 800mg, 9-18 years: 1,300mg, 19-50 years: 1,000mg, 51 and over: 1,200mg.

Factors That Pull Calcium Out Of The Blood/Bones

  1. Animal protein: For every gram of dietary protein above 47g/day, we lose about 0.5mg of calcium through the urine. Animal protein is high in sulfur-containing amino acids which make our blood more acidic. The body restores blood pH balance by drawing on calcium in the bones.

  2. Sodium: High intake decreases the ability of our kidneys to reabsorb circulating calcium. For every 1 gram of salt (under ½ teaspoon) we lose 20-40mg of calcium.

  3. Caffeine: Can encourage bone loss if calcium intake levels are low.

  4. Alcohol: creates a negative calcium balance, where more calcium is lost than absorbed.

  5. Refined Sugar: Increases loss of calcium from the bone through urine. Calcium is pulled from bones to maintain blood calcium levels.

  6. Phosphoric Acid: Phosphates in soft drinks decrease calcium in blood and increase phosphate levels. Body must pull calcium from bones into blood.

Vitamin D:

Stimulates the absorption of calcium. It also maintains correct blood-calcium levels in three ways: absorption in the intestine, regulates losses through the urine, and storage in the bones. Children deficient in vitamin D will develop rickets and adults will develop osteomalacia, both conditions are an inability of the body to calcify the bone matrix.

Sources of Vitamin D

  • Sunlight: The skin makes vitamin D from the sun, through an oil-like substance similar to cholesterol. 10-15 minutes/day is adequate for people with light skin. Darker skin pigments may need from 30 minutes to 3 hours/day, as the melanin pigment of skin reduces vitamin D conversion.

  • Dark green leafy vegetables

  • fortified foods

  • supplementation with Vitamin D3

RDA: The recommended daily intake is between 400-800 IU/day. Even infants should be supplemented with 400 IU daily. The daily safe upper limit, according to Health Canada is 4000 IU/day.

Vitamin K1:

Vitamin K1 is the natural form found in plants. Its role is to convert inactive osteocalcin to active osteocalcin. Osteocalcin is an important protein in bones which anchors calcium molecules into the bone.

Sources of Vitamin K1

  • green leafy vegetables such as kale and turnip greens, spinach, lettuce

  • broccoli

  • cabbage

  • green tea

  • asparagus

  • oats

  • whole wheat

RDA: Recommended daily intakes are based on body weight. For women, 90 micrograms/day and men 120 micrograms/day.

Vitamin C

The primary function of vitamin C is the manufacture of collagen, an important protein in bone and cartilage. According to this study, it also functions “as a co-factor that is involved in gene regulation that can influence bone development/regeneration.”

Sources of Vitamin C

  • Acerola cherry powder and camu camu powder are both very high in bio-available vitamin C.

  • peppers

  • green leafy vegetables (kale, parsley, collard leaves, turnip leaves, swiss chard)

  • broccoli, brussels sprouts, cauliflower and cabbage

  • strawberries

  • papayas

  • oranges, lemons, grapefruit and tangerines

  • cantloupe

  • many other fruits and vegetables

RDA: The recommended daily amount is 60 milligram/day up to 2000 milligram/day. 60mg is the minimum that will avoid deficiency diseases such as scurvy. Increasing the dosage up to 2000mg/day for therapeutic purpose to boost the immune system or during times of stress when the body uses more vitamin C. As a therapeutic dosage, it is common for people to take vitamin C to bowel tolerance.


Responsible for cross linking collagen strands and contributes strength and integrity to the connective tissue matrix of bone. An important aspect to bone mineralization.

Sources of Silicon

  • Unrefined grains

  • Root vegetables

RDA: There is no recommended daily intake. Requirements vary from 20 to 50 milligrams/day.


A trace mineral which has a positive effect on calcium levels as it can reduce urinary calcium excretion. It is required to activate certain hormones including estrogen and vitamin D, both important for building and maintaining healthy bone structure.

Sources of Boron

  • Prunes and raisins

  • almonds, peanuts and hazelnuts

  • bananas, apples and cherries

  • broccoli.

RDA: There is no recommended daily intake. Requirements vary from 1 to 6 milligrams /day.

Physical Activity:

Exercise is a major contributor to bone health, it preserves calcium within the bones decreasing the chances of developing osteoporosis. A sedentary lifestyle depletes calcium from the bones. It is generally recommended to do weight-bearing exercise such as walking, running, dancing or cycling for 45-60 minutes, 3-5 times a week. Also beneficial is to include resistance exercise two to three times per week.


Natural food sources of vitamins and minerals are preferred as a variety of other protective molecules will also be present in the whole food. However, if whole foods cannot provide the optimal intake, supplementation can help to maintain strong bones.


  • Bones are living systems that can be strengthened through diet and lifestyle choices.

  • A vegetarian diet has been shown to decrease osteoporosis and build stronger bones, both for the multitude of vitamins, minerals, phytochemical and other protective molecules in fruits, vegetables, nuts, seed, legumes and whole grains and also for their contribution to a blood pH that does not take calcium out of the bones.

  • Eat a rainbow variety of fresh vegetables and fruits every day.

  • Animal proteins including red meat, white meat, fish and dairy products deplete blood-calcium levels and the body will pull calcium out of the bones to maintain levels within the blood.

  • High protein diets will increase the level of calcium excreted in the urine, increasing the chance of developing osteoporosis.

  • A range of nutrients including calcium, Vitamin D, Vitamin K1, Vitamin C, boron and silicon act together to maintain and build bone.

  • Substances which can create a negative calcium balance, and should be minimized: animal protein, excess sodium, caffeine, refined sugar, alcohol, phosphoric acid.

  • Be active! Get regular physical exercise including weight bearing exercise.

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