(November 2023) Bone health is a multi-faceted subject, even from just a nutritional perspective. As we age, it’s harder to maintain strong bones. When you notice someone shrinking, that’s a symptom of bone loss. Aching joints are another, as is hunched posture, weakened bones and, ultimately, breakage. It could mean loss of mobility and function, and often signals the end of the line for an old person.
There are many contributors to bone loss, such as age, genetics, hormones, diet, and lack of exercise. We can’t do much about the first two or three, but we can improve our diets and get more active. My interest is always the nutritional approach. I think it holds the most promise. Otherwise, I’m not qualified to speak on drugs, surgeries, or the like; except to warn against them. I’m also not a physical fitness expert, but recognize its importance. Together, nutrition and a healthy lifestyle are the keys to strong bones and a longer, more active life. The earlier we get to it, the better.
As for bones, it’s about balance and, in particular, acid:alkaline balance. Much of the food we eat is acid-forming, and we need to balance it with alkaline-forming vegetables and fruits. Grains, meats, oils, and alcohol slowly rob minerals from our bones over a lifetime. We pay for it in old age, with stiffness, ailing joints, weak bones, and immobility. It’s a growing burden on our healthcare system, and a symptom of an unhealthy, unbalanced diet.
Conversely, it’s the dark leafy, bitter vegetables that restore those minerals and build strong bones. Plants like asparagus, celery, collard greens, endive, kale, kohlrabi, mustard greens, onion, parsley, parsnip, radish, rutabaga, yams, and winter squash are more alkaline-forming than most (Brown and Trivieri, 2006). Fruits like blackberries, cantaloupe, kiwi, lemon, lime, mangos, Mandarin oranges, papaya, persimmon, pineapple, raspberries, strawberries, tangerines and watermelon, are more potent alkalizers than other fruits. Organic, biodynamic varieties are especially beneficial. Apollinaris, Sanfaustino, and San Pelligrino waters have the greatest alkaline effect. Alkalinizing herbs and spices include burdock root, ginger, horseradish, paprika, and unrefined sea salt. Other alkaline-forming superfoods include chestnuts, lotus root, miso, tamari, seaweed, tarot root, apple cider (and Umeboshi) vinegar. There are also liquid formulations like Trace Minerals, colloidal minerals, coconut water and vegetable juice. Mineral supplements are also useful, which I will review in more detail.
Bones harbor most of the minerals in our body, and serve as a reservoir for mineral loss. The body steals minerals from the bones as necessary. Many of the major foods we eat—be they fat, protein or carbohydrate—are acid forming in the body, and need to borrow from the bones to be metabolized. It’s largely unavoidable. But the American diet is especially devastating to bone health, with all the processed crap, and the lack of minerals in the soil from decades of synthetic fertilizer use. It’s time for change.
The fact is, we need good fat and protein, but we don’t need all those empty carbs (and bad oils). Thus, my first recommendation is to moderate the carbs, especially if you have weight to lose. Carbs are acid-forming, especially when fried or processed. Foods like pasta, bread, cereal, grains, rice, pastries, crackers, cookies, soda and sugar are slowly melting our bones. Plus, the bad fats used to make them are rancid, which results in fatigue and lack of exercise. Meat-only diets also steal from the bones, as seen with the Inuit people. Even keto diets need to be balanced, eventually. We would do our country a great favor by cutting out processed junk food, corn syrup, seed oils, and even alcohol, God forbid.
Balancing with super alkaline-forming foods is key. Getting minerals wherever you can is paramount. One way to increase pH balance is with alkaline salts like potassium bicarbonate. It can provide around 10% of the daily need for potassium, which is hard to get enough of from food. A pinch or two in your water or food could make a big difference. You can measure that difference in urine with pH strips. Increasing pH also protects against urinary tract infection. Baking soda would also work, but it’s a little heavy on the sodium. I don’t want more sodium, because I already go heavy on the salt. Unrefined sea salt is full of minerals. Play around with dark, exotic salts. Don’t be afraid of them.
Other minerals that make up bone, are calcium, magnesium, boron, silica, manganese, etc. Most of these minerals should come from the organic plants we eat. The longest-lived people have very high vegetable intakes. Concurrently, these minerals can be found in a good multivitamin. I recommend the Two-Per-Day Multi from Life Extension, or the Daily Energy Multi from Wellness Resources. They’re made from the active, natural forms of each vitamin and mineral, and can help in numerous ways. It’s best to take a multi with meals, twice a day. And don’t opt for drugstore brands: the big corporations have reduced them to synthetic chemicals and non-bioavailable forms. There are also fancier multis, loaded with antioxidant extracts and whole-food nutrients. But for those who eat well, a simpler, foundational brand suffices.
In my mind, there is little need for calcium supplementation, since I’m eating lots of dairy, sardines, seeds, nuts, dark, leafy greens and an assortment of healthy veggies. They also fortify everything with calcium these days, so it’s a bit much. Better to concentrate on magnesium, as most people are lacking in it. It helps especially with constipation, cramps, moodiness, fatigue, sleep and headaches. The co-enzymated (activated) B vitamins in the multis I mentioned also help with energy, sleep and attitude, as well as bones. Zinc is another important mineral for bone building, found mostly in meat, fish and animal products, or from a multi. Silica may be in there too. For organic silica, we sprinkle a little horsetail herb on our salads daily. And we add a little Borax (boron) to our water. No holds barred, when it comes to bone issues.
One way to get more calcium is via bone broth. It contains the gelatins and minerals that help restore bone. My wife Gloria takes a bone broth supplement and we take collagen daily. She used to have issues, but we’ve managed to improve her bone mineral density over the years. Many women have these bone-loss problems after menopause. But there is hope.
Another approach is to improve calcium management in the body. That’s the role of three nutrients: vitamin D, magnesium and vitamin K2. I concentrate much less on the calcium, and more on these calcium helpers. Vitamin D increases calcium absorption, while magnesium and K2 soften calcium’s effect. Vitamin K2 is especially designed to escort calcium from the blood to the bones. Otherwise, calcium gets into the wrong places and hardens. Getting enough magnesium—from greens, beans, nuts and seeds—to soften calcium’s effect can be difficult, given the loss of this mineral from our soil and food. Consider taking 100-200 mg of magnesium (glycinate, taurate, malate, threonate or citrate, but not oxide). Unless you’re out in the sun often, you may not be getting much vitamin D. And, unless you eat unusual fermented soy foods and cheeses, you need more K2. I suggest supplementing: 2500-5000 IU vit D3 and 45-180 mcg vit K2. Life Extension has them bundled, or available separately in different dosages. There are also probiotics and certain bacteria that can make K2 in the gut. You also get a little D from cod liver oil, as well as omega-3s, which are important for joint, brain, eye, heart and bone health. Cod liver oil also provides real vitamin A, which many people can’t make from plant-based foods. Olde World Icelandic Cod Liver Oil (Garden of Life) improved my gum inflammation quite a bit.
Yet another approach for bone health is to target inflammation directly and resolve infection. Nutritionally, this is done with antimicrobial/antioxidant foods and extracts. Nature has provided many from which to choose. Those related to bone health include fisetin from strawberries, pterostilbene from blueberries, lycopene from tomatoes/watermelon, silymarin from milk thistle, olive leaf extract, grape seed extract, comfrey, arnica, nettle. Gloria eats a couple of prunes daily, which contain anthocyanin antioxidants connected to bone health. Vitamin E, in the form of tocotrienols, are fat-friendly antioxidants tied to bone health. Basically, an argosy of antioxidants help rejuvenate the body, protect your energy-producing machinery, and reduce inflammation that can interfere with bone growth.
For immediate pain relief, eat three sticks of celery, or combine turmeric and frankincense extracts (Curamin). For long-term health and healing, follow a high anti-oxidant regimen, eat a high alkaline-forming diet, get more minerals from foods and supplements, and keep your gut microbes happy. It’s much healthier and far more effective, in the long run, than resorting to drugs.
Meanwhile, increase veggie and fruit intake and reduce grain and bad oil (seed oil) consumption. Keep adding alkaline-forming foods until you find balance. You’ll know it when you feel it.
To your health,
Dr. Phil
The Science of Nutrition 