Bone Health and Nutrition
The role of nutrition in keeping bones healthy
Nutrition and lifestyle play a critical role in bone health. As mentioned in the previous article, bone is an active tissue that is continuously remodelled through a balancing act known as bone homeostasis. Bone formation requires a constant supply of energy and nutrients, including protein and a variety of minerals and vitamins.
A diet rich in bone-supporting nutrients is important for the prevention of excessive bone loss and the treatment of bone disorders including osteoporosis. This article will explore these nutritional considerations in greater detail. You can read more about other key lifestyle and hormonal influences on bone health here.
Energy intake and availability
Adequate energy availability is essential for bone homeostasis. Energy availability (or EA for short) can be defined as the amount of dietary energy left over and “available” to the body to sustain physiological function after the energy expended from exercise has been accounted for. Short-term low EA has been shown to increase bone resorption (a process involving the breakdown of bone) and decrease bone formation amongst physically active women, whilst longer-term low EA is associated with lower bone mass, reduced bone strength, increased risk of fracture and osteoporosis [1].
Negative energy balance and its impact on bone health is summarised in the ‘Female Athlete Triad’ model which illustrates the link between low EA, missing periods (amenorrhoea), and low bone mineral density (BMD) [2]. Although the model suggests that these three factors are interrelated, it is now accepted that they can each occur independently of each other, and that low EA can lead to both amenorrhoea and low BMD.
Mechanisms to explain the link between low EA and reduced BMD are not yet fully understood but are likely to include changes in body composition (including reduced fat mass), decreases in sex hormones (including oestrogen and androgens), leptin, insulin, and insulin-like growth factor-1 (IGF-1), alongside increases in cortisol (our main stress hormone) and interruptions to growth hormone levels [3]. Overall, the literature suggests that low EA negatively impacts bone and so ensuring energy (calorie) intake is appropriate to meet your daily needs, is key to supporting the health of your bones, alongside the individual requirements of your life and your exercise.
As mentioned in the previous blog post, emerging evidence suggests that insulin may have anabolic (building) effects on bone by stimulating the development of bone forming cells (osteoblasts). Insulin is a hormone produced by the pancreas when we eat carbohydrate rich foods and the subsequent presence of a simple sugar (glucose) in the bloodstream. Insulin allows glucose to enter our cells so that it can be used as energy. It follows that dietary carbohydrate restriction and/or a reduced concentration of insulin in the blood, as seen in functional hypothalamic amenorrhoea, may not be as favourable for bone health as a moderate carbohydrate diet. So, gently increasing carbohydrate intake may improve your bone density following a very low carbohydrate or calorie restricted diet, by restoring insulin secretion and promoting bone formation.
Protein
A common misbelief is that calcium and vitamin D are the only nutrients needed for healthy bones. However, this notion does not account for the presence of collagen; a protein that forms the structural matrix within which bone minerals are deposited. As proteins (including collagen) make up around 50% of the volume and 20% of the weight of bone [4], bone metabolism is dependent on a consistent supply of amino acids (the building blocks of proteins) from the diet, including proline and lysine.
Eating protein-rich foods may also increase the absorption of calcium in the gut. The mechanism for this is not well researched, but it is thought that protein could increase the solubility of calcium by stimulating the production of stomach acid or through the interaction of calcium with dietary peptides, the products of protein digestion [5].
As well as increasing calcium absorption, high protein diets may increase blood levels of the hormone Insulin-like Growth Factor 1 (IGF-1) [4]. IGF-1 has a positive impact on bone formation, increases absorption of calcium and phosphorus in the gut, increases reabsorption of phosphate in the kidney and promotes the production of calcitriol, the most active form of vitamin D.
What’s more, adequate protein intakes combined with resistance exercise promote muscle growth and the accumulation of lean body mass. As muscle ‘pulls’ on bone, this adds mechanical stress to the skeleton, which strengthens to adapt to the added force.
Interestingly, early studies suggested that high protein intakes (2.1g/kg) could induce bone loss. The increased dietary acid load associated with high protein diets has been thought to result in the mobilisation of calcium from bone to neutralise the acidity [6]. However, more recent high-quality studies have shown that – provided calcium intake is adequate – protein intakes higher than current population recommendations could be protective (rather than damaging) to bone, reducing bone loss and fracture risk [7].
Currently, there are no specific recommendations for protein intake to support healthy bone turnover and research in the area is lacking. For general health and wellbeing, UK guidance currently recommends a daily intake of 0.75g protein per kg body weight [26]. However, given the importance of protein for bone health, a higher protein intake is usually ad, provided this does not compromise your intake of other nutrients. Generally, I advocate for around 30% of dietary energy to be obtained from protein (40% from carbohydrate and 30% from fat), allowing for individual variances in metabolism, activity levels, health status and age. It is also worth remembering that protein is best consumed alongside some carbohydrate to promote insulin secretion, which encourages our ability to take up and use amino acids from protein.
Fat
The role of fat-soluble vitamins D and K in bone health is well-documented. Put simply, we need to eat enough fat to be able to efficiently absorb these nutrients, in addition to vitamins A and E. Ultra-low-fat diets can lead to deficiencies in these fat-soluble vitamins which may negatively impact bone and general health.
However, research has shown that high consumption of saturated fats (as seen in the typical Western diet) can inhibit calcium absorption. This is because calcium forms complexes with saturated fatty acids which are resistant to digestion in the gut. Some animal studies have shown absorption of calcium decreases in proportion to increasing fat content with a considerable decline in calcium absorption in the gut with 45% fat diets [8].
When it comes to other types of fat in the diet, there is conflicting research surrounding the role of omega-3 fatty acids and bone. Some studies have suggested that the intake of omega 3 fatty acids from fish oil (EPA and DHA) can inhibit bone resorption and stimulate bone formation, potentially through regulation of a receptor (osteoprotegerin) that favours bone formation [4]. A 2019 systematic review found evidence of reduced hip fracture occurrence amongst those consuming higher levels of omega 3 fatty acids from fish [9], although similar studies have not revealed any significant findings.
Whilst further research is required to substantiate the protective role of omega 3 in bone, these fats have many other health benefits beyond bone health that are worth considering. For this reason, I often help my clients assess and optimise their intake. You can read more about omega 3 fatty acids in this previous blog post and their role in supporting recovery from hypothalamic amenorrhoea (HA), specifically.
Calcium and Vitamin D
Calcium (in the form of calcium phosphate and other salts) is the main mineral component of bone and forms part of the inorganic mineral matrix known as hydroxyapatite. Unsurprisingly, adequate intakes of calcium can reduce bone loss. In a 2015 systematic review of evidence, it was found that increasing dietary calcium led to significant increases in BMD at several bodily sights after 2 years [10].
Aside from its major role in bone, calcium also helps to regulate blood clotting, muscle contraction, nerve transmission and a healthy heartbeat. Due to the critical nature of these and other processes, blood calcium levels must be tightly controlled. If dietary calcium is deficient, the body has no choice but to take reserves from bone to keep blood levels stable, resulting in bone loss [11]. Due to the way that the body regulates blood calcium levels (always keeping them stable), dietary calcium deficiency has few symptoms and cannot be diagnosed with blood testing. This is one of the reasons that osteoporosis is known as a ‘silent’ disease that often goes undiagnosed until a bone is broken.
If you are worried about your bone health, a DEXA scan can give you a quick and accurate measurement of your bone density, so you know what your risk is. The scan is quick, non-invasive and if you can’t get one through your GP, private options are available and affordable. If you’d like help with this, or how to support bone health in general, please book in a free call to discuss.
Vitamin D works alongside calcium in bone health. Calcium is absorbed in the small intestine by the action of various vitamin-D dependent calcium transport proteins, and so calcium absorption is optimised with sufficient vitamin D availability. One of the channels through which calcium enters the intestinal cells is called TRPV6 and this channel is regulated highly by vitamin D. Studies have shown that the expression of TRPV6 declines with age in women, which partly explains why calcium absorption also declines with age [12]. On average, we absorb around 30% of the calcium we consume, but calcium absorption in vitamin D deficiency reduces to around ~10-15%. Not only does vitamin D deficiency decrease calcium absorption in the gut, but it also reduces reabsorption of calcium in the kidneys and increases the concentration of parathyroid hormone. The net effect of these changes is an increase in bone breakdown.
Indeed, a study published in 2018 found that daily consumption of milk enriched with both calcium and vitamin D led to significant improvements in vitamin D status and increases in BMD amongst healthy postmenopausal women [13]. I’ve given further details of the different sources of calcium and vitamin D towards the end of this article alongside ways you can optimise dietary absorption.
Experts agree that the ideal way to get the nutrients we need to stay healthy is from food. However, when it comes to certain nutrients like calcium, some of us may not find it practical or possible to meet the recommended nutrient intake (RNI) from diet alone. Generally-speaking, there are two main forms of calcium supplements: carbonate and citrate.
Calcium carbonate tends to be the best value and contains the highest amount of elemental calcium. It's best taken with food since calcium carbonate needs stomach acid for absorption. However, some people may experience mild constipation or feel bloated when taking calcium carbonate supplements. The other option is calcium citrate supplements, which can be taken on an empty stomach and tend to be absorbed more easily, especially by those taking heartburn medications regularly. However, you may need to take more supplements to get your daily requirement.
There are other factors to consider when making the decision to take calcium (or any other) supplements, especially long term. A doctor or registered nutrition professional is always best placed to advise on supplements. For instance, I would take into consideration competitive mineral absorption, dosages, forms, interactions with medications and synergy with other nutrients to meet my client’s specific health goals.
Phosphorus
Phosphorus is another major mineral component of bone and combines with calcium to form hydroxyapatite crystals. Bone contains around 85% of the body’s phosphorus, so it’s perhaps unsurprising that adequate dietary phosphate intake is required to support bone formation. High phosphate intake has been associated with improvements in BMD, whilst the risk of osteoporosis reduces by around 45% in adults with normal calcium and phosphate intakes [14]. Phosphorus deficiency is rare in developed countries since most adults eat more than the recommended amounts every day.
Conversely, some studies have suggested that high intakes of phosphoric acid from soft drinks could be linked to an increased risk of fracture [15]. There are several proposed mechanisms to explain this correlation. The first is that a high phosphorus intake combined with a low calcium intake can stimulate parathyroid hormone, triggering bone resorption (breakdown). Secondly, a high intake of phosphorus may reduce the activation of vitamin D in the kidney, decreasing calcium absorption with a potentially negative knock-on effect on bone turnover. However, other studies have found no such correlation between phosphoric acid and bone. Confounding factors in some soft drink studies (such as the high sugar and caffeine content of such drinks, or the replacement of calcium-rich beverages for soft drinks) may explain the observed reduction in bone mineral density, rather than a direct relationship to phosphate.
Magnesium
Around 50-60% of the body’s magnesium is found within bone. Magnesium plays a role in the exchange of calcium and potassium ions across cell membranes and aids in the structure of hydroxyapatite crystals within bone by improving their solubility to phosphorus and calcium. As well as this, magnesium is thought to induce osteoblast (bone forming cell) proliferation, further supporting bone formation. Magnesium deficiency has been shown to lead to reduced osteoblast activity and reduced bone mass [16]. Magnesium is also involved in the activation of vitamin D, since several enzymes needed for vitamin D metabolism require magnesium [17]. This highlights the importance of adequate magnesium intake to support the role of vitamin D in your body.
Unfortunately, similarly to calcium, blood levels of magnesium do not necessarily reflect the body’s magnesium status and so a ‘normal’ level of serum magnesium cannot rule out moderate to severe deficiency. Ensuring you are eating magnesium-containing foods on a regular basis is important and, if you are in any doubt or concerned, seek advice from a registered nutritionist or dietician.
Vitamin K
Vitamin K plays a role in the formation of the bone matrix during mineralisation. This role centres on the involvement of vitamin K in the production and function of specific calcium binding proteins (known as Gla proteins), including osteocalcin [4]. Vitamin K takes two main forms: vitamin K1 and vitamin K2. Vitamin K1 is found mostly in plant foods, whereas the less abundant vitamin K2 is found in animal and fermented foods. The body can partly covert vitamin K1 to vitamin K2, which is also produced by bacteria in our guts.
Although the mechanism linking vitamin K to bone health is plausible, this effect has not been well-documented in clinical studies. A 2019 meta-analysis found vitamin K supplementation to have little significant impact on bone mineral density or fracture risk [18]. Although the study found less-frequent fracture occurrence amongst post-menopausal women and those with osteoporosis taking vitamin K supplements, this effect was much smaller when bias was accounted for. Overall, more high-quality research is needed to investigate any clinically significant effect of vitamin K supplementation on bone mineral density. However, recognition of the importance of vitamin K to bone health is growing and adequate dietary intakes of vitamin K1 and K2 are certainly an important consideration when seeking to support your bones. You’ll find some further details of sources of these nutrients below.
Vitamin C
Vitamin C is one of the lesser-known nutrients supporting bone health. Vitamin C is an antioxidant, meaning it plays a role in scavenging free radicals that could be detrimental to bone [19]. Vitamin C is also involved in the production of collagen (a key component of bone), as well as stimulating osteoblast differentiation. A study that investigated the impact of vitamin C supplementation on BMD in post-menopausal women found significantly higher BMD compared to those who did not supplement with vitamin C, even after adjusting for factors such as age and body mass index [20].
What’s more, a 2018 systematic review [21] concluded that greater intake of vitamin C was associated with increased BMD at the femoral neck and lumbar spine, as well as decreased risk of fracture and osteoporosis. Although the extent of the association varied between studies, this is likely explained by differences in study design and lack of control for potential confounding factors.
Other nutrients
Other nutrients involved in bone health include potassium, copper, manganese, and boron.
Although it remains a controversial subject [22], dietary potassium may help reduce acidity and help maintain an alkaline state in the body [4]. In turn, this prevents calcium mobilisation from bone to form calcium salts that neutralise acidity. A study that observed the effect of supplementation with alkaline potassium salts found a significant reduction in urinary calcium excretion and acid excretion, supporting the idea that potassium works as a buffer (preventing acidic conditions that could lead to resorption of calcium from bones). This study also observed significantly reduced markers of bone resorption, providing evidence to suggest a benefit of potassium salts to bone health [23].
Several other trace elements are involved in the metabolism of bone and may have an impact on bone health. Copper is a component of various enzymes involved in the synthesis of collagen and elastin, whilst disorders affecting bone and cartilage are observed in copper deficiency [24]. Similarly, manganese is a cofactor for enzymes involved in bone metabolism and recent studies have revealed that women with osteoporosis have lower blood levels of manganese compared to healthy populations [25]. Boron is a trace mineral that appears to play an important role in bone formation. Boron stimulates the production and activity of steroid hormones which in turn aids in the prevention of calcium loss and bone demineralisation. Supplementation with boron has been shown to reduce calcium and magnesium excretion, increase oestradiol and increase calcium absorption in women [26].
Is a Mediterranean style diet the answer?
Given the associations between the above nutrients and bone health, it is perhaps unsurprising that the Mediterranean-style diet is typically associated with higher bone mineral density and lower risk of fracture [27]. Mediterranean diets are typically high in antioxidant rich fruit and vegetables, providing plentiful vitamins and minerals including vitamins C, K, and potassium. What’s more, individuals with greater adherence to the Mediterranean style diet appear to have higher serum vitamin D levels [28], suggesting another potential mechanism by which this dietary pattern may be bone protective.
Olive oil features heavily in the Mediterranean diet, and its high phenol content may help prevent bone loss. It has been suggested that phenolic compounds may promote maturation of osteoblast (bone forming) cells. Individuals with high intakes of extra-virgin olive oil have also been shown to have the lowest risk of osteoporosis and fractures [29].
Overall, a dietary pattern with a high intake of fruit and vegetables and that includes dairy, wholegrains, poultry, fish, nuts, and legumes has been shown to promote healthy bone, increasing BMD and lowering the risk of osteoporosis and fracture [4].
The Gut-bone axis
The gut microbiota (GM) refers to the microbes that inhabit the gastrointestinal tract. GM have been shown to promote health via a range of mechanisms including enhancing absorption of nutrients and immune system regulation. Several factors including age, diet and use of antibiotics can disturb the balance of the GM, leading to ‘gut microbiota dysbiosis’. This dysbiosis has been associated with several disorders, including increased risk of bone loss.
The role of GM in bone health is a new and emerging area of research, and most studies have been conducted on animals (mainly mice). A 2021 systematic review of available studies [30] found that antibiotic-induced dysbiosis increased the risk of bone loss in mice, whereas treatment with probiotics prevented osteoporosis induced by ovariectomy. This review suggested that probiotics could be a potential therapy for the prevention of bone loss in post-menopausal women, although there is still a lack of understanding of the mechanisms explaining these associations. These mechanisms include GM assistance in the absorption of bone-supporting nutrients, immunomodulation, and regulation of bone-trophic hormones (known as the gut-brain-bone axis) [31].
To date, there have been few human clinical trials evaluating the use of probiotics on bone health, and the limited studies that do exist have not yielded clinically significant findings. However, at this early stage, these results should not diminish the importance of good gut health and the potential significance of the GM in optimising our bone health.
The Role of Nutritional Therapy
This article has explored some of the most well-researched nutritional considerations when it comes to bone health. However, you may need different nutrients and/or nutritional practices to help you recover or reach your health goals. For example, data from human intervention studies are mixed in relation to the potential beneficial effects of phytoestrogens on bone health.
For this reason, personalised nutrition can be so powerful. From improving your hormone health, energy and nutritional status, to optimising absorption and gut health, to helping you manage sources of stress – these may all form part of a unique plan to support you and your health. If you’d like to learn more about how I can support you, feel free to get in touch with me.
For more advice on any of these tests, including private DEXA scans, blood tests and more, you are welcome to contact me or set up a short free call so we can discuss your needs together.
Tips for increasing nutrients for bone health
I’ve listed the recommended daily intake and the most common food sources of bone-supporting nutrients below along with some comments that may affect how well your body can absorb and use certain nutrients. As always, it’s best to work with a registered health professional to determine your specific needs.
Calcium
Recommended daily intake: 700mg
Note, those with osteoporosis requiring treatment should have between 1000-1200mg per day
Sources
Milk and dairy products (cow, goat, or sheep)
Calcium-fortified plant-based milks/yoghurt
Small-tinned fish with bones (e.g., sardines and pilchards)
Tofu
Fortified cereals and bread made with fortified flour
Green leafy vegetables
Nuts and seeds (especially sesame and poppy seeds)
Calcium absorption factors:
Absorption requires adequate stomach acid
As the amount of calcium taken increases, the percentage absorption decreases. For this reason, it is helpful to spread calcium intake across the day to maximise total absorption
High levels of sodium/salt can decrease calcium absorption and increase calcium excretion in urine. Try to keep salt intake <6g daily
Caffeine may act as a mild diuretic promoting calcium excretion before the body can make use of it. Tannins in tea and coffee may also bind calcium, inhibiting absorption in the intestine. Avoid caffeine containing food and drinks (e.g., tea and coffee) with meals or calcium supplements, where possible
Coeliac Disease can decrease the absorption of calcium and fat-soluble vitamins (including vitamin D) due to changes in the lining of the intestine. This can have a knock-on effect on bone health
Efficiency of calcium absorption declines with age (~80% in an infant consuming breastmilk, ~40% in an adolescent female, ~30% in a young female, ~25% in a middle-aged female, and as low as ~5% in an elderly female)
The presence of oxalic and phytic acid may inhibit calcium absorption by binding to calcium and forming insoluble calcium salts. A healthy balanced diet should contain these compounds (which have several health promoting properties) so there is no need to exclude them. However, a varied diet is important so make space for other foods when possible. Foods rich in oxalic acids include spinach, collard greens, sweet potatoes, rhubarb, and beans. Phytic acid is usually found in fibre-rich foods such as wholegrains, beans, seeds, and nuts.
It’s important to remember that a calcium blood test will not measure whether you are getting enough calcium in your diet or whether you might need a supplement.
Checking for low or high calcium levels is generally more useful to indicate whether you have an underlying medical condition that is affecting your bones (e.g., hyperparathyroidism).
Vitamin D
Recommended daily intake: 10μg
Note, higher levels will be required under supervision to correct a deficiency
Food Sources
Oily fish
Red meat
Egg yolks
Liver
Fortified foods (such as milks and cereals)
Sunlight and Vitamin D
In the UK, we can get some Vitamin D from exposure to sunlight during the summer months (April-October). However, if you are someone who spends a lot of time indoors, covers their skin, has darker skin, or wears sunblock, you may be at risk of deficiency.
The UK government now recommends that we all take a 10μg/d vitamin D supplement during the autumn and winter.
If you are at risk of deficiency (you are in one of the groups mentioned above), you may need to supplement year-round and/or require a higher dose formula. Speak to your GP or my practice to arrange a simple vitamin D blood test.
Phosphorus
Recommended daily intake 550mg
Requirements are higher in teenagers (625mg), breastfeeding mothers (+440) and pregnancy
Food Sources
Dairy
Red meat
Offal
Poultry
Seafood
Legumes
Nuts
Sunflower + pumpkin seeds
Wholegrains
Phosphorus deficiency is rare in developed countries as it is found widely in foods.
Processed foods commonly contain phosphorus in the form of phosphate additives to prolong shelf life.
Artificial phosphates and phosphorus from animal sources are better absorbed than plant-based phosphorus. Soaking or fermenting foods such as beans and pulses can help aid absorption.
As mentioned above, there is some evidence to suggest high intakes of phosphorus from carbonated drinks could be damaging to bone health.
Magnesium
Recommended daily intake for adult females 270mg (for males it is 300mg)
280mg females aged 11-14y, 300mg females aged 15-18y. Additional 50mg/day needed whilst breastfeeding.
Food Sources
Green leafy vegetables like chard, kale and spinach*
Nuts (especially cashews, almonds and Brazils
Seeds (especially pumpkin, chia and flax)
Wholegrains and wholegrain bread
Avocado
Legumes, tofu
Banana
Dark chocolate
Most people should consume enough magnesium from a healthy, balanced diet. However, poor soil quality raises increasing concerns as to whether needs are being met. In addition, if you are very active or under a lot of stress, you may wish to consider increasing your overall intake of these foods.
Try to include some magnesium-rich foods following exercise (e.g., a banana and a handful of nuts).
Certain magnesium supplements can cause uncomfortable side effects. Always seek advice from a registered health provider.
Vitamin C
Recommended daily intake: 40mg
Requirements may be much higher in certain situations. Vitamin C is used in large amounts by the body when under stress and during infections, so much higher levels are needed when the body is fighting a virus, for example.
Food Sources
Citrus fruit and juices
Strawberries and other berries
Broccoli
Brussels sprouts
Bell peppers, chillies
Fresh tomatoes
Potatoes
Onions
Frozen fruit and vegetables tend to be good sources of vitamin C as they are usually frozen as soon as they are picked, locking in the nutrients.
Steaming fruit and vegetables retains more vitamin C than boiling as vitamin C is lost to the water during the boiling process.
Vitamin K
Recommended daily intake: 1μg/kg body weight
Food Sources
Green leafy vegetables such as kale, collard greens, spinach*, turnip greens, broccoli and Brussel sprouts (K1)
Natto and other fermented foods (K2)
Eel
Hard, aged cheeses (K2)
Meat and other animal products (K2)
Vitamin K1 is found mostly in plant foods, whereas vitamin K2 is found in animal and fermented foods. K2 is less abundant in the diet but can also be produced by bacteria in our intestine.
The body can partly covert Vitamin K1 to Vitamin K2.
The use of antibiotics has been shown to reduce levels of vitamin K2, leading to reductions in osteocalcin and bone strength [33].
Potassium
Recommended daily intake: 3500mg
Food Sources
Bananas
Some vegetables including broccoli, parsnips, and brussels sprouts
Beans and pulses
Nuts and seeds
Fish
Some meats including beef, chicken, and turkey
Copper
Recommended daily intake: 1.2mg
Food Sources
Nuts
Shellfish
Offal
Cocoa powder and dark chocolate
Boron
Recommended daily intake is not established as this is a trace mineral
Food Sources
Leafy green vegetables
Wholegrains
Dried fruit including prunes and raisin
Nuts
* Whilst spinach can be a good source of vitamins K1, magnesium, folate and iron, it does contain oxalates which can inhibit calcium absorption.
Take-home messages
Imbalances in energy intake, alongside a diet that is lacking in essential bone supporting nutrients can be considered a risk factor for low bone density.
For most people, a varied and balance diet should provide enough of the vitamins and minerals needed to support bone health (with exception to vitamin D). However, if you are concerned and/or looking for tailored support to optimise your nutrition or bone health, it is worth getting the right support.
A vitamin D supplement of 10μg/day is recommended during the winter months in the northern hemisphere.
There are some dietary practices and foods that have been suggested to be detrimental to bone (e.g., high intakes of caffeine, salt, and saturated fats).
High intakes of phosphoric acid from soft drinks could be detrimental to bone health, but the evidence is conflicting, and it is unlikely to be a major consideration.
A Mediterranean style diet has been shown to be bone-protective and reduces the risk of bone loss and osteoporosis/fracture.
The gut microbiota plays a role in bone health and research suggests that probiotics have the potential to prevent bone loss (although much more evidence is needed to support this).
As always, it’s also important to remember that there is no one approach to optimise bone health that works for everyone. If you'd like to find out more about what you can do to support bone health, please book a free call so we can discuss your particular needs.
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This article was researched with the help of Emily Boorman (BSc Human Nutrition), a Band 4 Dietetic Assistant Practitioner and a wonderful intern at Holly Dunn Nutrition.
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