LINUS PAULING INSTITUTE HEALTH Your work hard. Give them the support they need to keep you going strong.

The Skeleton’s Major Functions

1. Enables us to move 3. Contains bone marrow 2. Supports and protects the body 4. Stores large amounts of and phosphorus

Strong Bones Need

Essential Nutrients Balanced Lifestyle Build and maintain bone tissue Keeps bones strong throughout all life stages

Bone Biology

BONE IS MADE OF

Type 1 that constitutes the interior scaffolding of bone Calcium and Phosphorus Crystals that add strength to bone Bone Cells that are responsible for bone (re)modeling

BONE MASS OVER A LIFETIME Bones grow throughout childhood, adolescence, and well into adulthood. Around age 34, there is an inevitable loss of bone mass with age, accelerated with in women. Modeling During childhood and adolescence, bones grow in size and shape. Remodeling During adulthood, new bone replaces brittle bone, cracks, and deformities. Balanced Lifestyle

Drinking 2–3 cups of coffee a *30–60 min of daily Eating a balanced diet is Light drinking is safe for bone day is safe for bone health. moderate-to-high physical essential to support bone health, but excessive amounts activity is recommended to health. are harmful. strengthen bones and muscles.

Most people consume too Quitting smoking improves Avoid soft drinks in place of *Any amount of physical much sodium; reduce your bone health and lowers other milk and other calcium-rich activity is better than none and sodium intake to prevent its health risks. foods. will bring some benefits to bone harmful effect on bone health. health throughout life.

Essential Nutrients

* Calcium and Vitamin D are of primary importance for bone health

Recommendation for dietary intake of essential nutrients: Recommended Dietary Allowance (RDA) 1. Covers the needs of ~98% of the population in a given gender and life-stage group 2. Can be used as a goal for intakes by individuals Adequate Intake (AI) 1. Used when an RDA cannot be determined Essential Nutrients Continued

CALCIUM VITAMIN D FLUORIDE

Good Sources to help meet the Good Sources to help meet the Good Sources to help meet the ai rda for Calcium rda* for Vitamin D for Fluoride

Women  years, , mgday All Adults > years,  µgday , mg  µg  mg Men,  mgday Men  years, , mgday

Women ≤ years, , mgday Men ≤ years, , mgday All Adults – years,  µgday Women,  mgday

Plain Yogurt ( cup) Salmon ( ounces)  mg . µg

Supplements  µg Fluoridated Water Sardines ( can) ( cup)  mg .–. mg  µg  mg Milk, Fortied  mg Collard Greens ( cup) (½ cup) Black Tea ( cup) . µg  mg . mg  mg mg  milligram  µg µg  microgram,  µg   IU  mg mg  milligram

Functions Functions Function

1. Calcium is a major structural 1. Vitamin D is a fat-soluble 1. Fluoride increases the component of bones. vitamin that promotes bone health structural stability of bones through regulating calcium and through interacting with calcium 2. Calcium in bone can be released phosphorus balance in the body. phosphate salts. in the blood when the need arises. 2. Severe deficiency in children Fluoride exposure through Children with low calcium intakes and adults results in serious community water fluoridation will not reach their maximum skeletal disorders. (<3.4mg/day) has no benefit in the bone density and strength. prevention of and Older people are at high risk fracture. Low calcium intakes in adults can of poor vitamin D status due accelerate bone loss and increase to little sun exposure, a lower Fluoride supplementation is not the risk of osteoporosis and capacity for vitamin D synthesis approved for use in the prevention fracture. in skin, and reduced dairy intake. or treatment of osteoporosis. Supplementation has been Supplemental calcium (and recommended to support bone vitamin D) primarily benefit health and help prevent falls in elderly adults in nursing care. this population. Whether calcium intakes beyond the RDA can reduce risk in * The LPI recommends 50 µg (2,000 community-dwelling older adults IU)/day of vitamin D for adults. In is debated. a 25-hydroxyvitamin D serum test, you should aim for at least 30 ng/ mL (75 nmol/L). Essential Nutrients Continued

MAGNESIUM POTASSIUM PROTEIN

Good Sources to help meet the Good Sources to help meet the ai Good Sources to help meet the rda for Magnesium for Potassium rda for Protein

, mg  g  mg All Adults, , mgday Men,  gday Men  years,  mgday Men – years,  mgday

Women,  gday Women  years,  mgday Women – years,  mgday

Spinach ( cup) Potato with Skin  mg ( medium)  mg Turkey ( oz)  g

Brown Rice ( cup) Prunes (½ cup)  mg  mg Peanuts (½ cup)  g , mg Almonds ( ounce, Banana ( medium)  g Pinto Beans (½ cup)  mg  nuts)  mg  g  mg  mg mg  milligram  mg mg  milligram  g g  gram

Function Function Function

1. About 60% of magnesium is 1. Potassium salts may prevent 1. Proteins are essential to build found in bone, which can supply calcium release from bone and strong bones. the body when need arises. loss of calcium in the that are caused by the consumption Adequate protein intakes are Higher magnesium intakes are of diets with high sources of needed to maintain muscle mass linked to lower risk of poor vitamin acid (fish, meat, cheese) and low and limit falls and fractures in D status. in sources of alkali (fruit and older adults. vegetables). There is no evidence that Higher protein intakes are likely magnesium supplementation Adopting a diet that increases to be protective unless calcium could help prevent osteoporosis potassium intake and reduces intakes are inadequate, in which and fracture. sodium intake (i.e., high in fruit, case higher protein intakes may be vegetables, and dairy; low in meat) harmful. might help support bone health. Essential Nutrients Continued

VITAMIN A VITAMIN C VITAMIN K

Good Sources to help meet the Good Sources to help meet the Good Sources to help meet the ai rda for Vitamin A rda for Vitamin C for Vitamin K

, µg   mg All Adults,  mgday  µg Kale ( cup) Men,  µg day  µg

Women,  µg day

Sweet Potato, Canned (½ cup) Sweet Red Pepper  µg  (½ cup)  mg

Carrot (½ cup) Spinach ( cup)  µg  Kiwifruit  µg ( medium)  µg   mg  mg Men,  µgday  µg Egg ( large) Women,  µgday  µg  Strawberries ( cup) Canola Oil ( tbsp)  µg  µg  microgram; RAE  retinol activity equivalents  mg  µg  µg  mg mg  milligram µg  microgram

Function Function Function

1. Vitamin A (retinol) is a fat- 1. Vitamin C is required during 1. Vitamin K is essential for the soluble vitamin involved in the the synthesis of collagen, which activity of several bone proteins growth and differentiation of constitutes 90% of the bone involved in bone formation and virtually all cells in the body. matrix upon which bone minerals turnover. are deposited. Striving for the RDA for vitamin There is little evidence A is a safe goal for optimizing The evidence is too limited to supporting a benefit of vitamin K bone health. Habitual vitamin A suggest a benefit of vitamin C supplementation in the prevention intakes greater than the RDA may supplements in the prevention of of osteoporosis. increase the risk of osteoporosis bone loss. and fracture. Taking vitamin K supplements can be dangerous for people at risk Vitamin A supplements should of blood clots and those taking be reserved for undernourished blood-thinning medications. populations and those with evidence of vitamin A deficiency. Essential Nutrients Continued

VITAMIN B6 VITAMIN B12

Good Sources to help meet the Good Sources to help meet the Good Sources to help meet the rda for Vitamin B6 rda for Folate rda* for Vitamin B12

 mg  μg  µg DFE Pregnant Women,  µg DFEday Clams ( oz)  μg Men ( ), . mgday

Women ( ), . mgday . μg Adults (–), . μgday Adults (–), . mgday Adults,  µg DFEday Lentils Turkey ( ounces) (½ cup) . mg  µg DFE

Salmon ( ounces) Spinach . mg (½ cup)  µg DFE Turkey ( oz) Pistachio Nuts . mg Enriched Sliced . μg ( ounce)  µg DFE Bread . mg ( slice) . μg Egg ( large)  µg DFE . μg  µg DFE µg  microgram; DFE  Dietary Folate Equivalents  µg µg  microgram  mg mg  milligram

Functions of B vitamins

1. Vitamin B6, folate and vitamin B12 work together to lower blood concentration.

2. Too much homocysteine in the blood is associated with reduced bone mineral density and .

Meeting recommended intake levels for B vitamins with food and/or supplements helps to lower homocysteine concentration in blood.

However, B-vitamin supplementation does not reduce the risk of fracture.

*For adults over 50, the LPI recommends 100–400 µg per day

of supplemental vitamin B12.

lpi.oregonstate.edu/mic © 2019 Linus Pauling Institute