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After age 65, bone fractures become important and a significant cause of death and major disability for men and women. They can also cause substantial suffering at the end of one’s life.

Prior to age 65, our goal should be to build and maintain an optimal bone mass so that we avoid this travesty later in life.

My own grandmother died one year after falling and fracturing her pelvis. She was 90 years old and she suffered her last year of life while confined to her bed, unable to have surgery because her bones were too frail. It was heartbreaking to see her in pain for more than a year until she passed.

I wish she had known in her younger years what I am about to share with you now.

My Grandma Lois loved to walk. In fact, even at age 80, I would often have to ask her to slow down because she had worn me out, and I was in my early 30s.

Yet, despite her high level of daily activity, at age 90 she fell and broke her pelvis. The doctors said there was nothing they could do, and she was never able to walk again.

Below are several of the critical nutrients required to ensure you build and maintain strong bones.

  1. Calcium
  2. Vitamin D
  3. Magnesium
  4. Vitamin K
  5. Zinc
  6. Phosphorus
  7. Alkalizing foods

Meeting the requirements for these nutrients, although with regular weight-bearing exercise, will help maintain healthy, strong bones.


We’ve all been taught that Calcium is important for our bones, yet it is clearly not the only nutrient we need to build and maintain a healthy skeleton. Calcium is the most common mineral in the human body. It also is critical for proper heart function, blood clotting, and muscle movement.

Good sources of calcium come from dairy products such as yogurt, cheese, and milk. Yet there are many non-dairy foods that can meet your nutrient needs as well, such as green leafy vegetables, tofu, beans, nuts, and calcium-fortified foods such as almond milk.

A key is getting calcium from age 15 to 30, which is when you build most of the bone density you will ever have. After age 30 we aim to maintain what we have built earlier in life.

Most of us need from 800 mg to 1,200 mg daily to meet our intake needs. Most people should be able to meet their calcium needs from food without a supplement, and I highly recommend that you meet your calcium needs from food. If you do take a calcium supplement, keep in mind that calcium carbonate, the most common source, is poorly absorbed and can cause constipation. Best is to take a form of calcium that is bound to protein, such as calcium malate which is far better absorbed and will cause less GI symptoms.

Vitamin D

I rank vitamin D more critical for bone health than calcium as, without vitamin D, you will not absorb calcium from food nor be able to store it in your bones. Vitamin D also decreases your risk for cancer, auto-immune disease, heart disease, and impacts nearly every cell in your body.

In theory, you could get enough vitamin D from sunshine, yet this is not realistic for 95% of people in today’s world. Most people need at least 2000 IU of a vitamin D supplement daily to meet their nutrient needs. Be sure to have your medical provider check your vitamin D level over time to ensure that you are not deficient. Inadequate vitamin D levels are below 32 ng/ml. Optional levels should be between 40-70 ng/ml.


Magnesium helps make your bones and teeth harder, reducing your risk for a fracture. Magnesium is critical to bone health as it improves calcium absorption and helps convert vitamin D into its most active form. It is also essential for heart health, brain function, blood sugar and blood pressure control, and hundreds of anti-aging actions in the body.

Good sources of magnesium are seeds, nuts, green leafy vegetables, beans, and whole grains. Yet 70% of Americans are magnesium deficient. You need at least 400 mg of magnesium daily to meet your nutrient needs. Again, protein-bound sources are the best absorbed and have the least GI side effects when taken, such as magnesium glycinate or a magnesium chelate.

Important to know is that calcium supplements block magnesium absorption. Most experts recommend that if you take a calcium supplement that your supplement plan also must provide magnesium in a 2:1 or 3:1 calcium to magnesium ratio. For people taking a calcium supplement, my first choice is OsteoForce as it provides calcium, magnesium, vitamin D, and vitamin K in the same pill.

Vitamin K

If you don’t have adequate Vitamin K levels, you will shift calcium from your bones to your arteries—a super bad exchange!  Vitamin K is also well known for proper clotting and is essential for cardiovascular health as well.

Vitamin K is one of the easiest nutrients to obtain from food as 1 cup of most dark green leafy vegetables provides between 250 mcg to 1000 mcg of vitamin K1 daily, enough for meeting your vitamin K needs.

Vitamin K2 is commonly taken as a supplement to help strengthen bones and has been used in clinical studies to treat osteoporosis. A typical supplement dosage varies from 45 mcg to 200 mcg of vitamin K2 daily. In clinical studies in Japan, even higher dosages have been used to treat osteoporosis.


Zinc is essential to bone health as it helps form the protein threads that hold bone matrix together as calcium phosphate. Zinc is also needed for calcium absorption in the gut.

Good food sources of zinc are beans, seeds, nuts, whole grains, and animal protein. Most people can meet their zinc requirements by taking a high-quality multi-vitamin with 12-15 mg of protein-bound zinc daily.


Phosphorus is the second most common mineral in the body. It combines with calcium to give bones and teeth structure.

Good dietary sources for phosphorus are protein sources, such as dairy, poultry, fish, and beans, as well as nuts. The recommended RDA for phosphorus for adults is 700 mg daily.

Alkalizing Foods

An acidic diet loaded with animal protein and grains pulls calcium and phosphorus out of bones into the blood to neutralize blood acidity, resulting in bone loss and elevated fracture risk. High acid diets are one of the most common causes of long-term bone loss.

An alkaline rich diet featuring vegetables, fruits, beans, and nuts prevents blood acidity and helps maintain calcium in the bones where it belongs.

You do not need to be vegetarian to have strong bones, yet the majority of foods that you eat need to come from vegetables, fruits, beans, and nuts. These foods should make up more than 50% of your plate at most meals.

This combination of bone nutrients is essential to optimal bone health. Other trace nutrients that are also needed for optimal bone health include manganese, boron, B vitamins, and chromium. These trace nutrients can be found in a high-quality multivitamin, such as Twice Daily Multivitamin.

My Grandma Lois was very active and ate a mostly healthy diet, yet she was likely deficient in several of the nutrients noted above (especially vitamin D and magnesium) plus she probably had more acid than alkalinity in her diet. If she had known to make these nutrient changes over the long term that would have helped to prevent the pelvic fracture and awful suffering she had to endure at the end of her life.

My goal is to help everyone avoid that type of agony at the end of their days.


I wish you the best of health!

Steven Masley, MD, FAHA, FACN, CNS


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