Most people know about calcium and vitamin D for strong bones. But new research suggests other powerful nutrients may work synergistically to prevent osteoporosis. Aren’t sure you need a bone supplement? Everyone loses bone mass with age. Individual risk depends on gender—80 percent of people with osteoporosis are women—family history, dietary calcium intake, and physical-activity level. Focusing on prevention during the crucial growing years and as you age makes sense: Osteoporosis often progresses slowly, without symptoms. Here’s what bones need.

By the numbers

10 million            Americans with osteoporosis

34 million            Americans with low bone density

Calcium

This bulky mineral won’t fit into a multivitamin so choose a separate supplement, preferably one combined with cofactors vitamin D and magnesium. Check labels for elemental calcium amounts per serving. Organic, or chelated, forms, like calcium citrate or ascorbate (which also contains bone-building vitamin C), are well absorbed any time, but take inorganic forms with food to improve absorption. If you take heartburn medications, choose a form like citrate, says Linda Massey, PhD, RD, a nutrition professor at Washington State University. “It’s well absorbed even in the absence of stomach-acid production.” 

Dose:  1,000 mg daily for adults ages 19–50, and for men up to age 71; 1,200 mg daily for women over age 51 and men over age 71. Youths ages 9 to 18 should aim for 1,300 mg daily from food and supplement sources. For optimal absorption, split into 500-mg doses (the amount the body can absorb at once) and take with magnesium and vitamin D.

Magnesium, vitamin k

 

Magnesium

Half the body’s magnesium resides in bone, which suggests this mineral is just as crucial for bone density as calcium. It helps activate vitamin D and parathyroid hormone, “which influence calcium metabolism and absorption,” explainsMark A. Stengler, NMD, coauthor of Prescription for Natural Cures (Wiley, 2011). With age, your body absorbs less magnesium and excretes more, so supplementation makes sense. Check labels for elemental magnesium amounts. Well-absorbed forms include magnesium citrate or magnesium glycinate.

Dose:  Take 250–350 mg twice daily in divided doses. To avoid possible digestive upset, take with calcium at a 2:1 ratio of calcium to magnesium. Those with kidney disease should consult a doctor first.

Vitamin K

Found abundantly in leafy greens, vitamin K regulates both blood clotting and bone metabolism. More biologically active vitamin K2—specifically the MK-7 (menaquinone-7) form of K2—benefits bones most, says Susan E. Brown, PhD, author of Better Bones, Better Body (Keats, 2000).

Dose: 250–1,000 mcg vitamin K1, 45–180 mcg K2 (MK-7 form) daily. Don’t take vitamin K if you also take blood-thinning medications such as warfarin.

Vitamin D, Lycopene

 

Vitamin D

Among its myriad health benefits, vitamin D helps bones absorb calcium. In a recent, multiyear study of more than 3,000 women ages 66 to 71, supplementing with vitamin D3 (800 IU daily) and calcium (1,000 mg daily) significantly increased bone-mineral density compared to a control group.

Dose: Test blood levels to see how much you need. General recommendations are 600 IU daily for adults, 800 IU daily for those over age 70, according to the Institute of Medicine. Most vitamin D experts believe these amounts are much too low; for example, prominent researcher Robert P. Heaney, MD, suggests aiming for 3,000 IU daily from all sources (food, supplements, and sun).

Lycopene

Research suggests a positive link between fruit and vegetable intake and bone health, highlighting the importance of nutrients such as lycopene, a carotenoid found in tomatoes. In a recently published study, supplementing with lycopene for four months helped slow bone turnover—the balance between the natural removal of mature bone tissue and new bone tissue formation—in a group of 60 postmenopausal women. Researchers believe lycopene may reduce oxidative stress and slow bone-mineral breakdown.

Dose: 30–70 mg lycopene daily in the form of either capsules or tomato juice or paste (1 cup tomato juice or ½ cup spaghetti sauce both have more than 20 mg lycopene)

Does calcium raise heart attack risk?

A controversial research review published last year in the British Medical Journal suggested taking calcium-only supplements may contribute to breast-artery calcifications, raising heart attack risk. Not so, say experts such as Susan E. Brown, PhD, director of the Center for Better Bones. Still, take calcium with cofactors vitamins D and K2 (in MK-7 form) as well as magnesium to maximize benefits and reduce risks, she says.