Your diet can directly impact your overall health and well-being, including the strength of your bones. The foods you eat contain vitamins, minerals, and nutrients that are essential for keeping you healthy. In particular, calcium and vitamin D are vital for keeping your bones healthy and strong [1-4]. The lumbar spine is one of the greatest areas affected by not enough calcium and vitamin D causing the vertebrae to progressively collapse and lose height over time as we age into senior years. Decreased lumbar spine vertebral strength and height can sometimes cause compression fractures and/or vertebral wedging and all can potentially lead to nerve impingement issues causing pain.

The Role of Calcium for Healthy Bones

The most abundant mineral in your body is calcium, and your bones contain calcium salts, including calcium sulfate, which helps to harden and strengthen your bones. Your body is unable to make calcium. Therefore, you must obtain this calcium from foods, drinks, and supplements to keep your bones strong and healthy [1].

Calcium isn’t just important for strong bones; it also helps your heart, muscles, and nerves work properly. If you don’t consume enough calcium in your diet, your body starts to take the calcium it needs to function properly from your bones, which weakens them and increases your risk of developing osteoporosis [1,3]. 

Food sources of calcium include dairy products such as milk, cheese, and yogurt, as well as fish, leafy green veggies, tofu set with calcium, and foods and drinks that are fortified with calcium, including juice, oatmeal, and cereal [1]. 

The Role of Vitamin D in Healthy Bones

Similar to calcium, vitamin D plays an essential role in bone health. Vitamin D helps your body absorb the calcium you consume in your diet [3]. It also helps to promote the optimal functioning of your immune system and muscles [1,4].

If children do not get enough vitamin D, they are at risk for developing rickets, a disease in which the bones become weak, soft, deformed, and painful [1]. If adults do not get enough vitamin D, they can develop osteomalacia, a condition that weakens muscles and bones, making them more likely to deform and fracture. Low levels of vitamin D also increase the risk of developing osteoporosis [1].

Vitamin D is naturally produced in your body through exposure to sunlight [3]. There are not many food sources of vitamin D, but some types of fish, including salmon, mackerel, tuna, and trout, as well as mushrooms, eggs, and beef liver, provide some vitamin D. Additionally, fortified foods, including juice and cereal, can provide vitamin D [1,4]. 

Recommended Amounts of Calcium and Vitamin D

The amount of calcium you need for healthy bones depends on your sex and age [1]:

• Healthy adults aged 19 to 50 years need 1,000 mg per day
• Women over the age of 50 and men over the age of 70 years need 1,200 mg per day
• Men aged 51 to 70 years need 1,000 mg per day
• Pregnant and breastfeeding adults need 1,000 mg per day
• Children and young adults aged 9 to 18 years need 1,300 mg per day
• Children aged 4 to 8 years need 1,000 mg per day
• Children aged 1 to 3 years need 700 mg per day
• Babies aged 6 to 12 months need 260 mg per day
• Babies aged 0 to 6 months need 200 mg per day

The amount of vitamin D you need for healthy bones also depends on your age [1]:

• Adults aged 70 years and older need 20 mcg (800IU) per day
• Children and adults aged 1 to 70 years need 15 mcg (600IU) per day
• Babies under the age of 1 year need 10 mcg (400 IU) per day

How Can Your Physical Therapist Help?

Your Physical Therapist can help ensure that you maintain the strength of your bones by educating you on diet changes that you can make to increase your intake of vitamin D and calcium. They can also educate you on supplements that you can take if your diet lacks vitamin D and calcium. By keeping your bones strong, you minimize the risk of developing osteoporosis and associated complications, including falls and fractures, which helps you to maintain an optimal quality of life. 

References

1. Calcium and vitamin D. National Institute of Arthritis and Musculoskeletal and Skin Diseases. Updated May 2023. Accessed October 15, 2023. https://www.niams.nih.gov/health-topics/calcium-and-vitamin-d-important-bone-health 
2. Mendes MM, Sahni S. Calcium and vitamin D in the management of osteoporosis. Marcus and Feldman’s Osteoporosis (Fifth Edition). October 9, 2020. Accessed October 15, 2024. https://www.sciencedirect.com/science/article/abs/pii/B9780128130735000708. 
3. Voulgaridou G, Papadopoulou SK, Detopoulou P, et al. Vitamin D and calcium in osteoporosis, and the role of bone turnover markers: a narrative review of recent data from RCTs. Diseases. 2023;11(1):29. Published 2023 Feb 8. doi:10.3390/diseases11010029
4. Dominguez LJ, Farruggia M, Veronese N, Barbagallo M. Vitamin D sources, metabolism, and deficiency: available compounds and guidelines for its treatment. Metabolites. 2021;11(4):255. Published 2021 Apr 20. doi:10.3390/metabo11040255