Most people assume bones are made up of calcium, and many foods have been fortified with it to keep bones strong – however calcium alone won’t keep bones strong after age 50.

Exercise, avoiding alcohol and sodium consumption, and using supplements all play an essential part in keeping bones strong. Weight bearing activities help strengthen bones by regularly exercising with weights on them.

1. Eat Dairy Products

Dairy foods are one of the primary natural sources of calcium and vitamin D. Dairy products provide 50-60% of our daily calcium consumption and 20-30% to 30% of protein intake; additionally they also contain magnesium, phosphorus, boron and zinc that benefit bone health; in addition many dairy products are fortified with Vitamin D; meta-analyses have revealed that calcium + Vitamin D combined is superior than either one alone.

Women of childbearing age have long been advised to increase their dairy product consumption, particularly fortified milk, but this advice has recently come under question due to inconclusive evidence showing how dairy supplements enhance bone health in healthy individuals. Furthermore, studies show an association between increased dairy product consumption and an increase risk of osteoporotic fractures.

Reasons behind these findings remain hazy; in some instances, high calcium intake from dairy could contribute to increased fracture risks; alternatively, other ingredients, like vitamin D or protein may be at play; either way, dairy remains a significant source of calcium for most people and represents an excellent way to supplement this essential mineral source.

To address these concerns, researchers have conducted numerous systematic reviews and meta-analyses of RCT examining dairy products’ relationship to bone health, specifically regarding both bone mineral density (BMD)/bone mineral composition (BMC) and fracture risk reduction. Their analyses include both full-fat and low-fat dairy foods; those which go through fermentation such as yogurts and cheeses tend to contain less lactose while providing healthful gut bacteria to maintain optimal digestive functioning.

Even though most studies show a correlation between higher dairy calcium intakes and improved BMD/BMC and reduced fracture risk, and overall effect size being small; only three out of seven studies that measured specific bone sites saw any noticeable change. Lanou et al’s ( Lanou, Berkow and Barnard 27 ) trial directly comparing dairy products with calcium supplements found that effect to be less than in other trials while Huncharek et al’s recent meta-analysis (Huncharek Muscat and Kupelnick 16 ) included only those RCTs which directly compared dairy products directly with calcium supplements directly.

2. Eat Vegetables

While dairy products may be known for being rich sources of calcium, other food can provide substantial amounts as well. Dark leafy vegetables like spinach and kale provide 100mg per half cup, as do broccoli, Brussels sprouts and collard greens – not to mention they help balance blood acidity levels, helping prevent bone loss. Furthermore, digesting vegetables produces alkaline-forming chemicals which support balanced pH levels throughout your body.

Plant-based foods contain chemicals that help neutralize acidity while simultaneously providing magnesium and vitamin K, essential components in calcium absorption. Try including two cups of vegetables and one cup of fruit every day in your diet for maximum bone health benefits.

Other foods high in calcium include figs, black beans, edamame and canned sardines. If dairy avoidance is an issue or you’re vegan or vegetarian, try including leafy greens, fortified soy milks and whole grains into your diet to increase calcium intake.

Diets that focus on healthy sources of protein and fat should include lean meats and skinless fish as they provide protein as well as omega-3 fatty acids to absorb calcium more easily and strengthen bones and tissue.

These protein-rich foods not only offer essential vitamins and minerals, but they’re also low in saturated fat and sodium content. Protein is the building block for cells in our bodies, powering chemical reactions that support overall bodily processes including bone health.

Plant-based proteins such as nuts and seeds should be eaten over animal-derived protein sources for maximum bone health. Almonds, chia seeds and flaxseeds all contain omega-3 fatty acids which have numerous health benefits for bones; moreover, plant-based proteins contain estrogen-like compounds which protect against bone loss.

3. Eat Fish

To ensure you’re getting enough calcium for strong bones, including fish in your diet should be top of mind. Most people know fish is an excellent source of protein but many are unaware it contains bone-building nutrients as well.

Fish is packed with calcium, but also boasts vitamin D and omega 3 fatty acids that may help improve bone health by keeping calcium from being lost through urine and improving calcium absorption. A recent study conducted on premenopausal women who consumed the most fish (particularly salmon and sardines) preserved their bone density better than those who didn’t eat fish at all.

Salmon, trout, sardines, mussels, oysters and anchovies are excellent sources of calcium from fish, with salmon being especially high in vitamin D for increased calcium absorption and sardines and anchovies being especially high in B12 which plays a key role in cell development and red blood cell production.

But even if seafood isn’t your thing, leafy green vegetables provide many of the same bone-building benefits. Bok choy and Chinese cabbage are rich sources of calcium while they’re also packed with other essential vitamins and minerals like Vitamin C, potassium and magnesium.

Nuts, seeds, beans and whole grains are other non-dairy sources of calcium that should be included as part of your daily diet in order to maximize absorption. Your body can only absorb around 500-600 mg at one time; thus you should space out these foods during your day for maximum absorption.

Broccoli is one of the most beloved non-dairy sources of calcium, offering not only fiber and cancer-fighting nutrients. Available fresh or frozen throughout the year, broccoli can easily be added to meals from salads to soups; in one cup cooked broccoli contains about 30 percent of your recommended daily calcium allowance.

4. Take Supplements

Bone health often receives inadequate consideration until people start losing density and becoming more susceptible to fractures. Luckily, certain nutrients are essential for bone development and strength – often fulfilled through diet alone; supplements or vitamins may be beneficial if diet alone cannot meet all requirements.

Although calcium is the go-to nutrient for bone health, vitamin D plays an equally essential role. Studies indicate that vitamin D helps the body absorb and use calcium and other essential minerals more effectively – this makes getting enough vitamin D particularly helpful when it’s difficult to access foods rich in calcium (see table below).

If you’re lacking protein for optimal bone health, take a plant-based protein supplement such as whey or pea protein in powder or tablet form as they can easily be mixed into beverages or food. Other important nutrients to consider include magnesium – one of calcium’s key partners in supporting bone health – and vitamin K which works alongside it to strengthen bones. Magnesium can be found naturally in green leafy vegetables, nuts and seeds but is also widely available as a supplement in different forms such as magnesium oxide, glycinate and gluconate; these forms being readily absorbed than others.

Weight-bearing exercises such as weight lifting are vital to bone health. By increasing bone density and decreasing osteoporosis risk, regular physical activity such as walking, yoga or jogging may reduce osteoporosis risk. Making time for these activities in your daily routine will help reach recommended activity levels.

While multiple nutrients play an essential role in bone health, it’s essential that you consult your physician regarding which supplements to take. When making your choice, ensure they meet high quality standards – look for USP (United States Pharmacopeia) marks to verify they are pure and safe.