Nutrition for Healthy Bones

Bone health is important for every one as we get older and even more so for people with spinal cord injury (SCI). Following SCI a person can lose anywhere from 30-50% of their bone mass and this usually occurs below the level of injury in the weight bearing bones of the hips, thighs and shins. These weakened bones can make a person more susceptible to the development of osteoporosis and fractures. 

The incidence of osteoporosis following SCI can be as high as 88%.

Fractures can occur from typical injuries such as those sustained in car accidents or playing sports, but individuals with SCI are also at high risk fragility fractures.  These are low trauma fractures that can occur when performing basic activities such as transfers, stretching, a fall from the wheelchair or even turning in bed.  When a person with SCI has a fracture they are susceptible to other serious health conditions such as pressure sores, blood clots, weight gain and further impairment of mobility which can significantly impact quality of life.

The good news is there is a lot that you or your clients can do to help keep your bones as strong and as healthy as possible. Proper nutrition and following a good supplementation program can be a practical and cost effective way for you to help reduce your risk of bone loss and of developing osteoporosis.

Calcium is widely known as a key nutrient in bone health. Often people are placed on calcium supplements to ensure they are getting enough calcium. However the latest research shows that it may be better to get your calcium from food sources as opposed to taking a calcium supplement. This is because the supplemental calcium may increase calcium blood levels too quickly and increase the risk of kidney stones, bladder stones and cardiovascular disease. Although dairy is often the go to for calcium it can be very inflammatory to the body (people with SCI want to avoid inflammatory foods as they tend to have systemic inflammation) and often contains hormones and antibiotics.  Great alternative sources of calcium include broccoli, dark leafy greens ie. kale, collard greens, as well as salmon and sardines (with their bones in), parsley, almonds, walnuts and Greek yogurt. Coffee, alcohol and salt can interfere with calcium absorption. If you’re a coffee lover, you’ll be pleased to know that you need to drink about 3 or more cups of coffee before it will start affecting calcium levels.  Alcohol however not only interferes with calcium absorption it can actually be toxic to bone cells.

If you are going to supplement with calcium consult with your health practitioner. Take your calcium supplement with food to maximize absorption and it’s best to take calcium in the form of citrate or microcrystaline hydroxyapatite which are very well absorbed in the body. Calcium carbonate is inexpensive but has a poor absorption rate.

Magnesium is another key nutrient needed to help increase calcium absorption and can reduce the risk of kidney stones and heterotrophic ossification. Consuming magnesium rich foods such as almonds, whole grains, black beans, halibut, avocado, sunflower seeds, sesame seeds, and quinoa is a good start. If you are going to supplement with magnesium consult with your health practitioner first.  The recommended supplement dose is between 400-800mg a day and it is best to take it with your meal to maximize absorption. Magnesium has other benefits such as softening stool, improving sleep, reducing anxiety, muscle spasms and stress levels.

Vitamin D is a big player for healthy bones but unfortunately this vitamin is not found in abundance in our food supply. Sources of vitamin D in foods include oily fish such as salmon, cod liver oil, mackerel and cod liver oil, egg yolks, and fortified cereals and milks. The vitamin D our skin makes from the sun has a longer life cycle in the body than vitamin D from food but this also can be tough to get in you live in colder climates. Vitamin D is best to be taken in supplement form although dosages will be dependent on age, skin pigmentation, geographical location, lifestyle and season and is usually based on blood work. Consult your health practitioner about the right dosage for you.

Boron is often overlooked but is an important trace mineral the helps reduce calcium loss from the body. It also helps to activate vitamin D and estrogen which are needed to maintain healthy bones. Foods high in boron include almonds, avocados, red apples, dried organic apricots and bananas.

Other Bone Boosting Foods- Incorporating bone boosting herbs such as rosemary, thyme and sage into your meals can help to inhibit the breakdown of bone.  Consuming foods high in silica such as bananas, beans, raisins, carrots, and also found in herbs such as oat straw and horsetail helps absorb calcium and increase the strength and integrity of your bones.

One important item to take out of your diet is soda and any other sparkling beverages. The phosphorous levels in these drinks are extremely high and contain no calcium. In fact the more soda you consume the lower your blood calcium levels.

Incorporating these nutritional recommendations into your daily diet can help ensure you have healthy strong bones and reduce your risk of osteoporosis.

Bone Building Smoothie
This smoothie contains calcium, magnesium, boron and silica all nutrients that help to build strong, healthy bones.


  • 5 almonds (or 1 tablespoon of almond butter)
  • 5 walnuts
  • ¼ of an avocado
  • 2 cups of spinach
  • 1 scoop of protein powder
  • Add water or almond milk


Mix in a blender until smooth

Kylie James and Joanne Smith Co-authors of the book Eat Well Live Well with SCI and Other Neurological Conditions. For more nutritional tips.