As we get older, our bones become brittle, leading to an increased risk of fractures. This process is called osteoporosis.
Although women are at a higher risk of osteoporosis, men also suffer from it.
Osteoporosis is associated with an increased risk of disability and mortality. Often when people fall and break their hip or femur, they are immobile for many months, which increases the risk of stroke or heart disease.
Osteoporosis also has been associated with an increased risk of heart disease (R), Alzheimer’s disease (R,R,R) and even more wrinkles (R). This is because the same mechanisms involved in bone health also play a role in skin, brain and blood vessel health.
Osteoporosis is an inherent part of aging. Fundamental aging processes cause osteoporosis, such as cellular senescence and stem cell dysfunction.
More specifically, bone-forming cells (osteoblasts) become senescent (R) preventing them from properly carrying out their function, while stem cells that create bone-forming cells become dysfunctional (R).
These are all inherent aging processes, as we explain here.
How to get strong bones
However, just because osteoporosis is a part of aging does not mean we cannot do anything about it.
Various factors accelerate osteoporosis, such as not exercising enough (exercise subjects the bones to pressure making them stronger), not taking enough calcium, vitamin D and other micronutrients important for bone health, or taking medication that makes the bones brittle, like corticosteroids.
Given osteoporosis is so widely prevalent, various medications have been developed to treat it.
Typical osteoporosis medications include bisphosphonates (such as alendronate, risedronate, zoledronic acid), calcitonin, estrogen agonists/antagonists, RANKL inhibitors (denosumab) or parathyroid hormone analogues.
Often these medications are given when it’s already too late. Luckily, various supplements can improve bone health and reduce the risk of osteoporosis. Or, when you already have osteoporosis, slow down its progression.
We will first focus on specific supplements that can slow down aging while also improving bone health.
Then we will mention some common supplements that can also support strong, healthy bones.
Anti-aging substances to improve bone health
Alpha-ketoglutarate (AKG) is a substance naturally found in our body.
Alpha-ketoglutarate has many functions, such as maintaining stem cell health, improving metabolism and maintaining the epigenome.
Unfortunately, the older we get, the less AKG circulates in our body.
Alpha-ketoglutarate has been shown to ameliorate osteoporosis by improving the epigenome of stem cells that create bone for example (R).
Alpha-ketoglutarate is also involved in collagen production; collagen is a component of bone, providing flexibility to the bone.
In postmenopauzal women, alpha-ketoglutarate has been shown to reduce bone loss (R,R).
2. NMN (nicotinamide mononucleotide)
NMN is a precursor to NAD+, which is a pivotal molecule to maintain cell health and metabolism.
Unfortunately, the older we get, the less NAD+ our cells contain (we explain more about NMN and aging here).
Studies show that NMN can stimulate bone marrow stem cells to form more bone, and that NMN can protect the bone from damage caused by aging and irradiation (R).
NMN can also protect bone against other forms of damage, like damage induced by glucocorticoids, which are well-known drugs to cause osteoporosis and osteopenia (weakening of the bone) (R).
NMN can also ameliorate many other aging mechanisms in animals, such as improved stem cell function and insulin sensitivity, which can result in improved bone strength, joint health and muscle function (R).
Glucosamine is a substance that is naturally found in our body. It’s an important component of cartilage, tendons and ligaments.
However, few people know that glucosamine can also extend lifespan and slow down aging and reduce mortality (R,R,R,R).
Studies have shown that glucosamine could help to maintain healthy, strong bones (R).
Glucosamine can do this by improving mitochondrial function, reducing inflammation and improving autophagy. These mechanisms all play a role in maintaining healthy bones, and healthy aging.
4. Hyaluronic acid
Hyaluronic acid is a substance that occurs naturally in our bones, skin and tendons. It provides structure and glues cells together.
The older we get, the less hyaluronic acid our body produces.
Hyaluronic acid is often applied to the skin to improve wrinkles.
However, studies show that when taken orally, hyaluronic acid can also reduce wrinkles (R,R,R) and improve osteoarthritis (the wearing down of the joints) (R,R).
Studies have shown that oral hyaluronic acid can improve bone strength in animals (R).
This is possible because during digestion, hyaluronic acid is broken down into smaller parts. These smaller parts of hyaluronic acid can cross the gut wall and end up in the bloodstream.
These small parts of hyaluronic acid signal erroneously to cells that hyaluronic acid is being broken down. After all, when hyaluronic acid is broken down in the body, parts of it end up in the bloodstream, too.
This leads cells to produce more hyaluronic acid in the skin, joints and also in the bone.
5. Other supplements to improve bone health
Apart from the longevity supplements we highlighted above, there are also various “health supplements” to improve bone health. We explain the difference between “health supplements” and “longevity supplements” here).
6. Vitamin D
Vitamin D is needed for proper calcium absorption. It helps gut cells to absorb calcium better from our food.
People who are low in vitamin D have an increased risk of osteoporosis; giving people vitamin D supplements reduces their risk of osteoporosis and makes their bones stronger (R).
Calcium is an important component of bone.
If you take calcium supplements, it’s important not to take too much calcium at once. Too much calcium (e.g., more than 1000 mg at once) causes a calcium spike in the blood, which can accelerate calcification of the arteries.
Therefore we recommend to split your dose of calcium into two daily doses, e.g., one in the morning and one in the evening before bedtime (calcium can also calm the mind and help with sleep).
8. Don’t drink milk
Many people drink milk to increase their calcium intake.
They believe that milk is needed for strong bones. That’s indeed what dairy-industry funded government campaigns have told us for decades.
However, recent research has shown that drinking a lot of milk does not lead to stronger bones (R,R). One reason is that milk is acidic and can actually draw away calcium from bones.
Also, milk consumption has been associated with an increased risk of prostate cancer (R), Parkinson’s disease (R), and even increased mortality (R).
This is not surprising, given milk stimulates all kinds of growth-inducing pathways. These growth-inducing pathways are also aging pathways.
In essence, milk is intended by nature to make calves grow fast. Therefore milk contains lots of growth-inducing substances which stimulate insulin, IGF and mTOR pathways.
However, these pathways are also canonical aging pathways: stimulation of these accelerates aging (R).
Milk also contains galactose (not to be confused with lactose), a substance scientists actually use in the lab to accelerate aging in organisms (R).
We therefore do not recommend drinking animal milk. As an alternative to animal milk, you can drink vegetable milk, such as almond milk, cashew milk or soy milk (make sure you buy the low-sugar variants). You can also take calcium supplements.
There is also calcium in cheese. However, cheese is an animal-based food that also often causes irritation of the gut and over-stimulates the immune system.
Plant-based milk, calcium supplements and calcium-rich vegetables (like broccoli) are better options.
9. Vitamin K2
When you take calcium and vitamin D, it’s always important to combine these supplements with vitamin K2.
Vitamin K2 ensures that the calcium ends up in the bone and not in the artery walls.
Vitamin K2 has been shown to improve bone strength and health. For example, women who took vitamin K supplements had an 81 percent less risk of bone fractures (R).
It’s important to take sufficiently high-dosed amounts of vitamin K, between 180 and 360 ug per day. Ideally, take vitamin K2, not vitamin K1.
You can also consume natto, which contains a lot of vitamin K. Studies demonstrated that women who eat natto regularly have less bone loss (R).
Boron is a mineral needed for bone formation. Studies in animals show that supplementation with boron improves bone strength (R).
Dried plums are rich in boron. Clinical trials in which people are given dried plums show an improvement in bone health (R,R,R).
For example, postmenopausal women who consumed 50 to 100 grams of dried plums per day had significant bone density improvements over 6 months (R).
11. Soy products
Soy contains isoflavones, which are substances that have various health effects, including improving bone health (R,R,R).
Isoflavones resemble estrogen. Women who enter menopause experience a steep drop in estrogen. This drop in estrogen plays an important role in the development of osteoporosis.
Isoflavones like genistein and daidzein bind to estrogen receptors and exert estrogen-like effects.
However, these isoflavones can also protect the bone via various other mechanisms: they have anti-inflammatory, antioxidants and other protective effects (R).
Some men are afraid that consuming too much soy containing estrogen-like substances can reduce male fertility or induce feminizing effects. This is however not the case (R).
Also, soy products could protect men against an enlarged prostate and prostate cancer, which is very prevalent in men 50 years and older.
Silicon is a mineral needed for proper bone formation. It improves bone formation, bone matrix quality, and facilitates bone mineralization (R,R,R,R,R).
Silicon-rich foods are beer, raisins, high-bran cereal, and green beans.
Silicon supplements can also help you to get enough silicon. The recommended dose is around 20 to 30 mg per day.
Magnesium plays a role in bone formation. It works synergistically with calcium.
When you take calcium, it’s important to also take sufficient amounts of magnesium.
Most magnesium supplements sold in stores and pharmacies are the magnesium oxide form.
However, the magnesium oxide form is less ideal.
We prefer magnesium malate, which is better absorbed, less taxing for the gut (magnesium oxide is also used as a laxative), and contains malate, which has been shown to improve mitochondrial function and longevity (R).
14. Omega-3 fatty acids
Omega-3 fatty acids are known to improve heart health, eye health and brain health. However, they are also important for strong bones.
One way to achieve this is by reducing inflammation.
During aging, inflammation increases in the body (this is called “inflammaging”). This lingering, smoldering low-grade inflammation also contributes to bone loss (and many other aging diseases).
By inhibiting inflammation, omega-3 fatty acids can help to protect the bone.
Omega-3 fats also induce stem cells to produce bone cells (osteoblasts) instead of fat cells (R).
Osteoporosis is often considered as an inevitable part of aging.
However, various supplements, including supplements that slow down aging, can slow down the progression of osteoporosis, and lead to stronger, healthier bones.
Supplements like these can be health supplements (like vitamin K or calcium) and longevity supplements (like alpha-ketoglutarate and NMN).
These longevity supplements have two advantages: they can improve bone health both directly and indirectly by slowing down aging, which is the main and fundamental reason why people get weak and brittle bones.
Learn more about the best longevity supplements here.