The First 1000 Days: Nutrients for Strong Bones
Infant bone development.
In pregnancy, and throughout the formative first 1000 days, calcium is often removed from the maternal bones, as a means of aiding the formation of bones in the child. While this obviously implies that calcium intake and supplementation in new mothers is critical, the process relies on an excellent supply of other nutrients, such as specific vitamins and minerals. Low levels of these nutrients will lead to insufficient bone formation in children, as well as a lack of replenishment and remodelling in the mother – severe cases can therefore lead to well-known skeletal issues (such as osteoporosis, as an example).
Bone supplements?
As bone development starts towards the end of the first trimester (continuing until a child completes puberty), it is vital that, from around the time of conception, bone-related nutrition be maintained with adequate levels of the nutrients listed below.
Nutrients needed for strong bones
Vitamins for bone health
The developing skeletal system require a steady intake of Vitamins C & D. These can be obtained through fish, dairy, fruit and (green, leafy) vegetables. Table 1 below summarises the effects each of these vitamins, with respect to skeletal growth.
Table 1: Summary of vitamin effects on the skeletal system.
| Vitamin | Effect | Reference |
| Vitamin C | Essential requirement to create collagen, which is required for normal bone development; Animal models show a decreased level of bone formation in cases of Vitamin C deficiency. | [1-2] |
| Vitamin D | In conjunction with the parathyroid hormone, activity causes bones to donate minerals to the blood to maintain normal serum levels of calcium and phosphorus; supplementation of pregnant mothers with higher doses of vitamin D has been linked to improved bone mineralization in children at 6 years of age. | [3-4] |
Minerals for bone health
Calcium, magnesium, phosphorous, zinc, and fluoride are normally found in high amounts in most dairy, red meats, fruit, vegetables, and fortified bread. They can also be consumed through supplements and infant formulae, as these elements are routinely added to such products. Table 2 below summarises the effects each of these elements upon the skeletal system.
Table 2: Summary of mineral effects on the skeletal system.
| Mineral | Effect | Reference |
| Calcium | Structural component of bones and teeth; key element involved in nerve, muscle, and blood vessel activity. When calcium in the body is low, parathyroid hormone and vitamin D cause body to extract calcium from bones; hence, dietary calcium deficiency will cause bone quality to decrease (this is particularly a problem in pregnant women).
Studies have shown that calcium supplementation during pregnancy improves bone quality in post-partum mothers, though this process may be ineffective if calcium intake is already low. |
[3, 5-7] |
| Magnesium | Multiple functions within the body; particularly involved in regulating the role of the parathyroid hormone and vitamin D. Maintaining levels of magnesium may be linked to improved vitamin D status. | [3, 8] |
| Phosphorous | Makes up more than half of the mineral of bones in the body; deficiency is rare. Supplementation of calcium and phosphorus in pre-term infants may reverse bone strength problems associated with such a birth. | [3, 9-10] |
| Zinc | Required for normal bone growth and maintenance; deficiency is associated with abnormal skeletal development in utero and post-delivery. Zinc supplementation of mothers has been shown to improve femur bone growth in babies. | [11-12] |
| Fluoride | Structural component of bones, teeth; well-known element in improving dental health (particularly teeth). Supplementation in products (such as toothpaste) prevent dental cavities and poor dental hygiene. | [13-15] |
Summary
| Benefit | Nutrients |
| Bone development | Vitamins C, D; Calcium, Magnesium, Phosphorous, Zinc, Fluoride. |
References
- Peterkofsky. Am J Clin Nutr.1991;54(Suppl 6):S1135–S1140.
- Hasegawa et al. Biomed Res. 2011 Aug;32(4):259-69.
- Angelo et al. [Internet]. Oregon (USA): Linus Pauling Institute Micronutrient Information Center (Oregon State University). Bone Health In Depth; 2019 April 19 [cited 2021 April 22]. Available from https://lpi.oregonstate.edu/mic/health-disease/bone-health.
- Brustad et al. JAMA Pediatr. 2020 May 1;174(5):419-427.
- Cullers et al. Am J Clin Nutr. 2019 Jan 1;109(1):197-206.
- Ettinger et al. Nutr J. 2014 Dec 16;13(1):116.
- Jarjou et al. Am J Clin Nutr. 2010 Aug;92(2):450-7.
- Deng et al. BMC Med. 2013 Aug 27;11:187.
- Raupp et al. Ann Nutr Metab. 1997;41(6):358-64.
- Pereira-da-Silva et al. J Pediatr Gastroenterol Nutr. 2011 Feb;52(2):203-9.
- Merialdi et al. Am J Clin Nutr. 2004 May;79(5):826-30.
- Yamaguchi. Mol Cell Biochem. 2010 May;338(1-2):241-54.
- Ringe et al. Fluoride and bone health. In: Holick MF, Dawson-Hughes B, eds. Nutrition and Bone Health. Totowa, N.J.: Humana Press; 2004:345-362.
- Sharma et al. Environ Toxicol Pharmacol. 2017 Dec;56:297-313.
- Touger-Decker et al. Nutrition and dental medicine. In: Ross AC, Caballero B, Cousins RJ, Tucker KL, Ziegler TR, eds. Modern Nutrition in Health and Disease. 11th ed: Lippincott Williams & Wilkins; 2014:1016-1040.
