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]


Benefit Nutrients
Bone development Vitamins C, D; Calcium, Magnesium, Phosphorous, Zinc, Fluoride.


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  3. 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
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  12. Yamaguchi. Mol Cell Biochem. 2010 May;338(1-2):241-54.
  13. 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.
  14. Sharma et al. Environ Toxicol Pharmacol. 2017 Dec;56:297-313.
  15. 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.

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