Nutrition and Musculoskeletal Health: What to Eat for Stronger Bones, Joints, and Muscles
⌚️ read time: 4 minutes
I have to admit it. I've been dragging my feet on writing this article. I get asked some version of ‘what should I be eating for my condition” all the time.
One of the benefits of writing is if you get asked the same question repeatedly, you can answer it thoroughly once (in writing) and then direct each subsequent person to what you've written.
So here it is.
Here’s a warning and the reason I’ve been dragging my feet: nutrition research is notoriously tricky (at best) and downright unreliable (at worst).
Quick, what did you have for breakfast yesterday?
See what I mean? Our recall isn't great, and that's just the tip of the iceberg when it comes to studying nutrition. So of any article I've written, this is the most likely to one day include something that is just flat-out wrong. I will do my best to update this article in the future as our understanding evolves.
And as always, this is not medical advice. Just a broad-strokes educational summary of what we currently know.
How nutrition affects musculoskeletal health
Maintaining healthy bones, joints, and muscles isn't just about exercise and ergonomics. While I would put the bulk of my efforts in the exercise bucket, what you eat likely matters as well. Proper nutrition can support joint health, strengthen muscles, and reduce inflammation.
Muscles
The first, and in my opinion most important, area to consider is your muscle. Not only do muscles support healthy movement and prevent injury, but they also perform a huge percentage of your glucose disposal. Translation: the more muscle you have, the easier you can weather blood sugar variations. And the lower your risk of diabetes.
And what do muscles need? You guessed it. Protein, protein, and more protein. Our diet is notoriously under-served when it comes to protein. While the antiquated ‘Recommended Dietary Allowance” still inexplicably says we should only be getting about 0.36 grams of protein per pound of body weight daily, recent evidence pretty convincingly puts that number closer to 0.8 to 1 gram per pound of body weight.
Not only will this support your muscles, but just about every structure in the body will benefit from having enough ‘building blocks’ available.
Joints
The next area I would think about would be joint health. While your joints certainly need well-nourished cartilage to prevent pain and stiffness (and breakdown leading to arthritis), it’s a little less clear whether we can impact this in real-time through nutrition.
Nutrients like glucosamine and chondroitin sulfate are the ones we think about using to support cartilage health. In a laboratory setting, these are clearly critical to a functioning joint. But the evidence for taking these supplements and improving joint function? The evidence is pretty weak, unfortunately.
Another thing to consider. Chronic inflammation certainly seems to be linked to a predisposition towards arthritis and joint pain. While other factors like your genetics and personal history of injury are likely more important, managing your daily levels of inflammation is an important step you can take to maximize your joint health.
So anti-inflammatory foods are your friends here. If I had to give you one example of what that means, I’d point you to the “Mediterranean Diet.”
Bones
The last bucket to consider is bone health. While you may think of your bones as the scaffolding of your body (which is not wrong), they are far more than that. These bones are living structures that constantly remodel along the lines of stress applied to them. This is why lifting weights is likely the number one thing you can do to combat osteoporosis and the frailty of aging.
To accomplish this, your bones need the right building blocks. Again, I would point you towards protein as an absolute non-negotiable nutrient we must have enough of. But beyond that, we would typically think of calcium and vitamin D for this process.
You’d be surprised though. In today’s world, the rate of calcium deficiency is really quite low. So many of our foods are now fortified with calcium.
But Vitamin D? Vitamin D deficiency is a silent epidemic. Many of us don’t get nearly enough vitamin D in our diets or enough sun exposure to make up for it. This is one worth having checked by your doctor and supplementing if you’re deficient. The health benefits likely extend far beyond your bones.
Foods for stronger joints, muscles, and bones
While there’s no magic food to eat that will instantly cure all your musculoskeletal woes, a general guideline of ‘which foods have which benefits’ may be helpful.
Hey, I even learned a thing or two as I reviewed the latest literature for this!
Fatty Fish: Rich in omega-3 fatty acids, which have strong anti-inflammatory properties, among a host of other body-wide benefits. Think salmon, mackerel, sardines. These can help reduce inflammation and support joint health.
Leafy Greens: Packed with vitamins and minerals, including vitamin K, which supports bone health. Spinach, kale, collard greens - you know the drill.
** Two warnings here. One, Vitamin K doesn’t play nicely with some medications. Be sure to check with your doctor. Two, spinach has astronomically high levels of a compound called oxalate. As I unfortunately learned recently, this can cause kidney stones. Prior to this (terrible) experience, I had no idea.
Nuts and Seeds: In general, these foods are high in healthy fats, antioxidants, and magnesium. Examples would include, almonds, walnuts, flaxseeds, and chia seeds. These support joint function and muscle health.
Berries: Most berries are loaded with antioxidants and anti-inflammatory compounds. Blueberries, blackberries, and raspberries are your best bet within this class. They help reduce oxidative stress, or free radicals, generated from normal cellular processes in the body. Thsi will, in turn, theoretically decrease inflammation in joints and muscles.
Protein: Even though protein intake is no secret, I still think it is the most underrated nutrient discussed in our society. The obvious benefits include support for muscle strength, repair, and growth. But proteins are needed at every step of the way in every system in our body. Chicken breast, turkey, and tofu would be considered your leaner sources of protein.
Citrus Fruits: This is a great example of the problem with nutrition science. It is abundantly clear that vitamin C is crucial for our body to synthesize collagen, which is itself a critical protein structure for bone and joint health. But does loading up on vitamin C have any effect on collagen health in the average person? Maybe it would if you were vitamin C deficient. I’m just not sure many of us are anywhere close to that point. Certainly, if you have a reason to think you are low in Vitamin C intake, oranges, grapefruits, and lemons are your answer.
Bone Broth: I find a percentage of my patients are borderline obsessed with bone broth. Even the name is seductive. What could be better for your musculoskeletal health than drinking something called bone broth? Most formulations contain various compounds like collagen, glucosamine, and chondroitin. Again, in theory, these might support joint repair and reduce symptoms of arthritis. But honestly, the evidence is pretty thin. Just because you eat collagen doesn’t mean it somehow transports to your bones. It just gets broken down in your stomach into the same old protein building blocks any other protein would, and then your body starts over to build it back into collagen wherever necessary.
Supplements for musculoskeletal health
Now, I'm always hesitant to recommend supplements because, let's face it, the supplement industry is basically unregulated. Trusted sources can be difficult to find and knowing what is actually in your supplement is a bit of a gamble.
But here are a few that have some evidence behind them:
Protein: Pick your favorite protein source (mine is whey protein). If you’re going to reach for the updated protein-per-day recommendations (see above), you may need to supplement with a protein shake or two each day!
Glucosamine and Chondroitin: May help maintain cartilage health and reduce joint pain. Basically, there is one decent study that showed glucosamine might slow down arthritis symptoms, specifically in the knees. So the jury's still out on this one, but some people swear by it.
Omega-3 Fatty Acids: It’s pretty clear these guys are essential to a host of body functions at the cellular level. If you're not a fan of fish, fish oil supplements will help reduce inflammation, among numerous other benefits.
Vitamin D: As discussed above, this one is a common vitamin deficiency in our population. It is essential for calcium absorption and overall bone health. This is especially important to consider if you don't get much sun exposure!
Turmeric (Curcumin): This is an interesting one. Relative to the other compounds on this list, there are fewer studies on turmeric. But the ones we do have largely point in a positive direction. So much so that my primary care doctor said this is the one supplement he takes every day. He’s totally convinced by the evidence. I’d have to say, on my read, I’m not quite as convinced. In a nutshell, it has the potential to be a potent anti-inflammatory and thus might help reduce joint pain and inflammation.
Calcium and Magnesium: In theory, these are both important for bone health and muscle function. But be careful - more isn't always better with these and many of our foods these days have calcium. If you’re likely to be deficient in one of these, it’s magnesium.
The elusive ‘silver bullet’ of nutrition
As a whole package, there’s no doubt nutrition plays a big role in maintaining healthy bones, joints, and muscles. The trap we fall into as humans is seeking out the single high-leverage change or “biohack” nutrient to solve all your woes. Unfortunately, it just doesn’t work like that.
Nutrition is a long game that you win over years of good habits. By eating a variety of nutrient-rich foods and considering appropriate supplements for you, you can absolutely support your musculoskeletal health.
Takeaways:
Likely your single best bet at an impactful change in your health would be a focus on eating enough protein to support your bones, muscles, and just about every system in the human body
It is also likely that a reasonable balance of foods with omega-3 fatty acids (such as fish) and antioxidants (like berries) will help manage inflammation levels in the body
Consider supplements if needed, but you must know that this industry is essentially unregulated. There’s no FDA looking at the ingredients and certifying their safety. Proceed with caution.
Remember, the key is balance. And that includes making a healthy diet part of other lifestyle choices like appropriate exercise and sleep.
Be sure to check back periodically, as I’m sure the above will change over time as we refine our understanding of nutrition and how our body works. That’s the beauty and the curse of science…there are no absolutes!
