As most patients are well aware, good nutrition and a balanced diet are important components of overall health. What may surprise people with back problems is that diet, exercise and maintaining a healthy weight also play a major role specific to back health including the prevention of many problems and improved healing.
The bones, muscles and other structures in the spine need proper nutrition so they are strong enough to support the body and to perform their other functions. As a general rule, it is recommended to include the following back-friendly nutrients into a daily diet.
Choosing the Right Foods for Optimal Nutrition
Eating a balanced diet with the right amount and variety of vitamins and nutrients can reduce back problems by nourishing the bones, muscles, discs and other structures in the spine. While a healthy diet calls for many vitamins and nutrients, this partial list highlights a number of healthy choices that can be directly beneficial for back pain patients.
Calcium has received much attention as the most prominent of bone minerals. It is essential for bone health and helps maintain the necessary level of bone mass throughout the lifespan, and especially in old age. Adequate calcium intake is particularly important to help prevent the development of osteoporosis, a disorder characterized by weak and brittle bones that can results in painful vertebral fractures in the spine.
However, calcium alone will not make strong bones as evidenced by the high rate of osteoporosis despite high calcium supplementation. Calcium must be balanced with other synergistic nutrients for strong bones.
Calcium is found in many foods, most popularly in dairy products such as yogurt, cheese, and milk. Other common sources of calcium include dark green leafy vegetables such as kale and bok choy, many legumes, some types of fish such as sardines and salmon (for example, canned with bones), and a variety of other foods such as almonds, oranges, tofu, and blackstrap molasses.
Magnesium is a key mineral in the structure of the bone matrix and is also required for more than 300 biochemical reactions in the body. If blood magnesium levels drop, magnesium will be pulled from the bones. Magnesium deficiency is common and supplementation can assist in maintaining bone density and preventing back problems. This nutrient also helps in relaxing and contracting muscles, making it necessary for strengthening the muscles that support the spine.
Magnesium is found in green leafy vegetables, fish, beans, seeds, nuts, whole grains, yogurt, avocados, bananas, and dark chocolate (70% cocoa or higher).
Vitamin D3 helps the body absorb calcium, which is crucial for the development of strong and healthy bones. Without sufficient vitamin D, bones can become thin, brittle, or misshapen. Vitamin D deficiency is common. Levels in the body can be measured with a blood test that can be ordered by your healthcare professional.
Vitamin D is found naturally in only a few foods, including fatty fish (salmon), liver (or cod liver oil), and egg yolks. In the U.S., milk and some cereals, juices, and breads are fortified with vitamin D. It can also be attained through nutritional supplementation and time spent in the sun.
Vitamin K2 acts as a director for bone minerals, properly distributing calcium out of the soft tissues and depositing it into bone. It is critical for healthy bone metabolism and is often deficient in the diet.
The combination of vitamin K2 and calcium works to help bones in the spine and throughout the body stay strong and healthy. Vitamin K1 is the plant form of vitamin K, which is converted to vitamin K2 by healthy digestive bacteria.
Vitamin K2 is found in healthy fats of meats, cheeses, egg yolks, and other dairy products, and K1 is found in green leafy vegetables such as spinach, kale, and broccoli.
Vitamin C is necessary for collagen formation, the substance that holds the body together, found in the bones, muscles, skin and tendons, and is an important part of the process that enables cells to form into tissue. It also functions as an antioxidant. Adequate vitamin C intake is vital for healing injured muscles, tendons, ligaments, and intervertebral discs, as well as for keeping the vertebrae strong.
Vitamin C can be found in fruits such as strawberries, kiwi and citrus fruits (oranges, guavas, grapefruits), as well as in many vegetables such as tomatoes, broccoli, spinach, red and green peppers, and sweet potatoes. It is commonly available in supplement form.
Proteins are critical components of bone, although they can be easily overlooked with all the focus on minerals. Protein is a key building block for body structure, so daily consumption is critical for maintaining, healing and repairing the bones, cartilage and soft tissues. Proteins also play a key role in digestion and the functions of the immune system.
Collagen proteins make up 30% of the dry weight of bone. Collagen formation requires a regular supply of amino acids along with adequate vitamin C to incorporate them.
Glucosamine is an amino acid, which can be found in high concentrations in cartilage and connective tissue. Chondroitin is a substance that occurs naturally in connective tissues and as a supplement, is often taken with glucosamine.
As a cautionary tale, some studies have shown that when patients consume too much protein in relation to calcium over a long period of time, calcium can be leached from the bones as excess protein is burned. While both protein and calcium are deemed necessary for healthy bones, more research is needed to determine the recommended consumption ratio of protein to calcium and how the two substances affect each other.1
Vitamin B12 is required in the formation of the body’s bone-building cells and is necessary for healthy formation of red blood cells in the bone marrow. Vitamin B12 deficiency anemia has been associated with osteoporosis.
Vitamin B12 is found in animal proteins such as eggs, fish, poultry or meat products, and dairy products such as milk, yogurt, and cheese. Since vitamin B12 is not found in plants, vegetarians should consider supplementing to prevent anemia.
Iron plays a role in the production of collagen and in the conversion of vitamin D to its active form. It is also a component of hemoglobin and myoglobin, two proteins responsible for delivering oxygen throughout the body, including to the tissues that support the spine.
A severe iron deficiency is not common, but can result in anemia. Overall, iron is not a key nutrient generally associated with bone health, but does contribute to other systems that assist in bone development.
Iron is found in many meat products such as liver, pork, fish and shellfish, red meat, and poultry; green leafy vegetables; and lentils, beans, soy, eggs, and whole grains.
Other Sources of Vitamins and Nutrients
If one is not able to incorporate sufficient amounts of certain vitamins and nutrients into the diet through food, nutritional supplements can usually be taken to make up the deficit. Patients should take care to always consult a medical professional before significantly changing their diet or taking nutritional supplements.