6 Best Mediterranean Diet Foods for Bone Health, According to Dietitians

Eating for bone health is essential in all stages of life. Recent surveys have found that approximately 43% of adults over the age of 50 have low bone mass in key areas like the femur and spine, which can lead to osteoporosis. While many diets can support bone health, the Mediterranean diet emphasizes a variety of nutrient-dense foods that contribute to bone health. “The Mediterranean diet focuses on the consumption of minimally processed, whole foods such as fruits, vegetables, beans, legumes and whole grains, as well as healthy fats from nuts, olive oil and fatty fish,” says Mandy Tyler, M.Ed., RD, CSSD, LD. Many of the foundational foods of the diet contain nutrients like calcium, vitamin D and potassium to support healthy bones. Dairy, especially fermented dairy foods, is also an important bone-building component of the diet. Read more about the top six best Mediterranean diet foods you should be eating for healthy bones.

1. Sardines, Anchovies & Other Fatty Fish

“Canned sardines and anchovies (with bones) are packed with calcium, which contributes to bone density and strength,” says Kelly Powers, M.A., RDN, a meal planning and Mediterranean diet dietitian. The Mediterranean diet prioritizes fish as a primary source of protein and unsaturated fats in the diet. Other types of fish also offer essential nutrients for healthy bones. “Fatty fish such as salmon, mackerel, tuna and sardines are high in vitamin D, which helps your body absorb calcium effectively,” says Powers. While calcium is found in a variety of foods, it’s more difficult to meet recommended intakes of vitamin D through food. Fatty fish can offer an important source of vitamin D, particularly when regularly included in the diet. Try our favorite Garlic-Anchovy Pasta with Broccolini or this delicious Greek Salad with Sardines the next time you want to up your weekly fish servings.

2. Leafy Greens

Leafy greens are a staple of the Mediterranean diet. Powers points to the vitamin K in greens as a nutrient that helps the body use calcium. Leafy greens are also a source of calcium, but our body can’t absorb the calcium as easily as that from other calcium-rich foods because of a compound called oxalates.

Instead of considering leafy greens as a primary source of calcium, think of them as offering complementary nutrients to support bone health. No leafy green is off-limits on the Mediterranean diet, so get creative with the ones you choose and how you enjoy them. Try kale in a smoothie, or spinach sautéed in a sauce. “Turnip greens, also known as grelos, are another good source of calcium and grow abundantly in northwest Spain,” says EA Stewart, M.B.A., RD. We love this Turnip Green Pesto for an untraditional twist on a classic sauce.

3. Cheese

Dairy is one of the most well-known sources of nutrients to support bone health. It can be part of the Mediterranean diet, though it’s recommended in slightly lower amounts compared to a healthy American-style diet pattern. The Dietary Guidelines for Americans recommends 2 to 2.5 cup-equivalents of dairy daily as part of the healthy Mediterranean diet pattern. A cup-equivalent is 1 cup of milk or 1½ ounces of cheese.

“Cheeses like mozzarella, Parmigiano-Reggiano, ricotta and Asiago are an excellent source of calcium, making them a great choice for bone health,” says Powers. Keep in mind that cheese can also be high in saturated fat and sodium, so total daily servings should be limited, while considering the dietary pattern as a whole. This Hasselback Tomato Caprese Salad is a perfect way to enjoy fresh mozzarella along with flavorful basil and potassium-rich tomatoes.

4. Tomatoes

“Tomatoes and tomato products are high in potassium, which helps to maintain bone mineral density,” says Powers. The standard American diet is typically high in sodium and low in potassium due to limited fruit and vegetable intake and greater intakes of high-sodium foods. This creates an imbalance that results in bone mineral loss via multiple mechanisms, including calcium excretion. Focus on upping potassium-rich foods for optimal bone health by including produce as part of both meals and snacks. We love a fresh salad that features tomatoes and plenty of other nutrient-rich vegetables, like this Tomato, Cucumber & White-Bean Salad with Basil Vinaigrette or this simple Cucumber, Tomato & Feta Salad.

5. Prunes

Eating prunes regularly not only helps keep you regular, but it can also benefit your bone health. Prunes are high in potassium, a nutrient known to help with bone density, aka keeping your bones strong. Most studies have found beneficial effects when eating between 50 and 100 grams of prunes (aka dried plums) each day, which is equivalent to approximately ¼ to ½ cup of prunes. Work prunes into your diet by having them as a snack along with nuts or seeds, blending them in a smoothie, or enjoying them as a special dessert, like these Sokolatakia (Chocolate-Dipped Walnut-Stuffed Prunes).

6. Olive Oil

Olive oil is a hallmark of the Mediterranean diet, used in everything from cooking to salad dressing. Its unsaturated fatty acids are known to benefit heart health, and while often overlooked, olive oil may also benefit our bones. Olive oil is generally considered to be an anti-inflammatory food, which may offer benefits to bone health when included as part of a balanced Mediterranean diet pattern. It’s also thought that olive oil plays a role in reducing bone resorption rates and prevents increases in enzymes that aid in protein breakdown, which, combined, results in greater bone mass. Try incorporating olive oil in your diet by making your salad dressing with an olive oil base, braising vegetables with olive oil, or by switching to olive oil when cooking.

Other Strategies for Better Bone Health

Eat Foods with Vitamin K

Vitamin K is a fat-soluble vitamin that’s found primarily in dark leafy green vegetables, soy and some fruits, as well as in small amounts in some meats and eggs. “Individuals consuming diets with inadequate intakes of magnesium and Vitamin K2 appear to be at an increased risk of low bone mineral density as well as bone fractures,” says Tyler. The effect of vitamin K supplementation on bone density has been studied with mixed results. Diets that include optimal intakes of vitamin K are associated with greater bone density, but studies investigating the effect of vitamin K supplementation on bone health have not been conclusive. Choosing vitamin K-rich foods can ensure you’re getting enough through your diet. If supplementation is required, working with a registered dietitian or medical professional can help you identify the right dosage for your individual needs.

Optimize Protein Intake

Protein is most often discussed in the context of muscle maintenance and repair, but it also plays an important role in bone health. Protein makes up much of the bone’s mass and volume. and is involved in promoting bone growth and bone mass. Without adequate protein intake, these processes may be impaired. Importantly, it’s recommended that protein comes from a variety of sources (animal and plant) while also ensuring calcium and vitamin D needs are met.  

Limit Alcohol

Drinking alcohol may negatively affect bone health. “When consumed in excess, alcohol may impair the body’s absorption of certain nutrients, including calcium, which is necessary for the formation of healthy bone,” says Tyler. “Individuals who choose to drink should do so in moderation, which is defined as one drink per day for women and up to two drinks per day for men.” That said, drinking within these guidelines still increases your risk of fractures as you age, compared to avoiding alcohol altogether. If you’re looking for creative ways to reduce your alcohol intake, try swapping in zero-proof drinks like mocktails or flavored sparkling water.

Stay Physically Active & Incorporate Strength Training

Living a physically active lifestyle benefits your health in a multitude of ways. Not only does exercise support cardiovascular health and help you stress less, it also helps you get a better night’s sleep and keep your bones healthy. “In addition to a healthy diet, regular weight-bearing exercise and strength training are essential for bone health,” says Stewart. It’s important to focus on activities you enjoy and ones that are accessible to you. This will ensure that you can include physical activity as a regular part of your daily life.

Recipes to Try

Tomato, Feta & Spinach-Stuffed Portobello Mushrooms

4.5

Greek Walnut Spice Cake

4.8

Creamy Pesto Beans

4.9

The Bottom Line

Following a Mediterranean-style diet can be beneficial for your bone health. Many foods included in the diet are rich in nutrients that help maintain bone mineral density. Fatty fish, dairy, vegetables like leafy greens and tomatoes, fruits such as prunes, and unsaturated fats like olive oil are all encouraged on the Mediterranean diet plan and will benefit your bone health. Remember to include weight-bearing physical activity and limit alcohol for better bone health.