Manganese is required for bone mineralization and for synthesis of connective tissue in cartilage and bone. At least half of the manganese in a typical diet is lost when whole grains are replaced by refined flour.

Folic acid is important in bone health due to its involvement in the metabolism of homocysteine, a potentially toxic compound. Studies have shown that people with high levels of homocysteine developed severe osteoporosis at an early age, possibly due to an adverse effect of homocysteine on bone. It appears that menopause is associated with a requirement for folic acid, probably to keep homocysteine levels in check.

Boron has shown to increase serum concentrations of the estrogenic hormone,17B-estradiol without the side effects of HRT. In fact, the levels of 17B-estradiol in boron-supplemented women were the same as in women receiving estrogen therapy.

Other nutrients that are used for bone strength are silicon, vitamin B-6, zinc, Vitamin C and copper. Since a typical American diet contains only about 50% of the RDA (2mg/day) for copper, deficiency of this trace mineral may be quite common.