Musculoskeletal health is a broad term which can encompass many different conditions that can affect the bones, joints, tendons, ligaments and muscles. Conditions include osteoarthritis, rheumatoid arthritis, osteoporosis, fibromyalgia, sarcopenia and many more. Symptoms can range from stiffness, pain, swelling, joint deformity and restricted movement.
Health of the musculoskeletal structures of the body is largely dependent on the nutrition. There is a close relationship between the health of bones, muscles and joints of the body and the routine diet. A well balanced, healthy meal can help in management and prevention of various bone-related and musculoskeletal disorders.
The most important nutrients that play an essential part of maintaining bone health are Vitamin D and calcium. The bone tissues comprise a large amount of calcium, which is the reason why calcium is termed the building block of the bone tissue.

We are often advised to eat healthily to promote and maintain our brain health or the health of our hearts – and this is also crucial for our musculoskeletal health. Eating a varied, well-balanced, nutrient-rich diet is a good place to start, as an insufficiency of key nutrients puts yourself at risk for bone, muscle or joint disease.

• 1. Calcium – The bones present in the human body contain almost 95 percent calcium. calcium is the most important component of the skeleton. Calcium helps bones develop, improves the height and stature of children during puberty, helps maintain strong bones. Calcium also plays an important role in the muscular system; muscle contraction would not be possible without calcium. Because calcium helps with muscle contraction, low levels of the mineral mean you might experience more muscle cramps specifically in your back and legs. Other symptoms include brittle fingernails, bone-related injuries, irregular heartbeat and tingling in arms and legs.
  Calcium is derived from various food items. Milk and dairy products are one of the best sources of calcium. If the physician suggests to increase the calcium intake, then along with dairy products, calcium supplements can also be taken on a regular basis to increase the body’s calcium content.
• 2. Protein – Dietary protein is necessary for an optimal gain of the bone mass during the growth years of an individual. Proteins are the building blocks of the body and are essential for the body’s natural wear and tear. While the primary role of protein is to repair damaged tissues, it can also be used to produce energy for muscle contractions when other sources of adenosine triphosphate (ATP, the cellular form of energy), namely fats and carbohydrates, are not available. Muscle contains about 30% protein by weight. You might be surprised to learn that bone contains a higher percentage of protein than muscle weight for weight. This is because, in muscle, the proteins are mainly found inside the muscle cells, which contain a lot of water, while in bone, much of the protein is found outside of cells in densely packed fibers that contain little water. Skeletal muscle contractile proteins are the largest protein reservoir and can be rapidly utilized to supply amino acids to the entire organism during fasting or stress. Insufficient protein intake to satisfy daily requirements leads to negative protein balance and results in skeletal muscle atrophy, impaired muscle growth, and functional decline. Therefore, it is important that the proper amount of protein is consumed to prevent muscle wasting and maintain skeletal muscle mass and function
  Deficiency of protein causes lack of muscle strength which can also hamper the repairing capacity of the body after an injury. Legumes, pulses, lean meat, fishes, nuts are excellent sources of proteins that should be consumed regularly.
• 3. Vitamins -
  Vitamin B complex – The vitamins present in the B-complex are often associated with the maintenance of bone density levels. It has been found out that deficiency of these vitamins can increase fracture risk in a person.
  The B vitamin group has been found to have positive effects on bone health. B6, B9 and B12 are cofactors for the enzymes that are involved in the metabolism of homocysteine, and deficiencies have been shown to coincide with elevated homocysteine levels. High levels of homocysteine can impair bone health by increasing osteoclast activity resulting in increased bone resorption. This explains its relationship with decreased bone mineral density and why it is implicated in increased fracture risk. High levels of homocysteine have also been linked to lower muscle strength in women. Good sources of B vitamins include wholegrains, dark leafy vegetables, meat, fish, eggs and dairy products.
  Vitamin C – Vitamin C helps in the formation of collagen which provides structure for minerals in the bone. It also plays a role in stimulating osteoblast activity and thus bone formation. In addition, it has been shown that vitamin C can have positive effects on calcium absorption. Fruit and vegetables are excellent sources of vitamin C, particularly citrus fruits.
  Vitamin D – This vitamin belongs to the fat-soluble vitamins category and is necessary for helping the body to absorb calcium, enhances calcium absorption and bone mineralization, promotes maintenance of muscle function, and is crucial for musculoskeletal health. Low vitamin D status triggers secondary hyperparathyroidism, increases bone loss, and leads to muscle weakness.
  This vitamin is received mainly from sunlight, but due to an increase in trend of indoor workplaces, it has been observed that many people suffer from the deficiency of this vitamin very commonly, People who have low levels of vitamin D often have joint pain. Vitamin D supplements may treat joint pain in some people who have a vitamin D deficiency. When vitamin D levels are low and the body isn't able to properly absorb calcium and phosphorus, there is an increased risk of bone pain, bone fractures, muscle pain and muscle weakness. In order to overcome its deficiency, supplements of Vitamin D can be taken. Other sources of vitamin D are egg yolk and fatty fish.
  Vitamins K – Vitamin K has been shown to work synergistically with vitamin D and have positive effects on bone mineral density, calcium balance and bone metabolism. (Those on blood thinning medication should consult their doctor before taking vitamin K supplements.) Good sources of vitamin K are found in green leafy vegetables such as kale/ collard greens and spinach.
• 4. Magnesium – For skeletal muscle, Magnesium has direct physiological and metabolic roles, including maintenance of protein synthesis and turnover, Magnesium plays an important role in bone formation. Magnesium may also affect muscle performance though energy metabolism (production of ATP), transmembrane transport, and muscle contraction and relaxation. Magnesium is particularly essential for the electrolyte balance, energy metabolism and bones. It also plays an important role in the function of muscles, heart and nerves. Several dietary supplements are utilized to help reduce pain, Magnesium as a dietary supplement has been commonly used and studied for possible benefit to both acute and chronic pain, migraine, muscle cramps, and overall well-being. Good sources of magnesium are green vegetables, nuts, legumes and fish.
• 5. Zinc – This mineral has been found to be linked with the renewal of bone tissue, Specifically, in skeletal muscle. Zinc has been found to affect myogenesis and muscle regeneration due to its effects on muscle cell activation, proliferation and differentiation. Zinc is an essential mineral that is required for normal skeletal growth and bone homeostasis. Furthermore, zinc appears to be able to promote bone regeneration. Zinc plays a major role in regulating every phase of the wound healing process; ranging from membrane repair, oxidative stress, coagulation, inflammation and immune defense, tissue re-epithelialization, angiogenesis, to fibrosis/scar formation. Good sources of zinc include poultry, cereals, pulses and red meat.
• 6. SODIUM – Sodium is an essential ion for nerve conduction and skeletal muscle contraction via the Na/K pump. The body uses sodium to control blood pressure and blood volume. Your body also needs sodium for your muscles and nerves to work properly. Salt helps to regulate the concentration of our bodily fluids, which constantly hang in a delicate balance. It helps our cells to absorb all the vital nutrients they need, and it is also required for healthy muscle and nerve activity
• 7. SELENIUM – Selenium is essentially required to induce the proliferation and chondrogenic differentiation of mesenchymal stem cells. Free radicals can promote inflammation and destroy cartilage and collagen in joints, contributing to the pain of rheumatoid arthritis. As an antioxidant, selenium can help limit free radical production and therefore ease the pain of arthritis. Individuals who had less selenium than normal in their systems faced a higher risk of osteoarthritis in one or both knees. Additionally, the severity of their arthritis was related to how low their selenium level was.
• 8. COPPER – In cellular medium with copper ions, copper plays a significant role in maintaining the formation of proteoglycan and collagen II of cartilage, which are important components of the cartilaginous matrix. It helps maintain healthy bones, blood vessels, nerves, and immune function, and it contributes to iron absorption.
  Sufficient copper in the diet may help prevent cardiovascular disease and osteoporosis too. Copper is a mineral that is found throughout the body. It helps your body make red blood cells and keeps nerve cells and your immune system healthy. It also helps form collagen, a key part of bones and connective tissue. Because copper is used in so many different body systems, a copper deficiency can cause a wide range of symptoms and side effects, including weakness, numbness, pain, fatigue, paleness, frequent infections, neurologic deficits, and bone and cardiovascular issues.
• 9. PHOSPHORUS – About 85% of the body's phosphorus is in bones and teeth. Phosphorous is also present in smaller amounts in cells and tissues throughout the body. Phosphorus helps filter out waste in the kidneys and plays an essential role in how the body stores and uses energy. It also helps reduce muscle pain after a workout. Symptoms of severe hypophosphatemia include: Muscle pain and bone pain, Muscular weakness. An altered mental state, such as experiencing confusion or irritability.
  Deficiency of phosphorus (lack of phosphorus) causes some bone diseases like rickets in children and osteomalacia in adults. An improper balance of calcium and phosphorus may also cause osteoporosis. Dietary sources of phosphorus are egg yolk, milk products, nuts, legumes, and whole grains.
• 10. Astaxanthin – Astaxanthin is a strong antioxidant which by reducing oxidative stress will support muscle function. Astaxanthin increases muscle endurance, lowers lactic acid and might prevent muscle atrophy in aging. During periods of heavy physical exercise, the human body increases the production of free radicals and reactive oxygen species (ROS). Although ROS is vital for several functions of the human body, an imbalance, known as oxidative stress, can damage proteins, lipid and DNA. As a result of the overproduction of ROS, muscle damage, soreness and fatigue can cause inflammation which might decrease muscle performance. Since astaxanthin is the strongest antioxidant, impact of an astaxanthin-supplemented diet during physical exercise.

To maintain an optimum musculoskeletal health, it is necessary to consume adequate nutrients. Supplementation of the nutrients can also be done to provide the body with necessary nourishment.