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5 Steps to Optimal Bone Health

Updated: Jul 1, 2021

Did you know that nearly 54 million adults in America have been diagnosed with osteopenia or osteoporosis? That's half of the adult population.

What is osteoporosis?

Osteoporosis is a severe weakening of the bones. Characterized by low bone density and diminished bone strength, it is responsible for 1.5 million fractures every year. Hip fractures are the most serious consequence of osteoporosis -- a hip fracture can lead to surgery, serious disability, and a 10-20% increased mortality. Osteopenia is the precursor to osteoporosis; bone density is still lower than normal, but not as low as osteoporosis.

Whom does it affect?

It occurs primarily in post-menopausal women because they no longer benefit from the bone-protecting effects of estrogen. Other risk factors include female gender, increased age, estrogen deficiency (post-menopausal or amenorrheic), white race, low weight and body mass index, family history of osteoporosis, smoking, and history of prior fracture. Very physically active women and/or women who try to lose weight by severely restricting caloric intake are at a substantially increased risk of osteoporosis.

The Science

Bone, mostly made of collagen and calcium phosphate, is constantly undergoing a process of bone remodeling, wherein old bone is removed (resorption) and new bone is added (formation). At approximately age 30, we reach our peak bone mass -- after that, the rate of resorption exceeds formation. We can never attain our peak bone mass again.

But don't lose hope! With special attention to nutrition and exercise, we can significantly slow the rate of bone resorption by following these 5 steps:

  1. Good Nutrition: Vitamins C, D, K and calcium are essential for bone health. In fact, a deficiency in either vitamin D or calcium almost always precludes optimal bone health. And since collagen is the building block for bones, it wouldn't hurt to be sure you're getting enough collagen (start drinking a high quality bone broth). But be wary of supplements! Unless prescribed by your doctor, strive to attain these essential nutrients from your diet, not with a pill.

  2. Healthy Lifestyle: Smoking, eating disorders, and depression contribute to bone weakening. Research suggests that those who lose weight through exercise and good nutrition (as opposed to calorie restricting) do not have the same reduction in bone mineral density as those who lose weight through calorie restricting only.

3. Weight-Bearing and Resistance Training Exercise It may sound counterintuitive, but by stressing our bones, we actually make them stronger and improve our bone mineral density. We stress our bones by engaging in weight-bearing cardio exercise (like walking, hiking, or running) and by engaging in resistance/strength training. Exercise in the later years of one's life likely slows the decline in bone mineral density and increases muscle mass and strength more than twofold in frail persons. Resistance training includes weights, bands, or own body weight -- the key is to stress the muscles, which will then stress the bone making it stronger.

4. Prevent Falls If a person does not fall, even with brittle bones, he or she is not likely to break a bone. In addition to muscle strengthening, engage in balance training (try tai chi). Assess your home today for any hazards that may contribute to falling.

5. Visit Doctor Regularly If you are over the age of 40, or if you have a family history of osteoporosis, or if you have one of the risk factors listed above, be sure to request a bone mineral density test (called a DXA bone scan) from your doctor at least once a year as well as a blood test to check vitamin levels.

Now that we've boned up on bones, let's get to work -- start strengthening those bones today! It's never too late!

*all information contained herein is from The American Council on Exercise's Sports Nutrition for Health Professionals and The Mayo Clinic (

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