A combination of age-related changes, sedentary lifestyles, and inadequate nutrition combine to gradually steal bone mass–at the concerning rate of 1% per year after age 40–which makes osteoporosis a concern for all of us. Though women are at greater risk of osteoporosis, two million American men have osteoporosis and one in four over age 50 will suffer an osteoporosis-related fracture (1). Genetics drives much of osteoporosis risk, but because diet and lifestyle play a big role–this means you can work to prevent osteoporosis with simple strategies starting today.

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When Osteoporosis Erodes Your Bones

Osteoporosis is a systemic disease characterized by low bone mineral density, or BMD. Bone mineral density decreases with age, but when it falls too low it increases the fragility of your bones and the risk of fractures.

Osteoporosis (weak and brittle bones) is usually preceded by osteopenia (the weakening of bone) when the body doesn’t make new bone as quickly as it reabsorbs existing bone.

This means someone with osteopenia is more likely to fracture a bone than someone with an average bone density but is less likely to fracture a bone than someone with osteoporosis.

Causes of osteoporosis/osteopenia include a calcium or vitamin D deficiency, smoking, menopause, hormone changes, and certain medications. Women are most at risk for osteoporosis, but men can also experience this disease.

One of the most troubling aspects of this condition is that there are typically no symptoms until fractures occur. At which point you may notice back pain, a slumped posture, or other fractured bones. 

Treatment for osteoporosis and osteopenia include strength training exercise, diet changes, and in some cases, medication to protect bone density. 

Risk factors for osteoporosis include:(2) 

  • Age 
  • Sex 
  • Family History 
  • Bone structure 
  • Previously broken bones 
  • Some medications 
  • Smoking 
  • Excessive alcohol use 

Osteoporosis isn’t a guarantee, so let’s find out how to prevent osteoporosis, what the science says about common remedies like calcium to prevent osteoporosis, and treatments available to help you build and maintain healthy bones.

Preventing Osteoporosis with Integrative Medicine

Osteoporosis and osteopenia are largely influenced by genetics, but diet and lifestyle also play a crucial role in building and maintaining healthy bone.

The functional medicine approach to preventing osteoporosis will help you dial in nutrition, find the right kind of physical activity, and address hormone imbalances plus lifestyle factors that can weaken bones. 

Menopause and Bone Health

Why does menopause affect bone health and your risk of osteoporosis or osteopenia? Simply put, postmenopausal women are susceptible to osteoporosis since osteoporosis is closely related to estrogen deficiency. 

During menopause, the drop in estrogen levels leads to more bone resorption than formation, resulting in osteoporosis. The average reduction in bone mineral density during menopause is about 10% (5).

Diagnosing Osteoporosis

Bone mineral density (BMD) is measured by dual X-ray absorptiometry, which is considered to be the gold standard to diagnose osteoporosis. The results are referred to as a “T-score”.


According to WHO criteria, osteoporosis is a T-score of less or equal to 2.5 and osteopenia as the T-score between 1.0 and 2.5. This is usually measured in a location within the hip or lower spine.

Osteoporosis mainly occurs in women 10 to 15 years after menopause and elderly men around 75–80 years old (5).

Is My Calcium Supplement Enough to Prevent Osteoporosis?

The conventional advice to prevent osteoporosis and osteopenia is “Get more calcium!” But is that really what the research supports?

The Institute of Medicine recommends a calcium intake of 1,000 to 1,200 mg a day for most people. But recently, research has shown that increasing calcium (particularly with a calcium supplement) isn’t without risks. 

Some research suggests that a high calcium intake, particularly from supplements, can increase the risk for coronary artery calcification, which increases risk for heart attack and stroke (3). 

Calcium Deficiency

In one study, completed in the mid-90s, women who had low bone density, as well as low calcium intake and low vitamin D levels, reduced their risk of fracture by 23% when they supplemented with calcium and vitamin D. These women also continued to build bone (4).

However, healthy, active people who don’t have a calcium or vitamin D deficiency may not be likely to see those kinds of results from increasing dietary or supplemental calcium.

Should You Keep Taking Calcium?

Studies support optimizing calcium intake through calcium-rich foods (which you’ll learn more about shortly), but supplementing with calcium or vitamin D–or a combination–if you’re not deficient doesn’t guarantee protecting bone health.

However, adequate calcium and vitamin D intake is still essential for healthy bone. A deficiency of either can increase the risk of diseases like osteopenia and osteoporosis.

Though it’s impossible to know everyone’s specific calcium needs, aim to get as much calcium as you can from food. If your doctor advises you to get 1,000 to 1,200 mg of calcium a day, ask him or her if they recommend a lower-dose supplement. 

Want to know how your calcium status stacks up? It’s a great time to speak with a provider about bone health. Find out if a calcium supplement is right for you!

Vitamin D is also crucial for bone health, learn more about optimizing vitamin D here.

Bone Building Co-Factors

As you might’ve guessed by now, calcium doesn’t tell the whole story when it comes to preventing osteoporosis and weak bones. So let’s find out what other vitamins and minerals are essential to bone health, and the role they play in preventing osteopenia and osteoporosis.

Calcium is what makes up the essential structural component of the skeleton, which is why it’s vital for both health and bone building.

Magnesium plays a role in directing your bones to absorb calcium, instead of storing it in soft tissues. Magnesium is also responsible for converting vitamin D into its active form to facilitate calcium absorption (6).

Vitamin K supports bone mineral density, and is involved in the activation of vitamin D, working synergistically with magnesium (7). 

Zinc is an essential mineral required for normal bone growth and maintenance (8). 

Vitamin C is another nutrient necessary for maintaining bone health. It plays a role in collagen production in bone matrix, and neutralizes free radicals which are detrimental to bone health (9). 

Vitamin D is required to effectively absorb calcium from the gut, and it also plays a role in phosphorus absorption. Without enough vitamin D, humans can suffer from rickets, a disease where the bones become brittle, thin, and misshapen.

Building Bone Naturally

Aside from a healthy diet and optimizing bone building nutrients, a few key lifestyle habits can also help you build and maintain healthy bones. 

Strength training–meaning not just walking or doing yoga–can prevent osteoporosis and even help rebuild bone (10). Numerous studies show that using free weights, machines, or doing floor exercises is beneficial in building not only muscle, but bone as well.

In addition, it’s imperative to kick habits like smoking or excessive alcohol use, which can rapidly accelerate bone loss and slow bone regrowth, even in your 20s, and 30s.

Foods for Healthy Bones

A healthy, well-rounded diet with plenty of animal proteins, healthy fats, and nutrient-dense veggies is the most beneficial for supporting bone density and preventing osteoporosis. Here are helpful foods for preventing osteoporosis:

For calcium:KaleSpinachArugulaYogurt or kefirRaw milkSardinesFor Vitamin D:Fatty fish, such as salmon, sardines, herring, mackerelGrass-fed beefLiverEgg yolksFor magnesiumChia seeds and pumpkin seedsDark chocolate (>70% cacao)Grass-fed beefGreensAlmondsAvocadosBlack beansFor zinc:Grass-fed red meatPumpkin seedsOystersSprouted or fermented lentilsHemp seedsCashews

Your Bone Health is in Your Hands with Integrative Medicine

Your integrative medicine doctor will evaluate your bone density, and help you build tools to protect the health of your bones.

Because bone density is heavily influenced by lifestyle and dietary factors, changes in these areas have the biggest impact over the long term. Your team of integrative providers will work with you to develop functional solutions like increasing bone-building nutrients, strength-training exercises, and leveraging the right supplements for bone health if necessary.


  1. https://www.health.harvard.edu/special-health-reports/osteoporosis-a-guide-to-prevention-and-treatment
  2. https://www.webmd.com/osteoporosis/guide/osteoporosis-risk-factors 
  3. https://pubmed.ncbi.nlm.nih.gov/27729333/
  4. https://pubmed.ncbi.nlm.nih.gov/8966494/ 
  5. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5643776/
  6. https://ods.od.nih.gov/factsheets/Magnesium-HealthProfessional/ 
  7. https://pubmed.ncbi.nlm.nih.gov/11684396/
  8. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7287917/
  9. https://pubmed.ncbi.nlm.nih.gov/26343111/
  10. https://www.health.harvard.edu/staying-healthy/strength-training-builds-more-than-muscles

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