Strong to the Bone: Your Ultimate Guide to Rock-Solid Bones

🦴 Did you know… that after age 30, our bones start to lose density, and after 50, the breakdown accelerates? Bones do more than keep us upright, they protect vital organs, help us breathe, store and release essential minerals, and even produce blood cells. Collagen fibers give bones flexibility, while calcium and phosphate provide strength.

This month, we’re putting bone health under the microscope! Our bones are the body’s support structure, but they do so much more than hold us up! Our bones also:

• Protect organs like a shield 🛡️

• Help us breathe 🌬️

• Store and release minerals ⚡

• Produce blood cells 🩸

The real MVP is calcium, especially when paired with vitamin D, magnesium, vitamin K, and regular exercise, which together help keep bones dense, durable, and fracture-resistant. While natural bone loss is normal with age, being proactive matters more than ever.

By focusing on bone-supportive habits, including nutrient-rich foods, supplements when needed, and weight-bearing activities, you can maintain strong, healthy bones well into the future. It’s never too late to start building better bone habits, protecting your mobility, independence, and overall health for years to come.

Self Quiz Check ✔️

Take a quick moment to check in with your bones! Answering yes or no to these questions can help you spot areas where a few lifestyle tweaks could strengthen your bone health and lower your risk of osteoporosis.

• Is your diet low in calcium-containing food sources?

• Are you currently in perimenopause (with irregular cycles) or post-menopausal?

• Do you get at least 2 resistance training exercise sessions each week?

• Has anyone in your family experienced a hip fracture?

• Do you smoke or drink alcohol (more than 7 standard size drinks weekly)?

If you answered “yes” to one or more, your bones may need some love; don’t worry small, consistent changes in nutrition and movement can make a big difference in protecting your bones for the long run!

Understanding Bone Health

Bones are living tissue that constantly adapt in size, shape, and density. Early in life, bones remodel themselves through bone modeling (building new bone) and bone resorption (breaking down old bone)

Bone Remodeling: The Life Cycle of Bone

Bones are constantly renewing in a process called remodeling, involving three key players:

• Osteoblasts = process of bone modeling involves cells that build new bone

• Osteoclasts = process of bone resorption involves other cells breaking down old bone 

• Osteocyte = directs osteoblasts & osteoclasts based on bone stress. 

Bone remodeling continues throughout life, repairing stress damage, preventing old bone buildup, and storing calcium and phosphorus. Between ages 25–50, bone density typically remains stable as formation and breakdown balance out. After 50, bone loss often exceeds formation, increasing the risk of bone-related diseases.

Bone Disease

As bone breakdown takes the lead, bone density drops and the risk for bone-related diseases increases.

Let’s define bone disease:

• Osteopenia = Mild bone loss. Think of this like scaffolding a few wobbly beams, which can be reversible with lifestyle changes such as diet, exercise, and supplements. 

  • Did you hear the good news? Again, it’s REVERSIBLE with proper lifestyle changes!

• Osteoporosis = Severe bone loss. Now the scaffolding is fragile, and even minor falls or injuries can lead to fractures. This is why prevention matters!

Signs & Symptoms (often silent)

Bone loss is particularly hard to notice….early warning signs include:

• Gradual height loss

• Stooped posture

• Stress fractures in wrists, hips, or spine

• Back pain from vertebral fractures. 

Sometimes, the first indication is a minor fracture.

Think of bones like a sponge: in your 20s and 30s, dense and resilient; by midlife, lighter and less dense. Osteopenia signals the first changes, while untreated, it can progress to fragile osteoporosis. Being proactive with nutrient-rich foods, supplements, and regular weight-bearing exercise helps maintain bone strength and reduces fracture risk well into the future.

Assessing Bone Health

The gold standard for measuring bone density is a DEXA scan (Dual-Energy X-ray Absorptiometry). This scan gives you a T-score, which compares your bone density to a healthy 30-year-old adult. Let’s look at how to interpret these values: 

T-Score	Interpretation
+1 to -1	Normal bone density
-1 to -2.5	Osteopenia (low bone mass)
-2.5 or lower	Osteoporosis (high fracture risk)

While a DEXA scan measures bone density, the FRAX (Fracture Risk Assessment tool) calculates your 10-year risk of major fractures (hip, spine, forearm, upper arm). FRAX uses femoral neck BMD along with age, sex, personal fracture history, and clinical risk factors such as BMI, rheumatoid arthritis, smoking, alcohol intake, and steroid use. This provides a more complete picture of fracture risk to guide prevention and treatment decisions. You can try a FRAX assessment yourself here. 

Blood Panel, Hormone and Urine Tests

In addition to imaging, blood and urine tests can reveal underlying issues affecting bone health and complement imaging by identifying underlying issues affecting bone health. Key assessments include: 

• Serum calcium and vitamin D for deficiencies

• Bone-specific alkaline phosphatase (Bone ALP) and osteocalcin for formation

• Urinary N-telopeptide (uNTX) for breakdown. 

• Routine labs = calcium, albumin, phosphate

• Kidney function (creatinine, GFR) detect conditions impacting bones. 

• Hormone testing = including parathyroid hormone (PTH), thyroid-stimulating hormone (TSH), and sex hormones, identifies endocrine factors influencing bone strength.

Together, imaging and lab tests give a complete view of bone health, helping you and your healthcare provider make informed choices for prevention and treatment.

Supporting the Bones

When it comes to keeping our bones strong and healthy, calcium is usually the first nutrient that comes to mind. While calcium plays a significant role, it is not the only nutrient that matters. Bone health depends on a team of nutrients working together, with the four most important being:

• Calcium

• Vitamin D

• Magnesium

• Vitamin K

Your nutrient needs change with age and differ between men and women. Meeting your daily requirements for these key nutrients is essential for maintaining bone strength, especially as you get older. See the chart below to determine your nutrient needs.

Sex / Age (years)	Calcium	Vitamin D	Magnesium	Vitamin K
Males
14-18	1300 mg/day	600 IU/day	410 mg/day	75 μg/day
19-30	1000 mg/day	600 IU/day	400 mg/day	120 μg/day
31-50	1000 mg/day	600 IU/day	420 mg/day	120 μg/day
51-70	1000 mg/day	600 IU/day	420 mg/day	120 μg/day
>70	1200 mg/day	800 IU/day	420 mg/day	120 μg/day
Females
14-18	1300 mg/day	600 IU/day	360 mg/day	75 μg/day
19-30	1000 mg/day	600 IU/day	310 mg/day	90 μg/day
31-50	1000 mg/day	600 IU/day	320 mg/day	90 μg/day
51-70	1200 mg/day	600 IU/day	320 mg/day	90 μg/day
> 70	1200 mg/day	800 Iu/day	320 mg/day	90 μg/day

Food Sources of the Bone Health Nutrients

Food source	Amount per portion	Calcium (mg)
Milk, and fortified plant-based milk	1 cup	300 mg
Yogurt (plain, low-fat)	¾ cup	225 mg
Cheese (cheddar)	28 g	200 mg
Tofu (fortified)	½ cup	250-350 mg
Broccoli (cooked)	½ cup	50 mg

Major Takeaways

• Calcium from food sources is more bioavailable and more readily absorbed. Always choose food sources of calcium first! Use supplements as an extra top-up to fill in the gaps if your calcium intake is low.

Food source	Amount per portion	Vitamin D (IU)
Salmon (wild)	3 oz	570 IU
Fortified milk	1 cup	100 IU
Egg yolk	1 large	40 IU
Fortified plant-based milk	1 cup	100 IU
Vitamin D supplement	1 drop	1,000 IU

Major Takeaways

• Food sources of vitamin D are very limited. To meet requirements, supplementation is needed, especially in areas with low sun exposure. Take 7 drops of 600-1000 IU once a week for vitamin D top up!

Food source	Amount per portion	Magnesium (mg)
Pumpkin seeds	¼ cup	150 mg
Chia seeds	3 tbsp	90 mg
Spinach, cooked)	1 cup	78 mg
Black beans (cooked)	½ cup	60 mg
Almonds	¼ cup	80 mg

Major Takeaways

• Magnesium from food sources is preferred as it is better absorbed. Take supplements only if dietary intake of magnesium is low or indicated by lab results. 

Food source	Amount per portion	Vitamin K (μg)
Spinach, raw	1 cup	145 μg
Kale, cooked	1 cup	500 μg
Collard greens, cooked	1 cup	770 μg
Broccoli, cooked	1 cup	135 μg
Brussels sprout, cooked	1 cup	315 μg

Major Takeaways

• Food sources of vitamin K are best! Requirements are easily met for most people through food sources, especially from darky leafy greens!

Bone Health Nutrient Calculator: [Link here]

Supplements 

It’s important to note that supplements are a great way to top up your nutrient intake. But, the doses are not all bioavailable and readily absorbed. The table below includes different types of supplement format and their absorption rate, and ideally, choose the version with the highest absorption rate while keeping tolerance and indications in mind.

Supplement Composition	Absorption Rate (elemental content)
Calcium carbonate	40% calcium
Calcium phosphate	40% calcium
Calcium citrate	21% calcium
Calcium lactate	13% calcium
Calcium gluconate	9% calcium
Vitamin D oil	100% vitamin D
Vitamin D powder (tablet)	70% vitamin D
Magnesium citrate	30% magnesium
Magnesium glycinate	24% magnesium
Magnesium carbonate	5% magnesium
Magnesium orotate	30% magnesium

Moving your bones: Exercise that strengthens 💪

Bones respond to stress, just like muscles - the more you challenge them safely, the stronger they become. 

According to ParticipACTION and Canadian Physical Activity Guidelines, adults should aim for muscle and bone-strengthening activities at least two days per week, targeting all major muscle groups with 8–12 repetitions per set. Exercises can include squats, lunges, push-ups, rows, and core moves using weights, resistance bands, or body weight. 

Pair strength work with weight-bearing aerobic activity; brisk walking, dancing, stair climbing, or jogging for at least 150 minutes per week. Daily movements like stairs or carrying groceries also help. These activities support bone density, muscle mass, balance, and reduce fall risk. Resistance and weight-bearing exercises are critical for improving bone density, maintaining muscle mass, enhancing balance, and reducing the risk of falls.

To make it easier, here are some practical exercise options and resources you can follow from home or in a class setting:

Resistance Training / Weight Lifting

• Beginner to advanced workouts using dumbbells or resistance bands

  • YouTube videos

    • Exercise for Osteoporosis, Osteopenia & Strong Bones

    • Best Exercises to Strengthen Your Bones (Backed by Science)

    • Strength Training for Osteoporosis (15 min)

    • Helpful resource from Health Bones Australia - Exercise & Bone Health

• Sample full-body strength routine: 1 set of 8–12 reps per muscle group, 2–3 days per week. For example; squats, push-ups, shoulder presses, plank, bicep curls and standing calf raises. 

Weight-Bearing Activities

• Brisk walking, stair climbing, jogging, dancing, or hiking

Pilates & Yoga

• Pilates routines targeting core strength and posture

  • YouTube videos

    • 15 min Pilates Workout for Beginners

    • 25 Min Full Body Pilates Workout For Beginners (No Equipment)

    • Helpful resource from Bone Health & Osteoporosis Foundation - Safe Pilates 

• Yoga flows to improve balance, strength, and flexibility

  • YouTube videos

    • 10 min Yoga for Beginners - Gentle & Simple Yoga Stretch

    • Gentle Seated Yoga For Beginners & All Levels | 30 Minute Practice

    • Helpful resource from Bone Health & Osteoporosis Foundation - Safe Yoga

Tips to Stay Consistent

• Choose activities you enjoy; fun increases consistency.

• Mix it up: combine strength, balance, and weight-bearing cardio.

• Track your progress to stay motivated, noting improvements in strength, balance, and endurance.

By following these guidelines, you’re not only strengthening your bones—you’re supporting overall mobility, posture, and confidence, making everyday life easier and more enjoyable.

Key Points

• Key nutrients for bone health include:

  • Calcium

  • Vitamin D

  • Magnesium

  • Vitamin K

• Always choose food sources of the bone health nutrients before supplements. Use supplements as a top up of your dietary intake.

• Move for stronger bones! Aim for at least 2 resistance training exercise sessions per week.

• Get checked and stay proactive. DEXA scans measure your bone density while the FRAX tool estimates your fracture risk. 

• Prevention is powerful! Making small lifestyle changes with nutrition and food can help maintain strong and healthy bones.

Don’t forget to follow along for our monthly newsletters that discuss trending and important nutrition topics to support your health goals!

Thank you for reading, informing, and growing with us! xoxo

Alissa Steinberg

Elisa Porretta

Alyssa Hewson