Bone Health Optimization 

Brandon Carlson, MD, MPH
University of Kansas Medical Center

Optimizing bone health is crucial for overall wellbeing, as the skeletal system plays a pivotal role in maintaining the structural integrity of the body. From providing support and protection to facilitating movement, healthy bones are essential. This article provides a blueprint of key strategies to optimize your bone health. 

Nutrient Rich Diet

Our diets are increasingly recognized as a key driver of our health across all body systems. A well-balanced diet rich in essential nutrients is fundamental for bone health. Calcium, phosphorus, magnesium, and Vitamin D are particularly vital. Dairy products, leafy greens, nuts, seeds, and fortified foods contribute to a robust bone-friendly diet.

Calcium Intake

Calcium is a cornerstone for bone health, constituting a significant portion of bone structure. Incorporate dairy products, such as milk and cheese, or opt for non-dairy sources like fortified plant-based milk, tofu, and leafy greens. Maintaining enough calcium intake through dietary sources is important for preventing your body from breaking down your bones to maintain a proper level of calcium in your body.

Vitamin D3

Intake Vitamin D3 plays a pivotal role in calcium absorption. Sunlight is a natural source of this vitamin, and spending time outdoors can contribute to properly maintaining Vitamin D3 levels in your body. Additionally, include fatty fish, fortified cereals, and egg yolks in your diet to keep Vitamin D3 levels optimized, especially during the rainy season or winter months.

Calcium & Vitamin D3 Supplementation

While dietary and natural sources of calcium and Vitamin D3 are recommended, some patients may still need additional supplementation to reach adequate intake goals. Consult with a healthcare professional to determine if supplements are needed. Proper dosing and monitoring blood levels is often necessary when supplementations are started.


Weight-bearing exercises, including walking, jogging, and resistance training, stimulate bone formation and help maintain bone density. Maintaining regular, moderate-intensity exercise promotes bone health maintenance.

Avoid Nicotine & Limit Alcohol

Nicotine is linked to decreased bone density, and excessive alcohol consumption can interfere with bone formation. Quitting smoking/vaping and moderating alcohol intake significantly contribute to overall bone health.

Maintain a Healthy Body Weight

Being underweight or overweight can adversely affect bone health. Strive for a balanced weight through a combination of a healthy diet and regular exercise to support your bones. Your primary care physician can discuss your optimal body weight and composition with you and how to achieve your desired weight goals.

Osteoporosis Screening & Surveillance

Annual health exams including screening for diseases are critical for early detection and treatment. This is especially important for osteoporosis screening and identifying low bone mineral density. DXA bone scans are performed to monitor bone density. Typically, women over 65 years and men over 70 years of age should have DXA screening performed. However, in the presence of risk factors for low bone density, such as certain other diseases and medications that accelerate bone loss, earlier DXA screening is imperative to early detection and treatment.

Fracture Prevention with Medications

The mainstay of avoiding fractures is early prevention of bone loss and maintenance of bone health, so asking your health care provider to evaluate your bone health status is important. Once a patient is diagnosed with either osteopenia or osteoporosis, a health care provider may initiate additional medications to help prevent fragility fractures (low energy fractures). These medications can either help prevent further bone loss and/or increase bone density & quality. Which type of medicine is right for each patient is multi-factorial and should be determined by the health care provider.

Bone Health & Musculoskeletal Surgeries

Musculoskeletal surgeries such as spinal fusions, total joint replacements, or fracture repairs are directly impacted by bone health. Patients with osteoporosis or poor bone health are at much higher risk for surgical complications. Spine surgeons and orthopedic surgeons now routinely evaluate and screen for bone health concerns prior to elective surgeries. In some scenarios, if low bone health is identified, pre-operative treatment to increase bone density/quality is initiated to try and prevent surgical complications.

In conclusion, optimizing bone health is a multifaceted approach that involves a combination of a nutrient-rich diet, regular exercise, lifestyle modifications, and periodic health check-ups. By incorporating these strategies into your daily life, you can enhance and maintain the strength and resilience of your bones, contributing to a healthier and more active life.