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Addendum: Practical Support & Nutrition for Bone Health

January 8, 2026

Addendum: Practical Support & Nutrition

(Bone Strength–Focused Care for Women and Men)

⸻

Food-Base Nutrition for Bone Strength

Bone strength is best supported through whole foods, with supplementation used strategically to correct deficiencies and support regulation. Calcium intake should be food-based whenever possible and always considered in context.

Non-Dairy Food Sources of Calcium

(Emphasizing bioavailability and mineral balance)

  • Sardines or salmon with bones
  • Bone broth
  • Tahini and sesame seeds
  • Chia seeds
  • Almonds
  • White beans, navy beans
  • Cooked collard greens, turnip greens, bok choy
  • Figs

Calcium utilization depends on adequate magnesium, vitamin D, vitamin K2, hormonal signaling, collagen integrity, and mechanical loading.

Collagen & Protein Support

Bone is approximately 30–40% collagen by volume. Collagen provides flexibility, tensile strength, and resistance to microfracture — properties not captured by DEXA scans.

Practical Collagen Support

  • Bone broth as a regular whole-food source
  • Whole-body collagen powder: typically 10–20 g daily
  • Pair collagen intake with vitamin C (500–1,000 mg/day) to support collagen synthesis

Adequate total protein intake is essential to support bone matrix and muscle mass.

Key Nutrients:

(Applies to both women and men)

  • Magnesium
    Foundational for calcium utilization, vitamin D activation, and bone remodeling
    Target framework: ~5 mg per pound of body weight per day
  • Vitamin D3
    Regulates mineral metabolism, muscle strength, and fall risk
    Target framework: ~45–50 IU per pound of body weight per day
    Common serum goal: 25-OH vitamin D ~50–70 ng/mL
  • Vitamin K2 (MK-7)
    Directs calcium into bone and away from soft tissues
  • Vitamin C
    Required for collagen synthesis and bone matrix strength
  • B-Vitamins (B6, Folate, B12)
    Support homocysteine metabolism and collagen cross-linking
  • Zinc & Boron
    Support osteoblast activity, mineral metabolism, and hormone signaling
  • Strontium (non-pharmaceutical forms)
    May support bone material properties; DEXA interpretation requires caution

Weight-Bearing & Resistance Exercise

(Primary signal for bone formation)

Bone responds to mechanical strain, not nutrients alone. Weight-bearing and resistance exercise provide the strongest stimulus for bone formation, particularly at the hip and femoral neck.

Minimum Effective Dose

  • 20 minutes daily
    or
  • 30 minutes, 3 times per week

Consistency and progression matter more than intensity initially.

Effective Weight-Bearing & Resistance Exercises

Lower Body (Hip & Femoral Neck – Critical):

  • Squats (bodyweight or weighted)
  • Sit-to-stand from a chair
  • Lunges or split squats
  • Step-ups (stairs or platform)
  • Heel drops (controlled)

Upper Body & Spine:

  • Push-ups (wall, counter, or floor)
  • Dumbbell or resistance-band rows
  • Overhead presses (light to moderate)
  • Farmer’s carries (holding weights while walking)

Impact & Dynamic Loading (As Tolerated):

  • Brisk stair climbing
  • Dancing
  • Light hopping or modified jump training (only when safe)

Walking alone supports cardiovascular health but is insufficient to preserve hip and femoral neck bone strength.

Balance & Fall–Prevention (Essential)

Because fractures result from falls as much as bone fragility, balance training is essential:

  • Single-leg standing
  • Tai chi or yoga
  • Core strengthening
  • Gait and posture work

Sarcopenia significantly increases fracture risk independent of bone density.

Objective hormone testing (salivary, serum, or capillary-based, as clinically appropriate) allows confirmation of hormonal patterns contributing to bone loss and supports targeted intervention rather than empiric therapy.

Key Clinical Takeaway

Bone strength depends on the coordination of estrogen, progesterone, testosterone, and DHEA, alongside mechanical loading and adequate nutrient regulation. No single hormone independently determines fracture risk.

Hormone & Bone Health Testing Checklist

(Especially important in midlife and older adults)

Hormones

☐ Progesterone

☐ Estradiol

☐ Testosterone (women and men)

☐ DHEA-S

☐ Cortisol (when stress or steroid exposure is relevant)

Nutrient & Bone-Relevant Markers

☐ Vitamin D (25-OH)

☐ Magnesium status (clinical assessment ± labs)

  • ☐Adequate protein intake
  • ☐PTH if Calcium and Vitamin D low

Functional Factors

☐ Evidence of sarcopenia

☐ Balance or fall-risk concerns

☐ History of steroid or anticonvulsant use

☐ Digestive or absorption issues

At-home testing options are available through VitalHealthPharmacist.com.

This content is intended for educational and informational purposes only and should not be construed as medical advice. The information presented reflects current evidence and clinical perspectives but does not substitute for individualized medical care. Readers should consult their physician or qualified healthcare provider before making changes to medications, supplements, exercise programs, or treatment plans.