Bone Health: It’s Not Just an “Old Age” Thing

Bone health is a lifelong health issue, not something that suddenly matters in old age. The choices we make in our youth are what set us up on the path toward osteopenia and osteoporosis later in life—and bone loss begins much earlier than most people realize. By the time osteoporosis is diagnosed, damage has already been occurring silently for years.

Osteoporosis is often labeled an “old ladies’ disease.” Those words are straight from my father’s mouth, by the way. But “old” isn’t as old as people think. To understand why prevention must start earlier, we need to understand what osteoporosis actually is and how it develops.

What Osteoporosis Really Is

Osteoporosis is a silent disease that occurs when bones become demineralized—losing calcium, magnesium, phosphorus, boron, and other minerals—to the point that they are fragile and fracture easily. It is considered “silent” because there are no early symptoms and no routine lab markers that clearly detect it before significant bone loss has already occurred.

This does not mean that someone who breaks an arm during a vigorous game of basketball has osteoporosis. When clinicians talk about osteoporotic fractures, they are referring to fractures that occur during normal, low-impact activities, such as stepping off a curb. In these cases, the bone breaks first, causing the fall—not the other way around.

Osteoporosis Doesn’t Happen Overnight

Osteoporosis develops gradually. Long before a diagnosis is made, a person spends years in a state of osteopenia—lower-than-normal bone density that often goes unnoticed. I think of osteopenia the same way as pre-diabetes. A person is not diabetic when they are told they are pre-diabetic, but they are clearly on the pathway toward disease if no changes are made. The same is true for osteopenia and osteoporosis.

This is why bone health cannot be treated as a concern that begins later on.

Why Waiting Until “Screening Age” Is Too Late

Osteoporosis has been labeled an older women’s disease largely due to screening guidelines set by the U.S. Preventive Services Task Force (USPSTF), which recommend bone density screening starting at age 65 for women and 70 for men. Based on these guidelines, bone health is often treated as a concern that begins after menopause or in late adulthood.

The problem is that a great deal of bone loss occurs long before these ages. Waiting until screening begins means waiting until prevention opportunities have already passed for many adults. At this point our bones are at a point where fractures have already started forming, if a fracture hasn’t already happened.

Bone Is Living, Metabolic Tissue

Bones are living metabolic tissue that continuously break down and rebuild throughout life. They serve as the body’s largest reservoir of calcium, phosphorus, magnesium, sodium, potassium, citrate, and trace minerals. Bones do far more than hold us upright—they interact with every system in the body.

The skeletal system plays a role in blood sugar regulation, cardiovascular health, and hormone signaling. Emerging research also suggests bone health is connected to cognitive health and brain protection. Bone health is not isolated—it reflects overall metabolic health.

Peak Bone Mass and Accelerated Loss

Peak bone mass is typically reached between the ages of 25 and 30. After that point, bone mass declines at an average rate of about 1% per year. For women, that rate speeds up to around 2% per year during the menopause transition—a window that can last nearly ten years. After the transition, bone loss typically slows back down to about 1% per year.

This makes midlife a critical window for prevention. The goal is not perfection, but preservation. Bone loss can be slowed through a nutrient-dense diet rich in protein and vegetables, combined with regular weight-bearing and resistance-based movement. All is not lost—but action matters.

Food First: Supporting Bone Health Through Nutrition

Before turning to supplements, it is important to understand that many of the nutrients necessary for bone health are best obtained through food. Food-sourced vitamins and minerals are generally more bioavailable, meaning the body absorbs and utilizes them more efficiently.

Calcium can be found in plain full-fat and Greek yogurt, as well as other fermented dairy products such as kefir and buttermilk. Leafy greens like spinach and kale, along with herbs such as basil and rosemary, are also valuable sources.

Phosphorus is found in plain yogurt, chicken breast, and shellfish. Magnesium is abundant in Swiss chard, spinach, basil, summer squash, broccoli, and kale.

Sodium has long been misunderstood. While highly processed foods should be limited, sodium is essential for hydration, nutrient transport, and cellular function. A daily intake around 1,300 mg appears to strike a balance—enough to support physiological needs without contributing to cardiovascular strain. Sodium can be easily sourced through lightly salting food and through naturally occurring amounts in fruits and vegetables.

Potassium is another key mineral involved in hydration and bone matrix formation. Swiss chard, spinach, and celery are excellent sources.

Spices should not be overlooked. Cinnamon and turmeric contribute minerals and flavor, reducing the need for excess sodium while supporting overall nutrient intake.

The Takeaway

In today’s fast-paced world filled with modern conveniences, it is easy to forget about bone health—until there is a diagnosis of osteoporosis or, worse, a fracture. At that point, many people feel overwhelmed and believe medication and immobility are the only options.

As a functional nutritionist, I believe prevention and healing begin at the bottom of an empty plate. Food is a powerful tool for supporting bone health, metabolic balance, and long-term resilience. If you want to better understand your bone health and take steps to prevent future fractures, I would love to help guide you on that path.

References

1.    Jeannie Di BonJeannie Di Bon is a movement therapist. (2025, April 29). How EDS affects Bone Health and osteoporosis: Jeannie Di Bon. Jeannie Di Bon - Specialist in movement therapy for hypermobility and EDS. https://jeanniedibon.com/eds-osteoporosis/ 

2.    U.S. Department of Health and Human Services. (n.d.). Office of dietary supplements - phosphorus. NIH Office of Dietary Supplements. https://ods.od.nih.gov/factsheets/Phosphorus-HealthProfessional/ 

3.    US Preventive Services Taskforce. (2025a, January 14). Osteoporosis to prevent fractures: Screening. Recommendation: Osteoporosis to Prevent Fractures: Screening | United States Preventive Services Taskforce. https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/osteoporosis-screening 

Mateljan, George. (2006). The World’s Healthiest Foods: Essential Guide for the Healthiest Way of Eating. GMF Publishing.