Osteoporosis: Prevent it Now, Enjoy Life Later

By Ashley Reaver, MS, RD, CSSD, May 25, 2016


Did you know that 1 out of every 2 women and 1 out of every 4 men over the age of 50 will break a bone due to osteoporosis? Roughly 10 million Americans have osteoporosis and another 44 million are at risk of it due to low bone density.1 May is National Osteoporosis Month - so there’s no better time to talk bone health! A broken bone can seriously sideline you from living a healthy lifestyle, and like many other diseases, prevention is the best way to protect yourself. While proper nutrition is a major component, calcium plays a critical role in developing and maintaining your overall bone health.

The National Osteoporosis Foundation details 5 steps to prevent osteoporosis:

  1. Get the calcium and vitamin D you need every day
  2. Do regular weight-bearing and muscle-strengthening exercises
  3. Don’t smoke or drink too much alcohol
  4. Determine if and when you should have a bone density scan with your physician
  5. Take medication if and when it is the right choice for you
How is your bone health?

Keys to increased bone density

Unfortunately, like many general guidelines, how do you know when and what is “enough” to maintain your bone health? Steps 1, 2, and 3 are right up our alley. An essential nutrient for optimal bone health, vitamin D is required for the absorption of calcium from the digestive system. Without adequate levels, calcium cannot be absorbed. With InsideTracker, you can see if you are getting enough vitamin D and how to increase your level if it is low. We provide you with the guidance and tools you need to track the effectiveness of your efforts.  

Weight-bearing and muscle-strengthening exercises are critical for two reasons. Primarily, weight-bearing exercise actually improves bone mineral density. A good phrase to remember is that “form follows function” when it comes to bones. Applying more weight to your body, and therefore, your bones, stimulates bones to deposit more minerals into their structure in order to support the weight. The denser and more sturdy your bones are, the less likely they are to fracture.2 For the same reason, individuals that carry more body weight on their frame tend to have denser bones than very thin individuals. Muscle-strengthening exercises promote good posture, strength, movement, flexibility, and balance - all of which are important as we age to support physical activity and daily living. Exercise also impacts a large variety of other biomarkers related to metabolism and inflammation.

For your overall health, not just for your bones—you shouldn’t smoke. A moderate amount of alcohol can be beneficial for inflammation and fasting blood glucose, but it can negatively impact bone mineral density and the liver. For women, a moderate amount is one drink per day and two drinks per day for men. InsideTracker can help track how your liver is being affected by your alcohol intake. Keeping your primary physician in the loop is also important - continue to see them for your yearly physical.


Your daily dose of calcium

When people think of bone health, they typically think of calcium, but the majority of Americans are not consuming enough of it. Researchers have coined the phrase “The Calcium Gap” to describe the significant difference between the recommended level of calcium and the actual intake of calcium. This gap is most pronounced in children aged 9-18, females aged 19-50, and individuals over 70 years of age.3

The recommended intake level for adults is 1,000mg of calcium per day. For individuals that do not consume dairy products, it is difficult to reach 1,000mg without consuming fortified foods or supplements. As discussed in this blog, dairy is not the only source of calcium available, but it is the best source, with each serving providing roughly 30% of the daily requirement. Yes, dark leafy greens do provide calcium, but you would need to eat 32 cups of raw kale each day to meet your needs, which is highly unlikely.

If you don’t consume dairy, you should be extra mindful to ensure that you are getting enough calcium from other sources. Fortified non-dairy milks (like almond, soy, cashew, etc.) typically provide 30-50% of the daily value. Incorporating one or two glasses per day can help you reach your calcium goals. Almonds, navy beans, tofu, and sardines are also good sources of calcium but it is difficult to meet your needs with those foods alone. When it is not possible to eat enough calcium, a supplement of 500mg per day may be necessary.4 Calcium supplements can be taken with or without food, but should not be taken at the same time as iron, magnesium, or zinc supplements since they compete for absorption.

Why calcium is critical

For females over age 50, the recommended intake rises to 1,200mg per day due to declining estrogen levels, which causes the resorption, or removal, of calcium from the bones at an accelerated rate.4 Because low DHEAS is an indicator of falling estrogen levels, females with low levels of DHEAS should pay special attention to their calcium levels as well - both of which are tested by InsideTracker.5 Developing healthy habits that include adequate calcium intake are critical when calcium needs are at their highest through periods of growth and development, such as childhood. And, the importance of continuing those habits through years 19-50 cannot be overstated. Having adequate levels of calcium is the best line of defense against developing osteoporosis for women that are becoming postmenopausal.


Calcium is difficult to monitor. In blood tests, calcium is almost always in the normal range, despite dietary intake of calcium because it is tightly regulated by hormones, namely, parathyroid hormone (PTH).2 The parathyroid gland senses calcium in the blood and will increase secretion of PTH if calcium is low and will decrease it if calcium is high. PTH has three main functions that regulate calcium levels. Most significantly, PTH causes calcium to be released from the bone in order to raise blood calcium levels. Over time, this leads to decreased bone mineral density and, therefore, increased risk of fracture. PTH also affects the amount of calcium that is excreted from the kidneys and influences the amount of calcium absorbed from the intestines by increasing the production of vitamin D.7

Since calcium levels will typically fall into the optimal range, we base our calcium recommendations on your food frequency questionnaire that’s part of your user profile and dietary preferences. Calcium levels that are chronically outside of the normal range could indicate a problem with the parathyroid gland, such as hyperparathyroidism.2 We recommend that you take your InsideTracker results to your physician and start a conversation about your calcium levels if they are out of range. In addition to bone health, calcium is also vital for muscle contraction, blood clotting, neurotransmitter release, and nerve function, among many other cellular reactions.

Preventing osteoporosis later in life is an investment you make for yourself today. InsideTracker can help you optimize and track your calcium and vitamin D levels—the two most essential aspects of bone health. Keeping your bones healthy, and therefore, remaining active will benefit many other important factors of health. Take the first step in your health by learning where your levels stand. Your future self will thank you!  

How is your bone health?

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[1] National Osteoporosis Foundation. https://www.nof.org

[2] Gropper, SAS., Smith JL, and Groff JL. Advanced Nutrition and Human Metabolism. Australia: Wadsworth/Cengage Learning, 2013. Print

[3] Ausman, Lynne, PhD, RD. "Calcium, Phosphorus, and Magnesium." Tufts University, Boston. Lecture.

[4] Van der Velde, Robert Y. et al. “Calcium and Vitamin D Supplementation: State of the Art for Daily Practice.” Food & Nutrition Research 58 (2014): 10.3402.

[5] Weaver, C. M. et al. “Calcium plus Vitamin D Supplementation and Risk of Fractures: An Updated Meta-Analysis from the National Osteoporosis Foundation.” Osteoporosis International 27 (2016): 367–376.

[6] Greendale, G. A., Edelstein, S. and Barrett-Connor, E. Endogenous Sex Steroids and Bone Mineral Density in Older Women and Men: The Rancho Bernardo Study. Journal of Bone and Mineral Research. 12 (1997): 1833–1843.

[7] Miller TR. Control of renal calcium, phosphate, electrolyte and water excretion by calcium-sensing receptor. Best Practice & Research Clinical Endocrinology & Metabolism 3 (2013): 345-58.


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