To Boniva or not to Boniva? Bone strength and the underlying causes of Osteopenia and Osteoporosis.

We spend so much time focused on what our outsides look like that it is important to reflect upon what’s underneath that holds us up.  Poor bone strength is an issue that is poorly understood by the conventional medical community.  The standard of care currently is pharmaceutical medications like Boniva and Fosamax and the ubiquitous 1500 mg of calcium daily.  Due to the side effects of these pharmaceutical medications, physicians prescribe them cautiously and patients have poor compliance in taking them (a Google search will tell you why).  Women diligently taking their daily calcium are not often rewarded with improved bone strength both because of the poor absorption of calcium from oyster shells (the source of most over-the-counter supplements).  So what are the fundamental factors that must be included in a successful bone-building plan?  Putting aside the pharmaceutical options, let’s take a logical look at what goes into building a strong skeleton.

All of us know someone, most likely a woman, who has been diagnosed with osteopenia or osteoporosis.  Poor bone strength is an issue that affects 10% to 18% (on the lower and upper ends of estimates) of women nation wide.  Men have far fewer problems with this issue, totaling only about .5% nationwide.  The most common time for the structural bones (hip, spinal vertebrae) to weaken is after 65 years old and this is when we begin to see the incidence of falls and fractures spike up.  That said, many women who go through early menopause will begin to see bone strength decline in their 40’s and 50’s.  Why is this?  Estrogen maintains bone strength and once the levels of this hormone start to decline in the body, one of the factors supporting healthy bones is taken away.  As all women will go through menopause, it is of the utmost importance to build strong bones before this point.

How come bone health has all of a sudden become an issue?  I would argue that there are two reasons: our increasingly sedentary lives and increasingly deficient digestive function.  The body fortifies the bones with calcium and other minerals according to how much physical pressure we put on our bone structure.  Weight-bearing exercise, meaning exercise in which we are in an upright position, supporting the weight of our body in our feet and legs, is the primary signal to the body that it is time to strengthen bones.  Because we no longer lead lives in which it is necessary to hunt and gather, or build our own homes or even walk to our destinations, our bodies no longer receive the signal to deposit these minerals.  Add to this both the mineral-deficient Standard American Diet (aka SAD) and the detrimental effects of stress on our GI tracts and you’ve got a recipe for progressive bone loss for both women and men.

So how do we reverse this disturbing trend?


Got milk?  For decades now the dairy industry has convinced us that the only thing we need to do to build strong bones is drink cow’s milk.  As it turns out, this plan is not working out very well for us.  Milk is not tolerable in the conventional pasteurized state for many children and adults as the heat involved in pasteurization kills off the beneficial bacteria that help us to break down lactose.  So, if you don’t drink milk, however will you get calcium?  The same way every other animal does, through elemental calcium present in all whole foods.  So, say it with me: for bone strength and any other health issue, the most important thing we can do for ourselves is ditch the processed crap and eat real food.  If you have digestive issues, time to figure out the underlying causes and get your gut on the road to health so that absorption of these minerals is possible.

Foods high in calcium include:

  • Almonds and other tree nuts
  • Seeds like sesame, flax and chia
  • Beans, especially white beans (makes a great soup base instead of milk)
  • Yogurt and cheese (good quality sources of course)
  • Leafy greens, including kale and broccoli
  • Dried fruit

Ditch the DC (or the Coke Zero)

Soda contains high levels of Phosphoric Acid, which leeches out calcium from our bones and creates structural instability.  Plus, those artificial sweeteners gunk up your liver and give you cancer, so there is pretty much no excuse for keeping this vice around.  If it’s the bubbles you’re after, switch to seltzer water and add a splash of juice or a lemon for flavor.  If its the caffeine, go for green tea.


Activity is a necessary component of maintaining all aspects of health, including bone strength.  Because many of us sit in an office throughout the day, activity is something that must be built into our schedules in order to get done.  Walking is great, adding in a free-weight program even better and best would be functional movement with weights (squats with a kettle bell are my personal favorite). Keep in mind that exercise has to be consistent to maintain the pressure on the bones that gives the body the signal to continue to build strong bone structure.  So, while a few days off to take care of a sick child or move or heal an injury is understandable, 3 months off during the summer is not going to cut it.

Vitamin D

Increasingly, the importance of Vitamin D levels as a determination of bone strength and balance is coming to the forefront of even conventional medical wisdom.  As modern day humans in Maine with fear of skin cancer and wrinkles, we simply do not spend enough time in the sun to have adequate stores of Vitamin D.  The scientific name of Vitamin D is cholecalciferol due to its integral relationship with Calcium.  Vitamin D not only helps to absorb Calcium from the foods that we eat, it also contributes to our balance, preventing the falls that cause fractures.  So, if you haven’t done it already, have your Vitamin D levels tested.  Your levels will determine how much of this super-important nutrient you should be taking on a daily basis.  Again, functional digestion is necessary to absorb supplemental Vitamin D, so if you have compromised digestion start seeking answers.

Think Preventatively

Risk factors for osteoporosis include:

  • Being over 60
  • Female
  • Sedentary lifestyle
  • Slender build/low BMI (BMI under 18)
  • Family history of osteoporosis or osteopenia
  • Early-onset menopause or low estrogen levels

If you believe you are at risk due to these factors, get yourself on to a good bone-loss prevention program including all of the above suggestions and also supplementary minerals and Vitamin K.  This way, you are stacking the strong bone deck in your favor and making your weight-bearing exercise work even better to ensure quality of life in those golden retirement years.