osteoporosis 2019

Osteoporosis 2019: New Year predictions for bone health 

Since 2010, I’ve sat down each year and tried to foresee what’s coming next in the world of bone health. I now have almost a decade’s worth of bone health predictions under my belt (some accurate, others still waiting to come to fruition). What a fun time it’s been, so here are my predictions for osteoporosis for 2019!

So without further ado, I’d like to share this year’s set of prognostications:

1. Your doctor will no longer be able to tell you that it is impossible to reverse osteoporosis. By the end of 2019, several studies will have documented the reversal of osteoporosis through a combination of nutritional supplementation and osteogenic loading exercises.

2. Bone density testing will fall out of favor due to its inability to predict fracture. Muscle mass testing and new technologies to measure bone strength will replace in part today’s bone density testing. 

3. Osteoporosis will be widely accepted as an inflammatory disorder, rather than dismissed as a product of the aging process. Sophisticated markers of inflammation will be used to monitor the success of bone therapies, both natural and pharmaceutical.

4. Acupuncture and traditional Chinese herbal medicine will become scientifically documented as powerful therapies for building and rebuild bone strength in people of all ages. New research reports will document the effectiveness of ancient traditional Chinese herbal formulas for bone health, and acupuncture treatments to tonify the kidney meridian will be encouraged for those age 45 and older.

5. The bone-building power of “mindful” exercises like yoga, tai chi, and qi gong will be found comparable to moderate strength training. These exercise modalities, while building bone, will also be found to reduce inflammation, decrease cortisol, and enhance the “rest and digest”  parasympathetic  nervous system.

mindful exercises for bone health


6. It will be shown that it’s possible to stimulate bone growth using pulsed electromagnetic field therapy devices. These devices will be available for home use and valued also for enhancing circulation through the 70 miles of capillaries within the human body. (Stay tuned more to come…)

7. Bone strength will be shown more dependent on the health of the living protein collagen matrix than on bone mineralization. Remember, today’s bone mineral density testing only looks indirectly at the mineralization of bone.  New tests of bone strength are on the horizon. One such test will be a simple test of muscle mass, which is associated with greater bone strength.

8. Doctors in the U.S. will follow the lead of Japanese researchers and begin checking for vitamin and mineral deficiencies as a major risk factors for osteoporotic fracture. While Japanese researchers have began assessing the status of only a few nutrients (vitamin D, vitamin K, and the B vitamins), new research will look at all the 20 key bone nutrients and show deficiencies clearly linked to increase fracture risk.

9. Bone health will be recognized as a marker of and predictor of overall health. Heart and cardiovascular health, in particular, will be linked to osteoporosis to such an extent that those with needless fractures will be tested for cardiovascular health, and those with severe cardiovascular disease screened for bone weakness.

10. The US organic food market grew by 6.4% in 2017, but will reach new heights in 2019 expanding by 25%. This explosion in the demand for organic food will be based on a growing public awareness of the carcinogenic nature of glyphosate (Round-up®), which contaminates the vast majority of our food supply.

organic foods


11. Bone drug advocates will return to suggesting that bone drugs should be prescribed for women with an “osteopenic” bone density, not just those with a diagnosis of osteoporosis. Brace yourselves for this one and push back — because while it’s true that many fractures occur in those with only “osteopenia” and even 20% of osteoporotic fractures occur in persons with “normal” bone density, the real predictive value comes from looking at  multiple risk factors, not bone density.

12. The 5 or so pounds of bacteria in our gut, known as our microbiome and “Second Brain”, will be proven a key player in the regulation of bone growth, maintenance and decline. Specific probiotics and bacteria-feeding prebiotic fibers will be prescribed to enhance the diversity and health of one’s microbiome.  

13. Potassium will be promoted as more important for bone health than calcium. While many of us consume near enough calcium, few, if any, consume the 4700 mg of potassium recommended daily. The daily requirement for potassium is nearly 5 times that of calcium, yet little attention is paid to this mineral found in vegetables, fruits, nuts, and seeds, which is positively associated with bone density and body chemistry pH.

14. Markers of both bone breakdown (as the urine NTX test) and bone formation markers will be commonly used to assess the success of natural bone-building programs. Bone density testing will be more limited, and more attention will paid to changes in the markers of bone formation and bone breakdown.

15. This one is too juicy of a topic to only give two lines to! Stay tuned for a major bone health revelation in 2019 that is going to change the way women are being treated with bone drugs in the future!

There’s a lot to be excited for on the horizon, but whatever comes our way, my best wishes are for you to reverse your osteoporosis in 2019! Keep Me Posted!

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vitamin D prevent fracture

Don’t be fooled: Vitamin D does prevent fracture

I recently recorded a Facebook Live video critiquing a new study that suggested vitamin D does not prevent bone fracture. This study was published in The Lancet in October 2018 and was clearly flawed in many ways. For those of you who did not catch my video commentary on the shortcomings of this study, I summarize them here.

Not all studies are created equal

I’ve been looking at the research on vitamin D for almost 30 years. It’s been clear for quite some time that you can reduce fracture risk with vitamin D if you obtain the therapeutic level of 32 ng/mL in your blood. So why would the new study claim that vitamin D doesn’t work to lower fracture risk?

To put it simply, the new study used a lot of vitamin D data that just wasn’t very good to start with. As a meta-analysis, it mined data from 80 studies on vitamin D from the past 20 to 30 years. But the problem is that most of these studies were flawed in the following ways:

They were mostly evaluating low doses of vitamin D (400–800 IU) that we know to be too low to affect fracture risk.

Many of them were too small and too short in duration to really assess the effectiveness of an intervention with vitamin D.

To be valuable, the study must document not only how much the participants took, but also whether they reached the therapeutic level. The vast majority of the studies didn’t report what blood level their participants reached—so none of them can say for sure that their participants had adequate vitamin D levels, particularly since few of them assessed the starting blood levels.

In those studies that did give higher doses of vitamin D, most of the time it was supplied in a single bolus of 100,000–300,000 units — which has been shown to be ineffective. To be most effective, the vitamin D dose should be given daily and it should always be given in the form of a natural vitamin D3 (cholecalciferol), not vitamin D2 (ergocalciferol).

The standard treatment for vitamin D deficiency uses 7,000 IU of vitamin D daily for 8 weeks, followed by testing of the new vitamin D level. Then the appropriate, long-term dose of vitamin D is determined. This is a dose that would provide at least a 32 ng/mL blood level of vitamin D, the minimum needed for health, with the goal of reaching an ideal range from 50–60 ng/mL.

Once vitamin D deficiency has been corrected, most individuals require 3000–4000 IU (or more) supplemental vitamin D daily to maintain an optimum blood level.

When you look at the data the study used, it’s pretty clear that this recent metanalysis is seriously flawed, and that the author’s conclusion that vitamin D is of no use in fracture prevention is both irresponsible and harmful.

So don’t be fooled — the value of vitamin D, established over many years of good research, is no different in 2018 than it was in 2008, when I first published my research review article on the subject.


Bolland MJ, Grey A, Avenell A. Effects of vitamin D supplementation on musculoskeletal health: a systematic review, meta-analysis, and trial sequential analysis. Lancet Diabetes Endocrinol. Published online October 04, 2018. DOI:https://doi.org/10.1016/S2213-8587(18)30265-1.

Brown SE. Vitamin D and fracture reduction: An evaluation of the existing research. Altern Med Rev. 2008;13(1): 21-33.

grandmother protecting children's bone health

Are we setting kids up for osteoporosis?

Recent studies point to a worrisome trend: children and young adults, especially girls, have become a great deal more sedentary in recent years, and it’s affecting their health. And while most of these studies talk about the short-term impacts this has — rising obesity and increased depression and anxiety being among them — I wonder about the impact of this lifestyle on children’s bone health and risk for osteoporosis as they grow older.

Sedentary lifestyles among kids and teens becoming the norm, especially for girls

Researchers from the U.S. National Institute on Aging in collaboration with Johns Hopkins’ Bloomberg School of Public Health and North Carolina State University, looked at activity levels in 12,589 participants grouped by age: children (6–11 years); adolescents (12–19 years); young adults (20–29 years); adults at midlife (ages 31–59); and older adults (60–84 years). Slightly more than half (51%) of the participants were female.

The findings that were most startling—and concerning—were that among children, more than 25% of boys and 50% of girls age 6–11 had not met the World Health Organization (WHO) recommendation that children age 5–17 get at least 60 minutes of moderate-to-vigorous physical activity every day. This is a much higher level of sedentary behavior than was previously thought to exist in children. And it’s even worse among adolescents: more than 50% of male and 75% of female adolescents age 12–19 did not meet WHO activity level recommendations.

What will happen to children’s bone health when they become adults?

Well, we know that the peak time for building bone happens in adolescence and young adulthood. And we also know that bone (and muscle) are a “use it or lose it” system — no exercise means muscle doesn’t move, and non-moving muscle means bone isn’t stimulated to turn over and strengthen. So if children, and especially adolescents, are sedentary, it means they are not maximizing their bone building during the crucial peak bone-building period of their lives. And that means that later in life, when losing bone is common, they won’t have as much to spare, putting them at risk of osteoporosis.

It’s especially problematic for the girls and young women in the study, because as we know, when women reach midlife, it is often the case that they lose bone during menopause. This menopausal bone loss isn’t necessarily a major problem — unless the woman did not build adequate bone reserves during adolescence and young adulthood. And this study suggests that the majority of girls in the study were particularly prone to being sedentary — which can have devastating long-term consequences.

 It is estimated that a 10% increase in children’s peak bone mass would delay the development of osteoporosis by 13 years. 

children's bone health chart

So what can we do to protect children’s bone health?

I have some thoughts:

  • Let’s all be aware that our daughters and granddaughters need to be more active. Start the habit of exercise early. We have this picture of little girls in our society as delicate flowers — but girls can be just as rough-and-tumble as boys if allowed to be! But whether it’s ballet classes or the soccer field, getting them involved in physical activities can only benefit them, short term AND long term.
  • And let’s also remember that when it comes to activity, it doesn’t necessarily have to be vigorous. Whether it’s a child or an adult, even low to moderate levels of physical activity can be beneficial (and they’re certainly more beneficial than sitting!)
  • If the children and adolescents in your life have sedentary habits, model a different lifestyle for them. I guarantee that no adolescent wants their mother or grandmother outdoing them on the hiking trail — so if you set the pace, they’ll keep up!

You can also help them by ensuring they get adequate nutrients for bone building in the teen years — via a healthful diet if you can manage it, but picky eaters may need nutritional supplements.


Verma VR, Dey D, Leroux A, et al. Re-evaluating the effect of age on physical activity over the lifespan. Prev Med 2017;101:102–108.

woman looking at her T score and Z score

The infamous T score and neglected Z score

I bet most of the Better Bones community have heard of the infamous bone density T score. But I suspect that few understand what the T score means, and even fewer know about the hidden value of the Z score. Contrary to popular (mis)understanding, the T score does not measure fracture risk or indicate that you need bone drugs.  So what then does the T score indicate?

Putting the T score in perspective

The T score measures how closely your bone density compares to that of an average 30-year-old of the same sex. This comparison is expressed in terms of the “standard deviation,” or SD, which you may recognize from a statistics class as being the amount that represents the typical distance above or below the mean for individual measurements. So, if your bone density differs from the average 30-year-old’s (which it probably will!), that difference will be characterized as “–1.5” if your bones are 1.5 SD below the mean, or “+1.2” if they’re 1.2 SD above the mean.

As the chart shows, a T score of –1.0 is described as osteopenia, and –2.5 is described as osteoporosis — even though bone density bears little relationship to fracture risk (but that’s <a href = “https://www.betterbones.com/testing/bone-density-tests-arent-enough/”>another story</a>).

The T score measures how closely your bone density compares to that of an average 30-year-old of the same sex. This comparison is expressed in terms of the “standard deviation,” or SD, which you may recognize from a statistics class as being the amount that represents the typical distance above or below the mean for individual measurements. So, if your bone density differs from the average 30-year-old’s (which it probably will!), that difference will be characterized as “–1.5” if your bones are 1.5 SD below the mean, or “+1.2” if they’re 1.2 SD above the mean.

As the chart above shows, a T score of –1.0 is described as osteopenia, and –2.5 is described as osteoporosis — even though bone density bears little relationship to fracture risk (but that’s another story).

In this second chart (below), 68%, or around two-thirds, of the population falls within 1 SD of the mean, either lower or higher than the average, and another 32% (the remaining third) of the population falls more than 1 SD beyond the mean. Keep in mind that, starting in her mid-30s, the average woman will lose 35% of her cortical bone mass and 50% of her trabecular bone mass over her lifetime (assuming she doesn’t take steps to limit bone loss). So it is totally reasonable to expect that an older woman is not going to have the bone density of a 30-year-old woman, and that her T score will be a negative rather than a positive number.

The overlooked Z score

Elsewhere in your testing results, you will find out your Z score. The Z score compares an individual to others their own age and sex — which makes it a much more realistic assessment of how your bones are faring in their lifelong journey. Where an active, healthy 80-year-old woman, compared to a 30-year-old, might have a T score of –2.0, when compared to other 80-year-old women, she could very well have a Z score of +1.0 or even +2.0!


It’s a pity that the Z score, which “compares apples to apples,” gets so much less attention than the T score. It hardly seems realistic to be worried about having lower bone density that a 30-year-old — but there’s good reason to pay attention when your bone density is much lower than people your own age. For instance, if your Z score is –2.0 or more, it means that very few people your age have a bone density that low, and it signals the need for a complete medical workup looking for all possible cause of excessive bone loss.

Unraveling the mysteries of bone density test results

Now that you know the story of the infamous T score and the neglected Z score, hopefully it will encourage you to learn more from your bone density test. If you want to do just that, look into our new online class: A worried woman’s micro-course on understanding bone density tests.  This class includes a live group Q&A with Dr. Brown where you can ask your questions about the course material. Details coming soon!

Hunter, D, and Sambrook, PN. Bone loss: Epidemiology of bone loss. Arthritis Res. 2000:2(6):441-445.

My Better Bones Builder

Why I created Better Bones Better Body® and the Better Bones Builder

As an anthropologist I could see that osteoporosis was not something that occurred to aging women and men all over the world. Even more, it was obvious that conventional medicine did not hold the answer to lifelong bone health.

As I came to fully understand the nature and causes of osteoporosis, I developed a burning desire to help solve the growing epidemic of poor bone health.

My goal became to develop a nutritional and lifestyle program which would allow all motivated individuals to enjoy life-long bone health. And, after two decades of research and clinical practice, I reached that goal when I developed the Better Bones Better Body® Program.

To provide motivated individuals with the optimum bone health supplement, I realized I had to create it — so I did just that.

See the video of Dr. Brown’s Grandma at 102 years old with Osteoporosis & Rickets which inspired Dr.Brown to make this her life’s work. 

Filling the gap with the best bone supplement for women

Early in my career, I uncovered a huge problem when it came to bone health supplements. No supplement existed that had all the nutrients in the dosage and forms I knew women really needed. Thousands of hours of research made this shortcoming very clear to me. Sure, there was calcium, but hundreds of research reports made it obvious that getting more calcium alone won’t do much for the health of your bones.

In one way of another all the bone supplements women could buy over the counter were incomplete and doomed to be ineffective.

Here’s why other supplements didn’t work:

  • None of the available bone supplements contained all the 20+ key nutrients I knew to be essential for optimum skeletal health
  • None offered the best form and proper dosage of the included nutrients,
  • None were designed to alkalize.

And even more, I formulated this product to be not only the optimum bone builder, but also to serve as your “all in one” comprehensive multivitamin/mineral. The unique supplement is known as Better Bones Builder.

Additionally, the good news is that more and more there is strong research coming out on bone health. And I keep evolving the Better Bones Builder formula, based on new clinical practice evidence and the best research about how nutrients can prevent bone loss.

Would you like to learn more about a specific nutrient? All you have to do is click on each nutrient’s name to study a selection of the research studies and articles about it: 20 key bone-building nutrients — an overview.

Why I choose to sell my supplements online

Occasionally I am taken to task by a blog subscriber who asks why I design and sell supplements…Why don’t I just write about my solutions of the poor bone health epidemic? My response is simple, after decades of research and clinical practice I know a safe and effective way to help everyone develop Better Bones and a Better Body and I am happy and proud to offer this solution to as many people as possible.

By the way, I give kudos to my readers for being so diligent about health information and products! It always is important to ask questions and take a look at sources and references for information. I invite you to do so for every Better Bones blog, article and product.

Finally, I hope you’ll make the investment in yourself by using the Better Bones Builder. But if not, you can still get my weekly insights about current bone health research and how to incorporate it into your everyday life. I’ll keep sorting the fact from fiction when it comes to bone health so that you can continue to get all of the benefits of the natural approach.

I send each of you my very best wishes for Better Bones and a Better Body!


why bone talk is important to you

Your bones listen and talk…really!

Our skeleton might seem like a silent partner that quietly provides us with a solid framework, a place for muscles to attach, an incubator for red blood cells and a gigantic storehouse for alkaline mineral compounds. In reality, however, our bones are anything but silent. Like text messages pinging back and forth on a smart phone, our bones and our bodies are in constant conversation.

What are they talking about?

Bones are the body’s “great communicator”

When your body talks to your bones, it does so through chemical messengers you’re likely familiar with: hormones like estrogen, progesterone, testosterone, growth factors, thyroid and parathyroid hormones, and vitamin D, among others.  This larger endocrine system regulates the development, maintenance and renewal of bone. Your amazing skeleton listens to these silent chemical messages very carefully — but it not only receives messages, it also sends them out to every other tissue in the body, creating a complex network of information flowing out of the bones.

Here’s a simplified overview of how our skeleton “talks” through the hormones it produces:

Osteocalcin: This osteoblast-derived hormone helps regulate whole-body energy metabolism and blood sugar control by stimulating the production of insulin. It also stimulates the brain to impact memory and mood. In men, osteocalcin encourages the testicles to produce testosterone.

Lipocalcin 2: A hormone dispatched by bone to help fight bacterial infections, manage fat as an important fuel source, and talk to the brain about appetite control.

Sclerostin: A bone-derived hormone known to control bone growth. Sclerostin is also dispatched by bone to manage fat as an important fuel source. In mice this hormone helps convert “bad” white fat to energy-burning beige or brown fat.

Leptin and adiponectin: These two hormones are produced by the bone marrow and white adipose (fat) tissue. Leptin is a key regulator of energy homeostasis and acts as an indicator of the body’s long-term energy reserves.  This hormone signals the hypothalamus to regulate satiety, energy balance, fertility and immune function.  Without leptin, you have insatiable hunger and obesity develops.

Adiponectin: This is a protein produced by bone marrow fat cells (adipocytes). Decreased circulating adiponectin is an established biomarker for increased risk of cardiometabolic diseases.

Fibroblast growth factor 23 (FGF 23): Bones use this messenger to tell the kidneys to rid the body of extra phosphates that build up in certain genetic disorders.

Why “bone talk” is important to you

Our skeleton is a very complex and intelligent organ directing system-wide essential functions. Much of this bone-derived chat is aimed at regulating whole-body energy metabolism, glucose control and appetite control—areas where bones benefit from being in the driver’s seat because our skeleton needs a great deal of energy to maintain and renew itself on a constant basis. Caring for our bones, we literally help care for the entire body.

Modern science is only beginning to understand the vast field of information and intelligence we identify as our body, and it’s on the brink of linking bone health to the development of diseases like diabetes and obesity. Bringing your awareness to the “wonders of you” enlivens that intelligence and enhances your well-being.


What else do your bones do?

6 Secret Wonders of Your Skeleton

Our skeletons are composed of hard tissue that provide us with a sound infrastructure allowing for upright posture, complex movements and amazing dexterity. While many people look upon their skeletons as little more than scaffolding — hard structures that hold us up and give shape to our bodies — many don’t realize that this is but one of the many ways our skeletons serve us.

For a fun analogy to help illustrate this point, consider this: our skeletons are not like a small store selling one kind of widget — they are more like a mini-mall offering us multiple goods and services. Your amazing skeleton offers:

  • “Parking” in the form of support for softer tissues and attachment points for skeletal muscle to assist in movement.
  • “Security” in the form of mechanical protection of internal organs.
  • A “supermarket” where the body can shop for “groceries” such as key minerals that play essential roles in cardiovascular function and overall health. This includes calcium (97.9% of which is in the skeleton), magnesium (50%), sodium (35%), and phosphorus (85%), as well as “specialty foods” — alkalizing compounds like citrate and carbonate, which attach to the minerals in bone and provide for the essential maintenance of minute-to-minute blood pH balance.
  • A “hardware store” in the form of bone marrow that offers blood cells (for moving nutrients and oxygen), platelets (for fixing leaks and patching holes), and “batteries” (reserve energy in the form of fatty acids).
  • A “locker room” for toxic metals, keeping these hazardous substances out of circulation.
  • And there’s even a “courier service” in the form of hormones that send messages to the tissues about glucose control, energy metabolism, body mineral balance, and body fat (Martin 2017).


6 functions of the skeleton

Our skeletons are a wonder, and with so much to offer, it’s no surprise most of us are satisfied customers!

Secrets of Your Skeleton



Martin C. Bones make hormones that communicate with the brain and other organs. Science News 2017;191(13):12.

What's wrong with proton pump inhibitor antacids?

PPI antacids increase fracture risk

Are the medications you’re taking for heartburn and acid reflux increasing your fracture risk?

Proton pump inhibitor antacids (PPIs) like omeprazole (Prilosec), lansoprazole (Prevacid), esomeprazole (Nexium) and others can seriously increase your risk of fracture  30 to 50% — and even up to 200% according to one study. In fact, the risk is so great the FDA issued a warning about it.

What’s more, this class of medications is among the most overprescribed drugs (as well as being available over the counter), and it is estimated that up to 70% of people taking them don’t really need them.

What’s the problem with proton pump inhibitor antacids?

One likely reason for the problems with the PPIs is that inhibition of stomach acid means less nutrient absorption and therefore reduced bone strength. The effects of PPIs on nutrient absorption is well-documented and affects calcium, iron, magnesium, B12, and other key bone nutrients.

Nutrient depletion in turn leads to lower trabecular bone density and susceptibility to low-impact fracture.

Recent research shows other serious damaging effects

  • 50% increase in risk of chronic kidney disease
  • 58% increase in risk of heart attack
  • 44% increased risk of developing dementia, including Alzheimer’s in people age 75 and older
  • A significant increase in serious gastrointestinal infections such as difficile.

Symptom suppression often leads to dysregulation of the entire body; that’s why the Better Bones, Better Body approach takes the perspective that identifying and correcting the root cause of a symptom is a more life-supporting approach.

PS: In the attached video, I interview my colleague, nutritionist Martie Whittekin, CCN, author of Natural Alternatives to Nexium, Maalox, Tagamet, Prilosec, and Other Acid Blockers.  While this is a serious topic, the interview is fun and informative and well worth watching.



Andersen BN, Johansen PB, Abrahamsen B. Proton pump inhibitors and osteoporosis. Curr. Opin. Rheumatol. 28(4):420–425, 2016.

Forgacs I, Loganayagam A. Overprescribing proton pump inhibitors. BMJ, 336(7634):2–3, 2008.

Gomm W, von Holt K, Thomé F, et al. Association of proton pump inhibitors with risk of dementia: A pharmacoepidemiological claims database analysis. JAMA Neurol. 73(4): 410–416, 2016.

Ito T, Jensen RT. Association of long-term proton pump inhibitor therapy with bone fractures and effects on absorption of calcium, vitamin B12, iron and magnesium. Curr. Gastroenterol.Rep. 12(6):448–457, 2010.

Wei L, Ratnayake L, Phillips G, et al. Acid suppression medications and bacterial gastroenteritis: a population-based study cohort. Br. J. Clin. Pharmacol., 2016 DOI: 10.1111/bcp.13205.

Maggio M, Lauretani F, Ceda GP, et al. Use of proton pump inhibitors is associated with lower trabecular bone density in older individuals. Bone, 57(2):437–442, 2013.

Moberg LM, Nilsson PM, Samsioe G, Borgfeldt C. Use of proton pump inhibitors (PPI) and history of earlier fracture are independent risk factors for the fracture in postmenopausal women. The WHILA study. Maturitas, 78(4): 310–315, 2014.

Schoenfeld AJ, Grady D. Adverse effects associated with proton pump inhibitors. JAMA Intern. Med., 176(2):172–174, 2016.

Shih CJ, Chen YT, Ou DM, et al. Proton pump inhibitor use represents an independent risk factor for myocardial infarction. Int. Cardiol., 177(1):292–297, 2014.

Whittekin M.  Natural Alternatives to Nexium, Maalox, Tagamet, Prilosec and other Acid Blockers. Square One Publishers, Garden City Park, New York, 2012.

Zhou B, Huang Y, Li H, Sun W, Liu J. Proton pump inhibitors and risk of fracture; an update meta-analysis. Osteoporosis Int., 27(1):339–347, 2016.




4 tips for restorative sleep

New research on sleep and bones

Bet you feel healthier after a good night’s sleep — well, so do your bones. Here’s what the scientists have found in their latest research about the connection between sleep and your bones:

  • Reduced sleep duration was associated with lower bone density in middle aged and older women in one Chinese study.
  • Obstructive sleep apnea, with its loss of sleep and oxygen deprivation, weakens bone.  A recent Taiwanese study found the incidence of osteoporosis to be 2.7 times higher among those with sleep apnea.
  • Insomnia was associated with a 52% increased risk of osteoporosis in a recent Norwegian study.
  • In animal models lack of sleep was found to halt new bone formation, cause cell damage,  and produce abnormal bone marrow, all likely to be associated with poor bone repair.

These studies highlight that sleep is essential to give us a time and environment for crucial bone repair and regeneration. Inadequate sleep is a pro-inflammatory stressor that results in “repair deficit” — a deficit that goes bone deep.

How much sleep is enough?

While the amount of sleep needed varies by individual, the scientific evidence suggests 7 hours of sleep per night is needed to help reduce physiological and neurobehavioral deficits. Personally I feel best with 8 hours of sleep in the dark winter months, but do just fine with a bit less in the sunny summer.

Better Bones tips for restorative sleep

  1. Take care with caffeine. Try a few days without this stimulant and note any sleep improvement.
  2. Try a non-electronic quieting down period in the evening. Instead of plugging in, try a hot bath, short meditation or the Yoga Nidra sleep audio.
  3. Melatonin regulates nocturnal circadian rhythms. Using 3 mg before bed helps many women sleep better and also builds bone. There is good data that melatonin enhances bone formation, reduces bone breakdown, and has cancer-protective properties to boot.
  4. Finally, sharing my own story of sleep success. I am no stranger to sleep disruptions, and I suspect it’s due to mental over-activity and a “worry-wart” tendency (as my mother would say). Recently I have found the cortisol-controlling adrenal support formula known as Serinisol from Women’s Health Network to be a godsend. Using the natural product I feel more calm and at ease during the day and sleep happily, solidly through the night. If you give it a try, let me know how it works for you.



Chen, Y. L., S. F. Weng, Y. C. Shen, C. W. Chou, C. Y. Yang, J. J. Wang, and K. J. Tien. 2014. Obstructive sleep apnea and risk of osteoporosis: A population-based cohort study in Taiwan. Journal of Clinical Endocrinology and Metabolism 99(7):2441–2447.

Everson, C. A., A. E. Folley, and J. M. Toth. 2012. Chronically inadequate sleep results in abnormal bone formation and abnormal bone marrow in rats. Experimental Biology and Medicine 237(9):1101–1109.

Everson, C. A., C. J. Henchen, A. Szabo, and N. Hogg. 2014. Cell injury and repair resulting from sleep loss and sleep recovery in laboratory rats. Sleep 37(12):1929–1940.

Fu, X., X. Zhao, H. Lu, F. Jiang, X. Ma, and S. Zhu. 2011. Association between sleep duration and bone mineral density in Chinese women. Bone 49(5):1062–1066.

Sivertsen, B., T. Lallukka, P. Salo, S. Pallesen, M. Hysing, S. Krokstad, and S. Øverland. 2014. Insomnia as a risk factor for ill health: Results from the large population-based prospective HUNT study in Norway. Journal of Sleep Research 23(2):124–132.

Swanson, C. M., S. A. Shea, K. L. Stone, J. A. Cauley, C. J. Rosen, S. Redline, G. Karsenty, and E. S. Orwoll. 2015. Obstructive sleep apnea and metabolic bone disease: Insights into the relationship between bone and sleep. Journal of Bone and Mineral Research 30(2):199–211.

what is the most important thing for bone health

1 minute with Dr. Brown: What is the most important thing for bone health?

Got a minute? Every week I receive dozens of questions from women like you with concerns about their bone health. In my new series, “1 Minute with Dr. Brown,” I will try to answer your most pressing questions. If you have a question, send it in to us at center@betterbones.com

Question: What is the single most important thing I can do to take care of my bone health?