The Better Bones Blog

by Dr. Susan Brown, PhD.

Osteopenia? 5 steps for stronger bones


If you’re among the millions of people who’ve been told they have osteopenia, I know it can be confusing and scary. But you’ve come to the right place.

I talk all the time with women wondering what to do next when they get diagnosed with osteopenia.

I always start with this:

Osteopenia does not mean you will always suffer from osteoporosis or a fracture. Osteopenia means that your bone density measurement is less, but not excessively less, than a woman who is 30 years old. And what that really signifies for you will depend on your individual body type, lifestyle, history and many factors you can take control of right now.

5 steps to build stronger bones

Here’s what you can do to make sure your bones are getting everything they need to stay strong.

1. Get the correct amount of key bone building nutrients.

  • Eat a wholesome alkaline diet and try high quality nutritional supplementation. Be sure the supplements you use are designed to alkalize so they spare both bone and muscle.
  • Make sure your mineral intake is adequate. This can be easily done by measuring your first morning urine pH. A first morning urine pH reading of 6.5 to 7.5 suggests you’re obtaining adequate minerals from your diet and supplements.
  • Test your vitamin D level and supplement with enough to reach a 50 to 60 ng blood level all year round.

2. Build muscle strength. Chronically low muscle mass is associated with low bone mass. Even stronger grip strength and stronger back muscles are associated with higher bone density. If you have been told you have osteopenia in the hip, try to walk more, hop, do heel drops, and jump if you can. All provide bone-stimulating impact to the hip. Also consider using a weighted vest when walking. It makes each step deliver a greater bone stimulating impact to hip.

3. Avoid bone depleting anti-nutrients. The list is long so you might have to pick away at bone depleting anti-nutrients little by little. High on the list are excessive alcohol (more than two drinks a day), smoking, colas, excessive caffeine, and high sugar intake. Many drugs and medications damage bone and the list seems to expand daily. Steroid drugs such as prednisone rank as the top drug bone-busters, causing roughly 20% of all osteoporosis in the U.S.

4. Eat enough wholesome food daily. The body is one single unit; if you lose weight you lose bone. The bone weakening from weight loss before menopause is more easily compensated for than that from weight loss after menopause. Make sure you get between 50 and 80 grams of protein daily, depending on your physical activity level.

5. If needed, work with your doctor to see if there’s any medical cause for osteopenia. If you have ongoing excessive bone loss as measured either by sequential bone density testing or by a bone breakdown marker test such as the NTx , or if you have experienced a low-trauma fracture, steps should be taken to detect hidden causes of this bone loss. My Medical Osteoporosis Workup details the most common tests used to detect hidden secondary causes of bone loss. You might share this document with your health practitioner and see which tests they will do looking for your hidden causes of bone loss.

As you can see, you aren’t powerless when it comes to building stronger bones — even if you’ve been diagnosed with osteopenia. Consider this a window of opportunity to make some nutritional and lifestyle changes. My Better Bones Builder Program is a great place to start, because it puts everything together for you.


Read more:  What does osteopenia really mean?

See why osteopenia doesn’t always mean you’ll suffer from osteoporosis or fracture — or that you will need a bone drug.



Alonso-Coello, P et al. 2008. Drugs for pre-osteoporosis: Prevention or disease mongering? BMJ 336:126.  DOI:

Looker, AC et al. 2010. Prevalence and trends in low femur bone density among older U.S. adults: NHANES 2005–2006 compared with NHANES 111. J Bone Miner Res  25 (1):64–71.

Petersen, BA et al. 2017. Low load, high repetition resistance training program increases bone mineral density in untrained adults. J Sports Med Phys Fitness 57(1–2):70–76.

woman outside with bike

How to reduce the risks of too much sitting

If you’re looking for extra motivation to get up and get moving, there’s a powerful new study documenting how sitting for 8 hours a day can take years off your life.

The increased risk of early death adds to what we know about the harm of inactivity — which also includes increased risk of diabetes, cancer, heart disease, and obesity.

What’s your risk?

Researchers analyzed data from 16 different studies world-wide involving more than 1,000,000 people, most of whom were over 45. Study subjects were classified into activity levels of less than 5 minutes a day for the least active to 60 to 75 minutes for the most active.

The greatest risk was for people who both sat for long periods of time and were physically inactive. One interesting point was that people who sat for 4 hours and got no exercise each day were worse off than people who sat for 8 hours but got an hour or more of exercise daily.

And watching TV makes it worse. Sitting watching TV for more than 3 hours per day was associated with increased risk of death in all activity groups except the most active. And at more than 5 hours per day of TV, it didn’t matter how much you exercised, risk of death was increased.

What can you do to reduce your risk?

Here are more ideas to get moving

  • Determine your daily sitting time and set your daily exercise requirement.
  • Establish a routine for getting in those necessary minutes of physical activity: take a 15-minute walk before work, or park your car 10 minutes’ walk from your office. Then take a 20-minute brisk walk at lunchtime and another after work — and just like that, you’ll have negated most of the day’s sitting.
  • Consider using an activity monitor like a Fitbit that can be set to track your minutes of active exercise. I set mine for 60 minutes a day to ensure I get up and out daily.

If you want to learn more about the risks of sitting, check out my blog Is sitting the new smoking?

So let’s make 2017 our year to get out and moving — I’d love to hear about your exercise plan for 2017!



Ding, Ding, et. al. 2016. The economic burden of physical inactivity: A global analysis of major non-communicable diseases.  The Lancet, 388(10051):1311–1324.

Ekelund, U., et al. 2016. Does physical activity attenuate, or even eliminate, the detrimental association of sitting time with mortality? A harmonised meta-analysis of data from more than 1 million men and women. The Lancet,  388(10051):1302–1310.



Vitamin K2: A Valentine’s message for heart and bones


This Valentine’s Day, when you’re thinking about what’s closest to your heart, keep your bones in mind too!

If you’re a regular reader of my blog, you already know how important vitamin K is to bone health — but you may not realize its importance in cardiovascular health. It’s a key nutrient in blood coagulation, of course, but that’s far from its only role.

Why your heart and bones love vitamin K

Vitamin K has a special relationship to both heart and bone health through its contribution to the metabolism of calcium. Here’s a closer look why:

  • Vitamin K has the unique capacity to activate proteins that help to keep calcium in the bone and out of the arteries (which prevents arterial calcification), and to regulate inflammation.
  • Its importance is underscored by several studies that show that people who took a form of vitamin K2 called menaquinone (MK-7) had a reduced risk of coronary calcification and heart disease.
  • Even in patients with kidney disease, who are at risk of atherosclerosis and heart disease, small doses of MK-7 and vitamin D helped slow the progression of the disease.

Source: NattoPharma, “Calcium Perfected”, n.d.

Researchers have known there’s a link between osteoporosis and heart disease for a while now. It’s so significant that some researchers think that if patients are diagnosed with heart disease, they should be evaluated for osteoporosis — and vice versa.

Top foods for getting vitamin K

You can eat good quality, lean meats, organic eggs, and hard or soft cheeses knowing they can supply you with some of the vitamin K2 your bones need. But before you rush out to buy kale and leafy greens, you should know that vitamin K2, unlike vitamin K1, is not found in vegetables.

Natto is fermented soybeans and an excellent source of the MK-7 form of vitamin K2. Fermented vegetables like sauerkraut and seaweed are also pretty good sources of vitamin K2. If you follow a vegetarian or vegan way of eating, consider supplementing with vitamin K2 to ensure that your heart and bones have this important nutrient.

Beulens JW, Bots ML,  et al. High dietary menaquinone intake is associated with reduced coronary calcification. Atherosclerosis. 2009 Apr;203(2):489–493.

Geleijnse JM, Vermeer C,  et al. Dietary intake of menaquinone is associated with a reduced risk of coronary heart disease: The Rotterdam Study. J Nutr. 2004;134(11):3100-3105.

Harshman SG, and Shea MK. The role of vitamin K in chronic aging diseases: Inflammation, cardiovascular disease, and osteoarthritis. Curr Nutr Rep. 2016;5(2):90-98.

Kurnatowska I, Grzelak P, et al. Effect of vitamin K2 on progression of atherosclerosis and vascular calcification in nondialyzed patients with chronic kidney disease stages 3-5. Pol Arch Med Wewn. 2015;125(9):631-640.

Shea MK, and Holden RM. Vitamin K status and vascular calcification: Evidence from observational and clinical studies. Adv Nutr. 2012;3(2):158-165. doi: 10.3945/an.111.001644.

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