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November 10, 2010


Ken Leebow

Interesting post and thank you for the information.

I also recommend listening to this enlightening (and disturbing) report on how Osteopenia became a disease. -

I also recommend watching this video (Christina Economos - Nutrition and Physical Activity for a Lifetime) about exercise - It's the one that convinced me to start doing strength training.

Healthy Librarian

I second Ken's recommendation for the award-winning investigation journalism that produced the NPR Story about how Osteopenia became a disease! There is a transcript of the story as well as the audio, and the summary of the NPR story. It really opened my eyes. Thanks for the vidoo recommendation, too!


Miriam Nelson's book "Strong Women Stay Young" is a good intro to strength training for older women, with lots of info on how strength training benefits bones. I don't think much of her nutritional advice, but the exercise part is great!

Kiki Ohio

One aspect of calcium absorption that cannot be stressed enough is that the calcium in plants is *more* bioavailable than that found in dairy due to the presence of phosphorous in plant foods. The ratio of calcium to phosphorous is important in absorbing calcium and plant foods hit this mark just right. Dr. Neal Barnard has discussed this in several of his books in a very understandable way if you want more information about it. It should also be noted that there have never been any protein or calcium deficiencies recorded in the United States which clearly suggests that eating more of these foods won't make bones stronger.

Healthy Librarian

Thanks Carol, and thank you Kiki! I had heard that the calcium from plants was more "bioavailable" than from dairy products, but I didn't know why--or have the background info. I will definitely look at Dr. Barnard's books to get his explanation. I really appreciate that you pointed this out!

Mike Gorn

Here's one very important point - vitamin K2 is what tells the body where to send that calcium - to the bones or to the blood vessels. Go ahead and do your research on vitamin K2 - if you already take enough vitamin D to have your blood levels around 55ng/ml and you have sufficient calcium intake, adding 100mcg of vitamin K2 will make sure you will not have that heart attack. Also, you need plenty of magnesium in your body to metabolize that vitamin D. I believe 1mg of boron and 20mg of zinc per day is also used up if you take a few thousand IU of vitamin D per day. But I can't understate the importance of K2. Let me know what you think.

Cynthia Bailey MD

This is an OMG long post AND you are amazing. You do us all a great service with your tenacious research ability, excellent judgment on the medical literature and access to stuff hot-off-the-press plus 'curb side' chats w/ the leading authors. I love your blog and send at least one of my patients here everyday.

With bone health, my intuitive sense has long been that medicine/science is on the wrong track. This post reaffirms that. I remember an article in the NEJM a while back where the conclusion was that the history of a wrist fracture is a better indicator of bone health than bone density analysis from a bone scan. Add to that the vacillating recommendations over my professional career on the types of calcium supplements, exercise, hormone replacement etc and it all doesn't stack up for me.

My personal opinion and goals for my own bone health have been: 1. regular weight bearing exercise including walking (remember when studies said it only helped bone density in the hips, well I didn't believe it & now it turns out that's only in the guys, we gals get spinal benefit too so swing those hips!), yoga and some free weights and 2. a prominently veggie/fruit diet w/ low animal protein (mostly in the form of salmon and goat dairy) and 3. only moderate alcohol intake (don't know the science on that but at least the acid/alkaline impact matters & my intuitive sense is that it's important for the bones). I have to admit that I take an occasional food based calcium supplement to hedge my bet while the dust settles on the science.


Great post, but being new to this, I am totally confused.
I never took a calcium supplement. However, I just purchased Vit D and someone said take it with 800 mg of calcium. I am a vegetarian and do eat signigicant dairy and eggs. Will be cutting down ont the dairy after reading this post. I do juice greens daily..Any summation of all the above would be helpful
How much vitamin D? Should I supplement with calcium? Thanks.

Healthy Librarian


Make sure you get enough calcium from your diet first. If you're eating dairy, and lots of greens, you should be. Count up the milligrams in a typical day.

For more about vitamin D (and get tested your levels tested by your doctor first) read these posts that explain all about it:

"Everything You Ever Wanted to Know About Vitamin D from the Expert, Dr. Michael Holick. How Much Do We Need? Why Is It So Hard to Get Enough? What About Breast-Fed Babies? Why Is It So Important for Good Health?"

"How Vitamin D Works - Answers From Dr. Bruce Hollis--Its Role in Cancer, Musculoskeletal Pain, Heart Disease, Inflammation, Infection, and the Brain"

Chris G.

Animal protein makes our bodies acidic. Animal protein induced inflammation. I wonder if these two phenomenon are related / one in the same?

Gael in Vermont

After reading Raye's THE BONE ARCHITECT blog, I was led to this piece in the TIMES:

I am eternally grateful that sites such as yours and Raye's (and many others) help to keep us informed so we can make educated decisions. I believe there is so much that we can do to improve the state of our health. Research has proven that lifestyle and dietary changes can alter the course of disease. The longer we live, the more osteoporosis we'll see. And the longer we continue to abuse our bodies with "food-like" substances (as Michael Pollan says), the more we will degenerate. I, for one, have undertaken a lifestyle course of action and have already seen positive results. At 63, I've never felt better! The more we know and understand, the better we'll do.

Rebekah Rotstein

Thanks so much for your posts and leads to evidence-based research and findings. A wonderful resource! I will include your blog for my Pilates and exercise students/instuctors who take my bone health and osteoporosis workshops.

Katie Powell

Hello! If you're not familiar with Dr Loren Fishman, this may be of interest to you:

Yoga for Osteoporosis: The Complete Guide [Paperback]
Loren Fishman (Author), Ellen Saltonstall (Author)

Also, you've probably see this, but if not this is from the NYT: PERSONAL HEALTH
Ancient Moves for Orthopedic Problems
Published: August 1, 2011

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