Bone health is influenced by a variety of factors that go beyond simple nutrient intake, requiring a comprehensive approach to maintain and improve it. Addressing bone health from a holistic perspective involves understanding the interplay of nutrition, lifestyle, environmental factors, and underlying biological processes.

1. Nutrients

Bioavailable forms of calcium are essential for bone structure. It can be found in dietary sources like leafy greens, seeds, and certain fish.

Vitamin D is necessary for calcium absorption and bone health, maintaining adequate vitamin D levels through sun exposure or supplementation is crucial
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Vitamin K2 helps direct calcium to the bones and away from soft tissues like arteries, playing a key role in bone mineralisation and cardiovascular health.
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Magnesium is critical for converting vitamin D into its active form. It also supports bone density. A diet rich in magnesium contains foods, such as nuts, seeds, and leafy greens.
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Vitamin C, which aid collagen production, is important to maintain bone structure and resilience. Since bone is partly composed of collagen, adequate protein intake is essential.
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2. Gut health and nutrient absorption

Gut health plays a key role in nutrient absorption. Intestinal permeability, dysbiosis, or inflammation can impair absorption of key nutrients like calcium, magnesium, and vitamin D. A healthy microbiome also contributes to proper bone metabolism by supporting nutrient utilisation.

3. Inflammation

Chronic inflammation can lead to increased bone breakdown (osteoclast activity) and decreased bone formation (osteoblast activity). Inflammation can be controlled through an anti-inflammatory diet (rich in omega-3s, antioxidants, and phytonutrients), addressing hidden food sensitivities (like gluten or dairy), and lifestyle modifications.

4. Hormonal balance

Hormones like oestrogen, progesterone, testosterone, thyroid hormone, and cortisol play a critical role in maintaining bone density.

Menopause and bone health: Declining oestrogen levels during menopause can accelerate bone loss.
Adrenal function: Chronic stress and elevated cortisol levels can weaken bones, so stress management and adrenal support are essential.
Thyroid function: An underactive thyroid (hypothyroidism) or overactive thyroid (hyperthyroidism) can impact bone turnover and density. Thyroid function can be assessed by measuring thyroid hormones TS, free T3, free T4, and reverse T3.

5. Detoxification and bone health

Exposure to environmental toxins, such as heavy metals (like lead or cadmium) and endocrine-disrupting chemicals, can adversely affect bone health. Supporting the body’s natural detoxification processes by promoting liver function, ensuring adequate hydration, and consuming antioxidant-rich foods can be recommended.

6. Exercise and mechanical stimulation

Weight-bearing and resistance exercises are essential for stimulating bone growth and maintaining bone strength. Activities like walking, resistance training, yoga, and Pilates apply beneficial stress to bones, promoting remodelling and maintaining density. Exercise programs can be customised based on individual bone density levels, fitness, and mobility, ensuring that movement supports bone health safely and effectively.

7. Acid-alkaline balance

The acid-alkaline balance in the body is often considered. An overly acidic diet, high in processed foods, meats, and dairy, can lead to calcium being drawn from bones to buffer the body’s pH. Incorporating more alkaline foods, such as vegetables, fruits, and whole grains, helps maintain a healthier pH balance, potentially reducing calcium loss and supporting bone density.

8. Genetic considerations

Genetic predispositions such as variants in genes related to vitamin D and calcium metabolic pathways can influence bone health.

9. Chronic conditions

Conditions like autoimmune diseases (e.g., rheumatoid arthritis), chronic kidney disease, or digestive disorders (e.g., Crohn’s disease) can impact bone health. A focus on identifying and treating the underlying causes of these conditions, particularly when they involve systemic inflammation or impaired nutrient absorption, can help slow or reverse bone loss.

10. Stress, sleep, and bone health

Chronic stress and inadequate sleep elevate cortisol levels, which can lead to increased bone breakdown. Managing stress through techniques such as meditation, breathwork, and mindfulness practices, combined with improving sleep quality, can help lower cortisol levels, supporting overall health and bone preservation.

A comprehensive approach to bone health summary:

Nutrient optimisation: Ensuring adequate intake of calcium, vitamin D, K2, magnesium, and collagen to support bone density.
Gut health: Maintaining a healthy digestive system to enhance nutrient absorption.
Inflammation control: Reducing chronic inflammation through diet and lifestyle modifications to protect bones.
Hormonal balance: Addressing hormonal changes, particularly in menopause or thyroid function, that impact bone health.
Detoxification: Reducing exposure to environmental toxins that harm bone integrity.
Exercise: Incorporating weight-bearing and resistance exercises to stimulate bone growth.
Acid-alkaline balance: Encouraging an alkaline diet to reduce calcium loss from bones.
Genetic considerations: Recognizing genetic predispositions.
Chronic conditions: Treating underlying health issues that contribute to bone loss.
Stress and sleep: Managing stress and improving sleep to regulate cortisol and protect bones.