Bone Density, Osteopenia & Osteoporosis: How to Build Stronger Bones for Lifelong Health
Bone density plays a critical role in long-term mobility, independence, and overall health—yet it often goes unnoticed until a fracture occurs. Osteopenia and osteoporosis affect millions of Canadians, increasing the risk of fractures that can significantly impact quality of life as we age.
When I first read the statistics on bone density and fracture-related mortality, they were sobering. According to data from the Public Health Agency of Canada, 1 in 5 Canadians aged 40 and older dies from any cause within one year of sustaining a hip fracture. While a fracture may seem like a single event, it often reflects deeper changes in bone strength, balance, and overall resilience.
In clinical practice at Antidote, bone density concerns often arise alongside changes in hormones, mobility, stress, or recovery from injury. Taking a whole-person, preventive approach - grounded in naturopathic support and movement based care - allows us to support bone health in a way that aligns with each individual’s physiology, lifestyle, and stage of life.
The good news is that bone loss is not inevitable. Bone health is dynamic and responsive to the right inputs—nutrition, movement, lifestyle, and early assessment. Understanding what bone density really means, how osteopenia and osteoporosis develop, who may be at risk, and how to support bone health proactively can make a meaningful difference in maintaining strength, mobility, and independence across the lifespan.
Osteopenia vs Osteoporosis: What’s the Difference?
Bone density often goes unnoticed until something goes wrong—like an unexpected fracture after a minor fall.
Osteoporosis is a condition in which bones become thinner, weaker, and more likely to break. This happens when old bone is broken down faster than new bone can be rebuilt.
Osteopenia refers to lower-than-normal bone density that is not severe enough to be classified as osteoporosis. It often develops due to:
Low peak bone mass earlier in life
Bone loss after the age of 30
You can think of osteopenia as “pre-osteoporosis.” While fracture risk is higher than normal, it is not as elevated as with osteoporosis. Without intervention, however, ongoing imbalance in bone remodeling can eventually progress to osteoporosis.
How Is Bone Density Tested?
The most effective way to assess bone density is through a DEXA scan (dual-energy X-ray absorptiometry). This safe, painless X-ray compares your current bone density to the peak bone mass expected for someone of your same sex and ethnicity at ages 20–25.
In Ontario, OHIP-covered DEXA scans are recommended for:
Women aged 65+
Men aged 70+
Younger individuals with risk factors, including:
Prior fracture
Long-term steroid use
Thyroid disease
Inflammatory conditions (e.g. rheumatoid arthritis)
Family history of fracture
Early menopause (before age 45)
Malabsorption syndromes (e.g. celiac disease)
Low adult body weight or eating disorders
Because peak bone mass is typically reached between ages 25–30, I also consider your health during that period as an important clue to your current bone density.
Who Is at Risk for Low Bone Density?
Canada ranks among the top 25% of countries worldwide for major osteoporotic fracture risk. Each year, approximately 30,000 Canadians experience a hip fracture, and this represents only a fraction of the total burden. Many more sustain fractures of the spine, wrist, shoulder, and pelvis.
As a Naturopathic Doctor, one of my guiding principles is prevention whenever possible. Even if bone health isn’t your primary concern, I routinely ask about:
Exercise habits
Nutrition
Family history
Medication use
Overall health history
These factors help determine your risk of low bone density. If your risk appears high, I may refer you back to your primary care provider for further assessment and potential medication support. In the meantime, we can begin addressing the foundations of bone health through nutrition, movement, and targeted supplementation.
How to Improve Bone Density Naturally
Our bones are constantly breaking down and rebuilding. To stay strong, they rely on a steady supply of nutrients and mechanical stimulation.
Nutrition for Osteoporosis Prevention
Calcium and magnesium are essential minerals for bone strength. If dietary intake is insufficient, the body will draw these minerals from bone, weakening structure over time.
Most adults require ~1000 mg of calcium per day
This can be achieved through 3 servings of calcium-rich foods, such as:
Milk or yogurt
Fortified plant-based milks (~300 mg per serving)
Tofu
Canned fish with bones
I often recommend using the Osteoporosis Canada calcium calculator to assess baseline intake.
Protein is equally important—it forms the structural framework that holds calcium in bone and supports muscle strength. Since protein needs increase with age, calculating individualized requirements is critical for maintaining both muscle and bone mass.
Vitamins D and K also play key roles in bone metabolism and can be supported through diet and supplementation when needed.
Movement: A Powerful Tool for Bone Strength
Physical activity is one of the most effective ways to maintain and improve bone density. When muscles pull on bone, bone responds by becoming stronger.
I often recommend weight-bearing and resistance training, including:
Squats, lunges, hinges, and bridges for lower body strength
Push, pull, and press movements (rows, pulldowns, counter or floor push-ups)
Core and posture exercises such as planks, side planks, and bird dogs
These exercises should be performed at least twice per week, starting with body weight and progressing as strength improves.
Activities that support balance, flexibility, and agility—such as yoga and Pilates—are equally important, as they reduce fall risk. Personally, I combine strength training, yoga, and Pilates to support my bone health. The most important factor is finding movement you enjoy and can do consistently.
Lifestyle Factors That Matter
Avoiding smoking and excessive alcohol intake supports bone health. Maintaining a healthy weight is also important, as being underweight increases the risk of bone loss and fractures.
A Final Word on Bone Health
By assessing and protecting your bone density, you’re investing in long-term mobility, independence, and overall well-being. Osteoporosis is common, treatable, and largely preventable.
It’s never too early to think about bone health. The choices you make today can have a lasting impact on your skeletal strength and quality of life in the years ahead.
References:
Public Health Agency of Canada, Canadian Chronic Disease Surveillance System (CCDSS), August 2022. Available from: https://health-infobase.canada.ca/ccdss/data-tool/.
Osteoporosis Canada, Risk Factors, 2026. Available from: https://osteoporosis.ca/about-the-disease/
OrthoInfo, American Academy of Orthopedic Surgeons, 2025. Available from: https://orthoinfo.aaos.org/en/diseases--conditions/osteoporosis/
Raybould G, Babatunde O, Evans AL, Jordan JL, Paskins Z. Expressed information needs of patients with osteoporosis and/or fragility fractures: a systematic review. Arch Osteoporos. 2018 May 8;13(1):55. doi: 10.1007/s11657-018-0470-4. PMID: 29736627; PMCID: PMC5938310.
Salminen H, Piispanen P, Toth-Pal E. Primary care physicians' views on osteoporosis management: a qualitative study. Arch Osteoporos. 2019 Apr 26;14(1):48. doi: 10.1007/s11657-019-0599-9. PMID: 31028556; PMCID: PMC6486622.
