I have recently re-remembered one of my favorite bone-building tips… one kind of non-obvious bone-building food, a simple exercise, and a comment about lab tests.

Bone-Building Foods
Building bones starts with protein and—if you tolerate dairy—calcium-rich dairy foods. There is another one, a food I like but rarely have. The October 2022 issue of The American Journal of Clinical Nutrition found that eating five or six prunes a day helped women past menopause preserve bone mineral density in their hips! (Plus, particularly stewed, they are great if your bowels tend to be on the sluggish side. BUT they are high in sugar, so don’t overdo it.)

Quick Bone Help
Bone building is really all about feeding your bones while you work to build MUSCLES (which help keep us moving, build better bones, and strengthen our brains!)—especially around the places your bone density is measured (back and hips) but also around your ankles! “What, do I have osteoporosis of my ankles?” Probably not, BUT around your ankles are important “fast-twitch” muscles that help prevent falls when you step on ice, miss a step off a curb, etc. It’s really hard to train those tiny muscles.

First, feed them—lots of protein and Creatine Monohydrate (5 grams daily).
To exercise them, be like a stork, but safely!

Stork Pose: Stand on one leg at a time.

Start where you are:

• If it’s easy, stand on one foot and wave the other leg in figure 8’s around your body (and I’m impressed!)
• If it’s HARD, know that you can get stronger.

Stand on one foot at a time, holding on if needed. Gradually increase:

• Your time on each leg
• How little help you need holding on
• When you get fairly stable, try moving—gently at first—the leg you’re NOT standing on!

Lab Tests
Reading over patients’ medical records, I sometimes think doctors are a bit too “stingy” with lab orders and perhaps with attention to the labs they order. I recently found myself speeding over an important part of my usual bone labs.

Background: As mentioned in the food section, some people cannot get calcium from dairy, as they avoid it for various reasons. It’s possible to get calcium from other foods, but you may be calcium deficient if you don’t eat dairy.

Calcium normal range is about 8.5 to 10.5, depending on the lab.

• Optimal: 9.3-9.9 or 10

• Below 9.3: Deficient, ask why. Are they urinating it out or just not eating enough? Different solutions for each.

• Above 10: Ask why calcium is high. Are they taking too much (calcium supplementation can be too high and increase the risk of vascular & cognitive illness), or is something else driving their calcium to be too high?

The error I’ve made recently is passing on a level of 9 for someone not eating dairy and not supplementing. My bad! They should be supplementing. In general, I limit my supplement recommendations to 500-600 mg of calcium—that seems to be the sweet spot.

Other labs I check for bone health start with sex hormones and bone metabolism (CTX and P1NP), and move on to omega-3s, B vitamins, and other hormones as well!

Now, excuse me, I’m going to take a break and do a bit of stork pose.