What Can I Do to Prevent Osteoporosis?

Osteoporosis: “The Silent Disease” 

A lot of you have been asking me about how to prevent osteoporosis—the condition where bones become fragile and prone to fractures.

Osteoporosis is often called a “silent disease” because it progresses without symptoms until a fracture occurs. And when we think of how to prevent it, we generally focus on calcium, vitamin D, and bone density.

But what if I told you there was something so new about osteoporosis that most doctors aren’t even aware of it?

The New Key Player in Osteoporosis Prevention

See, most doctors and laypeople alike consider low bone density to be a consequence of menopause, aging, or side effects of certain other conditions (such as cancer treatments, thyroid disease, or chronic steroid use).

But did you know that your immune system plays a critical role in bone health? New research shows that osteoporosis isn’t just about brittle bones and low estrogen levels—it’s tightly linked to inflammation and immune function.

Here’s what the science says:

• Chronic Inflammation Weakens Bones: The immune system releases inflammatory molecules called cytokines (like TNF-α and IL-6), which can accelerate bone breakdown. Research in Nature Reviews Endocrinology published in 2022 confirms that chronic inflammation increases the activity of osteoclasts (i.e cells that break down bone tissue) leading to faster bone loss.
• Autoimmune Diseases Increase Fracture Risk: Conditions like rheumatoid arthritis (RA), lupus, and inflammatory bowel disease (IBD) increase osteoporosis risk because chronic immune activation damages bone structure. According to a 2021 study in The Journal of Clinical Investigation, patients with autoimmune diseases have higher levels of bone-damaging cytokines, making them more susceptible to fractures.
• Your Gut Health Impacts Bone Density: Your gut bacteria influence immune regulation and bone metabolism. As a doctor and a nutritionist, I cannot emphasize this enough: A healthy microbiome helps regulate inflammation all over the body and augment nutrient absorption, but an imbalance (dysbiosis) has been linked to lower bone density in postmenopausal women.

What Can Women Do to Protect Their Bones?

The good news? A lot! There are proactive steps women can take to support bone health—and most importantly, their immune system.

Here’s an immune-focused bone healthy system you can follow:

1) Prioritize an Anti-Inflammatory Diet

• Eat more omega-3-rich foods (salmon, walnuts, flaxseeds) to reduce inflammation.
• Increase polyphenol-rich foods (berries, turmeric, green tea) to combat oxidative stress.
• Limit processed foods, sugars, and excessive alcohol, which can trigger inflammation.

2) Optimize Vitamin D & Calcium

• Vitamin D: Supports immune function and calcium absorption—low levels have been linked to both osteoporosis and immune dysfunction. Aim for approximately 800 IU/day from sunlight, foods, or supplements.
• Calcium: A critical component in strong bones. But don’t overdo it. Excess calcium without magnesium and vitamin K2 can lead to arterial calcification (depositing in the arteries and not in our bones!). I recommend women over 50 or in menopause get their calcium from whole food sources (leafy greens, tofu, chia seeds) in the approximate amount of 1200 mg a day.

3) Exercise—Especially Strength Training & Weight-Bearing Activities

• Resistance training (lifting weights, resistance bands) stimulates bone formation.
• High-impact exercises like jumping, running, or dancing improve bone density and boost immune function.
• Yoga and balance training help prevent falls and fractures.

4) Manage Stress & Sleep

• Chronic stress raises cortisol, which can accelerate bone loss. Practicing mindfulness, meditation (I do Transcendental Meditation) and deep breathing can lower inflammation.
• Poor sleep affects bone remodeling—aim for 7-9 hours per night to support both immune and bone health.

5) Support Gut Health

• Take probiotic-rich foods (yogurt, kefir, sauerkraut) to support a healthy microbiome, which influences immune response and nutrient absorption.
• Focus on Fiber (aim for at least 25-30 grams a day) to provide a great pre-biotic for your gut bacteria.

Final Thoughts

Osteoporosis isn’t just a bone problem—it’s an immune problem.

Approximately one in two women over age 50 is expected to experience a bone fracture due to osteoporosis. One in two! In addition, a woman’s risk of breaking a hip is equal to her combined risk of breast, uterine and ovarian cancer.

But we can avoid becoming an osteoporosis statistic. We can strive for musculoskeletal power. We can get enough protein in our diet. We can lift heavy weights. And in terms of lowering inflammation? 

Remember that food is medicine. By focusing on nutrition, sleep, stress management, and gut health, women can proactively strengthen their bones and reduce fracture risk. It’s never too early—or too late—to take action.