Bone Health at 50+: What You Need to Know

There’s a lot of conflicting information out there, and for generations, the dairy industry has promoted a simple message: drink milk for strong bones. But the research paints a far more complex picture. While dairy does contain calcium, some of the countries with the highest dairy intake — including the US, the UK, and across Scandinavia — also have some of the highest hip fracture rates. The Nurses’ Health Study, which followed nearly 78,000 women for 12 years, found no bone-protective benefit from higher milk consumption.

Meanwhile, studies of plant-based eaters tell a nuanced story. The Adventist Health Study II found that vegan women who were not supplementing with calcium and vitamin D had roughly three times the hip fracture risk of non-vegetarians. But, and this is the encouraging part, vegan women who did supplement appropriately saw that excess risk disappear entirely.

So the picture isn’t about whether a plant-based diet is good or bad for your bones. It’s about whether you’re giving your bones what they need to stay strong.

In the recorded conversation below, you’ll see me sit down with Brenda Davis, RD, a million-copy bestselling author and one of the world’s leading authorities on plant-based nutrition, to walk through exactly what the science shows and what you can do about it.

We start by exploring how bones actually work, why bone density tends to decline with age, and which risk factors you can influence. We look at the foundational role of food — including the surprising truth about calcium absorption from plant foods versus dairy, the critical importance of protein, and a humble dried fruit that research suggests may help preserve bone density.

We also dig into exercise, because no amount of supplementation can replace the mechanical stimulus your skeleton needs. And we cover the key nutrients that work together to support bone strength — including how to approach supplementation in a way that’s both effective and safe for your heart.

You’ll walk away understanding what actually keeps bones strong, which everyday habits make the biggest difference, and how to take charge of your skeletal health at any age.

Because the structure that has carried you through every chapter of your life so far deserves your attention, so it can carry you through the chapters still to come.

Watch: A Bone Health Conversation with Brenda Davis, RD

Prefer to read? The full conversation transcript follows below.

Ocean Robbins: I’m Ocean Robbins, CEO of Food Revolution Network. So glad you are here today. We’re going to be talking about something that affects every single one of us, whether we realize it or not — the health of our bones, our skeletons, our structures.

Now, to be clear, today is primarily an educational event. We’re going to give you real, science-backed information about bone health that you can start using today. I’m also excited to share that we have created a bone health supplement in partnership with Complement. We will introduce it near the end. And I want to be really clear — this webinar is not medical advice. The FDA has not approved anything we’re saying here today. None of this information is intended to treat any medical condition or disease. Always consult with a qualified healthcare professional about your specific medical needs and realities. That said, you are going to learn a lot today.

And to help me cover all this, I have the enormous privilege of being joined by my dear friend Brenda Davis. Brenda is a registered dietitian, a million-copy best-selling author, and one of the world’s foremost authorities on plant-based nutrition. She has been a leader in this field for many decades. She was one of the key experts who helped shape the research and thinking behind everything we’re going to share today. She’s also a treasured friend to our whole family and to me, and she was one of my dad’s most treasured colleagues.

Brenda, welcome. I’m so glad you’re here.

Brenda Davis, RD: Oh, Ocean, thank you so much. I’m really thrilled to be here. You know, bone health is something that I talk about with clients and colleagues constantly, and there’s really a tremendous amount of confusion out there. And I think we can clear that up for so many people today.

And this topic is really personal for me. My mother was diagnosed with osteoporosis in her early 50s, and she was very fit, very health-conscious. I think she ate, at that time, what most people would consider a healthy, omnivorous diet. So when I turned 50 — I was premenopausal at the time, and I had been vegan for about 20 years — I mentioned my mom’s osteoporosis to my doctor, and he was quite concerned, not just because of my family history, but because I’m a slim, white, vegan woman.

He ordered a bone density scan, and when I came back to his office for the results a couple of weeks later, he opened my file and his jaw literally dropped. My lumbar spine bone density was 2.5 standard deviations above expected, and my femur was nearly 2 standard deviations above expected. And he said to me, “I don’t know what you’re doing, but your bones are made of steel. Just keep doing it.”

And, you know, I’ll admit, I felt pretty invincible. But here’s the part that really humbled me. I am 67 now, and about 2 years ago, roughly 14 years post-menopause, I had my bone density tested again. I don’t have osteoporosis or osteopenia, at least not yet, but my numbers have declined, and they declined a lot more than I expected they would. Especially since I am a very physically active person — I probably exercise for close to an hour and a half a day on average — and I eat an extremely healthy diet with a ton of greens.

So it was a bit of a wake-up call for me. It reminded me that bone health isn’t static. It’s dynamic, and it changes with age, with hormones, with muscle mass, nutrient absorption, lifestyle — all of that. And it’s a powerful reminder that we can’t coast on our past results. We have to continually support our bones, especially after all the hormone changes that come along with menopause.

Ocean Robbins: Yes, thank you so much for sharing so personally about your journey, and also for the stand you take to help everybody be as healthy as possible. Brenda, you’ve helped so many people, and it’s one of the reasons I wanted to reach out to you, as I have done in recent years, to ask for your feedback on this topic, and then wanted to bring our community together for this event tonight.

A few years ago, my mom started getting worried about osteoporosis. She’d been vegan for decades, and she’d seen research showing that long-term vegans, especially lean women — which she is — could be at some increased risk. That really got my attention. Then a dear friend named Kim, who lives in a small eco-village community with my family, fell and broke her shoulder and her hip. She was later diagnosed with osteoporosis. And Kim was someone who got plenty of exercise, was fit, and ate what most people would consider a super healthy diet. I remember thinking, she was doing so many things right — how could this happen?

That sent me down a bit of a research rabbit hole, and what I found kind of alarmed me. Every three seconds, someone in the world experiences a bone fracture related to osteoporosis. In the United States alone, 54 million people are living with weakened bones. Two million fractures a year, $19 billion in healthcare costs, and most people have no idea they’re at risk until something breaks.

But what really stopped me in my tracks was when I discovered that the very things some of us think of as health advantages — like eating plant-based and being lean — actually could lead to higher risk when it comes to our bones. And I’m going to be honest, that shook me up a bit, because in almost every other area of health, plant-based eaters and lean people do better. Lower rates of heart disease, type 2 diabetes, many forms of cancer, obesity, hypertension, Alzheimer’s. Plant-based diets reduce inflammation, they improve gut health, and they support longevity. Being lean helps protect against metabolic disease and joint problems, and lots more.

But bone degradation seems to be an exception, and it’s a significant one. Brenda’s going to walk us through the key studies and exactly what they mean in a few minutes, but the short version is: This is a solvable problem when you know what to do.

First, though, I want to make sure we have an understanding together of how bones actually work, because that foundation is going to make everything else click into place. So, Brenda, give us a little primer here.

Brenda Davis, RD: Oh, for sure. So let’s start by understanding what we’re actually dealing with. Osteoporosis is often called a silent disease, and it really earns that name. There are usually no symptoms in the early stages. People walk around for years, sometimes decades, with bones that are gradually becoming more porous and fragile, and they have no idea it’s happening.

For many, the first sign is a fracture — a broken hip after a fall, or a compression fracture in the spine. Sometimes a fracture can even occur with something as minor as coughing hard or bending over to pick something up. And these fractures are not trivial. A hip fracture, for example, is associated with a significant loss of independence and even increased mortality risk in the year following the fracture. So this is not just about bone density numbers — it’s really about quality of life.

And one of the most fundamental misconceptions about bones is that they’re static. Nothing could be further from the truth. Your skeleton is a living, metabolically active organ. It’s constantly being remodeled. Specialized cells called osteoclasts break down old bone, and osteoblasts build new bone. This remodeling process is ongoing throughout life, and roughly every 10 years, much of your skeleton has actually been renewed. The bones you have today are not the same bones you had a decade ago.

And that’s really powerful, because it means bone loss is not inevitable in the short term. But it also means that if the balance between breakdown and rebuilding shifts in the wrong direction — which happens with aging, menopause, inactivity, or inadequate nutrition — bone density declines gradually and silently.

Ocean Robbins: You know, I’m thinking about how the skeleton that I’m building right now will be replaced in 10 years, and that is a fascinating concept, because I think of the skeleton as fixed and permanent, but it’s not. We can kind of take it for granted.

Brenda Davis, RD: Oh, exactly! And here’s the critical timeline. Your bone mass peaks around age 30, and after that, the balance starts to shift. You’re still remodeling, but you tend to lose a little more than you build. For most people, this is really gradual, but for women after menopause, the loss accelerates dramatically because of the drop in estrogen, which plays a major protective role in bone metabolism.

Many people develop a condition called osteopenia along the way, where bones are weaker than normal but haven’t yet reached the threshold for an osteoporosis diagnosis. I think of osteopenia as kind of a yellow warning light. Your bones are losing density, but you still have time to intervene.

And there are also a number of risk factors that can accelerate bone loss — smoking, drinking too much alcohol, a sedentary lifestyle, certain medications like long-term steroid use or proton pump inhibitors, medical conditions like celiac disease or inflammatory bowel disease. If any of those apply to you, you really need to pay attention to bone health, because it becomes even more important.

Ocean Robbins: So this isn’t just a concern for people in their 70s or 80s.

Brenda Davis, RD: Oh, not at all. The habits you’re building in your 30s, your 40s, your 50s, and the choices you make if you’re diagnosed with osteopenia, really shape your trajectory. And the critical question isn’t whether you’ll face some degree of bone loss as you age — it’s whether you’ll take action to slow, halt, or even, in some cases, reverse it.

Ocean Robbins: Now, let’s come back to what I mentioned earlier — the uncomfortable reality that plant-based eaters and lean folks face higher bone fracture risk. Brenda, can you walk us through the key research on this?

Brenda Davis, RD: Yeah, and there’s a lot of research on this. But two of the largest and most rigorous cohort studies examining diet and fracture risk are EPIC-Oxford in the UK and the Adventist Health Study 2 in North America, including both Americans and Canadians.

In EPIC-Oxford, researchers found that vegans had a higher risk of hip fracture compared to non-vegetarians, and the hazard ratio was about 2.3 — meaning roughly a 2.3-fold higher risk. And it’s important to note that the increased risk was seen primarily in postmenopausal women, and it was very strongly associated with lower body mass index — very thin individuals, especially those with a BMI below about 22.5. So it wasn’t a universal effect across the entire vegan cohort. Body weight mattered, and sex mattered. Of course, hormonal status mattered as well.

And then in the Adventist Health Study 2, the pattern was a little different. There was about a 55% higher fracture risk among female vegans, but no significant increase in fracture risk among male vegans. And in that cohort, the elevated risk was not observed among women who were supplementing adequately with calcium and vitamin D.

Now, here’s where we need nuance. Bone health is multifactorial. The elevated fracture risk observed in some vegan populations is unlikely to be due to a single nutrient. Yes, calcium and vitamin D matter, but so do protein, zinc, vitamin B12, vitamin K, magnesium, potassium — all of those things matter. Vegans tend to use less hormone replacement therapy, which can boost postmenopausal bone preservation. And having lower circulating IGF-1 levels, which vegans tend to have, can also be a factor.

So what we’re looking at is an interaction between leanness, menopause, nutrition adequacy, and endocrine factors. It’s not an indictment of plant-based eating itself. And it’s important to remember that some cohorts consistently show lower risk of other chronic diseases, especially among vegans.

What the fracture data tell us is something more specific: Plant-based diets, particularly in lean, postmenopausal women, require intentional attention to bone-supportive nutrients, adequate protein, resistance training, and maintaining a sufficient body weight. And while calcium and vitamin D supplementation appear to attenuate risk in the Adventist cohort, we can’t say definitively that supplementation alone eliminates risk across all populations. Bone health involves calcium, vitamin D, protein adequacy, resistance training, healthy body weight, hormonal status, and overall dietary pattern. All of these are important. So the takeaway is not fear — it’s really strategy.

Ocean Robbins: Yes, and so we have enormous choice in the matter. This is not just a fait accompli, and that’s why we’re here — to empower you with information. Brenda, when I heard about a 2.3-fold increase in hip fracture risk in one of the studies for plant-based eaters, it got my attention. And yet what gives me hope is that these risks appear to be modifiable. We really can do something about it.

Brenda Davis, RD: Oh, exactly. And this is really about understanding physiology. Lean individuals place less mechanical load on bone, and estrogen decline accelerates bone resorption. So if you combine leanness, menopause, lower IGF-1, and suboptimal calcium or protein intake, fracture risk can increase. But those are all variables we can influence.

In my clinical practice, when clients track their calcium intake, many plant-based women are consuming about 600 to 900 milligrams per day. And for a postmenopausal woman who likely needs around 1,200 milligrams per day, that’s a pretty meaningful gap. Not because they’re eating poorly, but because meeting that level consistently from unfortified plant foods alone requires pretty deliberate planning.

So the foundation absolutely starts with food, but for many individuals — especially lean postmenopausal women — food, resistance training, maintaining a healthy body weight, and targeted supplementation may need to work together.

Ocean Robbins: Yes, and a chain is as strong as its weakest link. Ultimately, you want all of the links in your chain to be strong, just like you want your bones to be strong. And I think the foundation is food, but what we’re seeing is that for a lot of people, food alone isn’t enough. That’s why we’re going to be exploring today the food strategies, the lifestyle strategies, and the supplementation strategies that work together in synergy to give your bones the best possible chance. Let’s start with the food.

Brenda Davis, RD: Well, when most people think about bone health, they think calcium. And when they think about calcium, they think about dairy, because that’s what we’ve been trained to think since we were in grade school. So let’s unpack the evidence and see what it actually shows.

Let’s start with why calcium actually matters so much. About 99% of the calcium in your body is stored in your bones and teeth. Your bones are essentially the body’s calcium bank. When your blood needs calcium for muscle contraction, nerve transmission, or maintaining a steady heart rhythm, your body withdraws calcium from that bank. If you’re not depositing enough through your diet, your body will compensate by drawing it from your bones. And over time, a chronic shortfall can contribute to osteopenia and eventually to osteoporosis.

So how much do we need? For adults 19 to 50, the recommended intake, or the RDA, is 1,000 milligrams a day. For women over 50 and everyone over 70, it increases to 1,200 milligrams a day.

You absolutely can meet your calcium needs on a plant-based diet, but it does require intention. For example, a cup of cooked kale provides about 177 milligrams, and it’s highly bioavailable. A cup of cooked collard greens provides about 268 milligrams. A half cup of calcium-set tofu will typically provide around 300 to 400 milligrams, depending on the brand, the firmness, and what it’s been precipitated with. Two tablespoons of chia seeds offer about 177 milligrams — about the same as a cup of cooked kale. And most fortified plant milks, whether soy, almond, or oat, provide about 300 milligrams per cup, which is totally comparable to cow’s milk. Fortified plant yogurts can contribute similar amounts.

So you absolutely can meet your needs with plant foods, but it does require consistency. And if you’re not consuming fortified foods or multiple calcium-rich plant foods every day, it becomes a lot harder to reliably reach 1,000 to 1,200 milligrams. For postmenopausal women, consistency really does matter.

Ocean Robbins: And this is where the dairy question comes in for a lot of people. Because dairy is high in calcium — a cup of cow’s milk has over 300 milligrams. So shouldn’t countries that consume the most dairy have the strongest bones?

Brenda Davis, RD: Well, you would think so. But the epidemiology is really complex. When researchers actually look at global fracture rates, they often find countries with the highest dairy consumption — like the U.S., the UK, Scandinavia, those northern European countries — many of them also have the highest hip fracture rates. Meanwhile, some regions of Asia and Africa with low dairy intakes historically have had lower fracture rates.

Now, we have to be cautious here. Ecological comparisons don’t prove causation. Fracture risk is influenced by genetics, body size, longevity, physical activity, sunlight exposure, and healthcare systems. But the so-called calcium paradox does remind us that dairy intake alone does not determine bone outcomes.

The Nurses’ Health Study was really interesting. It followed nearly 78,000 women for 12 years, and they found that higher milk consumption wasn’t associated with lower fracture risk, and in some analyses, those consuming the most milk did not experience protection. Other studies have shown modest benefits with dairy intake, so the picture is actually quite mixed.

Several factors contribute to this pattern. Many high-dairy-consuming countries are located in northern latitudes with limited year-round sunlight, and vitamin D insufficiency is common in these regions. Without adequate vitamin D, calcium absorption is impaired regardless of calcium intake. In addition, fracture risk reflects more than calcium intake alone. Overall dietary patterns, sodium intake, physical activity, body size, longevity, and healthcare systems all influence outcomes. High sodium intake, for example, increases urinary calcium excretion, and many Western dietary patterns combine dairy with processed foods that are sodium-rich.

And then finally, calcium does not act in isolation. It functions within a much broader nutrient matrix.

Ocean Robbins: Tell us more about that.

Brenda Davis, RD: Yeah, well, when calcium comes from whole plant foods, it doesn’t come alone. It’s packaged with magnesium, potassium, vitamin K, vitamin C, antioxidants, fiber, and even trace minerals like boron — all of which play roles in bone metabolism. Magnesium is essential for proper bone structure and vitamin D activation. Potassium helps buffer acid load and may reduce calcium losses. Vitamin K is critical for activating osteocalcin, a protein involved in bone mineralization. Boron appears to influence calcium retention and steroid hormone metabolism. So we’re not talking about just a single mineral — we’re talking about a coordinated system. It’s a team effort.

Ocean Robbins: To be fair, dairy also provides important nutrients. It delivers protein, phosphorus, potassium, and in many countries, vitamin D through fortification. Those are really meaningful contributions.

Brenda Davis, RD: But calcium does not function in isolation, and bone health reflects total dietary pattern, including plant-derived nutrients that are often under-consumed and underappreciated.

And here’s something that really surprises people. Your body actually absorbs about half — and I would say the range is around 40 to 70% — of the calcium from low-oxalate greens like kale, bok choy, collard greens, mustard greens, and broccoli. From dairy milk, the absorption rate is only about 30 to 34%.

Ocean Robbins: So you actually absorb a higher percentage of the calcium that’s in kale than the calcium that’s in milk.

Brenda Davis, RD: Yes, exactly. From low-oxalate greens, a significantly higher percentage. But I do need to add one very important caveat. Not all greens are created equal. High-oxalate greens such as spinach, Swiss chard, and beet greens very strongly bind calcium, resulting in absorption rates closer to 5%. And while cooking can reduce soluble oxalates somewhat — especially boiling and discarding the water, which can cut oxalates by around 40 to 70% — it still doesn’t convert high-oxalate greens into reliable calcium sources. They remain relatively high in oxalates, so the absorption rates for calcium are still fairly low.

Ocean Robbins: So if someone’s eating a big spinach salad every day thinking they’re covered on calcium…

Brenda Davis, RD: Not quite. They’re getting a lot of great nutrition — iron, folate, magnesium, potassium, provitamin A carotenoids — but almost no absorbable calcium from the spinach.

And a practical tip: If you enjoy cooking with high-oxalate greens like chard and spinach, you can mix them with low-oxalate greens like kale and collards. The small amount of oxalic acid from the chard won’t significantly compromise the calcium absorption from the kale. The same goes for salads or smoothies — if you include a smaller amount of spinach, that’s fine.

The greens we really want to prioritize specifically for calcium are kale, collards, mustard greens, broccoli, turnip greens, and some of the Chinese greens — bok choy, gai choy (Chinese mustard greens), gai lan (Chinese broccoli), and napa cabbage.

Ocean Robbins: What about beans? We know that phytic acid in beans can affect mineral absorption.

Brenda Davis, RD: Yeah, that’s a really good question. Phytic acid, or phytate, can bind minerals like calcium, iron, and zinc, and modestly reduce their absorption. But context really matters. Beans are extraordinarily nutrient-dense. They provide plant protein, magnesium, potassium, zinc, resistant starch, and fiber — all of which support overall metabolic and bone health. So while phytates can modestly reduce mineral absorption in a single meal, beans are overall protective to bone health. In fact, populations with higher legume intakes typically have very favorable health outcomes.

Preparation also makes a difference. Soaking dried beans overnight, draining and rinsing them, and cooking them in fresh water all reduce phytate content and improve mineral bioavailability. Sprouting and fermenting further reduce phytate as well.

It’s important to remember that mineral absorption is influenced by the overall meal. Including vitamin C-rich foods enhances iron absorption, and adequate overall calcium intake throughout the day matters more than the effect of phytate from any one food. So beans are absolutely an important part of a bone-supportive diet, especially when they’re properly prepared.

Ocean Robbins: Now, one of the great things about beans is all the protein they deliver, so let’s talk about protein, because I think it gets a little overlooked in the bone health conversation.

Brenda Davis, RD: Oh, I agree — it’s enormously overlooked. About half of bone volume is actually protein, primarily collagen, which forms the flexible matrix that mineralizes and gives bones strength and resilience. Calcium hardens that scaffold, but without adequate protein, bones can become structurally weaker, even if calcium intake is sufficient.

For older adults, the evidence pretty strongly supports aiming for about 1.0 to 1.2 grams of protein per kilogram of body weight. For a 150-pound person, that’s roughly 68 to 83 grams of protein per day.

Now, there’s been quite a debate around protein source and bone health. Earlier theories suggested that animal protein might increase acid load due to sulfur-containing amino acids, potentially increasing calcium excretion in the urine. However, more recent research suggests that adequate protein, including protein from animal sources, generally supports bone health when calcium intake is sufficient.

And here’s where plant proteins have a potential advantage. Plant foods naturally come packaged with potassium, magnesium, and other alkaline salts that support acid-base balance. So when you eat lentils, tofu, quinoa, nuts, and seeds, you’re getting protein along with buffering minerals that support overall metabolic balance.

Ocean Robbins: So the whole food matrix really matters — not just the protein itself, but what comes with it.

Brenda Davis, RD: Oh, exactly! Legumes, soy foods, quinoa, nuts, seeds — these are excellent choices for bone health precisely because of that complete package.

Ocean Robbins: Now, I want to mention one more finding that I loved, because it is so simple. Tell us about the prune study.

Brenda Davis, RD: Oh, yes, I can remember when this came out. It was a randomized controlled trial out of Penn State. Postmenopausal women consuming just 4 to 6 prunes daily maintained bone density over 12 months, whereas the control group experienced typical age-related decline in bone density.

Prunes provide boron (as do flax seeds), vitamin K, potassium, and polyphenols that may reduce bone resorption. It’s not magic, but it’s a simple food-based strategy that appears to modestly support bone maintenance.

Ocean Robbins: And help keep us regular, too. Four to six prunes a day, no prescription needed.

Brenda Davis, RD: No prescription needed. And they’re delicious. I use them myself as my main sweetener when I make chia pudding. I blend my non-dairy milk with some prunes and hemp seeds to increase the essential fatty acids and protein. The prunes add a beautiful flavor and texture. And when I make intact grain breakfast cereals, I’ll add a few prunes as well. It’s easy to eat your quota of prunes.

Ocean Robbins: Lovely. Now, before we leave food, let’s talk a little bit about what to limit or avoid.

Brenda Davis, RD: For sure. High sodium intake, as I mentioned before, increases urinary calcium excretion — meaning the more salt you consume, the more calcium you lose in your urine. So minimizing heavily processed foods, or what we call ultra-processed foods, and excess salt really does help preserve calcium balance over time.

Cola beverages deserve a brief mention as well, because colas contain phosphoric acid, which is an additive used for flavor and preservation. High intakes of cola have been associated with lower bone density in some studies. This may be partly because cola can displace more nutrient-dense beverages, like fortified plant milks, and partly because high phosphorus intake relative to calcium may influence bone mineralization when overall calcium intake is inadequate. Moderation is really the key.

Caffeine can slightly reduce calcium absorption in the short term, but the effect is pretty modest — roughly 2 to 4 milligrams of calcium per cup of coffee. In people with adequate calcium intake, it’s not very clinically significant. The practical advice is simply not to rely on caffeinated beverages in place of calcium-rich foods.

And then excessive alcohol is clearly detrimental to bone health. Chronic high intake interferes with bone formation and does increase fracture risk.

Ocean Robbins: Thank you. Now I want to shift to one of the most counterintuitive things I learned from our research. In most areas of health, being lean is an advantage, but bones seem to be an exception to this.

Brenda Davis, RD: Yeah, they are. Bone responds to mechanical strain — this is known as the mechanostat principle. When bones experience sufficient loading, they adapt by becoming stronger. When loading decreases, bone remodeling shifts toward loss.

One of the most constant sources of mechanical loading is simply carrying your body weight. A heavier body increases the gravitational force on the skeleton throughout the day, which stimulates bone maintenance. That’s one reason why very lean individuals, especially slender postmenopausal women, have higher fracture risk — their bones may be receiving less daily mechanical stimulus.

But I want to be clear: It doesn’t mean higher body fat is protective in a comprehensive sense. Excess adiposity carries metabolic risks and may increase fall risk as well. So the goal isn’t weight gain — it’s adequate mechanical stimulus.

Ocean Robbins: Yeah, absolutely. And just to be clear, carrying excess weight often makes it harder to exercise, because there’s more resistance, which can also be a negative for every aspect of health, including bone health.

Brenda Davis, RD: Yeah, absolutely.

Ocean Robbins: This really underlines how important exercise is, and it’s even more critical if you’re lean.

Brenda Davis, RD: Yes. Weight-bearing and resistance exercises are among the most powerful tools we have for preserving bone. Activities that create impact or strain — walking briskly, stair climbing, dancing, tennis, hiking — all stimulate bone. Higher-impact activities like jogging or jumping can be even more osteogenic when appropriate.

Resistance training deserves special emphasis, because when muscles contract against a load, they pull on bone, and that mechanical tension really stimulates bone formation. Progressive resistance training, where the load gradually increases over time, is particularly effective.

And there’s another critical piece: fall prevention. Stronger muscles tend to improve balance, coordination, and reaction time. Many serious fractures occur not just because bones are weak, but because people fall. Experts recommend at least 30 minutes of weight-bearing activity on most days, plus at least 2 or 3 sessions of resistance training per week — probably every second day is ideal.

Ocean Robbins: What about people who already have osteoporosis or significant bone loss? Is it too late for them?

Brenda Davis, RD: No, absolutely not. If you have existing osteoporosis, you want to start slowly. Consider working with a physical therapist who can design a safe, appropriate exercise program. Activities like stability and balance exercises, flexibility work, weight-bearing aerobics, and strength training that focuses on your upper back are really wonderful and commonly recommended. It’s never too late to start — it’s really important, however, to start at the right level.

Ocean Robbins: What about people with mobility limitations or joint issues?

Brenda Davis, RD: Well, that’s a little more challenging. Whole-body vibration platforms can offer modest benefits for bone density and balance. The evidence shows small but measurable improvements in some populations. They’re definitely not a replacement for traditional resistance or impact exercise when someone is able to do those, but they can provide mechanical stimulus when other options are really limited.

Ocean Robbins: And I think the key thing I really want to anchor in here is: Do what you can with what you’ve got. If you can only walk a little bit, don’t let that mean you don’t walk at all. Use what you have, do what you can, and your range of capacity may increase as you get stronger and more capable.

All kinds of people are dealing with different limitations. Some of the risk factors for osteoporosis may be unavoidable. That doesn’t mean you throw up your hands and give up. It actually makes doing all the other things even more critical, so that you can really take charge. If you already have osteoporosis, that means it’s even more urgent for you to do what you can so that you can restore your skeleton and make the best of this precious life.

So, friends, we’ve covered the food foundation, we’ve talked about protein and foods to limit, and we’ve talked about exercise. Now let’s get into the nutrients that are difficult for some people to get from food alone, and why, for a lot of people, supplementation may be really important.

Brenda, you mentioned earlier that many of your plant-based clients are falling short on calcium from food alone. So let’s get specific about supplementation. When is it necessary, and what is the smart approach?

Brenda Davis, RD: Well, if you’re not consistently meeting your calcium needs through food — and many people aren’t, especially postmenopausal women who should be aiming for about 1,200 milligrams a day — then I think supplementation is a smart, evidence-based decision. It’s not a failure of your diet. It’s just being strategic about a nutrient that can be challenging to get enough of.

And how you supplement matters as much as whether you supplement. The form I generally recommend is calcium citrate malate. It’s among the most absorbable forms of calcium available, and it’s pretty gentle on the digestive system. Unlike calcium carbonate — the cheap, chalky form in most supplements — citrate malate doesn’t require a lot of stomach acid for absorption. And that really matters, because stomach acid production tends to decline as we age, which means calcium carbonate becomes less effective over time for exactly the population that needs calcium the most.

Dosing is the other big part of this picture. We want fairly small amounts — 400 to 500 milligrams per serving, taken with food. If you need more than 500 milligrams in supplemental calcium per day, you definitely want to split it into two doses, because your body really maxes out absorption at around 500 milligrams at a time. Taking a giant 1,000-milligram dose all at once, which is what many cheap supplements provide, is wasteful — much of it just passes through unabsorbed.

And one more important point: more is not better. Total daily calcium intake from food plus supplements should generally stay below the tolerable upper limit, which is 2,000 to 2,500 milligrams per day, depending on your age. Excessive supplementation has been associated in some studies with kidney stones and possibly cardiovascular risk, though the data are pretty mixed on this. The goal is adequacy, not excess.

Ocean Robbins: Well, you just mentioned cardiovascular risk. So let’s talk about the cardiovascular question. I want to address it directly, because I know a lot of folks are thinking about it. Some cardiologists have raised concerns about calcium supplementation increasing risk of heart disease. And I want to be clear — we’re not going to brush this aside or pretend it doesn’t matter, because cardiovascular disease is the number one killer of women, as well as men, worldwide. It’s responsible for about 35% of all deaths among women on the planet — more than all forms of cancer combined, by far, or any other cause of disease. So when researchers raise a flag about anything that might affect heart health or increase the chances of death from cardiovascular disease, we’ve got to listen.

Brenda, is this a legitimate concern?

Brenda Davis, RD: Oh, absolutely, it’s a legitimate concern, and I think it really deserves thoughtful discussion. You should never feel like you have to choose between protecting your heart and protecting your skeleton. The good news is, you don’t have to.

I want to explain a little bit of what the research actually shows, because the details here really matter. The studies that raised the alarm were looking at people taking large doses of calcium — typically 1,000 milligrams or more at once — usually in a form that’s hard to absorb, on an empty stomach, and without companion nutrients like vitamin D3 or K2. When you take that much calcium all at once, it creates a very rapid spike in your blood calcium levels, much faster than what happens when you eat calcium-rich foods, where everything is absorbed gradually. That spike can affect how your blood clots, how your blood vessels function, and over time, excess calcium can start building up in your artery walls. None of that is good for your heart.

There was a large meta-analysis in the journal Nutrients that looked at 13 rigorous trials involving nearly 29,000 people, and they found calcium supplementation done that way — the large doses without the accompanying nutrients — was associated with about a 15% increased risk of cardiovascular disease in healthy postmenopausal women.

But here’s the key: It’s not that calcium itself is the problem. It’s how much, how fast, and what’s missing alongside it. The practical takeaway is that it seems best to avoid large, single doses. Take moderate amounts with food, and make sure you’re getting the companion nutrients — especially D3 and K2 — to help your body use calcium properly.

Ocean Robbins: I think the key word here is context. The cardiovascular risk is not inherent to calcium supplementation itself. It’s a product of how it’s been done — too much at once, in the wrong form, without the companion nutrients.

Brenda Davis, RD: Yeah, exactly. And I want to be transparent, because not all researchers agree on the magnitude of the risk. Some meta-analyses have found no statistically significant increase. One of the reasons for the conflicting findings is that many of the studies mixed together people taking calcium alone with people taking calcium plus vitamin D, and that really muddies the picture. Another reason is that getting calcium from food is actually associated with lower cardiovascular risk in observational studies — not higher. So it’s not calcium itself that’s the villain. It’s the way supplemental calcium has typically been delivered — a large bolus that hits the bloodstream all at once, without the nutrients your body needs to process it properly.

And that distinction is really the key to this whole conversation. When you take a modest dose with food, exactly the way we discussed, the calcium enters your bloodstream gradually alongside other nutrients, and you avoid that spike that causes problems. You’re mimicking what happens when you eat calcium-rich foods. The calcium trickles in rather than flooding in.

When you add vitamin D3, you ensure the calcium is actually being absorbed efficiently and directed into the processes where it’s needed, rather than passing through and creating imbalance.

And when you add vitamin K2 — and this is a piece that most people are still missing — you actually activate the proteins that specifically direct calcium into bone tissue, and you activate other proteins that actively prevent it from accumulating in your arteries. K2 is sort of like a traffic controller that says: calcium, go here, not there.

So the trio of calcium, vitamin D3, and K2 doesn’t just support bone health — it directly addresses the cardiovascular concern. The calcium gets where it needs to go, and stays out of where it doesn’t belong.

Ocean Robbins: So the research isn’t telling us to be afraid of calcium. It’s telling us to be smarter about it.

Brenda Davis, RD: Yes, that’s right. The research is actually a gift, in a way, because it showed us what not to do, and it pointed directly to what we should be doing instead. Don’t take high doses all at once. Don’t take cheap, poorly absorbed forms. Don’t do it in isolation. Take a moderate dose of a well-absorbed form, with food, alongside vitamin D3 and K2. That approach doesn’t just sidestep the cardiovascular concern — it actively supports cardiovascular health while building your bones.

And that’s why I don’t recommend calcium supplementation in isolation anymore. It’s that combination — the right dose, with food — that makes this both safe and effective. And when you look at the science of how these nutrients work together, you realize it was always meant to be a team effort.

Ocean Robbins: A team effort. Yes, absolutely. Okay, let’s talk a little deeper about vitamin D3, what you called an absorption enhancer.

Brenda Davis, RD: Yeah, so vitamin D really plays a dual role in bone health. It enhances calcium absorption in your intestines — without adequate D3, you can take in all the calcium you want and much of it just won’t get absorbed. And it also supports the muscles that help you maintain balance and avoid falls, which matters enormously for fracture prevention.

The scope of vitamin D deficiency is staggering. A 2014 systematic review found over a billion people worldwide are deficient. In the United States, about 1 in 4 adults has levels considered too low for bone health. And this isn’t just a northern latitude problem. Even in sunny climates, most people are spending their days indoors, wearing sunscreen when they go out, and not getting direct UV exposure — the exposure we need for our skin to produce vitamin D.

Your skin does produce D3 from sunlight, but most people benefit from 10 to 30 minutes of direct sun exposure over a good portion of their body each day. Those who live farther from the equator, like I do in Canada, or who have darker skin, or simply don’t get regular sun exposure, need more — or they need to rely primarily on supplementation. Many people in northern latitudes go 6 or 8 months without producing any vitamin D at all.

While the official RDA ranges from 600 to 800 IU per day depending on age — 800 if you’re over 70, 600 under 70 — a typical maintenance dose of 2,000 IU of vitamin D3 daily is common, though individual needs vary considerably. If you’ve never had your levels checked, you really should ask your healthcare provider for a 25-hydroxyvitamin D test, just to know your baseline. Many bone health experts suggest optimal blood levels between 30 and 50 nanograms per milliliter.

And since vitamin D is fat-soluble, meaning it accumulates in your body, it is wise to get your levels checked periodically if you supplement with significant doses. You don’t want to overshoot vitamin D, because excessive vitamin D can lead to hypercalcemia, which can damage kidneys and, paradoxically, can also impair bone health.

Ocean Robbins: Now, just to be clear, most vitamin D3 supplements are made from lanolin, which comes from sheep’s wool. But there is vegan D3 available made from lichen — it’s widely available and effective. There’s also vitamin D2, which is vegan-friendly, but it’s not as effective at raising blood levels. I recommend vegan D3 from lichen for anyone following a plant-based diet, and honestly, for most people.

Going back to the Adventist Health Study — vegan women who reported adequate vitamin D intake alongside calcium didn’t show the elevated fracture risk that was seen in those with lower intakes.

Brenda Davis, RD: Yeah, exactly. Those two nutrients together were the game-changer in that study. But there’s really a third piece that completes the system, and that’s vitamin K2.

Ocean Robbins: Yeah, you’ve described it as a traffic director. Tell us about that.

Brenda Davis, RD: Yeah, well, that’s exactly what it is. Vitamin D3 helps you absorb calcium from your gut into your bloodstream. But then the question becomes: Where does that calcium go?

Vitamin K2 — ideally the MK-7 form — activates proteins that direct calcium into your bones and activates other proteins that prevent calcium from depositing in your arteries and soft tissues. At a biochemical level, K2 activates a vitamin K-dependent protein called osteocalcin, which helps incorporate calcium into bone tissue. Elevated levels of inactive osteocalcin are actually a clinical marker of osteoporosis. Both K1 and K2 help regulate osteocalcin, and clinical studies have shown that K2 supplementation can prevent further bone loss and reduce fractures in postmenopausal women with osteoporosis. So K2 isn’t just preventive — there’s evidence it can actually be therapeutic.

Ocean Robbins: Yes. As far as where to get it from food — for omnivores, the main sources tend to be high-fat dairy like aged cheeses and organ meats. For plant-based eaters, fermented foods deliver some, particularly natto, which is a Japanese fermented soybean dish that’s very high in K2. Tempeh, sauerkraut, and kimchi provide a bit as well.

Your body can also make its own K2 — it can convert it from K1, which is abundant in leafy greens, cruciferous vegetables, prunes, peas, and parsley. But the conversion rate varies enormously from person to person, so it’s probably wise — especially for plant-based eaters — to consider a daily supplement. A dose of 50 micrograms of K2 as MK-7, especially combined with D3 and calcium, can really help with bone support.

Bringing all this together: D3 helps you absorb calcium from your food and supplements. Calcium provides the raw building material your bones need. And K2 directs that calcium into your bones instead of your arteries. Taking calcium by itself, without D3 and K2, is kind of like having building materials delivered to a construction site with no blueprint and no crew. The materials might just sit there, or end up in the wrong place entirely.

Brenda Davis, RD: Yeah, that’s a really great analogy. These nutrients really belong together. Taking them in a single formulation ensures optimal absorption and utilization, minimizes cardiovascular concerns, and eliminates the guesswork and pill burden of trying to piece it together from three or four separate bottles.

Ocean Robbins: Let’s talk about some of the other nutrients that play important roles, starting with B12.

Brenda Davis, RD: B12 deficiency is a risk factor for osteoporosis, and it’s far more common than most people realize. Researchers at Tufts found that about 40% of adults in the Framingham cohort had low-to-normal B12 status, and about 9% met the standard definition of deficiency. These were people across all dietary patterns — omnivores included. B12 deficiency can lead to megaloblastic anemia and neurological impairment, and it’s been associated with an increased risk of osteoporosis and fractures, especially in older adults.

For anyone eating a fully plant-based diet, I really need to be direct: B12 supplementation is absolutely not optional. There is no reliable plant food source of vitamin B12. It’s the one nutrient where supplementation is really non-negotiable for vegans. I’ve seen too many plant-based eaters skip B12 because they feel healthy, and by the time they test their levels, they’ve been deficient for years. Don’t let that happen to you. A daily dose of 50 micrograms is simple, inexpensive, and very protective — for your bones and for your nervous system.

Ocean Robbins: What about magnesium?

Brenda Davis, RD: About 60% of the magnesium in your body is actually stored in your bones, where it supports both structure and strength. Magnesium also plays a regulatory role, helping to dial down the activity of bone-resorbing cells.

And here’s a connection that’s often overlooked: Magnesium is essential for activating vitamin D. If you’re low in magnesium, your vitamin D supplement won’t be working as effectively as it could. So magnesium is really a key partner in the whole system. Magnesium bisglycinate is a well-absorbed, gentle form. About 150 to 200 milligrams a day is a reasonable supplemental amount.

Ocean Robbins: Thank you. Now tell us about boron.

Brenda Davis, RD: Boron is a trace mineral that’s a heavy hitter in a tiny package. It helps your body retain calcium and magnesium by significantly reducing the amount you lose in your urine. It also extends the active life of vitamin D and estrogen in the body, both of which are really vital for maintaining bone density as we age. We need about 2 milligrams a day, and one of the best dietary sources is flax seeds.

Ocean Robbins: Beautiful. What about zinc?

Brenda Davis, RD: Zinc acts as a biological stimulator for osteoblasts — the cells that build new bone — while simultaneously inhibiting osteoclasts, the cells that break bone down. It’s also required for the production of collagen, the protein matrix that gives bones their structural strength. Even a mild zinc deficiency can stall bone growth and repair. About 5 to 10 milligrams of elemental zinc per day is generally sufficient in supplement form. Zinc picolinate is the form with the best evidence for absorption — in a head-to-head study published in Agents and Actions, zinc picolinate significantly outperformed zinc citrate and zinc gluconate.

Ocean Robbins: And then there’s creatine. I think it’s one of the most fascinating pieces of this puzzle.

Brenda Davis, RD: Oh, I do too. Creatine monohydrate is best known for muscle support, but there’s a bone health connection as well. There was a 12-month randomized controlled trial at the University of Saskatchewan that studied postmenopausal women doing resistance training. One group was supplemented with creatine while the other took a placebo. The women taking creatine lost significantly less bone mineral density at the femoral neck — a key part of the hip and one of the most common fracture sites.

The mechanism is really intuitive. Creatine maintains muscle strength and size, which means stronger muscles putting greater force on bone during exercise — the very stimulus that tells bones to stay healthy. Stronger muscles also mean better balance and fewer falls. So creatine supports bone through the muscle-bone connection and through fall prevention simultaneously.

Ocean Robbins: Beautiful. So let’s put all this together. Calcium, D3, K2, B12, magnesium, boron, zinc, and creatine. That’s not just addressing one piece of the puzzle — it’s creating an ecosystem to support bone health.

Brenda Davis, RD: Yes, that’s exactly right. And it’s really that synergy that makes the difference. These nutrients amplify one another. Remove any one piece and the system is less effective. Together, they’re genuinely very powerful.

Ocean Robbins: And then, of course, you combine that with adequate protein intake, with an overall healthy dietary pattern, with steering clear of the bone-damaging ultra-processed foods and colas, and you add in lots of exercise — and you have a recipe for a strong, healthy skeletal system.

So, after everything we learned from the research, I started paying attention to how the people around me were actually handling this. My mom had a bunch of different supplement bottles lined up on her kitchen counter — one for calcium, one for D and K2, one for creatine, one for magnesium. She was trying to piece together what she needed from different products, different doses, and wasn’t totally sure she had the right forms or the right amounts.

And I thought to myself: This shouldn’t be this complicated. I started thinking, why isn’t there one product that does all of this? And I couldn’t find one.

So we set out to create one. And we took this really seriously, because Food Revolution Network has never put our name on a physical product before. We’ve endorsed products, but we’ve never identified with a product. This was new territory for us, and we wouldn’t have done it if we weren’t really convinced there was a need.

We went back through the interviews we’ve conducted with over 100 leading food experts in our Food Revolution Summits over the years. We consulted with Brenda and a number of dietitians, nutrition professors, and leading plant-based doctors. We asked them: If you could design the ideal bone health supplement based on everything the evidence shows, what would be in it? And then we partnered with Complement — a company we’ve been working with for years that has enormous integrity — to formulate and produce it.

The result is called Bone Vitality. Brenda, you were actually a part of designing this. Can you share a little bit about what you were recommending we bring in, and why?

Brenda Davis, RD: Well, I can remember when you sent me what you were doing, and I took a look at it. I wanted so much for that supplement to have all of the team players that were really critical — nutrients that may be lacking in the diet, especially in plant-based diets, but really for everyone. And so we talked about things like boron and zinc and magnesium, and I was just thrilled at the way it ended up coming together so beautifully.

Ocean Robbins: Yeah, and one of the key things was the purity. We wanted something that just gave the nutrients — no fillers, no sweeteners, no flavors, no gums, no preservatives. That was important to us and also to the team at Complement. Matt Tullman, Complement’s founder, was insistent about keeping it super clean. His philosophy is that you can always add flavor with your food, but the supplement itself should be nothing but what your body actually needs.

The format is a powder, not a pill or a gummy. There’s a practical reason for that — creatine is in the formula, and by weight it’s over half the volume. Capsules would have meant swallowing 6 or more pills a day. Nobody really wants that. And gummies mean added sugar of some kind, and they’re not great for dental health. So the powder was the perfect call.

You can stir it into a smoothie, sprinkle it on oatmeal, mix it into pasta or a grain bowl — really any food that’s got some moisture. A couple of teaspoons disappear into a smoothie completely. You won’t taste it. You take a couple of teaspoons a day, and that’s a full serving. And taking it with food or a smoothie is by design, because your body absorbs nutrients best in the context of a meal, as part of a full symphony of nutrition.

That said, if you just mix it in with water, that’s okay. It’s not the greatest taste — there’s not really any taste — it’s just a thing to do. But I think you’ll enjoy it more if you mix it into something with some flavor, whether that’s a smoothie or food.

Brenda Davis, RD: Yeah, and when we look at the amounts — every nutrient is in the best form we could find. Calcium is calcium citrate malate, 400 milligrams. It’s the most absorbable, the most gentle, and it’s just the right amount to get you to where you need to be, because many plant-based eaters will be getting 600 to 900 milligrams from food, and this gets you to that 1,200.

Vitamin D is 2,000 IU, which is perfect. Vitamin K2 is MK-7 at 50 micrograms. Creatine monohydrate at 2 grams for muscles and bones. Plus B12, magnesium — all of it is there.

The formulation was also designed with the cardiovascular concern in mind from the very beginning. The modest calcium dose — not the 1,000 milligrams plus that you find in a lot of supplements — and it includes K2 to actively direct that calcium to the bones and away from your arteries. It’s designed with a lot of care to be taken with food, which is the modern, evidence-based approach to bone health supplementation.

Ocean Robbins: Yeah, absolutely. And for anybody who’s already taking some of these nutrients separately — maybe you’ve got a D3 and K2 supplement, or a calcium supplement, or magnesium — Bone Vitality could replace several bottles with one daily scoop and simplify things.

If you’ve been thinking about bone health supplementation, or if you’re still piecing it together from multiple bottles the way so many people are, this can make it simpler and easier. Eight nutrients working together in synergy in one daily 2-teaspoon scoop.

And I want to say something to those of you who are thinking, “I should probably do this, but maybe I’ll get to it later.” Life gets busy, but this is exactly the kind of thing that’s easy to put off and hard to get back to. Your bones are remodeling right now, today. So whatever you do, please take action for your bones. Whether you subscribe to this product or not, please put what you’re learning into practice. And take care of the structure that takes care of you.

I’m not the owner of Complement — it’s an independent company. But I do know the owners of Complement, and they’re wonderful people, and we’ve been consulting with them from the beginning. They are whole foods, plant-based eaters who wanted to create a supplement line to complement a healthy diet and provide the critical nutrient needs that might be missing from even super-healthy eaters’ dietary patterns.

A couple of things that are special about this product. Every Complement product is third-party tested for heavy metals and other toxins. They publish those results openly on their website, and every batch is tested and published. I don’t know any other supplement company that does that.

They also deliver all products in compostable pouches that break down within 12 months in a typical compost pile — not right away, not the kind of thing that breaks down while you’re opening the package. But they will break down and biodegrade completely. That’s a really cool thing in a world overwhelmed and swimming in plastic.

Your skeleton is a living organism. It’s remodeling itself right now, as we speak. And the choices you make today — about what you eat, how you move, and whether you fill the nutritional gaps — are shaping the skeleton you’ll have 10 years from now.

I’ve been thinking a lot about what our bones actually do for us. Your skeleton is, quite literally, your backbone. It’s what holds you up. It’s what gives you the structural support to meet life’s challenges — to stand tall, to move freely, to show up for the people who depend on you.

And I know that a lot of people in this audience are givers. You take care of your families, you show up for your community and your friends, you pour yourself out for others. But here’s the thing: An overflowing cup gives most bountifully. The structure that holds you up could be quietly weakening, and when that happens, everything gets harder. So investing in your bones isn’t selfish — it’s how you make sure you can keep showing up for the people and the purposes you love, with strength and confidence.

Your bones have carried you through every chapter of your life so far. Every step, every dance, every hike, every morning you got out of bed without a second thought. They deserve your attention now, so they can carry you through the chapters still to come.

Brenda Davis, RD: Well, you know, Ocean, I’ve spent my entire career working to help plant-based eaters thrive, because I just so deeply believe in what this way of living can do — not just for our health, but for animals and for the planet. And one of the things that’s always motivated me is making sure people have the tools and the knowledge they need, so that choosing plants doesn’t come with unnecessary risk.

What we’ve shared today — the food strategies, the exercise, the supplementation — these are all tools. And I think each one of us has the knowledge now to protect our bones for decades to come. For the people who are here and listening, I just really hope you can use some of what you’ve learned. Your future strength, mobility, and independence are so precious and are really worth protecting. You’re in control, so do whatever you can to maintain your health for as long as possible.

Ocean Robbins: Beautifully said, Brenda. Thank you for your expertise, and thank you for your heart.

Whether or not you choose to participate in that opportunity, please take care of your bones and take care of your precious self. Your health is a treasure, and it’s worth protecting.

A little prevention now can mean a lot more freedom later. And we’re here with you — sending so much love and wishing you all vitality and wellness.

Featured image: istock.com/Wavebreakmedia

Tell us in the comments:

1. What’s one thing you learned today that surprised you about bone health?
2. What does your current routine for supporting your bones look like — and is there one thing from this article you’re inspired to add or change?

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