As soon as you are conceived, the process of growing new bone begins and continues for many years, peaking as a teenager and beginning to decline in the third decade of life.
The peak decline starts in the sixth decade when sex steroids start to decline significantly. The natural process of bone development is very complicated, with many hormones and micronutrients necessary for optimal function.
For the purpose of this article, I will focus on those aspects of bone development and maintenance that are controllable. As we age, it is imperative that we maintain as much bone volume as possible. Osteopenia and osteoporosis are conditions where the bone volume has significantly deteriorated to the point of fracture risk.
The biggest concern with early bone loss is major hip and leg fractures that predispose humans to early death as they age. Since bone is laid down during childhood in large volumes, it is imperative that we maximize this period of bone deposition.
The critical aspects of growing solid bone are all in place as long as one follows a few simple natural activities.
First, it is necessary to move and bear weight to stimulate the bones to lay down more of themselves. This was proven in hospitals when a patient would be immobilized from injury. The patient was noted to have significant bone loss that increased with the length of immobility. There are mechanoreceptors in bone that recognize movement and signal bone development. We need to move every day. We need to move a lot, at least 10,000 steps a day. I would also encourage light weight lifting, or better yet chores like sweeping the floor, raking leaves, general cleaning around the house.
Second, it is necessary to get adequate micronutrients in one’s diet to build the bone from. We primarily need calcium, magnesium, phosphorus, sodium, potassium, vitamin K2, vitamin D, and vitamin A. All of these minerals and vitamins except for vitamin D and K2 are easily acquired from a mediterranean diet that is predominantly vegetarian based.

Third, it is necessary to get adequate sun exposure daily for vitamin D. Spending time in the sun without sunscreen will stimulate your skin to produce vitamin D. Never burn, as that damages the DNA of your skin, causing cancer risk to increase. The darker your skin, the longer you will need to spend in the sun to get the same vitamin D amount.

Fourth, we must avoid excessive inflammation which can significantly damage the body’s ability to lay down new bone. The major source of inflammation in humans — especially children— is from a standard American processed food diet. Exposure to toxins is a close second. We know from many different systems in the body that the SAD diet promotes the wrong gut microbes, increasing inflammation and decreasing the production of insulin like growth factor 1, which is supposed to increase bone mass.

Fifth, vitamin K2 is produced in the body in our gut by the bacteria E coli converting K1 to K2, as well as conversion occurring in certain tissues. It is also obtained dietarily from animal livers and fermented foods like nato, kimchi and kombucha. Emerging research is pointing to vitamin K2 as a cofactor in the development of proteins like osteocalcin which helps lay down bone, and matrix GLA protein which helps direct calcium to the bones and away from blood vessels. If you do not consume enough vitamin K or take medicines that block vitamin K like anticoagulants, you are at increased risk for osteoporosis.

Part II next week.
We need healthy bones,
Dr. Magryta
Dr. Chris Magryta is a physician at Salisbury Pediatric Associates. Contact him at newsletter@salisburypediatrics.com