Bone health is influenced by much more than just calcium intake and is critical to healthy aging and long-term health. Peak bone mass is typically reached by age 17 in females and 21 in males, with 95% of adult bone mass formed by these ages.¹ After age 30, bone mass gradually decreases, influenced by both genetics and lifestyle factors like diet, physical activity, and hormone levels.¹ Failure to achieve peak bone mass in early adulthood increases the risk of bone density disorders, including early osteopenia or osteoporosis.¹ Osteopenia is a condition where bone density is lower than normal but not low enough to be classified as osteoporosis. Osteoporosis is a more advanced and progressive disease marked by significantly reduced bone mineral density, weakened bone structure, and a higher risk of fractures.^1-3

Bone is not a static structure; it is a highly dynamic and metabolically active tissue constantly undergoing remodeling through tightly regulated formation and resorption processes.⁴ Bone not only provides mechanical support and organ protection but also serves as a reservoir for essential minerals, maintaining calcium and phosphate balance in the body. Disruptions in this continuous remodeling process can impair bone strength and structure, contributing to disease and increased fracture risk. Dietary deficiencies in calcium and vitamin D, along with a sedentary lifestyle, smoking, excessive alcohol use, and long-term use of certain medications (such as steroids, cancer therapies, and antidepressants) are all factors that increase risk.²

Currently, 34 million Americans have osteopenia.¹ Women are disproportionately affected; 54% of postmenopausal women are osteopenic, and 30% are osteoporotic, with rates shifting further toward osteoporosis by age 80 and beyond.^1,3 Often asymptomatic until a fracture occurs, bone density problems such as osteoporosis are considered a “silent” disease with serious consequences.¹ Healthcare providers play a pivotal role in early identification, prevention, and management through risk assessment, lifestyle counseling, medication, and nutritional support.

Key Nutrients for Bone Health 

Nutrition plays a vital role in maintaining bone health across the lifespan. Emerging research highlights the importance of overall dietary patterns and specific nutrients like calcium, vitamin D, and phosphorus. A scoping review of 49 human studies showed that adherence to healthy, nutrient-rich eating patterns such as the Mediterranean diet or the Healthy Eating Index (HEI) (emphasizing fruits, vegetables, whole grains, lean proteins, legumes, nuts, and low-fat dairy) is associated with improved bone mineral density and reduced risk of osteoporosis and fractures.^5,6 In contrast, Western-style diets high in meat, fried foods, added sugars/sugar-sweetened beverages, and refined grains may negatively impact bone health.⁵ 

Studies clearly show that adequate protein, calcium, and vitamin D intake supports bone density.^6.7 Calcium and vitamin D work together to support bone health because vitamin D aids calcium absorption in the gut.^7.8 Inadequate levels of either nutrient can lead to reduced bone mineral density and increased risk of osteoporosis and fractures, especially in older adults.⁸  The National Institutes of Health recommends 1000mg of calcium for females and males 19-50 years, 1200mg for females 50 or older, and 1200 mg for all people 70 or older.⁹ Vitamin D serum levels are considered adequate for bone and overall health in healthy individuals at ≥50 nmol/L or ≥20 ng/mL and blood testing can help patients understand if the recommended dietary allowances (RDAs) of 600IU for people 51-70 years and 800IU for people 70 years and older is enough for them.¹⁰ 

While supplements may help deficient individuals, both animal and plant-based food sources like dairy, fish like salmon, fortified plant-based products, and plant sources of calcium (tofu, kale, spinach, chia seeds, beans) offer additional benefits by providing protein and other key nutrients.^7-9 Studies have shown that the positive effects of dietary protein on bone health appear to be dependent on sufficient calcium levels; protein, calcium, and vitamin D are closely intertwined when it comes to promoting strong bones.⁸

Nutrients like phosphorus, magnesium, vitamin C, and vitamin K are also essential for maintaining bone density and supporting bone formation, mineralization, and overall bone health.^6.7 Healthcare professionals should assess a patient’s diet to ensure they meet the recommended nutrients through food and/or dietary supplements. Flavonoid polyphenols found in fruits and vegetables, including compounds like quercetin, rutin, luteolin, kaempferol, and naringin, have also been shown to reduce the risk of osteoporosis through their antioxidant and anti-inflammatory properties.⁷

Emerging research suggests collagen supplementation may support bone health by improving bone mineral density and mass.¹¹ Human and animal studies indicate that collagen peptides may effectively help manage conditions like osteoporosis, though more research on dosing and timing is needed to make recommendations specifically for bone health.¹¹

Physical Activity for Bone Health

Physical activity is a critical modifiable factor for maintaining and improving bone health across the lifespan.¹² In children and adolescents, moderate to vigorous weight-bearing exercises (gymnastics, soccer, etc) are strongly associated with higher bone mineral density, improved bone structure, and long-term fracture prevention.¹² Although the impact of exercise on bone mineral density is less pronounced in older adults, even short durations of moderate to vigorous activity have been linked to better bone health scores and reduced osteoporosis risk.¹²

Weight-bearing and resistance exercises are the most effective for improving and maintaining bone mineral density, particularly in older adults. Activities such as jumping, jogging, aerobics, and weightlifting have shown the most significant benefits, while walking and swimming have little to no effect on bone mineral density.⁶ Aerobic and resistance training can enhance bone formation and reduce bone loss, especially when supported by adequate nutrition. For example, replacing sedentary time with physical activity in women aged 50-85 years (N=1052) has shown up to a 12% reduced risk of osteoporosis in the spine and decreased fracture risk.¹³

Takeaways for Healthcare Providers

Client bone health should be addressed across the lifespan with a comprehensive, individualized approach. Healthcare providers can encourage patients to consume a nutrient-dense diet beyond calcium, emphasizing overall dietary quality to support bone metabolism and work with each individual to assess their diet for possible deficiencies. Regular resistance and weight-bearing exercise at all ages is recommended to help preserve bone density, and health care professionals can help tailor fitness strategies based on each patient’s unique risk factors, health status, and life stage.

References:

1. Varacallo MA, Seaman TJ, Jandu JS, Pizzutillo P. Osteopenia. In: StatPearls. Treasure Island, FL: StatPearls Publishing; 2025. PMID: 29763053.
2. National Institute of Arthritis and Musculoskeletal and Skin Diseases. Osteoporosis. National Institutes of Health. Reviewed December 2022. Accessed April 5, 2025. https://www.niams.nih.gov/health-topics/osteoporosis
3. Looker AC, Hamner HC. Osteoporosis or Low Bone Mass in Older Adults: United States, 2017–2018. National Center for Health Statistics Data Brief No. 405. Centers for Disease Control and Prevention. Published April 2021. Accessed April 5, 2025. https://www.cdc.gov/nchs/products/databriefs/db405.htm
4. Wawrzyniak A, Balawender K. Structural and metabolic changes in bone. Animals. 2022;12(15):1946.
5. Movassagh EZ, Vatanparast H. Current Evidence on the Association of Dietary Patterns and Bone Health: A Scoping Review. Adv Nutr. 2017;8(1):1-16.
6. Papadopoulou SK, Papadimitriou K, Voulgaridou G, Georgaki E, Tsotidou E, Zantidou O, Papandreou D. Exercise and nutrition impact on osteoporosis and sarcopenia—the incidence of osteosarcopenia: a narrative review. Nutrients. 2021;13(12):4499.
7. Martiniakova M, Babikova M, Mondockova V, Blahova J, Kovacova V, Omelka R. The role of macronutrients, micronutrients and flavonoid polyphenols in the prevention and treatment of osteoporosis. Nutrients. 2022;14(3):523.
8. Webster J, Dalla Via J, Langley C, Smith C, Sale C, Sim M. Nutritional strategies to optimise musculoskeletal health for fall and fracture prevention: Looking beyond calcium, vitamin D and protein. Bone reports. 2023 Dec 1;19:101684.
9. National Institutes of Health Office of Dietary Supplements. Calcium—Health Professional Fact Sheet. Updated July 24, 2024. Accessed April 6, 2025. https://ods.od.nih.gov/factsheets/Calcium-HealthProfessional/.
10. National Institutes of Health Office of Dietary Supplements. Vitamin D—Health Professional Fact Sheet. Updated July 26, 2024. Accessed April 10, 2025. https://ods.od.nih.gov/factsheets/VitaminD-HealthProfessional/
11. Campos LD, Junior VD, Pimentel JD, Carregã GL, Cazarin CB. Collagen supplementation in skin and orthopedic diseases: A review of the literature. Heliyon. 2023 Apr 1;9(4).
12. Sheng B, Li X, Nussler AK, Zhu S. The relationship between healthy lifestyles and bone health: A narrative review. Medicine. 2021;100(8):e24684.
13. Ricci C, Gervasi F, Havemann Nel L, Smuts CM, Kruger SH, Leitzmann MF. Substitution of sedentary time with light physical activity is related to increased bone density in US women over 50 years old. An iso‐temporal substitution analysis based on the national health and nutrition examination survey. European journal of sport science. 2019;19(10):1404-13.

This month, we’re shining a spotlight on Colleen Sloan, PA-C, RDN, one of our valued Orgain Healthcare Advisory Panelists. Colleen has been an active Orgain Healthcare Ambassador and currently sits on our Healthcare Advisory Panel where she uses her 10+ years of experience bridging the worlds of medicine and nutrition to provide consulting support, insights and expertise to the Orgain Healthcare team.  She also uses her unique credential pairing to empower clinicians to talk to their patients or clients about nutrition through her podcast, Exam Room Nutrition.  Currently, Colleen is working as a pediatric care provider at Pediatric Associates of South Florida.

Orgain X Colleen Sloan, PA-C, RDN – Interview

1.      Please tell us a little bit about yourself personally and professionally so that our readers will be able to “get to know you.”

I’m Colleen Sloan, a Registered Dietitian and Physician Assistant with a passion for making nutrition education more accessible—for both patients and providers. I’ve been a dietitian since 2011, working across clinical settings, private practice, and specialty pediatric clinics. In 2017, I became a PA and have been practicing in outpatient pediatrics ever since.

Over the years, I kept seeing the same issue: clinicians weren’t confident talking about nutrition, even though it’s at the core of so many health concerns. That’s what led me to launch Exam Room Nutrition, a podcast designed to bridge the nutrition education gap for medical providers. It’s a place where we spotlight Registered Dietitians as the nutrition experts and give doctors, PAs, and NPs the tools they need to have better, more effective conversations with patients.

Beyond the podcast, I’m also launching a CME- and CPEU-approved course on obesity medicine and nutrition counseling, focused on real-world strategies that providers can use.

Outside of work, I homeschool my almost 15-year-old daughter (we’ve been at it for six years!), and our home is full of animal love—with two dogs, a cat, and four backyard chickens. I’m also a big fan of morning workouts and a really good cup of coffee to start the day.

2.     Being dually credentialed as a Physician Assistant and Registered Dietitian, what unique perspective do you bring to healthcare?

Being both a Physician Assistant and a Registered Dietitian gives me a unique lens in healthcare—especially in pediatrics, where nutrition is a key part of nearly every visit. From infant feeding and introducing solids to managing selective eating and supporting adolescent health, nutrition conversations come up constantly. Having a strong foundation in both clinical medicine and nutrition counseling allows me to approach these topics with both depth and compassion.

Pre-adolescence is such a sensitive time—kids are going through major body changes, and the way we talk about weight and health really matters. I’m able to guide these conversations in a way that builds trust and avoids harm, which is something I’m incredibly passionate about.

And of course, any clinician knows: nutrition questions always come up in the final minutes of a visit! My dual training helps me quickly determine whether I can offer a practical answer on the spot—or if a referral to a dietitian is the best next step. It’s a huge asset in making sure families get the right support, at the right time.

3.      Do you have any success stories using Orgain in your pediatric practice?

Absolutely! One success story that stands out is a teen boy I’ve been working with who’s navigating obesity and some tricky eating habits. He was regularly skipping breakfast and grabbing something like a pastry once he got to school—so we talked about making mornings easier and more nourishing. I suggested trying an Orgain shake before school, and it’s been really helpful. He actually likes it, it fits into his routine, and he told me he feels so much better throughout the day. What’s even better is that it’s sparked a ripple effect—he’s now choosing a piece of fruit at lunch and paying more attention to how food makes him feel.

I also use Orgain products for my selective eaters. When kids are still learning to like new foods, having a high-quality, nutrient-dense option to fill the gaps gives both the kids and their parents peace of mind. It’s not about perfection—it’s about progress, and Orgain helps make that possible.

4.      As a pediatric provider, what are some nutrition related myths you commonly have to address for patients in infancy through young adulthood?

There are quite a few nutrition myths I find myself addressing regularly—from infancy through adolescence. Here are some of the most common:

“Picky eating is just a phase—don’t worry about it.”
While many kids go through picky phases, it’s not always something to ignore. I help parents understand that selective eating can impact growth and nutrient intake. The good news is, there are evidence-based strategies to help kids expand their food variety—without turning every mealtime into a battle.

“Plant-based milks are just as nutritious as cow’s milk.”
This comes up often with toddlers and teens. While plant-based milks can be a great option for families with allergies or dietary preferences, they’re usually lower in protein and may lack key nutrients unless they’re fortified. I work with families to make choices that align with their values and still support optimal growth and development.

“Zero sugar drinks are a healthy alternative.”
More and more kids and teens are reaching for drinks with artificial sweeteners, assuming they’re better than sugary options. But we don’t have enough long-term research on the effects of these sweeteners in youth. Plus, they can sometimes maintain a preference for sweet flavors or disrupt natural hunger cues. I usually steer families toward water, milk, or nutrient-dense options that support hydration and health.

“Weight is the best measure of health.”
Especially during the preteen and teen years, I focus on shifting the conversation away from the number on the scale. Instead, we talk about how the patient feels in their body, their energy levels, strength, and daily habits. Health is about so much more than BMI.

“Athletes shouldn’t eat sugar.”
Teen athletes are often told to cut out sugar completely, but the reality is that carbohydrates—including quick-digesting sugars—can be a key part of fueling performance and recovery. I help families understand when and how to use nutrition to support their child’s sport in a sustainable way.

“Fruit has too much sugar.”
This is another common myth I hear, often fueled by social media. While fruit does contain natural sugars, it also offers fiber, antioxidants, and essential nutrients. I reassure families that whole fruit is not something to fear—in fact, it’s one of the most beneficial foods to include in a child’s or teen’s diet.

With the research supporting the use of creatine for mind and muscle support, have you considered recommending it to your patients or clients?  If so, Orgain is happy to share our Creatine Monohydrate Powder.  

Each serving delivers 5g of micronized creatine monohydrate that can dissolve more easily than the typical particle-size of creatine.** To achieve full muscle saturation, there are two ways to tackle it. You can start with a loading phase of 20g of creatine per day for 5-7 days followed by a maintenance dose of 3-5g per day or simply start with a maintenance dose of 3-5g per day and after about a month of use you will achieve full muscle saturation.  By starting with the gradual approach, the risk for mild gastrointestinal discomfort is minimized.  In keeping with our commitment to higher standards you can rest assured this product is made without dairy, soy, gluten, or GMO ingredients. You’ll find no sugar added and no artificial flavors, or colors here.  Just creatine, and nothing else – no additives, fillers, or preservatives. It offers a smooth taste experience and can be easily mixed into water, juice, smoothies, and more. 

Creatine maintains intracellular levels of ATP (a molecule that stores and provides energy for cells) that helps improve muscle size, strength, power^*, and recovery from strength training or high intensity activity.^1,2*† It also supports the brain – an organ that uses about 20% of your body’s energy – and its ability to function across a variety of domains that allows optimal brain function.^3,4*  

While Orgain’s Creatine Monohydrate Powder is not included in our sampling program, we encourage you to try it – available now on Orgain.com and Amazon.com, with additional retailers coming soon.  

*These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease. 

**Comparing Orgain® micronized creatine to typical regular-sized creatine
^ when used in conjunction with a regular exercise and weight training routine. 

†Studies show that a five-day loading protocol involving higher dosages (e.g. 20g) accelerates the saturation of creatine in muscle cells and supports muscle recovery. Consult a health care professional for recommended dosages.  

References:

1. Vilar Neto, Jose de Oliveira & Silva, Carlos & Lima, Antônio & Rosa de Souza, Francisco & Pinto, Daniel & Araujo, Jocasta & assumpção, Claudio & Daher, Elizabeth. (2018). Effects of Low-Dose Creatine Monohydrate on Muscle Strength and Endurance. Asian Journal of Sports Medicine. In Press. 10.5812/asjsm.62739.
2. Vandenberghe, Kamiel & Goris, Marina & Hecke, P & Leemputte, Marc & Vangerven, L & Hespel, Peter. (1998). Long-term creatine intake is beneficial to muscle performance during resistance training. Journal of applied physiology (Bethesda, Md. : 1985). 83. 2055-63. 10.1152/jappl.1997.83.6.2055.
3. Xu, Chen, et al. “The Effects of Creatine Supplementation on Cognitive Function in Adults: A Systematic Review and Meta-Analysis.” Frontiers, Frontiers, 21 Apr. 2025, www.frontiersin.org/journals/nutrition/articles/10.3389/fnut.2024.1424972/full.
4. Rae, Caroline, et al. “Oral Creatine Monohydrate Supplementation Improves Brain Performance: A Double-Blind, Placebo-Controlled, Cross-over Trial.” The Royal Society, 13 Aug. 2003, pmc.ncbi.nlm.nih.gov/articles/PMC1691485/pdf/14561278.pdf.

New Episode: Live Better, Longer: Tips to Improve Sleep Quality and Stress Management with Dr. Andrew Abraham (Ep – 60)

We all feel the effects of both lack of sleep and stress, but did you know they could be impacting your longevity? 

In this episode, host Dr. Ginger Hultin, MS, RDN, CSO, is back to explore this topic with integrative medicine physician and founder of Orgain, Dr. Andrew Abraham. He and Ginger round out the conversation on healthspan with an introspective discussion on sleep and stress management. Together, they dive into how stress can accelerate aging at a cellular level and why the right antidote could be the company you keep. They uncover the impact of stress-related hormones, their link to inflammation, and why having a toolkit of stress reducers like breathwork is beyond beneficial when managing stress. Then, they turn to sleep, breaking down what your body is really up to while you rest. From different sleep stages to their effects on aging, they explore what it all means for long-term health. Finally, they outline small but powerful habits you can introduce to bring more calm into your life, improve your sleep, and experience the true benefits of all your efforts.

Upcoming Episode: From Performance to Prevention: How to Take Advantage of Collagen with Dr Dana Lis (ep – 61)

Collagen might be trending, but what does the science actually say? In episode 61, available on May 20^th, host Dr. Ginger Hultin sits down with Dr. Dana Lis, evidence-packed conversation performance nutrition expert and consultant to the Golden State Warriors, to break down collagen’s role in the body, its rise in popularity, and where it really delivers.

They explore the ways, debunk type-specific marketing claims, and talk practical applications for everyone from elite athletes to aging adults. Whether you’re wondering about skin and joint health, injury recovery, or performance support, this episode covers what to know and how to personalize collagen use for your needs.Subscribe to The Good Clean Nutrition Podcast on your favorite podcast platform and listen to more episodes on a variety of platforms HERE.

Register for our upcoming webinar May 22nd at 2pm EST – Gluten Myths Busted: Separating Fact from Fiction by Jessica Lebovits, RD, CDN

If you work in healthcare, you have definitely been asked about gluten at some point in your career. With misinformation rampant, it can be difficult to separate fact from fiction. This webinar will debunk the myths relating to celiac disease and gluten-related disorders and describe the current available evidence on the recommendations given for a gluten-free diet. Register to learn more about how clinical practice has shifted away from teaching patients to avoid gluten and more so towards finding a balance between their diet adherence, healing, and quality of life.

Watch April’s on-demand webinar, How To Fiber: Personalizing Fiber Needs For Your Patients Across Different Gastrointestinal Conditions by Kate Scarlata, MPH, RDN, LDNThe Orgain Healthcare Professional Education Webinar Series can also be accessed on the Orgain Healthcare App. Whether on-demand or live, all the webinars in this series are available for free continuing education for RDNs and NDTRs.    

Orgain is excited to announce its presence at the following upcoming in-person conferences & symposiums. If you plan to attend, be sure to stop by our booth and say hello as we’d love to meet you!  

American Sports and Performance Dietitians Association Annual Conference
May 13-16th, Scottsdale, AZ











Food Nutrition Conference & Expo (FNCE)
October 11-14th, Nashville, TN