The Bare Bones of Bone Health

Bone Health | The Paleo Diet

Did you know that exercise works to strengthen your bones, just as it works to strengthen your muscles? Research shows that regular exercise, mimicking our hunter-gatherer ancestors,1 is critical to the health of our skeletal system. These exercise patterns include endurance activities; as well as weight-bearing, high intensity cross training with adequate rest for complete recovery. Physical activity has been shown to maintain bone mass and reduce age-related bone loss. Further, it preserves muscle strength and postural stability that reduces the risk of falls and fractures, both of which can be deadly.2  

Engaging in exercise that promotes strong, dense bones is an important consideration. Osteoporosis, diagnosed with a bone mineral density at the hip of 2.5 standard deviations below the average value for young adults,3 remains a major modern health problem.4  Worldwide, one in two women and up to one in four men age 50 and older will break a bone due to osteoporosis.5 Other kinds of bone disease, like osteopenia and osteomalacia,6 make bones prone to fractures and can lead to osteoporosis if untreated.

There are many factors that contribute to a healthy skeletal system. Deciphering the interactions between various permutations of elements helps us to understand the complexity of the development of bone disease and create strategies to maintain the integrity of our bones.7 Some are static and cannot be changed, such as age, gender, and genetics. Others, specifically lifestyle habits that can be controlled, which include physical activity type and intensity and dietary nutrient status, have been shown to play a large role in dense, well-functioning bones.

Bone health begins early in life,8 with consistent exercise during growth and young adulthood linked to reduced fracture risk in later decades.9 You can still take advantage at any age that the skeletal system operates as a metabolically activity organ that undergoes continuous remodeling, with typically about 2-4% being rebuilt annually.10


Exercise leads to improvements in skeletal development and maintenance, because weight bearing during exercise plays a crucial role in improving the mechanical properties of bone. 11 Due to the sedentary nature of our modern lifestyle, exercise adds the necessary challenges to alter the normal daily pattern of bone bending and strain through the application of force. The bone tissues responds to the load applied through the movement patterns by increasing formation that encourages increases mass, size, and moment of inertia to resist the altered bending.12

Different types of exercise benefit skeletal mechanical properties in different ways.13  Studies have found that the bone mineral density of young endurance runners is consistently lower than that of sprinters, gymnasts or ball sports athletes. In fact, those engaged in endurance and non-weight-bearing activities sometimes have weaker bones and a greater risk of fractures, both while actively competing and later in life, than their inactive peers.14 Those engaged in endurance activities should also do cross-training, involving weight lifting to maximize bone strength.15

As important as physical activity is for a fully functioning skeletal tissue, so is planned rest from load bearing, force-applying movements. Load induced bone formation is improved by periods of rest, stressing the importance of adequate recovery periods as part of any training program geared towards bone health.16  As no‐loading periods are lengthened, such as with 24 hours of rest, bone formation and restoration is further enhanced. 17

A proper exercise regime is one factor, in addition to the Paleo diet, in our control for supporting the health of our skeletal tissue. Follow a consistent fitness program that focuses on cross training, combing weight lifting and high intensity activities, with time to recover between exercise sessions. Our favorite ways to build bone strength include incorporating movements that add resistance and force to the entire skeletal system, such as barbell weight training, hanging and brachiating movements, push-ups/ pull-ups, and plank holds.


1 O’Keefe, James H., et al. “Exercise like a hunter-gatherer: a prescription for organic physical fitness.” Progress in cardiovascular diseases 53.6 (2011): 471-479.

2 Beck, Belinda R., and Christine M. Snow. “Bone health across the lifespan—exercising our options.” Exercise and sport sciences reviews 31.3 (2003): 117-122.

3 Siris, E., and P. D. Delmas. “Assessment of 10-year absolute fracture risk: a new paradigm with worldwide application.” Osteoporosis International 19.4 (2008): 383-384.

4 Cole, Zoe A., Elaine M. Dennison, and Cyrus Cooper. “Osteoporosis epidemiology update.” Current rheumatology reports 10.2 (2008): 92-96.

5 Cummings, Steven R., and L. Joseph Melton. “Epidemiology and outcomes of osteoporotic fractures.” The Lancet 359.9319 (2002): 1761-1767.

6 Rodan, Gideon A., and T. John Martin. “Therapeutic approaches to bone diseases.” Science 289.5484 (2000): 1508-1514.

7 Ilich, Jasminka Z., and Jane E. Kerstetter. “Nutrition in bone health revisited: a story beyond calcium.” Journal of the American College of Nutrition 19.6 (2000): 715-737.

8 Beck, Belinda R., and Christine M. Snow. “Bone health across the lifespan—exercising our options.” Exercise and sport sciences reviews 31.3 (2003): 117-122.

9 Turner C H, Robling A G. Designing exercise regimens to increase bone strength. Exerc Sport Sci Rev200331(1)45–50.50

10 Hadjidakis, Dimitrios J., and Ioannis I. Androulakis. “Bone remodeling.” Annals of the New York Academy of Sciences 1092.1 (2006): 385-396.

11 Carter, Dennis R. “Mechanical loading history and skeletal biology.” Journal of biomechanics 20.11 (1987): 1095-1109.

12 Cullen, D. M., R. T. Smith, and M. P. Akhter. “Time course for bone formation with long-term external mechanical loading.” Journal of Applied Physiology 88.6 (2000): 1943-1948.

13 Huang, T. H., et al. “Effects of different exercise modes on mineralization, structure, and biomechanical properties of growing bone.” Journal of Applied Physiology 95.1 (2003): 300-307.

14 Scofield, Kirk L., and Suzanne Hecht. “Bone health in endurance athletes: runners, cyclists, and swimmers.” Current sports medicine reports 11.6 (2012): 328-334.

15 Santos-Rocha, Rita Alexandra, Carla Sofia Oliveira, and António Prieto Veloso. “Osteogenic index of step exercise depending on choreographic movements, session duration, and stepping rate.” British journal of sports medicine 40.10 (2006): 860-

16 Turner, Charles H., and Alexander G. Robling. “Designing exercise regimens to increase bone strength.” Exercise and sport sciences reviews 31.1 (2003): 45-50.

17 Turner, Charles H., and Alexander G. Robling. “Designing exercise regimens to increase bone strength.” Exercise and sport sciences reviews 31.1 (2003): 45-50.

About Stephanie Vuolo

Stephanie VuoloStephanie Vuolo is a Certified Nutritional Therapist, an American College of Sports Medicine Personal Trainer, and a Certified CrossFit Level 1 Coach. She has a B.A. in Communications from Villanova University. She is a former contributor to Discovery Communications/TLC Blog, Parentables.

Stephanie lives in Seattle, WA, where she is a passionate and enthusiastic advocate for how diet and lifestyle can contribute to overall wellness and longevity. She has been raising her young daughter on the Paleo Diet since birth. You can visit her website at

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