Broken bones from risky playground hops, hard ball tosses, and bike accidents are all too common for kids — and worrisome for their parents. However, adults should be equally as concerned for their bones as they are for their childrens’. Osteoporosis , a bone disease characterized by reduced bone density and increased risk for breaks and fractures, is on the rise. The disease is becoming particularly more prevalent in older adults and women .

A systematic review published in 2016 by Connie M. Weaver and team identified that lifestyle factors including nutrient intake contribute 20–40% of the variance in bone mass. Nonetheless, diet research remains convoluted and studies, media, and data on nutrition and bone health are inconsistent, leaving people unsure about how to control their health.

Bones are living tissues, just like other parts of our bodies. They are composed of cells following a build-up and break-down life cycle driven by osteoblasts and osteoclasts . Osteoblasts aid development by strengthening existing tissue and growing new bone cells that act as fortifying varnishes or sealants. Osteoclasts are specialized cells for dissolving or breaking down old bone tissue, like a chemical paint stripper. Though osteoblasts and osteoclasts work harmoniously to rid the bones of unhealthy cells and replace them with new ones, according to Weaver, bones’ build-up function significantly deteriorates after 20–30 years of age, while the breakdown function remains steady.

Among crazes surrounding collagen, peptides, combinations of calcium and vitamin D, and even prunes , it's hard to weed out the truth of what might improve bone health. An article written by endocrinologist Meryl LeBoff and her team identified that while vitamin D is necessary for calcium absorption, the majority of people have sufficient amounts and should instead focus on increasing calcium consumption. Eating the approximately ~1300 milligrams of calcium recommended to reach peak bone density is extremely challenging, even with supplementation, because not all calcium that is ingested actually gets absorbed.

Articles such as LeBoff’s lead many to protein for answers. In Weaver and colleagues’ review, they analyzed a study by Vatanparast Hassanali and team that measures the influence of protein intake on bone mass in the presence of calcium. The study found that protein intake explains about 37% of the conditional variance in net bone mineral content gain in 8–21 year olds with medium–high calcium levels. This means that protein's effect on bone strength was not statistically significant but had some influence on bone mineral content. Therefore, while this study does not necessarily imply that increases in protein intake will guarantee improved bone mineral content, it does indicate protein is statistically associated with it for that subgroup.

Similar to the benefits from protein consumption, the association between fat intake and bone density are contested. The results of different fatty acids — a component of the macronutrient fat — showed a range that covers both negative and positive outcomes to bone density depending on the fatty acid. Interestingly, a UC Davis study reports that a maternal brain hormone (CCN3) prevalent in pregnant mice fed high-fat diets stimulated bone formation and strength; therefore, certain demographic characteristics may play a role.

While lifestyle factors such as diet are less effective after age 30, hope for youth remains, considering that 10% increases in bone mass density before the cutoff age can delay the onset of osteoporosis by 13 years. This decreases the likelihood of future fractures and breaks for the majority of the population. Without a concentrated effort to bolster the production of osteoblasts before their production stalls, damage to the “varnish” occurs faster than new “coats” can be applied. Therefore, overall diet and consumption patterns may play a larger role than originally understood in setting the foundation for the body’s framework, our bones. Further clarification on the relationship between diet and bone health is needed, but balanced nutrition, particularly at a young age, is a solid first step in preventing osteoporosis.