How to Increase Bone Density: What Osteopenia Really Means for Your Bones

Reviewed by Dr Ilma Imtiaz

Quick answer: Bone density is influenced by several factors, including resistance training, weight-bearing movement, calcium and vitamin D intake, hormones, age, and overall health. The most reliable foundation for supporting bone density is a consistent routine that combines progressive strength training, weight-bearing exercise, and adequate nutrition. Targeted nutrients, including specific collagen peptides such as Fortibone®, may offer additional support when used as part of a broader bone health routine. Fortibone® is a clinically studied bioactive collagen peptide designed to support bone mineral density, but it is not a replacement for exercise, calcium, vitamin D, or medical care when needed.

Why bone density matters after midlife

In the United States, low bone mass is very common after midlife. Among adults aged 50 and older, roughly 44–45% meet the criteria for low bone mass, a category that includes osteopenia [1]. That translates to tens of millions of Americans whose bone density is below the healthy range, even if they do not meet the diagnostic threshold for osteoporosis.

Osteopenia is sometimes thought of as a women’s health issue, but low bone mass can affect adults of all genders [2]. While bone loss often accelerates after menopause, bone density can also be influenced by aging, low nutrient intake, low activity levels, certain medications, hormonal changes, and underlying health conditions. Osteopenia can also be easy to overlook because it usually does not cause obvious symptoms. Many people only learn they have low bone mass after a bone density scan. This matters because many fragility fractures occur in people whose bone density falls within the osteopenia range rather than the osteoporosis range. That does not mean everyone with osteopenia will experience a fracture. But it does highlight why early awareness is valuable. Bone is living tissue that continues to remodel throughout life, and it can respond to the right combination of movement, nutrients, and lifestyle support.

Meaningful changes in bone density usually take months to years, not days or weeks. The earlier bone health is addressed, the more opportunity there may be to support long-term strength and resilience through strength training, weight-bearing activity, adequate calcium and vitamin D intake, and targeted bone-support nutrients.

What does bone density actually measure?

Bone density is usually measured with a DXA or DEXA scan. This scan assesses bone mineral density, often at the hip and lumbar spine, and compares your result to the average bone density of a healthy young adult [3]. The result is reported as a T-score. A T-score gives a snapshot of bone mass:

Osteopenia is not a completely separate condition from osteoporosis. It sits earlier on the same bone health continuum. It signals that bone density has moved below peak levels and may benefit from more focused support.

How bone density changes over time

Bone is living tissue that is constantly renewed through a process called bone remodeling. Throughout life, specialized cells break down older bone while others build new bone in its place. During childhood and early adulthood, bone formation generally outpaces bone breakdown, allowing us to build peak bone mass. As we age, particularly after menopause, the balance gradually shifts, and bone may be broken down faster than it is rebuilt. Over time, this can contribute to lower bone mineral density. Many of the strategies discussed in this article, including resistance training, adequate calcium and vitamin D, sufficient protein, and clinically studied nutrients such as specific collagen peptides, aim to support normal bone remodeling and help maintain healthy bone density over time.

Can you reverse osteopenia?

Bone density can improve over time in some people, and in certain cases may move back toward the normal range [4]. However, the extent of improvement depends on many factors, including age, hormonal status, baseline bone density, medications, vitamin D status, exercise habits, and whether there are underlying medical conditions contributing to bone loss. Rather than focusing on "reversing" osteopenia, it is more helpful to think about supporting bone density, maintaining bone strength, and addressing the factors you can influence. The most important strategies usually include:

• Progressive resistance training

• Weight-bearing movement

• Adequate calcium intake

• Adequate vitamin D status

• Enough protein and overall nutrition

• Addressing secondary causes of bone loss with a healthcare professional

• Supporting with targeted nutrients as part of a complete routine

What actually helps build and maintain bone density?

There is no single shortcut for bone density. Bone responds best to a combination of mechanical loading, nutrient availability, and overall health support.

1. Weight-bearing and resistance exercise

Bones respond to load. When muscles pull on bone during resistance training, or when the skeleton experiences impact and weight-bearing forces, this provides a signal for bone remodelling. This is why strength training and weight-bearing activity are often central to bone health plans. Examples may include:

• Squats, deadlifts, lunges, step-ups, presses, and rows

• Progressive resistance training using weights, machines, or bands

• Brisk walking, stair climbing, dancing, or hiking

• Supervised higher-intensity programs where appropriate

The key word is progressive. Bones need enough challenge to adapt. Very light movement is still valuable for general health, mobility, and circulation, but bone density usually responds better when the body is gradually and safely challenged over time. 

For anyone with very low bone density, a history of fractures, balance issues, or joint limitations, exercise should be guided by a qualified professional.

2. Calcium and vitamin D

Calcium and vitamin D are foundational for bone health. Calcium provides the mineral building block needed for bone structure. Vitamin D helps the body absorb and use calcium effectively. If calcium intake is low, or vitamin D levels are inadequate, the body may not have the nutritional support it needs to maintain healthy bone mineralization.

For many postmenopausal women and older adults, guidance often centers around achieving approximately 1,200 mg per day of total calcium from food and, if needed, supplements [5]. Food sources are generally preferred where possible, with supplements used to help close gaps. Calcium-rich foods include:

• Milk, yogurt, and cheese

• Calcium-fortified plant milks

• Sardines or salmon with bones

• Tofu set with calcium

• Leafy greens such as kale and bok choy

Vitamin D can come from sun exposure, food, and supplements, but many people still have low levels. Testing 25-hydroxyvitamin D with a healthcare professional can help determine whether supplementation is needed.

3. Protein and collagen support

Bone is often thought of as being made almost entirely of minerals such as calcium, but around one-third of bone is actually an organic matrix made primarily of collagen. This collagen framework provides the structural scaffold that helps support normal bone strength and mineralization. 

That is why collagen has become an area of growing interest in bone health research. However, not all collagen supplements are the same. Different collagen ingredients contain different peptide profiles, and research on one collagen ingredient cannot automatically be applied to another. Understanding this distinction is important when comparing collagen products designed to support bone health.

Why ingredient-specific research matters

Not all collagen supplements are interchangeable. Many collagen powders are marketed broadly for skin, hair, nails, joints, or simply as a source of protein. While these products all contain collagen, they do not necessarily contain the same bioactive peptides or have the same clinical evidence. Research on collagen is ingredient specific. A study showing benefits for one collagen peptide cannot automatically be applied to every collagen supplement. Instead, it's important to consider the evidence behind the specific ingredient being used. When comparing collagen products, it helps to ask:

• What type of collagen peptide is being used? 

• Has this specific ingredient been clinically studied? 

• What dose was evaluated? 

• What outcomes were measured? 

• Does it fit into an overall bone health plan?

Where Fortibone® fits in a bone health plan

Fortibone® is one example of an ingredient-specific collagen peptide that has been clinically studied for bone health. Rather than being a stand-alone solution, it is best viewed as one part of a comprehensive bone health plan alongside resistance training, weight-bearing exercise, adequate calcium and vitamin D intake, sufficient protein, and other healthy lifestyle habits.

A 12-month randomized, placebo-controlled study investigated 5 g per day of the specific collagen peptide ingredient marketed as Fortibone® in postmenopausal women with reduced bone mass. Compared with placebo, participants taking Fortibone® experienced favorable changes in bone mineral density at the lumbar spine and femoral neck, along with changes in bone turnover markers consistent with bone health support [6]. These findings suggest that specific collagen peptides, such as Fortibone®, may help support bone mineral density when taken consistently as part of an overall healthy lifestyle.

When should you talk to a healthcare professional?

Anyone with low bone density should discuss their results with a healthcare professional, especially if they have:

• A T-score in the osteoporosis range

• A history of fragility fracture

• Long-term corticosteroid use

• Early menopause

• Thyroid, parathyroid, kidney, digestive, or hormonal conditions

• A history of eating disorders or very low body weight

• Frequent falls or balance concerns

• Unexplained bone loss

• Pregnancy or breastfeeding

Lifestyle and supplements can support bone health, but they should not be used as a substitute for medical evaluation when fracture risk is elevated or when an underlying condition may be contributing to bone loss.

Take-home message

Bone density is not fixed. It is influenced by how you move, what you eat, your hormones, your age, your overall health, and the nutrients available to support normal bone remodeling. The strongest foundation for healthy bones remains progressive resistance training, regular weight-bearing activity, adequate calcium and vitamin D intake, sufficient protein, and an overall healthy lifestyle. Clinically studied ingredients such as Fortibone® can provide additional support as part of that foundation. Rather than looking for a quick fix, the goal is to build consistent habits that help support healthy bones over the long term.

FAQs

Can bone density go back to normal after osteopenia?

For some people, bone density may improve over time, especially when low bone mass is identified early and addressed with consistent exercise, adequate calcium and vitamin D, and appropriate medical guidance. However, results vary. It is best to focus on supporting bone density and maintaining bone strength rather than assuming osteopenia can always be fully reversed.

What is the best supplement for osteopenia?

There is no single best supplement for everyone. Calcium and vitamin D help support bone mineralization, while specific collagen peptides such as Fortibone® help support the collagen matrix of bone and bone mineral density. These nutrients work best alongside resistance training, weight-bearing movement, and healthy lifestyle habits.

Is Fortibone® the same as regular collagen?

No. Fortibone® is a specific bioactive collagen peptide ingredient studied for bone health. Generic collagen powders may not have the same peptide profile, dose, or clinical evidence. This is why it is important to look at the specific ingredient used in a supplement, not just the word “collagen” on the label.

How much Fortibone® was used in the clinical study?

The study used 5 g per day of specific collagen peptides over 12 months. This supports the idea that bone health supplementation should be consistent and long term.

Is it too late to support bone density after 60?

No. Bone remodelling continues throughout life. While changes may be slower with age, exercise, nutrition, vitamin D sufficiency, and targeted nutrients can still play an important role in supporting bone health after 60.

Is bone loss after menopause inevitable?

Some bone loss after menopause is common because of changes in estrogen and calcium metabolism. However, the rate of bone loss can be influenced by exercise, nutrition, lifestyle, and medical care when needed. Bone health is modifiable, even after menopause.

What is the fastest way to increase bone density?

There is no fast way to meaningfully increase bone density. Bone remodelling takes time. The most effective approach is a consistent routine that includes resistance training, weight-bearing movement, calcium, vitamin D, enough protein, and targeted nutrients such as Fortibone® where appropriate.

References

[1] Sarafrazi N, Wambogo EA, Shepherd JA. Osteoporosis or low bone mass in older adults: United States, 2017–2018. NCHS Data Brief. 2021;(405):1-8. https://doi.org/10.15620/cdc:103477

[2] Reid IR, McClung MR. Osteopenia: a key target for fracture prevention. Lancet Diabetes Endocrinol. 2024;12(11):856-864. https://doi.org/10.1016/S2213-8587(24)00225-0

[3] Karaguzel G, Holick MF. Diagnosis and treatment of osteopenia. Rev Endocr Metab Disord. 2010;11(4):237-251.https://doi.org/10.1007/s11154-010-9154-0

[4] Hedges WP, Bukhari M. Increasing body fat mass reverses bone loss in osteopenia as detected by dual-energy X-ray absorptiometry scans. Eur J Rheumatol. 2016;3(1):1-4. https://doi.org/10.5152/eurjrheum.2015.0025

[5] North American Menopause Society. The role of calcium in peri- and postmenopausal women: 2006 position statement of the North American Menopause Society. Menopause. 2006;13(6):862-880. https://doi.org/10.1097/01.gme.0000243566.25205.0b

[6] König D, Oesser S, Scharla S, Zdzieblik D, Gollhofer A. Specific collagen peptides improve bone mineral density and bone markers in postmenopausal women—a randomized controlled study. Nutrients. 2018;10(1):97. https://doi.org/10.3390/nu10010097

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.