Science-Backed Strategies for Healthy Bones in 2025: An Orthopedic Surgeon Explains

New Year, New Clarity (Not Just Resolutions)

Most New Year’s resolutions fail. Instead of making another list you’ll abandon, use this moment to clarify goals—especially around bone health, muscle preservation, and health span. In this piece, I’ll share three high-impact strategies to improve bone health and reverse osteoporosis—and how to set goals you’ll actually follow through on.

How to Set Goals You’ll Stick With: The SMART Framework

You’ve heard of SMART goals. Here’s how I apply them to bone health:

S — Specific
Don’t say “I’ll get healthier.” Say what you’ll improve and how.

“I will improve my bone mineral density by doing X and Y.”

M — Measurable
What gets measured gets managed. Track outcomes with imaging and biomarkers: DEXA, REMS, bone turnover markers (CTX, P1NP), hormones, food logs, etc.

A — Achievable
Be realistic. If your T-score is −5 with multiple fractures, start with “I will stop bone loss.”
If your T-score is −3 with good bone quality and a structured program, aiming to enter the osteopenic range by a specific date can be realistic.

R — Relevant
Tie goals to what matters: health span, independence, vitality. If it aligns with your values, you’ll do the work.

T — Time-Bound
Set dates and milestones.

“I will improve P1NP/CTX ratio in 12 weeks by doing A, B, and C.”
“I will increase REMS spine BMD by 5% by 12/31/2025.”

Example SMART Goal
“I will improve my spine BMD by 5% (Specific/Measurable) by 12/31/2025 (Time-Bound). I’ll hit 1 g protein per lb ideal body weight, track food, lift 3×/wk, do 100 heel drops 5 days/week, Power Plate daily, BioDensity weekly, 8,000 steps/day, and check bone turnover markers every 3 months with coaching accountability (Achievable/Relevant).”

The Top 3 Strategies for Bone Health in 2025

#3 — Test Early, Test Often: Let Biomarkers Guide You

Imaging (DEXA, REMS) moves slowly—6–24 months for clear change. Use bone turnover markers (BTMs) to steer in the near term:

• CTX = bone breakdown (osteoclast activity) → we want it not too high
  
  
• P1NP = bone building (osteoblast activity) → we want it robust
  
  

The ratio helps:
Because P1NP (µg/mL) and CTX (pg/mL) use different units, convert CTX to µg/mL by dividing by 1,000. Then calculate:
P1NP ÷ (CTX/1,000). Example: P1NP 90 ÷ (CTX 500 / 1,000) = 90 ÷ 0.500 = 180
Higher is generally better; we currently use ~150–200 as a working target while we keep learning from patient outcomes.

Caveats

• If you’re on bisphosphonates or denosumab, both CTX and P1NP can run very low—the ratio may look “good” but reflect globally suppressed turnover.
  
  
• Sampling matters: draw fasted, morning, same weekday, similar sleep, same pre-lab routine (workout/meal/fast) to minimize noise.
  
  
• Frequency: If budget allows, ~3 months is a great cadence; 6 months is a practical default.
  
  

#2 — Do the Right Activity: Impact or Simulated Impact

Movement is non-negotiable, but steps alone won’t build bone.

• Strength training is king—but to stimulate bone, add impact or simulated impact.
  
  
• Impact examples: heel drops, controlled box step-offs/jumps, LiftMOR-style eccentric pull-up releases.
  
  
• Simulated impact: BioDensity, OsteoStrong (osteogenic loading), Power Plate whole-body vibration.
  
  

If you have osteoporosis, don’t start jumping on your own. Work with a professional to tailor impact safely.

#1 — Nail Your Nutrition: Protein Leads

No matter your dietary pattern, hit adequate protein from high-quality sources.

• Target ~1 gram per pound of ideal body weight. Plant-forward eaters: combine sources to reach complete amino acids and increase total grams to offset lower protein quality.
  
  
• Track protein for a few weeks until you know what it takes for your body and routine.
  
  

Pulling It Together

If you test wisely, train for bone, and prioritize protein, you’ll create momentum you can measure—and stick with. That’s how you hit your SMART goals in 2025 for bone health, muscle mass, and true longevity.

“A diagnosis of osteoporosis isn’t the end—deciding to reverse it is the beginning.”

Want Help Building Your Plan?

👉 Join me inside the OsteoCollective. In 2025 we’re rolling out a new platform to make our deep library easier to search, connect with the community, and get step-by-step guidance. There’s a 14-day free trial, low monthly cost, and a ton of support to help you execute. If you prefer a lighter lift first, keep an eye out for our free live masterclasses with Q&A as well.

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