What Is the Difference Between Osteoporosis & Osteopenia?
15 Dec 2025 · 6 min
This is a podcast episode hosted by JJ Virgin (Ask the Health Expert) addressing the difference between osteopenia and osteoporosis and practical steps to protect/build bone health. The episode opens and interleaves several sponsor ads (Wayfair, Earth Breeze, Monarch, Chrysler, Columbia) and brief promos (Anne Bogle). JJ explains that osteopenia is an early stage of bone mineral loss that can progress to osteoporosis, emphasizes early detection, and recommends interventions: vitamin D3 with vitamin K (measure 25-hydroxy vitamin D and target ~50–80 ng/mL), estrogen or phytoestrogens around menopause, resistance/weight-bearing training, plant-rich diet to improve acid–alkaline balance, omega-3s (fish oil) and ground flaxseed, minerals (magnesium and calcium), improved digestion (enzymes), and targeted protein/collagen plus vitamin C in a daily smoothie. The host also discusses lifestyle risks (teenage dieting, acidizing diets, diet soda) and stresses prevention and early action.
Questions this episode answers
March 19, 2021
Approximately 50–80 ng/mL
Chapters
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What is the difference between Osteoporosis and Osteopenia? This is JJ Virgin, four time New York Times bestselling author, celebrity nutrition expert, and Fitness hall of Famer. I've been on a lifelong quest for answers to the toughest health questions, and now I'm sharing what I found with you. Welcome to Ask Ask the health expert. Keton M2020 from Instagram asks, what's the difference between osteoporosis and osteopenia? What are the best supplements for this? Besides vitamin D? Would collagen help? All right, I will debrief you on all of this when I come back. Stay with us.
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Okay, so osteoporosis is just osteopenia that has progressed. And so what you want to do with any of these types of things, and this is losing bone mineral. And remember, what happens with our bones is they're constantly remodeling. We are breaking bone down and rebuilding new bone. It's a process that we go through, but as we age, we start to break down more than we build up, and that is a problem. The beginning phases of that are osteopenia. When it advances, it gets to osteoporosis. The goal is to catch it before it even gets like when it's the beginning stages of osteopenia. I mean, the goal is never to have this at all. But if you do have it, the goal is to catch it early because it is not really easy as you age to build bone back. And the really critical times for building bone are when you're young, up until, like, your early 20s. And that's why it's really risky. If you have teenage daughters and they are doing a lot of, say, acidic foods, diet sodas, they're anorexic. This can really harm things. Okay, so what are the things that can really help you with bone health? And back when I wrote the virgin diet and I told people to pull dairy out, oh, my gosh. The biggest question I got asked was, well, what about calcium? Here's the crazy thing about dairy and bones. Dairy is very, very acidic. When you eat a higher acidic diet, your body must maintain acid alkaline balance. And in order to do that, it will buffer. It will use calcium to buffer your acid back to normal. So it actually is not the thing to do is to eat a bunch of dairy for great bones. That's kind of crazy. Here are the things that can make a big difference. Number one is vitamin D with K. So you want to take D3 with vitamins K1 and 2. And what you want to do is do a 25 hydroxy vitamin D test. Ideally, you're between 50 and 80 ngs per milliliter. This is so critical for immune function, for hormone function, for gut function, for brain function, for insulin sensitivity. But it's also super important for bone health because you need vitamin D to be able to absorb your calcium. And then K is going to help direct it so it goes to the right places. So vitamin D with K is super important. Now, another thing that's important is estrogen. And if you see where people start to get in trouble, where women start to get in trouble, it's when they go through menopause and estrogen goes down. So you can either start eating more phytoestrogens in your diet or look at bioidentical hormone replacement therapy. But understand that estrogen is important for your bones, for your brain and for your heart. Next up, weight training. So resistance training, things like squats, overhead presses, things that load your spine, load your hips are key and critical for putting the stress on your bones so your bones will respond by getting stronger. So weight training is super duper important. Something that has a little bit of impact and puts stress on your bones. Next step is maintaining good acid alkaline balance. Now I know there have been whole books written on acid alkaline balance, but it's actually easier than you think. What you can do is simply eat a lot of plants. We want you to do this anyway. So eating a lot of plants, eating a lot of greens, that helps balance out the acidic effect of animal products and grains. Of course, if you're in my community, you're probably not eating much in the way of grains, but lots and lots of plants. 5 to 10 servings of plants a day. Eat some at every single meal. Now, some of the things that also help with bone remodeling, fish oil and flaxseed meal, freshly ground flaxseed meal, both of those can help with bone remodeling. Of course, minerals, magnesium and calcium. People always think of calcium. Magnesium is super critical here as well. And then making sure that you're actually digesting what you're eating. And that is where it's important to make sure you're taking a good enzyme with protein digestion like proteases or betaine, fat digestion like lipase. So that is key, critical here as well. So those are some of the key things that I think of when I do this. One of the like kind of a bone building health shake would be to use my paleo inspired protein powder. That's, that's bone broth with amino acids added with branched chain amino acids. And then add some of my beauty collagen in there. Make sure you're getting vitamin C, good, high quality vitamin C in your diet. I use my sparkling C a couple times a day and then throw into that smoothie, smoothie, some freshly ground flaxseed meal. Or if you're using a nutribullet, you can just throw it in that way and it will crush it up and then you can throw some greens in there as well. And that is just a great bone health smoothie and yummy. And a great way to start the day too. There you go. This is JJ with Ask the Health Expert. I do this five times a week, so make sure you never miss a the show by going to subscribetoj.com.
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