Does anyone know of any evidence based articles regarding the possible link between osteoporosis and the ketogenic diet? I know that nutrients are absorbed with fat thus the ketogenic diet would be beneficial, but I was wondering about long term ramifications of a low carb/moderate protein diet on osteoporosis especially with intermittent fasting.

(Cathrine Helle) #2

I think @meganjramos uses extended fasts to increase growth hormones for bone density. I can’t recall which interview she elaborated on this, but it was a podcast published on YouTube. I’ll try to find a link :slight_smile:

(Cathrine Helle) #3

I think it was this one (osteoporosis about 12 minutes in)


There used to be a lot of worrying about keto and bone density because of some early studies on epileptic children who were being fed nutritionally inadequate shakes. I can’t find much in the way of studies specific to keto and osteoporosis or bone density in humans, but this one mentions it.

Our data suggest that maintaining a KD for more than 5 y does not pose any major negative effects on body composition, bone mineral content, and bone mineral density in adults with GLUT-1 DS, a finding that is at variance with previous reports focusing on children with intractable epilepsy. https://www.ncbi.nlm.nih.gov/pubmed/24800673

As with any diet, vitamin and mineral content is important and weight-bearing exercise will increase or maintain bone density. We’ve seen anecdotal evidence (DEXA scans by @Brenda @richard @TomSeest ) that density can increase on keto.


I am only an N=1, but I have been eating this way for over a decade. Since I have Hashimoto’s (hypothyroid) which supposedly contributed to bone loss, I have regular scans. I’m 76, and my latest scan shows only osteopenia (normal for my age) and NO osteoporosis.

And this is with a known issue (hypo) that can cause bone loss. So I personally think my ketogenic diet is fine.


Thank you all for weighing in on this topic. I was thinking about autophagy from intermittent fasting as perhaps a benefit. New bone formation, via osteoblasts,can only occur after the break down of old bone which is accomplished by osteoclasts. Wouldn’t it be interesting to study whether autophagy assists the osteoclasts for bone renewal? Great PHd topic!
Certainly nutrient dense foods are crucial for all body systems including the musculoskeletal system. Weight bearing and resistive exercises are a must as well.

(Marc) #7

The study “Fat, Sugar, and Bone Health: A Complex Relationship” is an interesting read. No attention is paid to fasting however. There seems to be a negative correlation between a high fat diet and bone mineral density.


(Margaret G) #8

I already had osteoporosis when I started my KD, last year at age 59. I was on weekly fosamax, and after a few months, added vitamin D3, K2, fish oil, magnesium, and strontium, based on the COMB study.
I’m due for a repeat DEXA next year, but happy to report no fractures yet. I stopped the drug after a year because I want my osteoclasts on duty. I’m doing some strenuous hiking and relish the sore feeling after a few miles, it’s good stress on my spine.

(Ekaterina Egorova) #9

I’m 40 and accidently found out that I have very low bone density which puts me to the high risk of bone fracture. Thanks to keto WOE and to my friend that I went for dexa scan to check my LBM and fat numbers! Could you please share what is the COMB study while Im waiting to see the Internal medicine doctor. And if you would not mind what is the doses for K2, D3, strontium and fish oils you are taking.

(Margaret G) #10

Hi Ekaterina,

I remember how shocked I was to learn that my bones were in danger of breaking, but I immediately started thinking about how I could make them stronger. In my research on vitamin K2, Dr. John Whitcomb mentioned the COMB study. https://youtu.be/jPWCJxyHAg4

The COMB study gave vitamin and mineral supplements to women with low bone density and found that it improved after a year. I have been doing this for about 6 months and I have had no fractures. The exact regimen is in the paper:

My own doctor has approved these for me, and I’m taking them daily. I hope that you will be able to increase your density.

(Ekaterina Egorova) #11

Thanks so much for sharing this! I’m shocked too. I’m going to do the same protocol as you and already closely studied this the study :slight_smile: Just ordered all the vitamins and minerals.

(Margaret G) #12

I hope it works, I get confirmation next year. I stopped my Fosamax because new bone requires both osteoclasts and osteoblasts working together. I feel like I have all my eggs in one basket, but it is really three: supplements, good diet, and exercise. Wish you success too!

(Ekaterina Egorova) #13

I started follwoing the protocol yesterday - yay, got all my supliments delivered! My doctor appointment is scheduled to August 21st :open_mouth: Will see what he has to say… Menawhile keep kalm and keto on + eat my vitamins and excersise :slight_smile:

(Margaret G) #14

More information keeps popping up. Here’s something about protein. It makes sense that bone is protein + minerals, aided by vitamins. If you’re not eating enough complete protein, the body will scavenge it. This abstract has links for other studies on osteoporosis.

I’m at 60kg now, so I’m trying to eat 60g/day of animal protein. That’s 2 eggs and 4 oz of meat, which is easy to manage.

(Ekaterina Egorova) #15

Thanks for sharing. My weight is 63kg. I usually eat two meals a day and each meal includes protein - eggs, bacon, meat or fish, sometimes homemade cottage cheese. So for me 2 eggs and 4oz of meat is not a problem at all. I gues I’ll just keep doing it :slight_smile:

(Margaret G) #16

Update: I took my follow up DEXA after 2 years, and the results are encouraging, so I will continue the COMB supplements for a few more years.
Specifically, I increased bone mineral density 5.4% in both femoral necks, and 7.0% in the lumbar spine. This is still in the osteoporosis range, but tending toward osteopenia.
Based on my experience, I would recommend this nutritional approach to osteoporosis treatment.

(Carole) #17

What is comb supplements?

(Margaret G) #18

Hi Carole, it is Combination of Micronutrients for Bone, in a study from 2012 in Canada. I heard about it in a video, which I linked farther up in this thread. Here is the paper, it goes into all the supplements and their amounts.

(Carole) #19

Thank you I found it. Very interesting