The Big O | February 2026 Newsletter
Bone Density & Joint Health
At Optispan, we don’t think small; we aim for exponential impact. The Big O notation* represents the growth of complexity in algorithms. At Optispan, we take a similar approach to scaling opportunities for optimal healthspans for everyone. Our mission is to redefine what’s possible in health, creating meaningful change on a global scale.
Clinic Updates
Strong Bones, Strong Future
By Dr. Nicki Byrne, MD
Bone health rarely comes up in conversations about longevity, yet skeletal integrity is closely tied to survival, resilience, and how well we function as we age. Bone isn’t inert. It reflects the cumulative effects of hormonal signaling, metabolic health, inflammation, and mechanical loading over decades. Declining bone mineral density often shows up as an early signal of biological aging, long before the first fracture ever occurs.
Low bone mineral density is associated with increased all-cause mortality, independent of age, sex, or fracture history. Large population studies show that for each standard deviation drop in hip bone density, mortality risk rises. Bone loss also tracks closely with other features of aging we care about: sarcopenia, insulin resistance, chronic inflammation, and hormonal dysregulation. In this sense, bone loss functions less like an isolated orthopedic issue and more like a systemic biomarker of declining physiological reserve.
When fractures do occur, they often mark a turning point. Many survivors never return to their prior level of function, with permanent mobility loss, accelerated frailty, and higher rates of long-term care placement. Hip fractures carry a 15–25 percent one-year mortality rate. Excess mortality persists for years after a hip fracture, reinforcing the idea that fractures tend to reveal underlying vulnerability.
Viewed through a longevity lens, bone density offers a window into overall physiological resilience. Early bone loss often parallels declines in muscle mass, metabolic flexibility, and hormonal balance, all of which shape long-term function. Paying attention to skeletal health earlier allows clinicians to identify risk long before irreversible loss occurs.
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Healthspan Coach Notes
Building (and Maintaining) Bone Density: The Lifestyle Foundation for Resilient Aging
By Will Merrick, NBHWC Certified Health & Wellness Coach
Building (and Maintaining) Bone Density: The Lifestyle Foundation for Resilient Aging
Bone is metabolically active tissue that responds to consistent input across all four lifestyle pillars: Eat, Move, Sleep, and Connect. Here's how to support skeletal integrity through evidence-based daily practice.
Eat: Fueling Bone Remodeling
Bone matrix is roughly 50% protein by volume, so prioritize complete protein sources at each meal (1.2–1.6 g/kg body weight). Pair calcium-rich foods with adequate vitamin D for optimal absorption, and round things out with magnesium, vitamin K2, and trace minerals from a varied, whole-food diet. Minimize bone-depleting patterns like chronic under-eating, excessive sodium, and high phosphoric acid intake from processed foods and sodas.
Move: Mechanical Loading as Signal
Resistance training, particularly movements that load the hips and spine, stimulates bone formation. Impact activities like jumping, running, and brisk walking create ground reaction forces that signal bone to adapt. Balance and coordination work, such as tai chi and yoga, reduce fall risk, which is just as critical as building density. Consistency over months and years matters far more than sporadic intensity.
Sleep: The Remodeling Window
Bone turnover is regulated by circadian rhythms and occurs predominantly during sleep. Chronic short sleep is associated with lower bone mineral density, while deep sleep supports growth hormone secretion, a key driver of bone repair. Aim for 7–9 hours of quality sleep.
Connect: Hormonal Balance and Inflammation
Prolonged cortisol elevation inhibits bone formation, and chronic low-grade inflammation, driven by loneliness, poor sleep, or unmanaged stress, accelerates bone breakdown. Strong social ties may be protective through stress buffering and behavioral support.
Bone health emerges from the interaction of all four pillars. Start where you are and build consistently. For the full deep dive, read the complete article below.