Bone health is an underappreciated concern on keto, particularly for women. Understanding how keto affects bone mineral density and how to optimise bone health on low-carb is important for long-term health.
The evidence is mixed. Some studies show reduced bone mineral density on long-term ketogenic diets; others show no significant effect. The therapeutic keto diet for epilepsy (very strict) has shown greater bone health concerns than moderate keto.
Insufficient calcium intake. Insufficient vitamin K2 (diverts calcium to bones not arteries). Insufficient vitamin D3 (essential for calcium absorption). Excessive protein relative to alkaline food intake.
Dairy provides calcium and protein. Green leafy vegetables provide vitamin K1 (converted to K2). Fatty fish provides vitamin D3. Consider supplementing: D3 (2000–4000 IU), K2 MK-7 (100–200 mcg), and magnesium glycinate.
Resistance training and weight-bearing exercise (walking, running, dancing) are the most powerful stimulants of bone mineral density — more important than diet alone.
Dairy-rich options from our keto breakfast collection and sardines (eaten with bones) from our keto main dishes.