Tips to Keep Your Bones Healthy and Strong

How to maintain your bones.

When we think about overall good health, we often skip over a critical component: our bones. Our skeleton provides support and allows us to move. Our bones protect all our internal organs from injury. They also store vital minerals like calcium and phosphorous, which not only keep them strong but also get released to the rest of the body when needed.

To keep your bones healthy and strong, follow these essential steps. As the National Institute of Health’s National Osteoporosis and Related Bone Diseases National Resource Center says, “the good news is that it is never too late to take care of your bones.”

Know your risk factors.

Some risk, like your age, gender, ethnicity and family history, affect your risk for bone disease and are beyond your control. For example, the National Osteoporosis Foundation says that 1 in 2 women and up to 1 in 4 men over age 50 will break a bone due to osteoporosis in their lifetime. However, many more risk factors are well within your grasp. The NIH lists:

— Diet.

— Physical activity.

— Body weight.


— Alcohol.

— Medicines you take.

Talk to your doctor about your bone health.

Go over your risk factors with your doctor and ask if you should get a bone density test. If needed, your doctor can prescribe medicine or supplements to help prevent bone loss and reduce the risk of a bone breaking.

Start protecting your bones early.

Get your kids active with regular exercise because the peak time for building bones is up to puberty, says Sherri Betz, a physical therapist and director of TheraPilates Physical Therapy in Santa Cruz, California, and Monroe, Louisiana, specializing in geriatrics and osteoporosis. Peak bone mass is reached between age 25 to 30. “We like to say osteoporosis is a pediatric condition with geriatric manifestations,” says Betz, a board-certified clinical specialist in geriatric physical therapy and spokesperson for the American Physical Therapy Association. “Your actions in your youth predict the quality of your bones in the future.”

Eat a balanced diet.

Eat a well-balanced diet rich in calcium and vitamin D. Some people may need to take nutritional supplements in order to get enough calcium and vitamin D. Ask your doctor if you are one of them before starting any new supplements. Fruits and vegetables also contribute other nutrients that are important for bone health.

Focus on calcium.

Shoot for 1,000 milligrams of calcium a day, and up to 1,500 a day when you are older or if you have osteoporosis, Betz recommends. Sources of calcium, according to the NIH, include:

— Tofu (calcium fortified).

— Soy milk (calcium fortified).

Green leafy vegetables such as broccoli, brussels sprouts, mustard greens and kale.

— Chinese cabbage or bok choy.

— Beans and legumes.

— Tortillas.

Sardines and salmon with edible bones.

— Shrimp.

— Orange juice (calcium fortified).

— Pizza.

— Bread.

— Nuts such as almonds.

— Dairy products such as milk, cheese and yogurt.

Don’t forget the D.

Body cells need vitamin D to absorb and process the calcium. Your body produces vitamin D from sunlight on your skin, so try to get a few minutes in the sun every day. Good food sources of vitamin D include egg yolks, saltwater fish, liver, fortified orange juice and milk with vitamin D. “You have to get blood levels checked to see if have enough D in your bloodstream,” Betz says. Talk to your doctor about taking supplements of calcium and/or vitamin D if you are low.

Get weight-bearing physical activity.

Bones, like muscles, become stronger with exercise — especially impactful, weight-bearing exercises, like tennis, short bouts of running, aerobic dance, weightlifting, walking and climbing stairs, Betz says. “Zumba is great for building bones and maintaining bone mass,” she says. Aerobic exercise like swimming and cycling are good for your cardiovascular health, but don’t do much for your bones. In fact, nonweight-bearing repetitive activities like these have been shown to be detrimental to bone density, she says. “This is not the occasional bike ride or swim, it is about using it as your primary source of activity. They are not the best for bones. You have to be on your feet at least four hours a day, with impactful exercise,” Betz says.

Live a healthy lifestyle.

Don’t smoke. If you choose to drink alcohol, don’t drink too much, both to preserve bone strength and to reduce the risk of falls. Also avoid excessive amounts of coffee and caffeinated beverages, and foods high in sugar, Betz says. Learn to manage stress, as high levels of cortisol “can eat your bones,” she says. Good sleep is also important. “If you are not sleeping well, that’s a sign your cortisol is too high,” she says. Finally, don’t spend too much time sitting at a computer or TV. “Sitting too much and poor posture actually reshapes bones and can lead to disc disease in the spine and other spinal diseases,” she says.

Prevent falls.

Falling can cause a bone fracture, especially in someone with osteoporosis. But most falls can be prevented. The NIH says:

— Check your home for trip-and-fall dangers like loose rugs and poor lighting.

— Have your vision checked regularly.

— Increase your balance and strength by walking every day.

— Taking classes like tai chi, yoga, or dancing, which improve balance.

Get tested if recommended.

If you have any risk factors for bone disease, have your bone density checked with a dual-energy X-ray absorptiometry scan. This uses low levels of X-rays to produce a T-score, which compares your bone density to that of a person at peak bone density. A DEXA scan is typically recommended after menopause, if significant risk factors are present, or at age 65, the NIH says. It can be done every two years if needed to monitor bone density.

Take medicine or supplements under a doctor’s care.

If you are diagnosed with osteoporosis or another bone disease, take your medicines as directed by your doctor. There are many options, including bisphosphonates, estrogen agonists/antagonists (also called selective estrogen receptor modulators, or SERMs), estrogen therapy, hormone therapy and a recently approved RANK ligand inhibitor.

If you need or want a calcium or vitamin D supplement, talk to your doctor first. “Get the cheapest form of calcium, because your body doesn’t know the difference,” Betz says. Take calcium carbonate, or calcium citrate if the carbonate form causes digestive upset, she recommends.

How to keep your bones healthy:

— Know your risk factors.

— Talk to your doctor.

— Protect your bones early on.

— Eat a balanced diet.

— Focus on calcium.

— Don’t forget vitamin D.

— Do weight-bearing physical activity.

— Live a healthy lifestyle.

— Prevent falls.

— Get tested.

— Take medicine or supplements.

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