Fact Checked By Lindsay Delk, RDN
August 25, 2021
About 10 million Americans have osteoporosis and another 44 million have osteopenia (low bone mass), which increase their risk for broken bones (1).
Studies show that about 50% of women and about 25% of men over the age of 50 will break a bone in their lifetime due to osteoporosis (2).
Most people reach their peak bone mass around age 30.
Before the age of 30, your bone mass increases as you gain new bone faster than you break down old bone.
But after the age of 30, you slowly break down bone faster than you make new bone. As a senior, your aim is to slow down this bone loss.
Risk Factors for Osteoporosis
Osteopenia is when your bones are weak but not yet to the point of osteoporosis.
Osteoporosis develops when your bones become weak and are more likely to break.
Osteoporosis is called a “silent disease” because you may not have any signs or symptoms until you break a bone (3).
But there are some factors that make you at higher risk for osteoporosis (4):
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Ways to Keep Bones Healthy
A bone mineral density (BMD) test compares your bone density to that of healthy young adults. The most common and most accurate BMD test is called the dual-energy x-ray absorptiometry (DEXA) scan (5).
The test results come as a T-score. Your doctor can interpret the T-score to see how strong your bones are, if you have osteopenia or osteoporosis, and your risk for broken bones.
Your bones store about 99% of the calcium in your body. If you don’t get enough calcium from your diet or a supplement, calcium will be taken from your bones (6).
Taking calcium from your bones will make them weaker and easier to break.
The Recommended Dietary Allowance (RDA) for calcium for women over the age of 50 and men over the age of 70 is 1,200 mg per day. Good sources of calcium are milk, yogurt, cheese, green leafy vegetables, and calcium-fortified juices. If you are not getting 1,200 mg of calcium each day from your diet, talk to your doctor about a supplement (7).
Many people concentrate on calcium for bones but forget about vitamin D. Calcium is not absorbed as well in your body without vitamin D.
If you get plenty of calcium but don’t get enough vitamin D, you still increase your risk of bone loss and broken bones.
The RDA for vitamin D is 600 IU (15 mcg) per day for ages 1 to 70 years and 800 IU (20 mcg) per day for over 70 years. Many healthcare professionals don’t think this is enough. The Endocrine Society recommends 1500–2000 IU (37.5–50 mcg) per day for all adults (8, 9).
Although your body makes some vitamin D when your skin is exposed to the sun and some foods have vitamin D (cod liver oil, fatty fish, cheese, egg yolks, and vitamin-D fortified milk), up to 42% of Americans have a vitamin D deficiency (10).
The only way to know if you have a vitamin D deficiency is to have a blood test. Ask your doctor to check your vitamin D level and to recommend a supplement dosage, if needed.
Just as vitamin D helps your body absorb calcium, vitamin K helps calcium get into your bones instead of your arteries.
Vitamin K is required by the protein, osteocalcin, to make bone tissue. And some studies show that people who eat more vitamin K have stronger bones and are less likely to break a hip (11, 12).
Men should get 120 mcg per day of vitamin K, and women should get 90 mcg per day. Although the bacteria in your gut make some vitamin K and many foods have vitamin K (green leafy vegetables, blueberries, meat, cheese, eggs, and vegetable oils), up to 31% of adults have insufficient levels of vitamin K. Ask your doctor if a vitamin K supplement is right for you (13, 14).
You may find that your appetite decreases as you get older. It’s still important to eat a healthy, balanced diet.
Your body needs enough protein (found mostly in meats, fish, eggs, and beans) to maintain your muscles and enough vitamins and minerals (found in fruits and vegetables and other wholesome foods) to maintain good health.
Many other nutrients, such as magnesium, zinc, boron, manganese, copper, silicon, iron, and selenium play roles in bone health (15).
Choosing nutrient-rich foods that are not ultra-processed can help you meet these nutrient needs.
Physical activity, especially weight-bearing activity, helps to strengthen your bones.
Exercises that use your own body’s weight include walking, running, push-ups, stair-climbing, dancing, and yoga. You can also use weights, such as dumbbells or resistance bands.
Try to get around 30 minutes of physical activity most days of the week.
Studies have shown a link between smoking (and other tobacco use) with lower bone density (16).
Smoking increases the risk of having a broken bone and has a negative impact on bone healing after it is broken.
Eating a lot of sodium (salt) causes your body to lose calcium, which can lead to bone loss (17).
Try not to eat a lot of ultra-processed foods and salt. Aim for 2,300 mg or less of sodium each day.
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