It’s Time To Bone Up: A Guide to Bone Health

By Diane L. Schneider, MD

As we age, bone loss is inevitable—but we cannot feel it or see it. You want to prevent the end result: breaking a bone. One in two women over the age of 50 will break a bone. Your risk for a fracture increases with age, and the consequences of fractures can be devastating: about one in five women die within a year of breaking a hip. More women die due to broken hips and backs each year than from breast cancer. In terms of quality of life, even a simple wrist fracture can have long-lasting effects.

Although optimizing your bone health may not be a priority now, regardless of your age it needs to be a conscious part of your everyday routine. You can make a difference in lowering your risks and slowing bone loss by following a simple guide; I call it the A-B-C-Ds of bone health.

A for Activity

You want to engage in weight-bearing activities, which load the bone with weight. These include walking, jogging, lifting weights, dancing, and even cleaning your house. In general, I recommend spending more time on your feet. You might consider a simple pedometer or other gadget to count your steps each day. The goal is at least 10,000 steps per day.

If you already have low bone density in your spine, you should have a few sessions with a physical therapist to learn to exercise safely and properly. Be aware: if you do have low bone density in your spine, everyday lifting can pose risks during common activities. For instance, you should not lean over to pick up a toddler from the ground; instead, sit down and have the child climb onto your lap.

B for Balance

Building balance is key to avoiding falls. If you do not fall, it is unlikely that you will break your arm or your hip, as 90 percent of hip fractures are the result of falls. Tai chi and yoga are good, but anything to work on core strength is helpful. You can try simple methods throughout the day, like balancing on one leg while holding on to a kitchen or bathroom counter. If you are more advanced, you could work on stability by standing on a BOSU ball or similar device used for balance training.

C for Calcium

The recommendations for daily calcium include all sources: food, drink, and supplements. For adult women up to age 50, 1,000 milligrams (mg) per day is recommended; for women over 50, 1,200 mg. Count your food and drink first before taking a calcium supplement, and take supplements only if you are not getting enough calcium in your diet. Dairy products are especially rich in calcium, but it is found in smaller amounts in vegetables and legumes. Kale, for instance, is a popular vegetable now and a very good source of calcium, as are turnip greens, collards, and black and white beans. Don’t forget to count the calcium that might be included in other supplements, such as multivitamins, that you may already be taking.

D for Vitamin D

Vitamin D is essential for bone health. Calcium absorption in the gut depends on adequate vitamin D. Sunlight absorbed through the skin is the main source of vitamin D, and recommended levels can be delivered through about 15 to 20 minutes of daily unprotected skin exposure to midday sunlight. In most parts of the country, however, there is sufficient radiation from the sun only May through October, so I recommend taking a vitamin D supplement, particularly during the winter, to ensure that you are getting sufficient amounts. The daily recommended amount for adults is 600 international units (IU) per day, but you may require more based on your body size and age.

Talk with your healthcare provider about your risk for osteoporosis and fractures and what you should be doing. A bone density assessment of your hip and spine will measure your bone mass and estimate your fracture risk. According to current US guidelines, all women should have a bone density scan at age 65, or at younger ages as early as the perimenopausal period if they have additional risk factors. It is never too early or too late to take charge of your bone health.

Diane L. Schneider, MD, is a geriatrician, epidemiologist, author, and co-founder of 4BoneHealth.org. An experienced writer and public speaker, Dr. Schneider is frequently featured as an osteoporosis expert on television and radio shows, in online articles, and in magazines, newspapers, and medical publications. Dr. Schneider is author of The Complete Book of Bone Health (Prometheus Books, 2011; $21).