How to Protect Your Bones As You Age

The risk of developing weak, brittle, or broken bones greatly increases as you age and lose muscle mass. A broken hip, pelvis or leg bone can mean months of limited mobility and rehabilitation. For women, estrogen is a key player in maintaining bone mass and strength. With the decrease in estrogen levels during menopause, many women lose some bone density, which can lead to fractures, osteopenia, and osteoporosis.

As you age, the changes to your bones, muscles and hormones may seem unavoidable. But you can adjust your lifestyle to strengthen your bones well into your retirement years. 

Beyond milk: how to get enough calcium from your diet

People with low calcium and/or vitamin D levels are at higher risk for developing low bone density, which can increase the risk of fractures.

Women over age 50 should get 1,200 milligrams of calcium each day. You may be tempted to just take a calcium pill to ensure your body is getting the calcium it needs for your age. But the best way to get your daily dose of essential minerals and vitamins is to include them in your diet. The research on supplement absorption and effectiveness is not as strong as the evidence supporting the health benefits of a well-balanced, nutrient-rich diet full of whole foods.

If you can tolerate dairy, plain (unsweetened) Greek yogurt (even the low-fat and nonfat varieties) provides more calcium than an equal serving of cow’s milk. In addition, you may be surprised that you can get all the calcium your bones need without consuming any dairy. The following vegetables, nuts, seeds, and plant-based foods are excellent sources of calcium. They are significantly lower in cholesterol and saturated fat than full-fat/whole-milk dairy products like cheese and ice cream.

• dark leafy greens (kale, bok choy; and turnip, beet, collard and mustard greens) 
• broccoli 
• almonds
• figs
• seeds (poppy, sesame, celery and chia seeds)
• edamame (soybeans)
• tofu (which is made from soybeans)  
• sardines  
• tahini 
• calcium-fortified foods (including orange juice and almond or rice milk) 

Your body also needs vitamin D to absorb and use calcium.

Women over 50 should get 800 to 1,000 IU of vitamin D daily. Daily sun exposure can help your body produce vitamin D, but you have to protect your skin to avoid skin cancer, sunburns and premature aging.

A healthier option is to enjoy some of the following vitamin D-rich foods at least twice a week.

• egg yolks 
• mushrooms  
• nonfat yogurt 
• wild caught salmon 
• tuna 
• trout 
• herring 
• sardines
• cod liver oil
• Vitamin D-fortified foods (like milk, cereal and oatmeal) 

Stronger muscles mean fewer fractures.

Regular exercise can help you maintain bone density, muscle mass, strength and balance as you age. Not only will this help you feel better and have more energy, strengthening your muscles and bones can help you avoid dangerous falls and broken bones. Building muscle can also help you maintain a healthy weight, whereas being underweight increases the risk of bone loss and fractures.

Strength-training exercises are those that involve weights or resistance.

Examples include lifting with free weights or weight machines, lunges and squats with resistance bands, modified push-ups, bicep curls, triceps extensions and chest presses. Combined with walking, cycling, and/or elliptical training, strength training can greatly improve your bone density. Getting stronger will also make it easier to complete daily activities like carrying groceries, climbing stairs and lifting grandchildren. 

If you’ve never lifted weights or used resistance bands to exercise, start light and go slowly as you build your strength. Strength training is not about speed. It’s a great idea to consult with a fitness trainer or physical therapist to learn proper form so you can avoid injury and create a full-body exercise routine that also improves your balance and fits your interests. 

Learn more: How to Stay Active to Benefit Your Brain, Bones, and Balance

Prevent falls to avoid broken bones. 

After age 65, you are far more likely to experience a fall that can cause bone fractures, commonly in the hip or wrist. In seniors, such injuries can take longer to heal fully, keeping you from living independently and doing some physical activities you enjoy. Once recovered from a fracture, seniors are highly likely to suffer another one within two years.

With some changes to your habits and environment, you can avoid the pain, daily challenges and recovery time of broken bones.

• Follow these tips to improve your balance.
• Remove tripping hazards like papers, books, clothing and loose shoes from walkways and stairs.
• Remove throw rugs or use double-sided tape.
• Eliminate the need for step stools by storing frequently used items in easily accessible cabinets.
• Install grab bars in your shower/bathtub and near your toilet.
• Use nonslip mats in the bathtub and shower.
• Install handrails on your home staircases.
• Ensure adequate lighting throughout your home so you can see what’s in your path.
• Wear properly fitted shoes with adequate support and nonslip soles.
• Tell your health care provider if you experience a fall or feel unsteady on your feet. 
• Avoid drinking alcohol, as that can alter your visual perception and coordination.

How your habits affect your bones

Over time, cigarette smoking contributes to poor bone health. According to the National Institutes of Health, “several studies support the effects of tobacco smoking on the skeletal system. Tobacco smoking causes an imbalance in bone turnover, leading to lower bone mass and making bone vulnerable to osteoporosis and fracture. Tobacco smoke influences bone mass indirectly through alteration of body weight, parathyroid hormone-vitamin D axis, adrenal hormones, sex hormones, and increased oxidative stress on bony tissues.”

If you’ve tried quitting smoking before, talk to your doctor about smoking cessation programs, medications and other therapies to help you give up cigarettes for good.

Similarly, heavy drinking can interfere with your bone growth and the body’s replacement of bone tissue. Researchers conclude that “alcohol consumption can disrupt the ongoing balance between the erosion and the remodeling of bone tissue, contributing to alcoholic bone disease.”

Speak to your doctor to better understand your risk for bone loss.

Women age 65 and older are advised to get routine bone density testing to measure their risk for osteopenia or osteoporosis. Your doctor can also perform a blood test to determine if you are deficient in calcium and/or vitamin D. 

In addition, certain medical conditions, illnesses and medications can negatively affect bone health. Ask your healthcare providers if your health status, therapies or medications may reduce your bone density, and follow their recommendations for managing this side effect. 

Medically reviewed by Ayse Canturk, M.D., C.C.D., an endocrinologist with the Comprehensive Women’s Health Alliance at the University of Miami Health System, which provides expert-led care for women of all ages. 

Our Women’s Nurse Coordinators can guide you through your healthcare journey and coordinate your care. To make an appointment, call 855-3-4-WOMEN (855-349-6636) or request an appointment.

Dana Kantrowitz is a contributing writer for UHealth’s news service. 

Tags: bone health, Comprehensive Women's Health Alliance, Dr. Ayse Canturk, strong bones