How to Keep Your Bones Strong as You Age

Reviewed by Michael W. Smith, MD on March 16, 2021

As you age, you may worry about health conditions such as heart disease or cancer. But there’s one that should be front and center on your radar: osteoporosis, a disease that weakens your bones.

Half of all women and a quarter of all men over the age of 50 will break a bone at some point due to osteoporosis. Yet there’s a lot you can do to protect your bones, even later in life, says Andrea Singer, MD, clinical director of the National Osteoporosis Foundation.

“As you age, you begin to lose more bone than you form, which raises the risk of osteoporosis,” she says. “But you can slow down that rate of bone loss if you take certain preventative steps.”

This is particularly important for women, as they can lose up to 20% of their bone density in the first 5 to 7 years after menopause.

These steps can help you keep your bones strong and healthy.

Eat the Right Foods

An anti-inflammatory diet, one that’s rich in vegetables, fruits, fish, nuts, and whole grains, slows down bone loss in post-menopausal women.

“This type of eating pattern is high in protein, calcium, and micronutrients such as vitamin K and magnesium, all of which are key to maintain bone health,” Singer says.

Women over the age of 50 and men over the age of 70 need 1,200 milligrams of calcium a day (men younger than that should still get at least 1,000 milligrams). The best way to get it is through food.

An 8-ounce cup of skim milk has 300 milligrams, a 6-ounce cup of low-fat plain yogurt has 310 milligrams, 3 ounces of canned salmon with bones has 180 milligrams, and 8 ounces of fortified orange juice has 300 milligrams.

Add fruits and veggies that are high in potassium, like bananas, sweet potatoes, and spinach, and foods high in magnesium such as nuts, seeds, dried beans, and whole grains. Research suggests that both nutrients are associated with better bone density.

And don’t forget the protein. “Many older adults don’t get enough, but we know it’s important to help bone repair and remodel itself,” says Robert Adler, MD, chief of endocrinology and metabolism at McGuire Veterans Affairs Medical Center.

A Korean study of almost 7,000 adults found that those who got around 20% of their total daily calories from protein were at the lowest risk to develop osteoporosis. Experts recommend about 54 grams of protein a day for a 150-pound adult.

Muscle Up

Exercise is key to maintaining bone density. Like your muscles, your bones also respond to exercise by becoming stronger. The best exercise for your bones is weight-bearing activity such as walking or lifting weights for 30 minutes most days of the week, Adler says. (If you’ve already had a spine fracture, talk to a professional before you try weight training. Certain moves that encourage your spine to bend forward, like bicep curls, aren’t good.)

Regular physical activity like walking is linked with reduced risk of hip and total fracture in postmenopausal women. But if you’re in good enough shape, don’t be afraid to take it up a notch. An Australian study showed that 30 minutes twice a week of high intensity resistance and impact training (moves like deadlifts, overhead presses, back squats, and jumping chin-ups) improved bone density, structure, and strength in postmenopausal women with low bone mass, without injury.

Focus on Balance

People over 55 with poor balance are more than two times as likely to have an osteoporosis related fracture than those without balance issues. They’re around three times more likely to have a hip fracture. “Good balance is key to prevent a fall, which can cause a fracture, even if you don’t already have osteoporosis,” Adler says.

You can easily check your balance with this simple self-test: Place one foot in front of the other, heel touching toe, for 10 seconds. If you can’t do that, or if you can’t stand on one foot for 10 seconds, you’re at higher risk of falling.

If this is you, talk to your doctor. One option is to join a class or group that practices tai chi to help with coordination and balance, Singer says. Research shows that older adults who practice tai chi can significantly reduce their risk of falls.

If you’ve already taken at least one tumble, Adler says it’s a good idea to do some physical therapy to strengthen your muscles and improve your balance. One study found that people over the age of 65 who did physical therapy were less likely to be injured when they fell compared to a control group.

It’s also important to get your vision checked regularly (every year or two after age 65). Age-related eye diseases like cataracts and age-related macular degeneration can steal your sight, which in turn affects balance.

Adler recommends an at-home safety consultation with an occupational therapist (some insurance companies will pay for it), who will check for potential hazards such as loose rugs and suggest modifications such as handrails on staircases and in the bathroom, to help prevent falls.

Use Supplements Wisely

If you don't get enough calcium through your diet, the doctor may suggest you take a supplement like calcium carbonate or calcium citrate. If you do and you get constipated, look for one that also contains magnesium, which can make it easier for you to move your bowels, Adler says. If you need to take more than 500 to 600 milligrams a day of calcium in supplement form, you should take it in separate doses, ideally with meals.

Both men and women over the age of 50 also need 800-1,000 IU of vitamin D daily to help their bones absorb calcium. Since it’s hard to get enough vitamin D from food alone, most people need to take a vitamin D supplement. Unlike calcium, you can take it with or without food, and all at one time. You don’t need to take it at the same time as a calcium supplement.

Stay on Top of Screenings

All women should have a baseline screening for osteoporosis, known as a bone density test, at age 65. Men need one at age 70. Talk to your doctor about getting one earlier if you:

  • Smoke
  • Have been taking steroid medications like prednisone for a long time
  • Have diseases that raise risk of osteoporosis like rheumatoid arthritis, diabetes, or early menopause
  • Break a bone after age 50

Scan results are measured in T scores, which compare your bone density to that of a healthy, 30-year-old adult. If your bone density scan is normal, you don’t need another one for up to 10 years as long as your risk factors for osteoporosis don’t change. If you have osteopenia, or low bone density -- defined as a T-score between -1.5 and -2 -- you should have a follow-up scan between 3 and 5 years later. If you have osteoporosis, defined as a T-score greater than -2, you’ll need repeat testing every 2 years.

Try to get follow-up scans at the same facility, Adler says. Bone density measurements are easier to compare if they have been taken on the same model.

Show Sources


National Osteoporosis Foundation: “Bone Density Exam: Testing,” “Bone Health Basics: Get the Facts,” “Calcium & Vitamin D,” “Osteoporosis by the Numbers.”

Andrea Singer, MD, clinical director, National Osteoporosis Foundation; director of bone densitometry, Department of Obstetrics and Gynecology, MedStar Georgetown University Hospital, Washington, DC.

Journal of Bone Mineral Research: “Dietary Inflammatory Index, Bone Mineral Density, and Risk of Fracture in Postmenopausal Women: Results from the Women's Health Initiative.”

University of Michigan: “High Potassium Foods.”

Cleveland Clinic: “Magnesium Rich Food.”

American Journal of Clinical Nutrition: “Dietary magnesium and potassium intakes and circulating magnesium are associated with heel bone ultrasound attenuation and osteoporotic fracture risk in the EPIC-Norfolk cohort study.”

Robert Adler, MD, chief of endocrinology and metabolism, Hunter Holmes McGuire VA Medical Center; professor of epidemiology, Virginia Commonwealth University School of Medicine, Richmond, VA.

Korean Journal of Family Medicine: “The Relationship between Prevalence of Osteoporosis and Proportion of Daily Protein Intake.”

Osteoporosis International: “Benefits and safety of dietary protein for bone health—an expert consensus paper endorsed by the European Society for Clinical and Economical Aspects of Osteoporosis, Osteoarthritis, and Musculoskeletal Diseases and by the International Osteoporosis Foundation.”

JAMA Network Open: “Association of Physical Activity and Fracture Risk Among Postmenopausal Women.”

Journal of Bone & Mineral Research: “High‐Intensity Resistance and Impact Training Improves Bone Mineral Density and Physical Function in Postmenopausal Women With Osteopenia and Osteoporosis: The LIFTMOR Randomized Controlled Trial.”

American Journal of Epidemiology: “Simply Ask Them About Their Balance—Future Fracture Risk in a Nationwide Cohort Study of Twins.”

CDC: “The 4-Stage Balance Test.”

International Journal of Gerontology: “Effect of Tai Chi Exercise on Fall Prevention in Older Adults: Systematic Review and Meta-analysis of Randomized Controlled Trials.”

Archives of Physical Medicine and Rehabilitation: “Randomized Controlled Trial of Screening, Risk Modification, and Physical Therapy to Prevent Falls Among the Elderly Recently Discharged From the Emergency Department to the Community: The Steps to Avoid Falls in the Elderly Study.”

UptoDate: “Patient education: Osteoporosis prevention and treatment (Beyond the Basics).”

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