How to help prevent osteoporosis and improve bone health

Bones are the foundation for our skeleton, and they are in a state of constant change. Knowing the facts can help keep them strong for an active life.

Although our bones stop growing in length during our adolescent years, bone density continues to change over the course of our lives. Bone density generally begins to decrease after age 50.^1,2 Bone density, also called bone mass, measures the health of our bones by the amount of minerals in a certain volume of bone.^3,4

According to data from 2018, more than 33 percent of men and 51 percent of women age 50 and over have low bone mass⁵ as measured by a bone mineral density (BMD) test.⁶ (A BMD test can be done at an imaging center, but a prescription or referral from a health care provider may be needed.) The gradual loss of bone mass can lead to osteopenia, a precursor to a more severe condition called osteoporosis.⁷ Latin for “porous bone,” osteoporosis makes bones weak and can put people at risk for fractures and breaks.⁸

Although genes do play a role in the makeup of our bones, there’s plenty that people can do to help safeguard bone health and even help diminish potential weakness as someone ages.⁹

For those curious about how to help prevent osteoporosis, learn the basics of healthier bones below.

In this article:

What is osteoporosis?

Osteoporosis, the most common type of bone disease, occurs when the body loses too much bone density or when the quality or structure of bone changes, and therefore bone strength can be compromised.¹⁰ “As a result, bones become weak and may break from a fall, or in serious cases, from a minor bump,” says Andrea J. Singer, MD, chief of the Division of Women’s Primary Care and director of bone densitometry in the Department of Obstetrics and Gynecology at MedStar Georgetown University Hospital.¹¹

What causes osteoporosis?

Beyond gender and age, there are a variety of reasons why some people are more likely to develop osteoporosis. Slender, thin-boned men and women, non-Hispanic white or Asian women, and people with a family history of osteoporosis may have a higher risk of developing the disease. Low levels of estrogen in women and low testosterone in men may also increase the risk.

Lifestyle factors, such as a long-term lack of physical activity, chronic heavy drinking of alcohol, smoking, and a diet low in calcium and vitamin D, may increase the risk of developing osteoporosis.

Bone loss has also been linked to chronic medical conditions like gastrointestinal diseases, rheumatoid arthritis, certain types of cancer, human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS). Certain medications, when used long-term, may also increase the risk of developing osteoporosis. These medications include selective serotonin reuptake inhibitors (SSRIs), proton pump inhibitors (PPIs), steroids and antiepileptic medicines, among others.¹²

Can exercise help prevent osteoporosis?

“In the same way that our muscles get bigger and stronger with use, so do our bones,” says Claire Gill, CEO of the Bone Health and Osteoporosis Foundation (BHOF).¹³ Bone is a living tissue and responds to force by building more bone. Regular exercise will help it become stronger and denser.^14, 15

Gill recommends two specific forms of exercise for this purpose: weight-bearing exercises, such as dancing, jogging and walking; and muscle-strengthening exercises, such as weight lifting (options like a five-pound Gaiam Neoprene Hand Weight are suitable for at-home use) or working out with resistance tools, such as a Gaiam Restore 3-in-1 Resistance Band or a two-pack Gaiam Restore Hand Grip.

However, check with a health care provider before starting an exercise program. This is especially important for those diagnosed with osteopenia or osteoporosis. Exercises to avoid with osteoporosis may include bending and twisting, which can put the spine at risk, and certain high-impact exercises, which could result in a fracture or break.¹⁶ Medical guidance and physical therapy can help. In addition to consulting a health care provider, consider an accredited exercise specialist to understand which workouts may be safe and the most effective.

Are women more prone to osteoporosis?

Generally speaking, men have higher peak bone density and a later onset of bone loss than women,¹⁷ and studies show that osteoporosis is four times more common in women over the age of 50 than in men.¹⁸ Postmenopausal women are particularly susceptible.^19, 20 But men can also get osteoporosis, and that risk can increase with age. Plus, there’s evidence that men tend to have a higher mortality rate after a hip fracture compared to women.

The BHOF recommends that all women age 65 years and older and all men age 70 years and older should get a bone density test.²¹ “However, if you are over 50 years old and have risk factors for osteoporosis, such as family history of the disease, broken bones over age 50 or one or more medical conditions that can put you at greater risk, then you should speak with your health care provider about getting a bone density test sooner,” Dr. Singer says.²²

At what age does peak bone mass occur?

Typically, we build our strongest and most dense bones by our mid to late 20s.²³ Our bodies break down old bone and replace it with new bone tissue throughout our lives. Around age 30, bone mass stops increasing, and as people enter their 40s and 50s, more bone may be broken down faster than is replaced, leading to a decrease in bone density.²⁴

Does calcium help build bones?

While it’s true that calcium is critical for bone health, that’s only one piece of the puzzle.²⁵ Calcium is the mineral that helps build strong bones, but the body requires vitamin D to help absorb that calcium.²⁶

Gill recommends getting these nutrients from food first. But if someone has trouble getting enough vitamins and minerals in their diet, they may want to consider taking a bone health supplement under the supervision of their doctor. Keep in mind that not all researchers agree that taking a calcium or vitamin D supplement should be part of an osteoporosis prevention strategy.^27, 28 A health care provider can help decide whether a calcium supplement, vitamin D supplement or multivitamin might be right for someone.²⁹

Can bone health improve even with osteoporosis?

Although bone loss by and large cannot be reversed, it’s possible to slow its progression, and treatments for osteoporosis are available.^30, 31 In addition to exercise, diet and lifestyle changes, there are a variety of prescription osteoporosis medications on the market today to help treat those diagnosed with this condition.³² Talking to a health care provider can help people determine what’s right for them.

Is osteoporosis painful?

While osteoporosis itself may not be painful, the bone fractures that may happen as a result of depletion of bone mass certainly can be. “Many people don’t know they have osteoporosis until they break one or more bones,” Gill says. Sometimes referred to as the “silent disease,” osteoporosis can lead to spine fractures.^33, 34 “These can be particularly painful and may sometimes go undiagnosed. People might think they are just experiencing muscle pain in their back and don’t realize they’ve actually fractured the vertebrae in their spine,” Gill says. “That’s why it’s important for people to know their risk factors for osteoporosis and get tested and treated.”