How to help prevent osteoporosis and improve bone health

The state of your bones is constantly changing. Knowing the facts can help you keep them strong for an active life.

Although our bones stop growing after puberty, bone density can continue to change over the course of our lives — and in many cases decreases after age 50. Bone density, also called bone mass, measures the health of our bones by the amount of minerals in a certain volume of bone. According to data from 2018, more than 32 percent of men and 51 percent of women over the age of 50 have low bone mass as measured by a bone mineral density (BMD) test. (You can have a BMD test done at an imaging center, but you may need a prescription or referral from your doctor.) The gradual loss of bone mass can lead to osteopenia, a precursor to a more severe condition called osteoporosis. Latin for “porous bone,” osteoporosis makes bones weak and can put you at risk for fractures and breaks.

Although genes do play a role in the makeup of our bones, there’s plenty you can do to help safeguard your bone health and even help diminish potential weakness as you age.

If you’re curious about how to help prevent osteoporosis, learn the basics of healthier bones below.

In this article:

• What is osteoporosis?
• What causes osteoporosis?
• Can exercise help prevent osteoporosis?
• Are women more prone to osteoporosis?
• At what age does peak bone mass occur?
• Does calcium help build bones?
• Can you improve bone health even with osteoporosis?
• Is osteoporosis painful?

What is osteoporosis?

The most common type of bone disease, osteoporosis, 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. “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.

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 your 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.

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). Bone is a living tissue and responds to force by building more bone. Regular exercise will help it become stronger and denser.

Gill recommends two specific forms of exercise for this purpose: 1) weight-bearing exercises, such as dancing, jogging and walking, and 2) 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 cord kit or a two-pack Gaiam Restore hand grip.

However, check with your healthcare 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 your spine at risk, and certain high-impact exercises, which could result in a fracture or break. Medical guidance and physical therapy can help. In addition to consulting your doctor, consider an accredited exercise specialist to understand which workouts may be safe — and most effective — for you.

Are women more prone to osteoporosis?

Generally speaking, men have higher peak bone density and a later onset of bone loss than women. And studies show that osteoporosis is four times more common in women over the age of 50 than in men. Postmenopausal women are particularly susceptible. 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. “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.

At what age does peak bone mass occur?

Typically, we build our strongest and most dense bones by our mid-to-late 20s. Our body breaks down old bone and replaces 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.

Does calcium help build bones?

While it’s true that calcium is critical for bone health, that’s only one piece of the puzzle. Calcium is the mineral that helps build strong bones, but your body requires vitamin D to help absorb that calcium. According to American Bone Health, other vitamins that help support bone health include vitamin B12 (found in dairy, meat and shellfish), vitamin C (found in citrus, broccoli and bell peppers) and vitamin K (found in brussels sprouts, olive oil and spinach). You should not take vitamin K if you are taking the blood thinner warfarin (Coumadin®).

Gill recommends getting these nutrients from food first. But if you have trouble getting enough vitamins and minerals in your diet, you may want to consider taking a bone health supplement under the supervision of your doctor — keeping in mind that not all researchers agree that taking a calcium or vitamin D supplement should be part of an osteoporosis prevention strategy.* Your doctor can help you decide whether a calcium supplement, vitamin D supplement or multivitamin might be right for you.*

Can you improve bone health 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. 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. Talk to your health care provider to determine what’s right for you.

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. “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.”