9 Ways to Maintain Bone Health as You Age

You have 206 bones in your body and although you can't see them, each one is hard at work. Your skeleton helps you move, protects your internal organs, and stores excess essential minerals, like calcium and vitamin D. The deep, spongy tissue inside your bones, known as bone marrow, even produces your blood cells.

Despite their rigidity, bones are living tissue. Like your skin cells, the cells that make up your bones are constantly sloughing off and regenerating. Until your 20s, your buildup of bone mass outpaces the bone cells you lose. That exchange evens out around middle age. Then, as you continue to grow older, the opposite becomes true: your bone mass declines faster than your body can make new cells to replace them.

One in five women over the age of 50 are likely to be diagnosed with osteoporosis, a condition that can severely weaken your bones. Follow these doctor-recommended suggestions to help your skeleton stay strong through the coming years.

Keep Moving

Any standing activity that requires you to move against gravity—think brisk walking, running, or tennis—compresses your bones, which stimulates them to become stronger. Without weight-bearing exercise, your body begins to pull necessary minerals like calcium and phosphate from your bones. "That can make them become weak and brittle," says Jeffrey Zarin, MD, an orthopedic surgeon at Cedars Sinai Kerlan-Jobe Institute in Los Angeles, Calif.

Aim for 150 minutes of moderate activity each week. Each time you use the elliptical trainer at the gym, play pickleball, or simply take the stairs instead of an elevator, to give your bones an opportunity to become denser.

Get Stronger

Studies show that resistance training is an excellent way to build or maintain bone health. "It lets your muscles use your bone as a fulcrum to move your joints," says Adhil Shahzad Ahmed, MD, an assistant professor of orthopedic surgery at Baylor College of Medicine in Houston, Texas. "Your skeleton physically gets stronger as you lift weights."

Free weights, weight machines, exercises that utilize resistance bands, and using your own body weight to do planks or pull-ups can all be beneficial, especially for post-menopausal women. "Estrogen is protective for your bones. Without it, you become more prone to fractures," says Dr. Ahmed. Aim for two to three strength-training sessions each week.

Practice the "90 minute" Rule

Prolonged sitting doesn't just challenge your posture. It can trigger inflammation that impacts your skeletal system, weakens your bones, and raises your risk for osteoporosis. Whether you're at your desk, on the couch, or on an airplane, "set a timer on your phone to go off every 90 minutes," says Dr. Zarin. "Get up, walk around, and shake off the cobwebs. That will help stimulate circulation."

Eat a Calcium-Rich Diet

"Calcium is vital for maintaining bone density for the overall strength of your bones, as well as proper muscle and nerve function," says Karen M. Sutton, MD, an orthopedic surgeon at the Hospital for Special Surgery in Stamford, Conn. Your body's ability to absorb calcium declines as you age, which is why a calcium-rich diet is so important.

Dairy products are the most well-known options, but other good choices include fruits and vegetables like broccoli, kale, oranges, and dried figs, and proteins like tofu, soybeans, shrimp, and nuts, particularly almonds. Plenty of cereals, plant-based milks, and orange juices are also fortified with calcium. People over the age of 19 should aim for 1,000 milligrams of calcium each day, while 1,200 milligrams is recommended for women over 50.

Stay Loose

Activities that improve balance and flexibility, such as yoga and tai chi, are also good for your bones. Stretching loosens the ligaments and muscles around your joints, "which allows you to build muscle faster because you have a full range of motion," says Dr. Ahmed. 

Strong muscles also contribute to better balance, which can help reduce your risk of injuries. For instance, balance training and tai chi have been shown to decrease falls by nearly 50 percent and lower your risk of hip fractures by 25 percent. 

Quit Smoking

Smoking isn't only harmful for your lungs. It reduces the blood supply to your bones, and interferes with the function of bone-forming cells called osteoblasts. "Smoking also decreases the absorption of calcium from your diet," says Dr. Sutton. Work with your doctor if you need strategies to break this habit.

Drink in Moderation

Having more than one or two alcoholic drinks per day interferes with your body's ability to hold onto calcium. "Long-term alcohol consumption decreases bone density and increases your risk of fracture," says Dr. Sutton. If you choose to imbibe, do so in moderation. The National Institute on Alcohol Abuse and Alcoholism recommends that women have no more than one alcoholic drink in a day and men have no more than two.

Try Yogurt for Breakfast

Numerous studies have shown that women, including postmenopausal women, who take probiotics retain a higher bone density. "More studies are needed to confirm the exact mechanism for probiotics and bone health, but the preliminary studies are optimistic," says Dr. Sutton. Start simple, by incorporating yogurt that contains lactobacillus, a "good" strain of bacteria, into your daily diet. 

Talk to Your Doctor About a Supplement

Vitamin D is essential for bone health; it helps your body properly use both calcium and phosphorus. Although sun exposure is the best way to get this nutrient, about 35 percent of women still don't get enough. "Vitamin D deficiency has been associated with osteoporosis. And outside of our bone health, it's also linked to cognitive decline, depression, cardiovascular disease, hypertension, diabetes, and cancer," says Dr. Sutton.

Symptoms of vitamin D deficiency include muscle or bone pain, a "pins and needles" feeling in your hands and feet, and muscle spasms or weakness. If you experience any of these signs, or feel you may be at risk for not getting enough vitamin D, talk to your doctor. A blood test can confirm if a supplement can help shore up your body's supply.