Your bones are, without a doubt, the foundation of your entire body, and yet, their health can often go be deprioritized.
Your skin frequently commands attention when it comes to preserving both its health and appearance. Muscle strength and definition are highly sought after. But underneath all that lies our skeleton, and that mineralized connective tissue may not get the fanfare, but it’s what’s really calling all the shots.
“Bones support our body, protect vital organs, and allow us to move freely,” says Lauren Redler, MD, orthopedic surgeon and sports medicine physician at New York-Presbyterian/Columbia University Irving Medical Center. “They’re also the storage bank for essential minerals, like calcium, that our body needs to function properly.”
Dr. Lauren Redler.
Charles Manley/CUIMC
Alas, as we age, we start to lose bone and bone mass, and it happens earlier than one might think: at around age 30. “Until then, we’re building bone mass, which peaks in our late 20s or early 30s.” says Dr. Redler. “Then the balance shifts and from this point onward, bone resorption—the process where bone is broken down and its minerals released into the blood—starts to outpace bone formation.”
In other words, we start losing more bone than we can replace, and it’s more accelerated for women than men. The problem with this degradation is that it puts you in a precarious predicament especially with the fragility and health concerns that come with advanced age.
“As you lose bone mass naturally, you become more susceptible to injuries such as fractures and stress fractures and your bones don’t tolerate other surgical procedures well, such as joint replacements,” says Kevin Stone, MD, orthopedic surgeon at the Stone Clinic and chairman of the Stone Research Foundation in San Francisco and author of Play Forever: How to Recover from Injury and Thrive. “So, anything we can do to build your bone mass and decrease your rate of loss is a big contribution to your health.”
How to Get Better Bone Health
So why care about the trajectory of your bone health? Well, as Dr. Redler explains, in addition to preventing the risk of fractures, maintaining strong bones can help in your everyday routine by allowing you to stay active, avoid pain, and maintain posture. And so, the goal becomes to decrease your rate of natural loss and build your bone mass.
Before you begin this journey, it might be a good idea to check with your doctor to see where you’re currently at in terms of bone health. “It’s worth testing and getting a measure of your bone density, especially if you are at risk,” says Dr. Stone. “I think blood work is reasonable and easy for anybody who’s interested in their bone health and total body health.”
For a more advanced assessment, there’s what’s called a fracture risk assessment tool, Dr. Redler explains, that uses clinical risk factors to calculate the 10-year probability of a hip fracture or other major osteoporotic fracture. “The score then helps clinicians make informed decisions about osteoporosis treatment, such as whether to recommend bone mineral density testing or medication and can also help identify those who might benefit from lifestyle modifications to reduce fracture risk,” she explains.
Beyond medical intervention, lifestyle changes can prove highly beneficial. From exercise to food intake, there may be daily habits you’re unaware of that could be compromising your bone health. But here’s the good news: Making key adjustments to your lifestyle will not only strengthen your bones but also enhance your overall well-being for years to come.
The Mistakes You’re Making
1) Not doing the right exercise
When it comes to bettering bone health and exercise, it’s all about resistance training. That means doing exercises like weightlifting, hiking, climbing, squats, and lunges (and don’t forget the upper body, says Dr. Redler!). These kinds of weight-bearing activities build bone. “Bone responds to force and there’s something called Wolff’s Law that says the more force on the bone, the more bone is built,” says Dr. Stone. “So you want to find that amount of force that doesn’t break the bone but stimulates the cells of the bone, called osteoblasts, to put out more mineral and build more bone.”
Your next question might be, how often do I need to do resistance training? “Every day,” Dr. Stone says. “The reason why is that you then become addicted to the exercise you feel, the pheromones, testosterone, adrenaline. And once you become addicted to it, then you feel bad when you miss it.”
As far as how much exercise per day to do, he doesn’t have a specific prescribed amount. Instead, it’s all about the build—a little more, a little farther, a little heavier every day. “It’s like interest rates: It’s shocking how much compounding can make you into a wealthy person, and compounding your exercise can make you into a healthier person,” he says.
2) Not drinking alcohol in moderation
The saying everything in moderation applies to many things we eat, drink, and do, alcohol included. So why is overdoing alcohol consumption particularly harmful to bones? “It can interfere with your body’s ability to absorb calcium, and it can also affect your balance, making falls more likely,” says Dr. Redler.
3) Not quitting smoking
An easy way to think about it: Every toxin that you put in your body extracts minerals from your bones in one way or another, says Dr. Stone. And smoking is one of the worst vices to have. “It reduces blood flow to your bones, which makes them more prone to breaking,” says Dr. Redler. Thankfully, it’s never too late to stop. Even if you quit later in life, you can reduce further bone loss and better bone density.
Stock image of woman speaking to doctor.
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4) Not having adequate calcium in your diet
You know the drill: Food is medicine. Neglecting to have adequate vitamins and minerals like calcium in your diet can be detrimental to bones. Dr. Redler’s preferred sources of calcium include dairy like milk, cheese and yogurt; leafy greens such as kale, collard greens, spinach and bok choy; fortified foods which include certain cereals and plant-based milks; and fish, like salmon and sardines with bones. Consider taking supplements if needed. “The general recommendation is about 1,000 mg of calcium per day for adults over 70 and 1,200 mg for those over 70,” says Dr. Redler.
Eating certain foods can also be detrimental. “Foods high in salt, caffeine, and sugar can leach calcium from the bones,” says Dr. Redler. “High sodium intake can cause the body to excrete calcium, while too much caffeine may increase calcium loss in urine, potentially weakening bones.” Excessive sugar is also best avoided, as it can interfere with calcium absorption.
5) Not addressing your mental health
Bone health and psychological health go hand in hand. “They’re connected incredibly tightly,” says Dr. Stone. “Whether it’s alcohol, smoking, a sedentary lifestyle, poor diet, low protein intake, or depression, all of these are toxic for your bones.” The happier you are, the more exercise you do, the healthier your diet, the more you optimize your weight—all these things are rolled up together to determine how fit and well you are.
6) Not getting enough sunlight
The sun’s rays are good for many things in nature, including being a source of vitamin D for us humans. Sunlight converts inactive forms of vitamin D to active forms that help your body absorb it and utilize minerals to build bone, says Dr. Stone. Vitamin D is so important to bones because it helps the body absorb calcium. The recommended amount of sunlight exposure we need ranges from about 15 minutes to 30 daily, but Dr. Stone suggests sticking to the higher end.
“We like to say 30 minutes minimum of total body exposure each day, which means everyone should go out and skinny dip or sun bathe nude,” says Dr. Stone. “Now of course that’s not realistic! So what we like to do is encourage people to simply be outdoors and absorb more light.” (Remember to apply sunscreen about 30 minutes prior to heading out!)
Know that you can also get vitamin D from fatty fish like salmon, egg yolks, and fortified dairy products. Says Dr. Redler: “The goal is 600 [International Units] a day for people under 70 and 800 IUs for those over 70.”
