Modern bones are struggling a bit with increasingly sedentary lifestyles, says Matthew T. Drake, MD, PhD, chair of the American Society for Bone and Mineral Research’s Professional Practice Committee. Too much sitting indoors eliminates two of the main ingredients of healthy bones: vitamin D and weight-bearing exercises. This isn’t exactly great news in the midst of a pandemic with no end in sight.
Fortunately, there are actions you can take to help your bones become (and remain) strong as you age. And while the most critical time for building a foundation for good bone health is up until your mid twenties, that doesn’t mean what you have is what you get thereafter. “Most people think of the skeleton as being very static, and that it doesn’t change,” says Dr. Drake. “In reality, we replace our skeletons about every 10 years—skeletons are always undergoing this constant process of remodeling.”
Bone-healthy habits can therefore be adopted at any stage in life; below, seven to start practicing sooner rather than later.
Tips to protect the health of your bones
1. Adopt a calcium-rich diet
Milk marketing isn’t a lie—calcium is a critical building block for bones. Intake is most important up until your mid-twenties; however, it’s also important during pregnancy. (Maya Feller, RD says you get another shot at supercharged bone building after giving birth, so that can be a crucial time for calcium, too.) You should maintain recommended calcium levels consistently throughout your life. Dr. Drake numbers it among the most important things to do consistently when it comes to bone health. And you may want to pay careful attention to it as you approach age 50, as women tend to lose two percent of their bone density per year for eight to 10 years around menopause.
The most obvious source of calcium is that aforementioned (cow’s) milk and other forms of dairy. If you’re a vegan, Feller says it’s possible to get enough calcium without animal products, but she notes that this requires planning, really depends on the individual, and can necessitate supplementation. To this end, nutrition expert Whitney English MS, RDN of Plant-Based Juniors, recommends calcium-rich tofu, broccoli, kale, collards, bok choy, and even some fruits (e.g. oranges and figs) as plant-based calcium carriers.
2. Up your vitamin D intake
Vitamin D is also critically important to bone health, and it works in tandem with calcium to build strong skeletons . “If you have a low vitamin D level you may be at higher risk for bone fracture or softening of the bones (rickets),” says English.
As Dr. Drake notes, it’s not as easy for many humans to obtain adequate vitamin D as it used to be, as we don’t get outside enough. And Feller says that the amount of sunlight you need exposure to in order to avoid deficiency depends on how far where you live is from the equator and the amount of melanin in your skin. Someone with darker skin requires more sunlight to reach healthy vitamin D levels than does an individual with lighter skin, and if you live in Iceland you’re going to need more primetime exposure than someone who lives in the Caribbean.
Vitamin D isn’t the easiest vitamin to obtain from food. Feller recommends eating eggs, fatty fish and—if you’re up for it—animal liver to up your intake. For those who are plant-based, English recommends UV-treated mushrooms. “Mushrooms that have been exposed to sunlight or artificial light produce large amounts of the bone-health supporting nutrient vitamin D,” she says.
3. Eat enough protein
Collagen, says Dr. Drake, is also an important bone building block, which is why protein can play an important role in skeletal health, too. To get the most bang for your buck, try sardines or anchovies, as they’re good sources of calcium and vitamin D, too.
You can get the protein you need on a plant-based diet, too—it just requires a little more attention and effort. Try adding soy, quinoa, and hemp and chia seeds to your diet to start.
4. Sprinkle in some vitamin K
Some studies show that vitamin K also plays an important role in bone health, and Feller says it’s often added to vitamin D supplements now to make the vitamin D more bioavailable. It can be found naturally in foods such as parsley, avocados, kiwis, dark leafy greens, and prunes. The latter are also rich in zinc, magnesium, potassium and boron, which can further help with bone formation, regulation, and structure (and they’re actually super delicious dipped in dark chocolate, too).
5. Mimic the Mediterranean Diet
If you can’t be bothered to pay attention to the nitty gritty of every nutrient you intake, you might want to try more simply mimicking the Mediterranean diet instead—new research has correlated it with better bone density in postmenopausal women.
6. Cut back on alcohol and caffeine
Research shows that heavy boozing is bad for bone health (and really, everything else, too). And Dr. Drake says you should probably cap your caffeine intake as well to about two servings per day.
7. Stay physically active
“One of the best things you can do to preserve bone health as you age is to stay active—especially with weight bearing exercises,” says dietitian Dana Hunnes, RD, PhD, adjunct professor at the University of California Los Angeles. “Running and walking are both good exercises to maintain bone health as it puts pressure on the bones which can help compress the structure making it stronger.” Wall squats, step-ups, and sit-ups are also good bone-strengthening exercises if you’re looking for indoor options. If you’re not sure whether or not your favorite workout is working your bones, check out the six factors that make an exercise superior for your skeleton.
It’s also important to exercise more generally, Dr. Drake explains, because muscle strength helps you stay upright and steady on your feet, which can prevent falls that lead to bone health-sabotaging breaks and fractures. With that said, he notes that you should try to avoid any type of exercise—or activity of any sort—that could lead to a fall, especially as you age. He also caveats yoga practice with respect to bone health for those who are aging, as he says that some of the moves are hard on the skeleton and increase the risk of fractures. “It’s really important if they’re doing those activities that they do them safely,” he says. “Everyone thinks yoga is sort of a cure all, but it needs to be done the right way.”
Whatever form of exercise you choose, it’s ultimately just important to make sure some portion of it requires that your bones be put to the test. “It’s really important to do what we call skeletal loading, which are things where you’re supporting your own weight or more than your own weight,” says Dr. Drake. “Without this, the bone atrophies.”
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