It’s no surprise that having a family history of osteoporosis—a condition in which bones become brittle and more vulnerable to fractures—makes you more likely to have the condition yourself. But certain everyday habits can also harm your bone health. The good news: By making some smart lifestyle changes, you can boost the health and strength of your bones.
If you take a 1,200 mg calcium supplement each morning—the daily recommended dose for adults over age 50—you have your calcium needs covered, right? Think again. Your body can't absorb the whole dose at once, says Felicia Cosman, MD, senior clinical director at the National Osteoporosis Foundation (NOF). In fact, as the dosage of calcium goes up, the percentage that's actually absorbed goes down, according to the National Institutes of Health (NIH).
“If you have a cup of low-fat milk with cereal at breakfast and a piece of low-fat cheese at lunch, you’re in pretty good shape, you only need to make up about 300 mg of calcium as a supplement,” says Dr. Cosman, who recommends getting the mineral from calcium-rich foods rather than supplements, if possible, because the body absorbs calcium better from food sources. If you don’t get enough calcium-rich foods in your daily diet, however, take a 600-mg calcium supplement in the morning or at lunch and another one with dinner, she adds.
Bones grow stronger when they’re met with resistance. “You want to strengthen the muscles around the bones,” explains Dr. Cosman. “Muscles that pull and push on the bone create forces in the bone that stimulate the growth of tissues.” Aerobic exercises such as running and walking, as well as weight-bearing or resistance training, help increase bone mineral density. But if you do exercises that work only your lower body, you’re bolstering only the bones in your legs. It's also important to do upper-body strength training to protect your bones above the waist. Dr. Cosman recommends performing aerobic exercises three to five times a week and strength training two or three times a week, making sure not to work the same muscle groups on consecutive days.
Adding salt to every dish saps calcium levels. “Excessive salt can cause you to excrete calcium in your urine,” says Dr. Cosman. “You can make it up by making sure you get enough calcium in your diet, but it’s still good to avoid excessive salt.” The 2010 Dietary Guidelines for Americans recommend limiting sodium to less than 2,300 mg a day, or 1,500 mg if you’re age 51 or older; African American; or have high blood pressure, diabetes or chronic kidney disease. That can add up quickly: One tablespoon of soy sauce, for example, has about 1,000 mg of sodium.
Vitamin D helps the body absorb calcium; without it, bones may become thin, brittle or misshapen. Recent research shows high rates of vitamin D deficiency among hip-fracture patients. Ask your healthcare provider about a blood test to check your vitamin D levels and whether you should take a supplement. You can boost your levels by eating foods rich in vitamin D, such as fish (salmon, mackerel) and fortified milk, orange juice and yogurt, or by getting 15 to 30 minutes of sunshine at least twice a week (less time if you're prone to sunburn or if it's summertime, when the sun's rays are strongest), according to the NIH. Most calcium supplements include vitamin D; or you can take a separate pill. On average, Dr. Cosman recommends getting 800 to 1,000 IU of vitamin D per day. And as with calcium supplements, do not take the entire amount in a single dose.
Need yet another reason to quit? Smoking wreaks havoc on essentially every organ in the body, but few people realize that it also affects bones. “Smoking accelerates the metabolism and excretion of any estrogen that might be in your system, and estrogen directly affects the cells that make bone," explains Dr. Cosman, “so your body makes bone less efficiently.” Protect your bones by nixing this unhealthy habit. Talk to your healthcare provider about help to stop smoking or get quitting tips from the National Cancer Institute.