Improving Your Bone Health
Diet and Exercise Are Important
Fortunately, in your older years, you can still take steps to protect your bones. You'll need a balanced diet rich in calcium and vitamin D, a regular exercise program, and, in some cases, medication. These steps can help you slow bone loss. In addition, you'll want to learn how to fall-proof your home and change your lifestyle to avoid fracturing fragile bones.
Bone is made up of calcium, protein, and other minerals. Getting enough calcium helps protect bones by slowing bone loss. Women over age 50 should consume 1,200 milligrams (mg) of calcium daily. Men between the ages of 51 and 70 should consume 1,000 mg of calcium a day, and men over 70 should consume 1,200 mg per day. To make sure you get enough calcium, make foods that are high in calcium part of your diet.
Sources of Calciuim
Calcium is found in many foods. You can get recommended amounts of calcium by eating a variety of foods, including the ones listed here.
- Milk, yogurt, and cheese are the main food sources of calcium for most people in the United States.
- Kale, broccoli, and Chinese cabbage are fine vegetable sources of calcium.
- Fish with soft bones that you eat, such as canned sardines and salmon, are fine animal sources of calcium.
- Most grains (such as breads, pastas, and unfortified cereals), while not rich in calcium, add significant amounts of calcium to the diet because people eat them often or in large amounts.
- Calcium is added to some breakfast cereals, fruit juices, soy and rice beverages, and tofu. To find out whether these foods have calcium, check the product labels.
Although foods rich in calcium are believed to be the best source of calcium, most Americans’ diets do not contain enough calcium. You can take calcium supplements to help fill the gap. The most common calcium supplements are calcium carbonate and calcium citrate.
Vitamin D Requirements
As you grow older, your need for vitamin D increases. People ages 51 to 70 should consume at least 600 international units (IU) of vitamin D daily. People over age 70 should consume at least 800 IUs daily.
Vitamin D helps your body absorb calcium. Exposure to sunlight causes your body to make vitamin D. Some people get all the vitamin D they need this way. However, many older people, especially those who are indoors most of the time and/or live in northern areas, are not getting enough vitamin D. Many people also have trouble getting enough vitamin D during the winter months when sunlight is limited.
Sources of Vitamin D
Very few foods naturally have vitamin D. Fortified foods provide most of the vitamin D in American diets. In some cases, supplements may be necessary to meet the daily requirements. Here are some dietary sources of vitamin D.
- Fatty fish such as salmon, tuna, and mackerel are among the best sources.
- Beef liver, cheese, and egg yolks provide small amounts.
- Mushrooms provide some vitamin D. In some mushrooms that are newly available in stores, the vitamin D content is being boosted by exposing these mushrooms to ultraviolet light.
- Almost all of the U.S. milk supply is fortified with 400 IU of vitamin D per quart. But foods made from milk, like cheese and ice cream, are usually not fortified.
- Vitamin D is added to many breakfast cereals and to some brands of orange juice, yogurt, margarine, and soy beverages; check the labels.
Exercising for Bone Health
Like muscle, bone is living tissue that responds to exercise by becoming stronger. For most people, bone mass peaks during the third decade of life. After that time, we can begin to lose bone. Women and men older than age 20 can help prevent bone loss with regular exercise. Exercising allows us to maintain muscle strength, coordination, and balance, which in turn helps to prevent falls and related fractures. This is especially important for older adults and people who have been diagnosed with osteoporosis.
(Watch the video to learn how exercise helped a 70-year-old woman with osteoporosis. To enlarge the video, click the brackets in the lower right-hand corner. To reduce the video, press the Escape (Esc) button on your keyboard.)
The best exercise for your bones is the weight-bearing kind, which forces you to work against gravity. Some examples of weight-bearing exercises include weight training, walking, hiking, jogging, climbing stairs, tennis, and dancing. Examples of exercises that are not weight-bearing include swimming and bicycling. Although these activities help build and maintain strong muscles and have excellent cardiovascular benefits, they are not the best way to exercise your bones. According to the Surgeon General, adults should get at least 30 minutes of physical activity on most days, and preferably every day.
For more on weight-bearing exercises that older adults can try, go to Exercises to Try: Strength Exercises.
Proper posture and body mechanics are important when doing exercises. If you have osteoporosis, you should avoid activities that involve twisting your spine or bending forward from the waist, such as conventional sit-ups, toe touches, or swinging a golf club.
If you have osteoporosis, ask your doctor which activities are safe for you. If you have low bone mass, experts recommend that you protect your spine by avoiding exercises or activities that flex, bend, or twist it. Furthermore, you should avoid high-impact exercise to lower the risk of breaking a bone.
You also might want to consult with an exercise specialist to learn the proper progression of activity, how to stretch and strengthen muscles safely, and how to correct poor posture habits. An exercise specialist should have a degree in exercise physiology, physical education, physical therapy, or a similar specialty. Be sure to ask if he or she is familiar with the special needs of people with osteoporosis.
If you have health problems—such as heart trouble, high blood pressure, diabetes, or obesity—or if you are age 40 or older, check with your doctor before you begin a regular exercise program.
Preventing Falls and Fractures
Preventing falls is a special concern for men and women with osteoporosis. Falls can increase the likelihood of fracturing a bone in the hip, wrist, spine, or other part of the skeleton. In addition to the environmental factors listed below, falls can also be caused by impaired vision or balance, chronic diseases that affect mental or physical functioning, and certain medications, such as sedatives and antidepressants. It is important that individuals with osteoporosis be aware of any physical changes that affect their balance or gait, and that they discuss these changes with their health care provider. Here are some tips to help eliminate the environmental factors that lead to falls.
- Use a cane or walker for added stability.
- Wear rubber-soled shoes for traction.
- Walk on grass when sidewalks are slippery.
- In winter, carry salt or kitty litter to sprinkle on slippery sidewalks.
- Be careful on highly polished floors that become slick and dangerous when wet.
- Use plastic or carpet runners when possible.
- Keep rooms free of clutter, especially on floors.
- Keep floor surfaces smooth but not slippery.
- Wear supportive, low-heeled shoes even at home.
- Avoid walking in socks, stockings, or slippers.
- Be sure carpets and area rugs have skid-proof backing or are tacked to the floor.
- Be sure stairwells are well lit and that stairs have handrails on both sides.
- Install grab bars on bathroom walls near tub, shower, and toilet.
- Use a rubber bath mat in shower or tub.
- Keep a flashlight with fresh batteries beside your bed.
- If using a step stool for hard-to-reach areas, use a sturdy one with a handrail and wide steps.
- Add ceiling fixtures to rooms lit by lamps.
- Consider purchasing a cordless phone so that you don’t have to rush to answer the phone when it rings, or so that you can call for help if you do fall.
(Watch the video to learn more about fall proofing your home. To enlarge the video, click the brackets in the lower right-hand corner. To reduce the video, press the Escape (Esc) button on your keyboard.)