Bone health is essential for muscle strength, movement, and balance. As you age, the risk of osteoporosis, a condition that causes bones to become weak and fragile, increases.

Bone density is a measure of the amount of minerals, such as calcium, in the bones. Bones with higher levels of minerals are stronger and less likely to break than bones with fewer minerals.

There are ways you can slow and prevent bone loss, even if you have osteoporosis. Certain lifestyle and dietary habits in the early stages of bone loss can help prevent further bone loss. Some medications can also help reverse severe cases of bone loss.

Calcium is an essential nutrient for bone health and bone density. It’s naturally found in milk, salmon, almonds, and leafy greens like spinach and kale. Research shows that dietary supplementation of calcium and vitamin D can help decrease the risk of fracture (breaks in bone) in postmenopausal women.

The Recommended Dietary Allowance (RDA) of calcium is 1,200 milligrams per day for women aged 51 and over and 1,000 milligrams per day for men aged 51 and over. However, many postmenopausal women consume less than this recommended amount.

Experts recommend that older adults supplement with 400-800 milligrams of calcium daily (in addition to calcium from foods) to ensure adequate calcium intake and protect bone health. It’s important not to exceed the RDA as very high levels of calcium supplementation have been associated with increased risks of kidney stones and heart attack.

Before starting any new supplement, speak to your healthcare provider. They can help you determine the appropriate dosage based on your dietary habits, age, and risk of bone loss.

Research supports the supplementation of vitamin D for bone health alongside calcium supplementation. Vitamin D is an essential nutrient that aids calcium absorption from food and optimal functioning of the immune system and muscles. Low vitamin D levels can lead to weaker bones and osteoporosis over time.

Many adults are deficient in vitamin D, which is obtained through sunlight exposure and dietary sources like fatty fish (such as salmon), fortified milk and milk products, and fortified cereals.

Women and men 51 and over should get at least 15 micrograms, or 600 International Units (IU) of vitamin D per day, with a Tolerable Upper Intake Limit (UL) of 100 micrograms (4,000 IU). Women and men over 70 should get at least 20 micrograms (800 IU) daily, with a UL of 100 micrograms (4,000 IU).

For bone health, research shows that vitamin D supplementation in the range of 700-800 IU per day may decrease the risk of fractures. Lower doses of 400 IU per day were not as effective for reducing fracture risk.

Please speak with your healthcare provider to determine your individual vitamin D needs.

Research shows that eating enough protein supports bone health and lowers the risk of osteoporosis, especially when consumed alongside sufficient amounts of calcium. However, more studies are needed on how protein and calcium interact to alter bone mass.

Some studies suggest that eating protein from animal sources (rather than plant-based protein) may be better for bone health and reducing fracture risk. However, further study on how specific food sources of protein impact bone health is needed.

Increasing protein intake is also crucial for maintaining and building muscle. It can help prevent sarcopenia, muscle loss common with aging, which can increase the risk of osteoporosis and fractures.

Talk to your healthcare provider or a registered dietitian about how much protein you should eat daily based on your age, sex, and health needs.

Resistance training, such as weight lifting and bodyweight exercises (like push-ups), has been shown to support bone health by pushing the muscles to work harder. Resistance training also puts stress on the bones, which makes them stronger.

Research shows that resistance training—when performed alone or in combination with other forms of exercise—may be the best form of exercise to improve muscle and bone mass in postmenopausal women, middle-aged men, and the older population.

Studies show that older adults who are overweight have a higher risk of falls, which can lead to fractures. Research also indicates that being underweight increases the risk of bone fractures and bone loss.

Maintaining a healthy weight is important for overall bone health. Talk to your healthcare provider about what a healthy weight is for you and how they recommend you manage your weight. They may suggest eating a nutritious diet rich in vitamins, minerals, and fiber; limiting alcohol; getting regular physical activity; and limiting salt, calories, and added sugar to support overall health.

In addition to resistance training, weight-bearing aerobic exercise—such as walking, dancing, stair climbing, and jogging—may improve bone mineral density and reduce fall and fracture risk. Weight-bearing exercises are impact-based activities that bear weight in the arms, feet, and legs.

Research has found that walking can help prevent progressive bone loss, but walking alone does not improve bone mass. Mix up your cardio sessions with resistance training to reap the full benefits of weight-bearing aerobic exercise on bone health.

Improving your balance, especially as you age, can help prevent falls and fractures. Try the following exercises to improve your balance:

• Perform lunges or step-ups
• Practice tai chi, a gentle, meditative form of exercise that helps maintain balance, flexibility, and strength
• Walk or take steps on unstable surfaces, such as a foam mat
• Stand with both feet together or on one foot, then shift your body weight backward and forward, trying to maintain balance

Studies show that balance exercises and tai chi can decrease the risk of falls by 47% and reduce the risk of hip fracture by about 25%.

Populations that are most at risk for developing low bone density include postmenopausal women, especially white and Asian women. About 1 in 5 women over the age of 50 will be affected by osteoporosis, while only 1 in 20 men will be affected by the condition.

Other risk factors for low bone density include:

• Family history of osteoporosis or broken bones
• Dietary patterns low in nutrient-rich whole foods and high in processed foods, unsaturated fats, sodium, and added sugars
• Low nutrient levels of vitamin D, calcium, or protein
• Long-term use of certain medications, such as antidepressants and proton pump inhibitors (a class of drugs that reduce the production of stomach acid)
• Heavy alcohol and tobacco use

While certain risk factors make it more likely for someone to develop low bone density, anyone of any gender, race, or ethnic group can develop low bone density or osteoporosis.

Certain signs and symptoms may indicate your bones are low in density. If you experience any of the following symptoms, see a healthcare provider for diagnosis and treatment:

• A decrease in height or weight
• A change in posture, balance, or the way you walk
• Changes in muscle strength

Your healthcare provider can test your bone density with a bone density scan, which compares your bone density to that of a person of the same age and sex with normal bone density. This scan, called a dual-energy X-ray absorptiometry (DXA), can determine whether you have low bone density or osteoporosis.

Bone density is the amount of minerals in your bones. Higher mineral levels mean stronger bones, while lower levels indicate weaker bones, which put you at risk of osteoporosis or falls that can lead to fractures.

Supplementing with vitamin D and calcium is essential for protecting bone health in older adults. Lifestyle changes like eating more protein, maintaining a healthy weight, and improving your balance can also help.

If you notice any signs of low bone density, including a change in posture or a decrease in height or weight, visit your healthcare provider.