When registered dietitian Toby Smithson gave presentations on bone health, she’d bring three bags of flour, each with a different amount. One bag represented osteoporosis. Another bag represented osteopenia, or bone whose density is lower than normal but not enough to be classified as osteoporosis. The third bag represented normal bone.

“You could see the flour and feel the heaviness and density,” said Smithson, a spokesperson for the Academy of Nutrition and Dietetics. “Osteoporosis was the lightest bag.”

It was a powerful visual reminder of why it is so important to invest in your bone health now, before it becomes a problem.

Consider this sobering thought: The U.S. Surgeon General has said that by 2020, half of Americans over 50 will have weak bones — unless we change our diets and lifestyle habits. Having weak bones puts
us at risk of developing broken bones and osteoporosis.

“People need to understand that this is preventable for the most part,” says Dr. Steven Hawkins, a spokesperson for the American College of Sports Medicine and a professor of exercise science at California Lutheran University in Thousand Oaks, Calif. “But you have to take responsibility.”

Bone Health Basics

Our bones give structure to our bodies. They allow us to move. They protect our heart, lungs and other organs. They anchor our muscles.

“Bone from an engineering perspective is kind of a marvel,” Hawkins says.

Our bodies continually break down and rebuild bone. Children and teenagers form bone faster than they lose bone, but after age 20, we start losing bone faster than we rebuild it. Over time, our bones can become less dense and more prone to breaking. Most people don’t realize they have weak bones until they break.

Osteoporosis is the most common type of bone disease. More than 53 million Americans have osteoporosis or are at high risk for fractures because of low bone mass, according to the National Institutes of Health. Each year, 1.5 million older Americans break bones because their bones are weak.

Osteoporosis happens when you lose too much bone, make too little bone or both. Although any bone can be affected, fractures happen most often in the hip, spine and wrist.

Who Is At Risk?

Both men and women can get osteoporosis, but women are more likely to get it. Women typically have smaller, thinner bones than men. Menopause also can lead to bone loss as estrogen levels drop. Estrogen is a hormone that protects bones.

Age and family history are also risk factors for osteoporosis. Older people are more at risk than younger people, as are people who had a parent or grandparent with osteoporosis.

People of all racial and ethnic backgrounds can develop osteoporosis, but it is most common in Caucasians and Asians.

What Doctors Recommend

Bones store most of the body’s calcium, so it’s important to get enough calcium. To absorb calcium properly, we also need Vitamin D.

How much calcium and vitamin D should you aim for each day? The answer depends on your age and gender. Men and women between 31 and 50 should aim for 1,000 mg (milligrams) of calcium and 600 IUs
(international units) of Vitamin D each day.

However, after age 50, the recommendations diverge slightly. Women between 51 and 70 should aim for 1,200 mg of calcium and 600 IUs of Vitamin D each day. Men in the same age group should still aim for 1,000 mg of calcium and 600 IUs of Vitamin D each day.

After age 70, men and women should aim for 1,200 mg of calcium and 800 IUs of Vitamin D.

Vitamin D is made in the skin after you’ve been in the sun. The typical recommendation is 10 to 20 minutes of sun exposure a day, Hawkins says. Vitamin D is also found naturally in fatty fish and fish oils and in some fortified foods like milk and cereals.

The best sources of calcium are dairy products like milk, yogurt and cheese. One cup of milk has 300 mg of calcium; one cup of yogurt has 200 to 450 mg. But other foods pack a calcium punch: green, leafy vegetables like broccoli and kale, salmon with bones and calcium-fortified foods.

“People want to live longer and better than the generation before them,” says registered dietitian Joan Salge Blake, a clinical associate professor at Boston University and a spokesperson for the Academy of Nutrition and Dietetics. “They want their bones healthy, heart healthy and weight healthy.”

7 Tips for Today

Most of us still don’t heed the advice for strengthening and protecting our bones. Good nutrition and physical activity habits are among the most important — if not the most important — tools in the fight for bone health, Hawkins says.

It’s never too late to take steps to help your bone health, Hawkins adds.

Certain risk factors, like age, gender and family history are out of your control. But other factors — like nutrition and physical activity — are things you can have a hand in. Here are seven things you can do now to help your bone health tomorrow:

1. Crunch the numbers.

Smithson encourages people to keep a diet history of the foods they eat each day. They can use that as a starting point to see if they are getting enough calcium. She also suggests people use the “calcium decoder.” Calcium is listed as a percentage on Nutrition Facts labels. To convert that amount to milligrams, just add a zero. Example: 30 percent calcium is 300 mg of calcium.

2. Remember that not all milk is created equal.

Some people cannot tolerate cow’s milk — or choose not to drink it — so they turn to other milks such as soy milk, almond milk, rice milk or the milk of the moment: coconut milk, Smithson says. One cup of cow’s milk has 300 mg of calcium and one cup of coconut milk has 38 mg. Read the labels.

3. Rely on foods first, then supplements if needed.

Our bodies absorb calcium much easier from food, plus you get the benefit of the other nutrients in the foods, Salge Blake says. With milk, for example, you also get protein and B vitamins. Get creative with foods, too, she says. Instead of grilling hamburgers, try canned salmon burgers. Use milk in your coffee instead of cream or powdered creamers. “Try to get the most bang for your bite,” she says.

4. If you use supplements, take no more than 500 mg of calcium at a time.

Your body can only absorb that much at once, Salge Blake says. That’s especially important if you use a calcium supplement that must be taken with food. Be sure to check with your health care provider about whether you should take supplements.

5. Don’t forget foods with potassium and magnesium.

Some research is emerging that these two minerals also have a role in bone health, Smithson says. Fruits and vegetables are good sources of potassium and magnesium.

6. Be active.

Weight-bearing activities like walking, jogging and weight-lifting are good for the bones, but don’t ignore other forms of physical activity, Hawkins says. “Weight-bearing activities seem to be the ideal way, but ‘ideal’ doesn’t exist,” he says. “If you can’t do those (weight-bearing) activities, cycling and swimming are a whole lot better than nothing at all.” The best exercise? Hawkins says it’s the one that you will do.

7. Get educated about falls.

The 50+ crowd should start talking about fall prevention now. We often focus on cardiovascular endurance and muscle strength, but balance training is also an important part of our overall health, Hawkins says. Typically, bones are not so brittle that they break first and lead to a fall, he says.

“We have a tsunami of baby boomers out there,” Salge Blake says. “The joke is that 60 is the new 40. They don’t feel their age. They take care of themselves. Changing our diet and lifestyle can have great impact.”

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