3 Habits That Can Improve Your Bone Health As You Age

Weakening bones are often thought of as an "older person's problem" to be addressed only after a fracture or break occurs, says Clare Masternak, PA-C, an orthopedic surgery physician assistant and the bone health and fragility fracture program coordinator at Michigan Medicine. As a result, young people are often left without any idea of how to care for their bone health—or if it's something they should prioritize in the first place. 

"I think we always hear growing up that calcium is good for bones and vitamin D is good for us," says Masternak. "But that's kind of where the discussion stops until we're older and maybe we have had a fracture."

The problem: By age 30, you'll reach your peak bone mass—the greatest amount of bone you'll ever have. After that point, you won't build much new bone, says Masternak. And as you get older, you're more likely to experience bone-related health concerns. 

As you age, your ability to build new bone (aka ossification) diminishes, but the process of bone breakdown (aka resorption) occurs at the same rate, creating an imbalance that can lead to osteopenia and osteoporosis, says Masternak.

Bones can become less dense, more brittle, and, consequently, more likely to fracture. And this process is generally heightened after menopause, when estrogen levels plummet, she adds; the hormone is known to regulate bone metabolism (the rate of bone breakdown to formation), and estrogen deficiency is one of the major causes of postmenopausal osteoporosis, according to research published in Scientific Reports1.

There aren't any clear-cut symptoms associated with weak bones, save for a fracture, says Masternak. "We don't have pain from low-bone density," she adds. "We only have pain when we break a bone." Bone density tests typically aren't recommended for young, healthy individuals either, says Masternak; women are generally advised to schedule their first screening when they are 65 years old, according to the Office of Disease Prevention and Health Promotion.

These two nutrients play a pivotal role in supporting bone health. Calcium makes up the majority of your skeleton's structure, and it also assists in blood vessel contraction and dilation, muscle function, and blood clotting, among other processes, according to the National Institutes of Health3 (NIH).

When you're not consuming enough calcium—either through food or supplements—your body will stimulate a process to pull the mineral from your bones, increasing the risk of bone loss, says Masternak. Similarly, vitamin D, which can be obtained through food, supplements, and sun exposure, promotes calcium absorption in the gut. Without enough of it, your body won't be able to properly utilize all of the calcium you're consuming, contributing to osteoporosis, per the NIH4.

To ensure you're consuming the recommended 1,000 to 1,200 milligrams of calcium daily (depending on your age), prioritize foods such as dairy products (e.g., yogurt, milk, cheese), fortified drinks (e.g., soy milk, orange juice), and fish (e.g., salmon and sardines with bones). If you need help meeting that guideline after adjusting your diet, consider a supplement, says Masternak, whether it's a well-formulated multivitamin or stand-alone calcium supplement.

Vitamin D is found primarily in fish and fortified milks and cereals, so it's often difficult for people to consume the recommended daily amount through diet alone, says Masternak. To increase your intake, look for a supplement containing vitamin D3, which has been found to increase serum levels of 25(OH)D (the byproduct of a process in the liver that activates the vitamin) to a greater extent than vitamin D2, according to the NIH4.

Physical activity, specifically weight-bearing exercise, is "hugely important" for maintaining bone health as you age, says Masternak. Practices that place more mechanical load on your bones than they experience in daily life, such as strength training, running, hiking, and stair climbing, may stimulate bone growth and increase bone strength, research suggests5.

Smoking and vaping can directly impact your bone health, says Masternak. Research suggests6 that tobacco smoking can create an imbalance in bone turnover, leading to reduced bone mass, and quitting appears to reverse its harmful effects and enhance bone health. And while the data is currently limited, a 2021 article7 in Bone & Joint Research suggests that high concentrations of nicotine (such as those found in e-cigarettes) may impair the function of osteoblasts (the cells responsible for bone formation) and osteoclasts (the cells responsible for bone resorption).

There's also a link between poor bone health and drinking, says Masternak. Chronic alcohol intake has been found to hinder the development of ideal peak bone mass in young people and accelerate bone loss in elderly individuals, though some early research suggests light drinking may be linked with higher bone mineral density in postmenopausal women, per a 2021 study8 published in PLoS ONE.