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How to Build Healthy Bones (And Keep Them Strong)

If sticks and stones may break our bones, how can we make them stronger? Hint: There’s more to it than calcium and vitamin D.
How to Build Healthy Bones (And Keep Them Strong)

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Bones are quite literally the support system of the body, so it’s super important to keep them strong and healthy. Though weak bones may seem like an old person problem, there’s plenty we can do early in life (like, say, in our teens and 20s) to make sure bones stay healthy later on down the line.

Photo by Jess Ivy

Bone Up — The Need-to-Know

Our bodies are building up those bones until about age 30, when they typically reach peak bone mass (which varies from person to person). Bones are constantly being broken down and rebuilt in tiny amounts. Before reaching peak bone mass, the body is creating new bone faster, but after age 30, the bone building balance naturally shifts and more bone is lost than gained.

Some people have a lot of savings in their “bone bank” because of factors including genetics, diet, and how much bone they built up as teenagers. The natural depletion of bone doesn’t affect these lucky ducks too drastically. But in those with less of a bone fortune, when the body can’t create new bone as fast as the old bone is lost, osteoporosis sets in, causing bones to become weak and brittle and allowing them to fracture more easily. But don’t worry about those bones starting to crumble in your youth — the disease is most prevalent in women over the age of 65 and in men over the age of 70.

Although all this talk of menopause and old age makes the threat of osteoporosis seem like a long way off, know that once it sets in, it’s extremely hard to reverse. Since there’s no way of being 100 percent positive you’ll develop osteoporosis, the best way to counteract it is to take steps earlier in life to beef up bone mass (and prevent its loss) as much as possible.

No Bones About It — Your Action Plan

Unfortunately, some are more likely than others to develop osteoporosis and weak bones in general (namely white and Asian postmenopausal women). Also unfortunately, it’s awfully difficult to change your race, gender, or menopausal status. But never fear — there are some things that can be changed to bump up bone mass. Here are ten tips to make deposits in your bone bank for a healthier future.

1. Know your family history.

As with many medical conditions, family history is a key indicator of bone health. Those with a parent or sibling who has or had osteoporosis are more likely to develop it. “So, how’s your bone density, Grandma?” might seem like an awkward question at Thanksgiving dinner, but ask anyway before she passes the gravy.

2. Boost calcium consumption.

When most people think bones, they think calcium. This mineral is essential for the proper development of teeth and bones. (Not to mention it’s a huge helper in proper muscle function, nerve signaling, hormone secretion, and blood pressure.)

But calcium isn’t the end-all, be-all bone loss cure. The key might be to help the body absorb calcium by pairing calcium-rich foods with those high in vitamin D. Some studies on postmenopausal women have shown that simply adding calcium alone to the diet doesn’t have a huge affect on bone density (though follow-up studies have suggested the opposite…) [1] [2] [3].

Foods that are good sources of calcium include yogurt, cheese, milk, spinach, and collard greens. Not a dairy fan? Check out our list of non-dairy sources of calcium.

3. Don’t forget the vitamin D!

Where there’s calcium, there must be vitamin D: The two work together to help the body absorb the bone-boosting calcium. Boost vitamin D consumption by munching on shrimp, fortified foods like cereal and orange juice, sardines, eggs (in the yolks), and tuna, or opt for a vitamin D supplement. Greatist Expert Eugene Babenko suggests getting your vitamin D (specifically vitamin D3) levels checked at your next doctor’s appointment, and to discuss the use of supplements with your doctor.

The body also produces vitamin D when exposed to the sun — 10 to 15 minutes of exposure three times per week will do. Vitamin D’s importance to bone health has been proven in studies on “seasonal bone loss” — elderly people can lose more bone mass during the winter because of lack of sun exposure [4] [5]. Though these and many other studies on bone loss looked at elderly people specifically, bone health is all about prevention, so younger folks should catch a few rays to stock up on D.

4. Boost bone density with vitamin K.

Vitamin K is mostly known for helping out with blood clotting, but it also helps the body make proteins for healthy bones. However, the exact way vitamin K contributes to bone health is unclear. Two studies on young girls showed that vitamin K had different effects: One showed that vitamin K slowed bone turnover, but it didn’t have any effect on bone mineral density, while the other found the reverse [6] [7].

Another study specifically compared the effects of vitamins K and D on calcium absorption in rats, and it turns out the two vitamins work well as a team: Vitamin D stimulated calcium absorption in the intestines, while vitamin K reduced the amount of calcium excreted by the body [8].

Regardless of how vitamin K might help, fill up on it with foods like kale, broccoli, Swiss chard, and spinach.

5. Pump up the potassium.

Potassium isn’t necessarily known for aiding bone health: It’s a mineral that helps nerves and muscles communicate and also helps cells remove waste. But it turns out potassium may neutralize acids that remove calcium from the body.

Studies in both pre- and postmenopausal women have shown that a diet high in potassium can improve bone health [9] [10].  In fact, the study involving premenopausal women showed an 8% difference in bone density between women with high potassium intake and those with low potassium intake [10].

Load up on potassium by eating foods like sweet potatoes, white potatoes (skin on!), yogurt, and bananas.

6. Make exercise a priority.

Seriously. Regular exercise is key to keep a number of health issues at bay, and bone health is no exception. In fact, living a sedentary lifestyle is considered a risk factor for osteoporosis [11]. One study comparing bone density in college women with various body weights and activity levels found that athletes with low body weight had the highest bone density of any group in the study, showing exercise (and low bodyweight) can have a positive effect on bone density [12].

What type of exercise is most effective? Weight-bearing exercises like running, walking, jumping rope, skiing, and stair climbing keep bones strongest. Resistance training has also been shown to improve bone health in several studies, so pick up the weights after going for a jog [13] [14] [15]. Bonus for the older readers: Improved strength and balance helps prevent falls (and the associated fractures) in those who already have osteoporosis.

7. Consume less caffeine.

Caffeine does have some health benefits, but unfortunately those benefits aren’t for our bones. Too much of it can interfere with the body’s ability to absorb calcium. One study showed that drinking more than two cups of coffee per day accelerated bone loss in subjects who also didn’t consume enough calcium [16]. Another study (albeit on elderly women) showed that more than 18 ounces of coffee per day can accelerate bone loss by negatively interacting with vitamin D [17]. So enjoy the java, but keep it in moderation and consume enough calcium, too.

8. Cool it on the booze.

…But like caffeine, there’s no need to quit entirely. While heavy alcohol consumption can cause bone loss (because it interferes with vitamin D doing its job), moderate consumption (that’s one drink per day for women, two per day for men) is fine — and recent studies actually show it may help slow bone loss [18] [19] [20]. Bottoms up!

9. Quit smoking.

Here’s yet another reason to lose the cancer sticks: Multiple studies have shown smoking can prevent the body from efficiently absorbing calcium, decreasing bone mass [21] [22].

10. Don’t be an astronaut.

Not to kill any childhood dreams, but because of those hours and hours of weightlessness and low-calcium diets, astronauts often suffer from space-induced osteoporosis. Space- anything sounds kind of awesome, but space bones definitely aren’t: Astronauts can lose up to one to two percent of their bone mass per month on a mission! For those who simply must visit the moon, there is a possible solution: Two studies have found that vitamin K can help build back astronauts’ lost bone — more than calcium and vitamin D [23] [24].

This article has been read and approved by Greatist Experts Eugene Babenko and Mike Reinold.

What are you doing to build bone health now?  Tell us in the comments below or tweet the author @llovermyer.

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Works Cited +

  1. Calcium supplementation on bone loss in postmenopausal women. Shea, B., Wells, G., Cranney, A., et al. Cochrane Database of Systemic Reviews, 2004;(1):CD004526.
  2. Evidence that increased calcium intake does not prevent early postmenopausal bone loss. Hosking, D.J., Ross, P.D., Thompson, D.E., et al. Division of Mineral Metabolism, City Hospital, Nottingham, United Kingdom. Clinical Therapeutics, 1998 Sep-Oct;20(5):933-44.
  3. Long-term effects of calcium supplementation on bone loss and fractures in postmenopausal women: a randomized controlled trial. Reid, I.R., Ames, R.W., Evans, M.C., et al. Department of Medicine, University of Auckland, New Zealand. The American Journal of Medicine, 1995 Apr;98(4):331-5.
  4. Seasonal changes in vitamin D status and bone turnover in healthy Irish postmenopausal women. Hill, T.R., McCarthy, D., Jakobsen, J., et al. Department of Food and Nutritional Sciences, University College, Cork, Ireland. International Journal for Vitamin and Nutrition Research, 2007 Sep;77(5):320-5.
  5. Supplementation with oral vitamin D3 and calcium during winter prevents seasonal bone loss: a randomized controlled open-label prospective trial. Meier, C., Woitge, H.W., Witte, K., et al. Bone Research Program, ANZAC Research Institute, University Sydney, Concord, New South Wales, Australia. The Journal of Bone and Mineral Research, 2004 Aug;19(8):1221-30.
  6. Vitamin K, bone turnover, and bone mass in girls. Kalkwarf, H.J., Khoury, J.C., Bean, J., et al. Children's Hospital Medical Center, Cincinnati, OH. The American Journal of Clinical Nutrition, 2004 Oct;80(4):1075-80.
  7. Serum percentage undercarboxylated osteocalcin, a sensitive measure of vitamin K status, and its relationship to bone health indices in Danish girls. O’Connor, E., Mølgaard, C., Michaelsen, K.F., et al. Department of Food and Nutritional Sciences, University College, Cork, Ireland. The British Journal of Nutrition, 2007 Apr;97(4):661-6.
  8. Comparative effects of vitamin K and vitamin D supplementation on calcium balance in young rats fed normal or low calcium diets. Iwamoto, J., Yeh, J.K., Takeda, T., et al. Department of Sports Medicine, Keio University School of Medicine, Tokyo, Japan. Journal of Nutritional Science and Vitaminology, 2005 Aug;51(4):211-5.
  9. The effects of high potassium consumption on bone mineral density in a prospective cohort study of elderly postmenopausal women. Zhu, K., Devine, A., Prince, R.L. Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Nedlands, WA, Australia. Osteoporosis International, 2009 Feb;20(2):335-40.
  10. Low dietary potassium intakes and high dietary estimates of net endogenous acid production are associated with low bone mineral density in premenopausal women and increased markers of bone resorption in postmenopausal women. Macdonald, H.M., New, S.A., Fraser, W.D., et al. Department of Medicine and Therapeutics, University of Aberdeen, Medical School Buildings, Aberdeen, United Kingdom. The American Journal of Clinical Nutrition, 2005 Apr;81(4):923-33.
  11. Osteoperosis: significance, risk factors and treatment. Coralli, CH, Raisz, LG, Wood, CL. The Nurse Practitioner, 1986 Sep;11(9): 16-20, 25-7, 30.
  12. Effects of physical activity, body weight and composition, and muscular strength on bone density in young women. Madsen, K.L., Adams, W.C., Van Loan, M.D. Department of Exercise Science, University of California Davis. Medicine and Science in Sports and Exercise, 1998 Jan;30(1):114-20.
  13. The effects of progressive resistance training on bone density: a review.  Layne, J.E., Nelson, M.E. Nutrition, Exercise Physiology and Sarcopenia Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA. Medicine and Science in Sports and Exercise, 1999 Jan;31(1):25-30.
  14. Regional bone mineral density after resistive training in young and older men and women. Ryan, A.S., Ivey, F.M., Hurlbut, D.E., et al. Department of Medicine, University of Maryland School of Medicine, Baltimore VA Medical Center, Baltimore, MD. Scandinavian Journal of Medicine and Science in Sports, 2004 Feb;14(1):16-23.
  15. Resistive training maintains bone mineral density in postmenopausal women. Ryan, A.S., Treuth, M.S., Hunter, G.R., et al. Division of Gerontology, Department of Medicine, University of Maryland at Baltimore, and Geriatrics Service/GRECC Baltimore VA Medical Center, Baltimore, Maryland. Calcified Tissue International, 1998 Apr;62(4):295-9.
  16. Caffeine and bone loss in healthy postmenopausal women. Harris, S.S., Dawson-Hughes, B. Calcium and Bone Metabolism Laboratory, USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA. The American Journal of Clinical Nutrition, 1994 Oct;60(4):573-8.
  17. Caffeine intake increases the rate of bone loss in elderly women and interacts with vitamin D receptor genotypes. Rapuri, P.B., Gallagher, J.C., Kinyamu, H.K., et al. Bone Metabolism Unit, Creighton University, School of Medicine, Omaha, NE. The American Journal of Clinical Nutrition, 2001 Nov;74(5):694-700.
  18. Alcohol and bone. Laitinen, K., Välimäki, M. Research Unit of Alcohol Diseases, Helsinki University Central Hospital, Finland. Calcified Tissue International. 1991;49 Suppl:S70-3.
  19. Association between alcohol consumption and both osteoporotic fracture and bone density. Berg, K.M., Kunins, H.V., Jackson, J.L., et al. Department of Medicine, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY. The American Journal of Medicine, 2008 May;121(5):406-18.
  20. Moderate alcohol intake lowers biochemical markers of bone turnover in postmenopausal women. Marrone, J.A., Maddalozzo, G.F., Branscum, A.J., et al. School of Biological and Population Health Sciences, Oregon State University, Corvallis, OR; Maine Medical Center Research Institute, Scarborough, ME. Menopause, 2012 Jul 9.
  21. Smoking and bone loss among postmenopausal women. Krall, E.A., Dawson-Hughes, B. USDA Human Nutrition Research Center on Aging, Tufts University, Boston, Massachusetts. Journal of Bone and Mineral Research, 1991 Apr;6(4):331-8.
  22. Smoking increases bone loss and decreases intestinal calcium absorption. Krall, A.E., Dawson-Hughes, B. Calcium and Bone Metabolism Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, Massachusetts. Journal of Bone and Mineral Research, 1999 Feb;14(2):215-20.
  23. Interventions to prevent bone loss in astronauts during space flight. Iwamoto, J., Takeda, T., Sato, Y. Department of Sports Medicine, Keio University School of Medicine, Tokyo, Japan. The Keio Journal of Medicine, 2005 Jun;54(2):55-9.
  24. Nutritional interventions related to bone turnover in European space missions and simulation models. Heer, M. Institute of Aerospace Medicine, German Aerospace Center, DLR, Cologne, Germany. Nutrition, 2002 Oct;18(10):853-6.