Build Stronger Bones

Building strong bones should start in childhood, and it’s something to work on throughout your life. Bones are made up of collagen and calcium. However, they’re far from the lifeless skeletons that appear every Halloween. Your body is constantly breaking down and renewing your bones through remodeling. Like remodeling a house, your body breaks down and discards old bone tissue and replaces it with new tissue.[1] Keeping bones strong is especially important for women because 1 in 2 women will have an osteoporosis-related fracture in their lifetime. For men, the lifetime risk is 1 in 4. While some people are naturally at a higher risk of weaker bones than others, there are many things you can do to build stronger bones throughout your life.

Steps

Eating for Your Bones

  1. Get plenty of calcium. About 99% of the calcium in your body is in your bones and teeth.[2] It’s important to get enough calcium to grow and maintain healthy, strong bones.[3] Unfortunately, many people -- especially women -- don't get enough calcium in their daily diets.[4] The recommended daily intake of calcium varies depending on your age and sex, but the daily upper limit is between 2,000-2,500mg per day. You shouldn’t consume more than this unless instructed by your doctor.[1]
    • Children under age 1 should get between 200-260mg a day. Children under age 3 should get about 700mg of calcium per day. Children from 4-8 should get 1,000mg. Older children and teens need about 1,300mg per day. During childhood and the teen years, your body adds new bone faster than it is removed, so you need extra calcium during these years.[1]
    • Adults under 50 should get about 1,000mg daily, and women over 50 should boost their intake to about 1,200mg daily. All adults over 70 should consume 1,200mg daily.
    • Your body may start to break down more bone than it replaces after age 20, though it usually starts in your early 30s. Getting enough calcium and other nutrients will help you keep your bones strong.
    • Calcium is available in dietary supplements, but you should only take these as instructed by your doctor. Too much calcium can cause constipation and kidney stones, among other unpleasant side effects.[5]The two main forms are calcium carbonate and calcium citrate. Calcium carbonate is the cheapest, but it should be taken with food. Calcium citrate can be helpful for those with inflammatory bowel disease or absorption disorders, as it does not require food.[1]
    • Calcium supplements are best absorbed in small doses (about 500mg at a time), several times a day.[6]
  2. Consume calcium through your diet. Getting calcium from the foods you eat is the best way to consume calcium.[7] Many people in the US get most of their calcium from dairy products such as milk, cheese, and yogurt, which are very rich sources of calcium.[1]
    • Choose calcium-fortified soymilk, almond milk, and other dairy substitutes. Tofu can also be enriched with calcium. Some juices and other beverages have added calcium, too.
    • Vegetable sources rich in calcium include turnip and collard greens, Chinese cabbage (bok choy), black-eyed peas, kale, and broccoli.[8] Spinach is healthy, but it’s not as effective as a source of calcium as other greens because its oxalic acid content reduces the availability of its calcium to your body.[9]
    • Canned sardines and canned salmon are excellent sources of calcium because the bones are meant to be eaten. Sardines and salmon are also excellent sources of omega-3 fatty acids, which improve brain health and may contribute to better mood.[10] They also contain vitamin D, which helps your body absorb calcium.
    • Particularly for children, choose whole-grain breakfast cereals that have been fortified with calcium and other nutrients. These are a consistent source of calcium because so many people eat these cereals daily with milk. Sugary cereals, though, can promote obesity, so look for cereals that have low sugar.
  3. Get plenty of vitamin D. Vitamin D helps improve your body’s ability to absorb calcium.[1] Vitamin D also plays a crucial role in bone remodeling. Without enough vitamin D, your bones can become brittle and weak. The amount of vitamin D you need varies depending on your age.[11]
    • Infants under 1 year should get at least 400IU of vitamin D. Human breastmilk cannot usually supply enough vitamin D; nutritional rickets can occur in infants who do not get supplemental vitamin D.[1] The American Academy of Pediatrics recommends that you supplement your infant’s breastfeeding with 400IU of vitamin D in an oral solution per day.[12]
    • Children 1 and up and adults should get about 600IU of vitamin D daily. People over 70 should increase this to 800IU daily.[13]
    • Most foods contain little or no Vitamin D. Fatty fish, such as swordfish, salmon, tuna, and mackerel are the best sources of natural vitamin D (and also provide omega-3 fatty acids). Foods like beef liver, cheese, and egg yolks also contain small amounts of vitamin D. Milk and breakfast cereals are commonly fortified with vitamins A and D.[1] Vitamin D also plays a crucial role in bone remodeling. Without enough vitamin D, your bones can become brittle and weak. The amount of vitamin D you need varies depending on your age.[1]
    • Your body synthesises vitamin D when it’s exposed to the ultraviolet rays in sunshine. People with higher levels of melanin have darker skin and produce less vitamin D from sun exposure. To synthesize vitamin D, spend between 5-30 minutes in the sunshine without sunscreen at least twice a week. (Spend less time in the sun if you burn easily, more if you tan more easily.)[1] Regular sun exposure does still elevate your risk of skin cancer, so be wise about your sun exposure.
    • Vitamin D is also available as a dietary supplement. This may be necessary for vegans and vegetarians who don’t consume animal products, as well as those who don’t live in an area with much sunshine or have darker skin. It is available in two forms, D2 and D3. Both seem equally potent in regular doses, although D2 may be less potent in high doses. Vitamin D toxicity is rare.
  4. Eat protein, but not too much. Your bones are made up mostly of collagen, a protein that forms the structure of the bone that calcium then strengthens.[1] Very low protein consumption may interfere with your body’s ability to form new bone.[14] However, too much protein is equally bad for your bones. High-protein diets such as the “Atkins diet” may be associated with increased risk of weak bones.[15][16] Your body’s protein needs vary depending on your sex and age.[17]
    • Children under 3 should get at least 13 grams of protein per day. Children aged 4-8 should get 19 grams a day. Children between 9 and 13 should get 34 grams a day
    • Teenagers need more protein than children, and boys usually need more than girls. Young women aged 14-18 should get at least 46 grams a day, and young men aged 14-18 should get at least 52 grams a day.
    • Adult women should get at least 46 grams of protein a day, although elderly women may need to eat 50 or more to help prevent bone loss.[14] Adult men should get at least 56 grams of protein per day.
    • High protein consumption can affect your body’s ability to absorb calcium. Eat plenty of fruits and vegetables, especially those high in potassium, to counteract any of these negative effects.[16]
    • Animal protein that is high in saturated fat, such as red meat and dairy products, can cause health issues if you eat them too often.[14][18] Healthy diets incorporate protein from a variety of sources, including lean meats, eggs, and vegetables and whole grains.
  5. Include magnesium in your diet. Nearly every part of your body needs magnesium to function, but many people don’t get enough magnesium in their diets. Between 50-60% of the magnesium in your body is in your bones. The amount of magnesium you need depends on your sex and age.[19]
    • Infants younger than 1 year should get between 30-75mg per day. Children from 1-3 should get 80mg daily. Children aged 4-8 need 130mg per day. Children from 9-13 need 240mg a day.
    • Teenage boys need 410mg per day. Teenage girls need 360mg. Pregnant teenagers should get at least 400mg daily.
    • Adult males should get between 400-420mg per day, and adult females should get at least 310-320mg per day.
    • There are many rich sources of dietary magnesium, including nuts, green leafy vegetables, whole grains, and legumes. Most food that provides dietary fiber will also provide magnesium.
    • Avocados, potatoes with their skins, and bananas are also good sources of magnesium.
    • Magnesium competes with calcium for absorption in your body, so if your calcium levels are already low, magnesium may cause a calcium deficiency. Getting enough calcium and magnesium will help keep you and your bones strong and healthy.[20]
  6. Eat foods rich in B vitamins. Vitamin B12 is responsible for many functions in your body, including neurological function, red blood cell formation, and DNA synthesis. A vitamin B12 deficiency can reduce the number of osteoblasts in your body; these cells help form new bone when the old tissue has been destroyed.[21] Getting enough B12 will help ensure that your bones are replenished and strong. The amount of B12 you need depends on your age.[22]
    • Infants under 1 year should get between 0.4-0.5mcg per day. Children between ages 1-3 should get 0.9mcg, and between ages 4-8 should get 1.2mcg. Children who are between 9 and 13 years old should get 1.8mcg per day.
    • Children 14 and older and adults should get at least 2.4mcg of Vitamin B12 daily. Pregnant and lactating women should get slightly more vitamin B12, between 2.6-2.8mcg.
    • Vitamin B12 is found mostly in animal products and is not generally found in plant foods. Good dietary sources of Vitamin B12 include shellfish, organ meats, beef and red meat, and fish. Fortified dairy products and cereals can also contain B12.[23][24]
    • Because B12 rarely exists naturally in plant-based food, vegetarians and vegans may find it more difficult to get adequate B12. B12 is also available as a dietary supplement as a capsule or sublingual liquid.[23]
  7. Get enough vitamin C. We usually think of calcium when we think “bone,” but your bones are actually made up mostly of collagen. This collagen provides a framework that the calcium builds on.[1] Vitamin C has been shown to stimulate procollagen and enhance collagen synthesis in your body. Getting enough vitamin C has many health benefits, including keeping your bones strong.[25][26] The amount of vitamin C you need depends on your age and sex, but most people get plenty.[23]
    • Infants under 1 year can get sufficient vitamin C from formula or breastmilk. Children 1-3 should get at least 15mg per day. Children 4-8 should get 25mg daily. Children between ages 9-13 need 45mg a day.
    • Older teens (14-18) need 65-75mg per day. Adult men should get at least 90mg of vitamin C per day, and adult women should get at least 75mg per day.
    • Pregnant women should get between 80-85mg a day, and breastfeeding women should get between 115-120mg a day.
    • Excellent dietary sources of vitamin C include Citrus fruits and juices, red and green peppers, tomatoes, kiwifruit, strawberries, cantaloupe, and Brussels sprouts.[23]
    • Cabbage, cauliflower, potatoes, spinach, and peas, as well as fortified cereals and other products, are also good sources.
    • People who smoke should consume at least 35mg more than the daily recommendation. Smoke decreases your body’s vitamin C levels.
  8. Get enough Vitamin K in your diet. Vitamin K increases bone density and strength, reducing your risk of bone fractures and breaks.[27][26] Most people get enough vitamin K from dietary sources and their gut bacteria, which also produce vitamin K.[28] The daily recommended amount of vitamin K varies by age.[29]
    • Infants under 6 months should get 2mcg per day. Infants 7-12 months should get 2.5mcg. Children between 1 and 3 need at least 30mcg daily. Children between 4-8 should get 55mcg. Children between 9-13 should get 60mcg.
    • Teenagers need 75mcg daily. Adult males (18+) should get at least 120mcg per day, and adult females should get at least 90mcg per day.
    • Vitamin K is found in many foods. Good sources include green leafy vegetables such as spinach and broccoli, and vegetable oils, nuts, fruits (especially berries, grapes, and figs), and fermented foods such as Natto and cheese.[29]
  9. Don’t take vitamin E supplements unless directed by a doctor. Vitamin E is an important part of your diet. It’s an antioxidant with anti-inflammatory properties and fights free radicals in your body that can cause cell damage. However, vitamin E supplements may provide 100IU or more per dose, much more than the daily recommended intake. Use of vitamin E supplements may decrease bone mass and prevent your body from making new bone tissues effectively, so don’t take them without consulting your doctor first.[30][31] The recommended daily vitamin E intake varies according to your age.[32]
    • Infants under 6 months should get 4mg/6IU daily. Infants 7-12 months should get 5mg/7.5IU. Children between 1 and 3 should get 6mg/9IU daily. Children 4-8 should get 7mg/10.4IU per day. Children 9-13 need 11mg/16.4IU per day.
    • Children 14+ and adults should get at least 15mg/22.4IU per day. Lactating mothers need slightly more, around 19mg/28.4IU daily.
    • You can usually get all the vitamin E you need from a well-balanced diet that incorporates fruits, vegetables, and nuts. Good dietary sources of vitamin E should include at least 10% of your daily value and include wheat germ oil, sunflower seeds, almonds, and plant oils. While not as concentrated, other dietary sources of vitamin E include peanuts, broccoli, kiwifruit, mango, tomato, and spinach.[26]
  10. Monitor your caffeine intake. Some caffeinated beverages, including colas and coffee, are linked by some studies to bone loss, although the exact relationship is still unclear.[1][33] Some health experts believe the problem lies in replacing healthier beverages such as milk and juice with cola or coffee.[34] It’s a good idea for adults to limit their caffeine to 400mg a day or less.[35]
    • Children and youth under 18 should not have caffeine, which has been linked to several health and development issues. Caffeine will not stunt growth in children, but it can cause many other issues including heart palpitations and anxiety.[36][37][38]
    • The phosphoric acid in cola may also leach calcium out of bones. Soft drinks like ginger ale and lemon-lime soda that don’t contain phosphoric acid are not linked to bone loss, although the sugar in many of these drinks isn’t good for you.[23]
    • Some caffeinated beverages, such as black tea, are not associated with bone loss.[23]

Making Healthy Lifestyle Choices

  1. Avoid “dieting” unless as recommended by a doctor. Severe calorie restriction is linked to weaker bones and bone loss. People with anorexia nervosa, an eating disorder in which people severely restrict calories for a long period of time, are at a higher risk of developing osteoporosis.[39] Your body needs a certain level of calories and nutrition every day to maintain strong bones and muscles, but many fad diets don’t provide a healthy balance.[39] If you need to lose weight, consult your doctor or a professional nutritionist or dietician for a healthy eating and exercise regimen.
    • People who are extremely thin, whether naturally or through dieting, are also at an elevated risk of osteoporosis.[40]
  2. Watch your alcohol consumption. Long-term, heavy alcohol consumption can interfere with bone remodeling. It weakens your bones and increases your risk of fractures and breaks. This is especially true for adolescents who consume alcohol.[41] If you do drink alcohol, do it only in moderation.
    • The National Institute on Alcohol Abuse and Alcoholism states that “low-risk” or “moderate” drinking is the safest way to avoid negative health effects from alcohol. This is defined as no more than 3 drinks on a given day, and no more than 7 per week for women. For men, it’s no more than 4 drinks on a given day, and no more than 14 per week.[42]
  3. Get at least 30 minutes of weight-bearing exercise every day. People who get regular exercise tend to have stronger, denser bones. Weight-bearing exercise, where your bones have to carry your body weight around, is especially important to building strong bones.[3]
    • Women reach peak bone mass earlier than men do, and they also have a lower bone mass threshold. Exercise is particularly important for women.
    • Getting regular exercise starting in childhood is the best way to continue healthy habits throughout your life. Encourage children to run around, jump, dance, and play sports.
    • The American Academy of Orthopedic Surgeons recommends activities like brisk walking, dancing, aerobics, racquet and team sports, and weight training to help build and maintain bone mass.[43]
    • Jumping as high as you can 10 times twice a day can help strengthen bones, too.[44]
    • Heavy yard work or gardening, skiing, skating, and karate are also good choices.
    • Exercises such as swimming and biking don’t require you to move your body weight around, so while they’re great as part of an overall fitness plan, they’re not as good for building bone.
    • If you have risk factors for osteoporosis or other health conditions, consult with your doctor or a physical therapist to make sure you get an exercise plan that is safe and healthy for you.
  4. Stop smoking and avoid secondhand smoke. Smoking is incredibly harmful for every part of your body, and your bones are no exception. Smoking interferes with your body’s use of vitamin D to absorb calcium and interferes with your body’s ability to use vitamin C to create new collagen. Both of these things weaken your bones.[45][46][47][3] In fact, smoking is directly linked to lower bone density.[40]
    • Smoking also lowers estrogen levels in men and women. Estrogen is crucial to helping your bones retain calcium and other minerals.[45]
    • Studies have shown that exposure to secondhand smoke exposure during youth and early adulthood may increase the risk of developing low bone mass later. Keep children and growing youth away from areas with secondhand smoke.[40]

Warnings

  • Don’t over consume calcium. Taken in excess, it can create kidney problems, aggravate arthritis, and cause muscle pain.

Related Articles

Sources and Citations

  1. ↑ 1.00 1.01 1.02 1.03 1.04 1.05 1.06 1.07 1.08 1.09 1.10 1.11 1.12 http://www.niams.nih.gov/Health_Info/Bone/Bone_Health/
  2. ↑ http://ods.od.nih.gov/factsheets/Calcium-HealthProfessional/
  3. ↑ 3.0 3.1 3.2 http://www.mayoclinic.org/diseases-conditions/osteoporosis/basics/prevention/con-20019924
  4. ↑ Ervin RB, Wang C-Y, Wright JD, Kennedy-Stephenson J. Dietary intake of selected minerals for the United States population: 1999-2000. Advance Data from Vital and Health Statistics, number 341. Hyattsville, MD: National Center for Health Statistics, 2004.
  5. ↑ http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0072714/
  6. ↑ http://www.niams.nih.gov/Health_Info/Bone/Bone_Health/Nutrition/
  7. ↑ http://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/calcium-supplements/art-20047097
  8. ↑ http://www.hsph.harvard.edu/nutritionsource/calcium-sources/
  9. ↑ http://nof.org/foods
  10. ↑ http://www.whfoods.com/genpage.php?tname=foodspice&dbid=147
  11. ↑ http://ods.od.nih.gov/factsheets/VitaminD-HealthProfessional/
  12. ↑ Wagner CL, Greer FR; American Academy of Pediatrics Section on Breastfeeding; American Academy of Pediatrics Committee on Nutrition. Prevention of rickets and vitamin D deficiency in infants, children, and adolescents. Pediatrics 2008;122:1142-1152
  13. ↑ http://www.nlm.nih.gov/medlineplus/magazine/issues/winter11/articles/winter11pg12.html
  14. ↑ 14.0 14.1 14.2 http://www.ncbi.nlm.nih.gov/pubmed/15018487
  15. ↑ http://aje.oxfordjournals.org/content/143/5/472.abstract?ijkey=616fc59218d11df565ddf833ecf9db852e0215af&keytype2=tf_ipsecsha
  16. ↑ 16.0 16.1 http://jn.nutrition.org/content/128/6/1051.abstract?ijkey=3622aa543d5eebfa7f3159455942e885bda49e43&keytype2=tf_ipsecsha
  17. ↑ http://www.cdc.gov/nutrition/everyone/basics/protein.html
  18. ↑ http://www.hsph.harvard.edu/nutritionsource/top-food-sources-of-saturated-fat-in-the-us/
  19. ↑ http://ods.od.nih.gov/factsheets/Magnesium-HealthProfessional/
  20. ↑ http://umm.edu/health/medical/altmed/supplement/magnesium
  21. ↑ http://articles.mercola.com/sites/articles/archive/2014/09/15/vitamin-b12-deficiency-bone-health.aspx
  22. ↑ http://ods.od.nih.gov/factsheets/VitaminB12-HealthProfessional/
  23. ↑ 23.0 23.1 23.2 23.3 23.4 23.5 http://ods.od.nih.gov/factsheets/VitaminC-HealthProfessional/
  24. ↑ http://www.dietitians.ca/Your-Health/Nutrition-A-Z/Vitamins/Food-Sources-of-Vitamin-B12.aspx
  25. ↑ http://www.ncbi.nlm.nih.gov/pubmed/11149477
  26. ↑ 26.0 26.1 26.2 http://www.ncbi.nlm.nih.gov/pubmed/21967159
  27. ↑ http://www.ncbi.nlm.nih.gov/pubmed/11684396
  28. ↑ http://umm.edu/health/medical/altmed/supplement/vitamin-k
  29. ↑ 29.0 29.1 http://ods.od.nih.gov/factsheets/VitaminK-HealthProfessional/
  30. ↑ http://www.nature.com/nm/journal/v18/n4/full/nm.2659.html
  31. ↑ http://www.ncbi.nlm.nih.gov/pubmed/22308007
  32. ↑ http://ods.od.nih.gov/factsheets/VitaminE-HealthProfessional/
  33. ↑ http://www.ncbi.nlm.nih.gov/pubmed/1609631
  34. ↑ http://health.clevelandclinic.org/2014/09/sodas-tea-and-coffee-which-can-lower-your-bone-density/
  35. ↑ http://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/caffeine/art-20045678
  36. ↑ https://www.aap.org/en-us/about-the-aap/aap-press-room/pages/Kids-Should-Not-Consume-Energy-Drinks,-and-Rarely-Need-Sports-Drinks,-Says-AAP.aspx
  37. ↑ http://kidshealth.org/parent/growth/feeding/child_caffeine.html
  38. ↑ http://www.hc-sc.gc.ca/dhp-mps/prodnatur/activit/groupe-expert-panel/report_rapport-eng.php
  39. ↑ 39.0 39.1 http://www.webmd.com/osteoporosis/living-with-osteoporosis-7/diet-weight-loss
  40. ↑ 40.0 40.1 40.2 http://www.niams.nih.gov/health_info/bone/Osteoporosis/conditions_Behaviors/bone_smoking.asp
  41. ↑ http://pubs.niaaa.nih.gov/publications/arh22-3/190.pdf
  42. ↑ http://www.niaaa.nih.gov/alcohol-health/overview-alcohol-consumption/moderate-binge-drinking
  43. ↑ http://orthoinfo.aaos.org/topic.cfm?topic=A00263
  44. ↑ http://www.prevention.com/health/health-concerns/jumping-increases-bone-density-more-running
  45. ↑ 45.0 45.1 http://www.upmc.com/patients-visitors/education/smoking/Pages/smoking-and-your-bones.aspx
  46. ↑ http://www.nhs.uk/Conditions/Osteoporosis/Pages/Prevention.aspx
  47. ↑ http://www.niams.nih.gov/health_info/bone/osteoporosis/osteoporosis_ff.asp

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