Arthritis Today

8 Ways to Keep Bones Healthy and Strong

Osteoporosis can make you weak, but here are ways to keep bones healthy and strong.


As many as half of all women and one­-fourth of all men older than 50 will fracture a bone at some point due to osteoporosis. Whether you are young and still building bone or older and trying to preserve it, these simple steps can help keep your bones healthy and strong.

1. Make Healthy Food Choices

Your bones need a variety of nutrients, including calcium and vitamins, C, D and K.

Low-fat dairy products are well-known sources of calcium, and many are fortified with vitamin D. You can also get calcium in nondairy foods, like salmon, mackerel, tuna, sardines, white beans and tofu.  Fruits and vegetables are the best way to get these important vitamins and minerals. You’ll get calcium and vitamin K from kale, collard greens, broccoli, spinach and cabbage.  Vitamin C is high in red and green bell peppers, strawberries, Brussels sprouts, oranges and pineapples.

If you're not getting the recommended amount of these important vitamins and minerals from food alone, you may need to take supplements, but talk to your doctor first.  

And cut the fat: Consuming too much saturated fat can lead to a high level of homocysteine – a chemical in the body known to decrease bone mass.

2. Supplement Your Diet

For osteoporosis prevention, taking a supplement will be advised by your doctor once you reach a certain age or have osteopenia (a condition in which bone mineral density is lower than normal but not low enough to be classified as osteoporosis). You doctor may suggest taking an over-the-counter (OTC) version of one or more of the vitamins and minerals mentioned above as well as folate, a B vitamin that can aid in reducing elevated levels of homocysteine.

There is also a prescription drug called Ostiva, an oral supplement containing calcium, magnesium, vitamin B­6, vitamin B­12, vitamin D and metafolin (a form of folate).

If you take corticosteroids, such as prednisone, you may need to increase your OTC vitamin D intake or get a prescription version. Prednisone blocks the body’s ability to absorb the bone­strengthening vitamin. If you’re taking prednisone, have your doctor regularly check your vitamin D levels.

Be aware that high doses of calcium from supplements could be hazardous to your heart. It’s also important to avoid calcium­-containing foods and supplements within an hour or so of taking bisphosphonates – bone­-building drugs prescribed for osteoporosis.

3. Quit Smoking

Smoking cigarettes is one of the worst things you can do for your health and your bones.

Several studies have shown that smokers have lower bone mass and a higher risk of fractures than non­smokers, and the risk increases with the number of years and cigarettes one smokes, according to the National Institutes of Health. Compared with nonsmokers, women who smoke often produce less estrogen and tend to experience menopause earlier, which may lead to increased bone loss.

4. Moderate Alcohol and Soda Intake

If you drink alcohol, stick to no more than one drink a day, or up to seven a week for women, and no more than two a day, or up to 10 a week for men. Consuming more than two alcoholic drinks per day raises the risk of falls and bone loss.

Research has also linked heavy cola consumption with lower bone density. While the mechanism has not been confirmed, experts say to substitute milk or calcium­-fortified juice for soft drinks when possible.

5. Exercise and Maintain a Healthy Body Weight

Being too heavy or too thin are risk factors for osteoporosis. Along with healthy eating, exercise is a key part of osteoporosis prevention and treatment. Like muscles, bones become stronger when they are active. Weight-bearing exercise strengthens bones by making them produce more cells. The best exercises for building stronger bones  include brisk walking, dancing or aerobics, and muscle­ strengthening exercises. But always check with your doctor before starting any new exercise program.

6. Spend Some Time in the Sun

Your skin makes vitamin D in response to sun exposure, and your body needs vitamin D to absorb calcium and build healthy bones. Depending on where you live and your skin pigmentation, you may get enough by spending as little as five to 30 minutes in the sunlight a couple of times a week. If you live in a northern state, don’t spend much time outdoors, always use sunscreen or have darker skin, you may need to increase your vitamin D-containing foods or add a vitamin D supplement to get your recommended daily intake of 600 to 800 international units.

Food sources of vitamin D include fatty fish such as salmon, mackerel and tuna; egg yolks; cheese and fortified milk; as well as fortified juice and cereal products. 

7. Review Your Medications

The medications you take can negatively affect your bones.

Chief among these are corticosteroids, such as prednisone, prescribed for inflammatory forms of arthritis. They weaken bones by decreasing the amount of calcium absorbed in the intestines and increasing the amount excreted by the kidneys. One way to minimize the risk of bone damage is to take the lowest dose for the shortest time possible to decrease inflammation. If only one or a few joints are affected, injecting corticosteroids directly into the joint(s) may relieve inflammation without the bone damage of oral corticosteroids. If you need corticosteroids in high doses or long term, ask your doctor about medications to prevent or treat osteoporosis.

Another class of drug to watch out for is proton pump inhibitors, like esomeprazole (Nexium) and omeprazole (Prilosec).They often are prescribed with anti-inflammatory drugs to control gastrointestinal irritation.

8. Consider Treatment Options

If you are taking corticosteroids or have already been diagnosed with osteoporosis or osteopenia speak to your doctor about treatment.

A number of medications are approved for treating or preventing osteoporosis. They are the bisphonates alendronate (Fosamax), ibandronate (Boniva), risedronate sodium (Actonel) and zoledronic acid (Reclast); hormones including estrogen products and calcitonin (Mialcin); the bone-forming agent teriparatide (Forteo); the selective estrogen receptor modulator raloxifene hydrochloride (Evista); and the biologic agent denosumab (Prolia).

Although there are many differences in these drugs, they work basically in one of two ways to increase bone mass: by slowing the breakdown of old bone or promoting the growth of new bone.