Osteoporosis: Prevention throughout the Lifespan

Although fractures due to thinning bones happen less frequently before age 65, the risk of this common and often debilitating condition is heavily influenced by choices we make decades earlier in life. Each phase of life offers a unique set of challenges and opportunities to maximize bone density or minimize bone loss.

This decade-by-decade guide outlines the most effective ways to protect bones at every age.

Teens

Even as teens approach their adult height, bone density and thickness continue to increase. Maximizing bone mineral gains early in life increases peak bone mass and reduces the risk of osteoporosis in later years. Calcium enhances the rate of bone mineral gains by providing more of the material of which bones are made.

Unfortunately, many teenagers fall short of the recommended daily intake of 1,300 milligrams per day of calcium.

Previous research suggested that increased soda consumption may lead to decreased bone mass. However, more recent research suggests the negative effect on bone density is likely due to the fact that teens who drink more soda also consume less calcium from sources like milk.

Recommendation: Make the most of bone formation throughout teen years by prioritizing foods rich in calcium and vitamin D.

Twenties

Bone mass continues to increase during the 20s, but the rate begins to slow. Young adults are often living on their own for the first time and are more likely to engage in behaviors such as binge drinking and social smoking, both of which can have a lasting and harmful impact on bone health.

Extreme dieting and other disordered eating patterns also are common at this age, especially in women. Weight loss leads to bone loss, and a history of repeated weight loss, such as yo-yo dieting, has been shown to have negative consequences on bone density later in life.

Recommendation: Continue to prioritize adequate calcium and vitamin D intake and avoid behaviors such as smoking, excessive drinking and yo-yo dieting, which rob the bones of minerals.

Thirties

By the early 30s, bone density has typically reached its maximum level. Osteoporosis prevention shifts from maximizing bone gains to maintaining strong bones.

Caffeine consumption typically increases throughout adulthood and is known to increase calcium loss in urine. The effect is relatively modest. However, as long as calcium intake is adequate, the effect on bone density appears to be minimal.

Research also suggests a positive relationship between fruit and vegetable consumption and bone health later in life. Unfortunately, those in their 30s consume less produce than any other age group.

Recommendation: Focus on eating more fruits and vegetables as part of a balanced diet. Heavy caffeine consumers should take extra care to ensure adequate calcium consumption.

Forties

Bone density continues its gradual decline in both men and women throughout this decade. Weight-bearing exercise — which includes walking, jogging, tennis, hiking and strength training (but not swimming or biking) — is one of the best ways to preserve bone mass.

Although the percentage of Americans who exercise regularly has increased over the last decade, only 26% of men and 19% of women get the recommended amount of exercise. Aim for around 150 minutes of activity each week.

Typical sodium consumption for Americans is also much higher than recommended. Try to limit daily intake to 2,300 milligrams or less. In addition to increasing the risk of hypertension, high-sodium diets also increase urinary calcium loss.

Recommendation: Develop or maintain a regular exercise habit, and be mindful of sodium consumption. Increase intake of fruits, vegetables and calcium-rich foods to limit effects of sodium on blood pressure and bones.

Fifties

Although bone mass may decline gradually in both men and women after their early 30s, the rate of bone loss speeds up dramatically when women reach menopause. The recommended daily intake of calcium for adults over 50 increases from 1,000 milligrams to 1,200 milligrams per day.

Women older than 50 are more likely than men or younger women to take calcium supplements, but several studies have found the benefits of supplementation are unclear. Other research has noted an association between calcium supplementation and increased risk of cardiovascular events in men and women over the age of 50.

Recommendation: Get as much calcium as possible from foods rather than supplements. Dairy and fortified soy milk and orange juice are excellent sources. Other options include leafy greens, such as kale and collards, which provide calcium and are rich in vitamin K, which helps move calcium out of the arteries and into the bones.

Sixties

Bone density continues to decline gradually in men and resumes a more gradual decline in postmenopausal women.

Declining protein consumption among older adults may contribute to bone density loss. Although protein consumption can increase urinary calcium losses, it also increases absorption of calcium from the gut.

Recommendation: Increasing protein consumption can help preserve bone density and muscle mass. Develop an exercise routine that includes activities to improve balance and flexibility.

Seventies and Beyond

Age-related osteoporosis occurs at approximately 70 years old and beyond. Nearly 40% of women have osteoporosis by their 70s; by age 80, that increases to 70%.

Although men never completely “catch up” with women in terms of osteoporosis risk, those living into their 80s and 90s are increasingly likely to be affected.

Elderly men and women who consume more protein have a reduced rate of bone loss. Vitamin D deficiency, which accelerates bone loss, is common in older adults, too.

Recommendation: Although calorie needs decline with age, protein requirements do not. Be sure to keep protein intake up, even as total food consumption diminishes. A vitamin D supplement may be necessary to maintain adequate levels.

This article originally appeared in Food & Nutrition Magazine^®, published by the Academy of Nutrition and Dietetics.