Calcium, Vitamin D and Exercise for Strong Bones

Bones are living tissue that is constantly rebuilt. Peak bone mass is reached around age 30; after that we slowly lose bone, faster in women after menopause. Calcium, vitamin D, protein and the right kind of exercise slow that loss and lower the risk of osteoporosis and fractures.

How much calcium do you need?

Best food sources

• Milk, yogurt and cheese (about 250–300 mg per serving)
• Canned sardines and salmon with bones
• Calcium-set tofu, fortified plant drinks and orange juice
• Kale, bok choy, collard greens and broccoli (spinach contains calcium but absorbs it poorly)
• Almonds, white beans, figs

Supplements — only to fill the gap

Try to get calcium from food first. If you can't reach your needs, a supplement can fill the gap; take no more than about 500 mg at a time for best absorption. Very high supplement doses don't add benefit and can increase the risk of kidney stones.

Vitamin D

Vitamin D lets your gut absorb calcium. Adults need 600–800 IU a day; sources are sunlight, oily fish, egg yolks and fortified foods. Many people — especially older adults and those with little sun exposure — benefit from a supplement; a blood test can check your level.

Protein and other nutrients

Enough protein, along with magnesium, vitamin K (leafy greens) and potassium from fruit and vegetables, supports bone strength. See protein needs.

Exercise that builds bone

• Weight-bearing exercise: brisk walking, jogging, stair climbing, dancing, tennis.
• Resistance training: weights, bands or body-weight exercises 2–3 times a week.
• Balance training: tai chi or yoga reduce falls — the cause of most fractures.

Swimming and cycling are excellent for the heart but do little for bone density, so combine them with weight-bearing activity.

What weakens bones

Smoking, heavy alcohol use, low body weight, long-term steroid use and some other medications. Women over 65 (and younger people with risk factors) should ask about a bone density scan (DEXA).