The toe bone’s connected to the foot bone… That childhood ditty left out more than a few crucial parts: Adults are held up by a skeleton composed of 206 bones that protect the body’s vital organs. Though it’s a sturdy frame, it’s vulnerable to problems—think issues like osteoporosis and stress fractures, says Chad Deal, MD, director of the Center for Osteoporosis and Metabolic Health at the Cleveland Clinic. But if you bolster your bones now, it will pay off for years to come, keeping you on your feet and feeling great whether you’re running errands or marathons.
Bone-builder No. 1: The right diet
GET LOTS OF…
Milk: The recommended daily value of calcium is 1,000 milligrams (1,200 if you’re over 50); a cup of nonfat or 1 percent milk has 311. Yes, foods like greens and fish provide calcium, but stick to the white stuff to really boost bone: “There have been so many studies linking dairy to bone health,” Dr. Deal says.
Dark leafy greens: They contain not just calcium (a cup of cooked kale has 94mg) but also hefty doses of vitamin K, which may help increase bone-mineral density. Get 90 to 120 micrograms of K daily (that cup of cooked kale has over 1,000).
Sardines: Their little crunchy bones are why a 3.75-ounce can holds about 351mg of calcium. They also pack 250 IU of bone-aiding vitamin D—try to get 600 IU daily.
RELATED: 11 Foods for Healthy Bones
STEER CLEAR OF TOO MUCH…
Salt: Ingesting excess sodium can make the body lose calcium—and bone. Aim for 2,300mg or less a day.
Booze: While research has found that women who drink one to two servings of alcohol a day have higher bone density than teetotalers, downing more than two servings a day may actually speed up bone loss.
Caffeine: Drinking more than three cups of coffee every day may interfere with calcium absorption, and some studies suggest that having cola at all is associated with bone loss, though the reasons why aren’t yet clear.
Bone-builder No. 2: Calcium is key
Do you need a calcium pill? It depends. “If you’re eating three or more servings of dairy a day, you’re likely getting close to the recommended 1,000mg from your diet, which is really the preferred way, since calcium is most easily absorbed by your body through food,” Dr. Singer says. But if you’re not, which is probably true if you’re lactose intolerant, vegan or over 50, consider taking a supplement. Since the mineral is best absorbed in doses of 600mg or less, divide your 1,000 to 1,200mg into two pills; take one in the morning and the other at night.
RELATED: 10 Healthy Calcium-Packed Recipes
Look for supps that contain vitamin D, too. While studies conflict when it comes to the benefits of taking D alone, experts agree that when paired with calcium, it’s a no-brainer for bone health: “You need D to help pull in calcium,” Dr. Deal says. A combination pill with up to 600mg of calcium and 400 IU of D, taken twice daily, should help most women. Talk to your doc if you’re unsure about your dosage.
Bone-builder No. 3: Moving it
“Putting stress on bones”—like by pounding the treadmill or hoisting kettlebells—”forces them to make new cells, building their density,” explains Cedric Bryant, PhD, chief science officer of the American Council on Exercise. Here’s what to do, and how often.
Weight-bearing exercise: The more body weight you put against your bones, the better, which is why relatively high-impact activities (like jogging and jumping rope) are ideal. Do half an hour most days, if possible—you can split it up into shorter bursts. If you’re out of shape or getting over an injury, a lower-impact workout, such as walking, is fine. While no-impact activities like swimming and biking are great for your heart and muscle, they provide only modest benefits to your skeleton.
Resistance training: Two or three days a week, either lift dumbbells or work with your own body weight (think squats and lunges).
Balance exercises (Yoga, Pilates, Tai Chi): Squeeze these in whenever you can: They improve your stability, so you’re less likely to fall and break a bone.
Bone-building workouts ranked from most effective to least effective:
Aerobic dancing (like Zumba)
Bone-builder No. 4: Estrogen power
In your 20s and 30s The estrogen coursing through your veins helps moderate bone growth. “When women are getting regular periods, their estrogen levels are normal, and their bodies are constantly remodeling bone, meaning there’s no net loss,” says Bismruta Misra, MD, director of Fairfield County Diabetes and Endocrinology at Stamford Hospital in Connecticut. That is, except for when you’re pregnant or nursing: Since any nutrients you consume nourish your wee one first, you must eat well to minimize the expected bone loss and regain bone density.
In your 40s and 50s Within five or so years of menopause, when estrogen levels start to drop, women can lose up to 20 percent of their bone density. MDs used to recommend starting the pill or hormone therapy as protection, but research doesn’t support doing this. Instead, keep exercising and getting 1,200mg of calcium—from food as much as possible to avoid problems like kidney stones.
RELATED: 17 Ways to Fight Osteoporosis
Could you have osteopenia?
This condition—which affects about half of all adults over age 50 but can be detected as early as age 30—is simply low bone-mineral density that’s not quite low enough to qualify as osteoporosis. Though osteopenia can raise your risk of fractures, it’s often symptomless, so the only way to know if you have it is to get a DXA scan (usually covered by insurance) to measure the actual density of your bone. A so-called T-score between -1.1 and -2.5 means you have osteopenia.
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Most mild cases can be treated with lifestyle modifications such as better diet and exercise; more severe cases may require meds. The National Osteoporosis Foundation (NOF) recommends that all women have a baseline scan at age 65. It also suggests one for postmenopausal women under 65 who have at least one risk factor. (“Most do,” Dr. Deal says.) If you’ve got any of those listed at right, talk to your doc about getting screened soon after menopause.
10 risk factors for osteopenia
• You’re underweight (your BMI is under 18.5).
• You get less than 1,000mg of calcium daily.
• You smoke or are a former smoker.
• You’re a couch potato.
• You have a history of eating disorders.
• You’ve got a family history of osteoporosis.
• You have more than two alcoholic drinks a day.
• You went through menopause before 40.
• You’ve got an autoimmune disorder (like RA or lupus), celiac disease, inflammatory bowel disease, diabetes or hyperthyroidism.
• You take steroid medications.
That’s the number of bones humans have in one foot; each of our hands contains 27. together they account for more than half the bones in our skeleton.
How we build bone
They may appear rock-hard, but bones are living tissue made mostly of collagen, a protein that keeps them flexible, and calcium phosphate, a mineral that gives them strength (which is why consuming calcium is so crucial). They constantly break down and rebuild themselves in a process called remodeling. “First, cells known as osteoclasts remove old, weakened bone,” explains Andrea Singer, MD, clinical director of the NOF. “Then osteoblast cells lay down new tissue.” During adolescence, new bone is added more quickly than the old stuff is removed. By age 25 or so, you reach peak mass; after menopause, old bone gets removed faster than new bone is built, which can lead to osteoporosis.
Shin splints: What a pain
Prone to shin splints (pain in your shinbone)? Your best recovery strategy is rest and icing your tibia (shin) for a few days, then switching to a no-impact activity (say, stationary biking) for a week. If the pain persists or returns, see your doc. He may recommend physical therapy, after ruling out a more serious problem like a fracture. Prevent splints by changing your sneakers every six months and doing toe raises regularly.
Fractures are any kind of break in a bone; stress fractures, specifically, are cracks most often caused by overdoing an activity. “Just touching one can send you through the roof, screaming in pain,” says Steve Hawkins, PhD, professor of exercise science at California Lutheran University. If you think you have a stress fracture, see your doctor. While it may not show up on an X-ray for 10 to 14 days, an MRI can spot one earlier. Treatment is physical therapy and possibly a brace or cast to keep weight off the area while it heals, which usually takes six to eight weeks.
First aid for breaks
If you suspect that you or someone you’re with has broken a bone, follow these four steps if you can, then head to the ER.
1. Stop any bleeding. Make a tourniquet with a sterile bandage or clean cloth and tie it above the fracture.
2. Immobilize the injured area. Don’t try to realign the bone or push one that’s sticking out back in. If possible, protect it by creating a makeshift splint: Place rolled-up newspaper or strips of wood along the limb, then tie them on with a belt or fabric.
3. Wrap ice in a towel and apply to the area to reduce pain and inflammation.
4. If you feel faint, lie down with your head slightly lower than your torso.
The blues and your bones
Women who suffer from major depression tend to have lower bone density than women who don’t, possibly because depressed women secrete higher levels of hormones, such as cortisol, that break down bone. Thankfully, many first-line treatments for anxiety and depression—exercising, maintaining a healthy diet—also work to boost bone.