Why Does Bone Health Matter?
Our bones support us and allow us to move. They protect our
brain, heart, and other organs from injury. Our bones also
store minerals such as calcium and phosphorous, which help
keep our bones strong, and release them into the body when
we need them for other uses.
There are many things we can do to keep our bones healthy
and strong. Eating foods rich in calcium and vitamin D, getting
plenty of exercise, and having good health habits help keep
our bones healthy.
But if we don’t eat right and don’t get enough
of the right kinds of exercise, our bones can become weak
and even break. Broken bones (called fractures) can be painful
and sometimes need surgery to heal. They can also cause long-lasting
But the good news is that it is never too late to take care
of your bones.
What Is Osteoporosis?
There are many kinds of bone diseases. The most common one
is osteoporosis (AH-stee-oh-por-OH-sis). With osteoporosis,
our bones become weak and are more likely to break. People
with osteoporosis most often break bones in the wrist, spine,
Our bones are alive. Every day, our body breaks down old bone
and puts new bone in its place. As we get older, our bones
break down more bone than they put back. It is normal to lose
some bone as we age. But, if we do not take steps to keep our
bones healthy, we can lose too much bone and get osteoporosis.
Many people have weak bones and don’t even know it.
That’s because bone loss often happens over a long period
of time and doesn’t hurt. For many people, a broken bone
is the first sign that they have osteoporosis.
People with osteoporosis most often break bones in the wrist,
spine, and hip.
Who Gets Osteoporosis?
There are many things that can increase your chances of
getting osteoporosis. These things are called “risk
factors.” Some risk factors are things you can control,
and some things are outside of your control.
Risk factors you can control
- Diet. Getting too little calcium can increase your chances
of getting osteoporosis. Not getting enough vitamin D can
also increase your risk for the disease. Vitamin D is important
because it helps the body use the calcium in your diet.
- Physical activity. Not exercising and not being active for
long periods of time can increase your chances of getting
osteoporosis. Like muscles, bones become stronger–and
stay stronger–with regular exercise.
- Body weight. Being too thin makes you more likely to get
- Smoking. Smoking cigarettes can keep your body from using
the calcium in your diet. Also, women who smoke go through
menopause earlier than those who don’t smoke. These
things can increase your risk for osteoporosis.
- Alcohol. People who drink a lot are more likely to get osteoporosis.
- Medicines. Certain medicines can cause bone loss. These
include a type of medicine called glucocorticoids (gloo-ko-KOR-ti-koids).
Glucocortiocoids are given to people who have arthritis,
asthma, and many other diseases. Some other medicines that
prevent seizures and that treat endometriosis (en-do-me-tree-O-sis),
a disease of the uterus, and cancer can cause bone loss,
Risk factors you cannot control
- Age. Your chances of getting osteoporosis increase as you
- Gender. You have a greater chance of getting osteoporosis
if you are a woman. Women have smaller bones than men and
lose bone faster than men do because of hormone changes that
happen after menopause.
- Ethnicity. White women and Asian women are most likely to
get osteoporosis. Hispanic women and African American women
are also at risk, but less so.
- Family history. Having a close family member who has osteoporosis
or has broken a bone may also increase your risk.
Am I Really at Risk?
Because more women get osteoporosis than men, many men
think they are not at risk for the disease. Many Hispanic
and African American women are not concerned about their
bones either. They believe that osteoporosis is only a problem
for white women. However, it is a real risk for older men
and women from all backgrounds.
Also, people from certain ethnic backgrounds may be more
likely to have other health problems that increase their
risk for bone loss. If you have one of the following health
problems, talk to your doctor about your bone health:
- Anorexia nervosa
- Cushing’s disease
- Inflammatory bowel disease
- Lactose intolerance
- Liver or kidney disease
- Lung disease
- Multiple sclerosis
- Rheumatoid arthritis
How Do I Know if I Have Osteoporosis?
Since osteoporosis does not have any symptoms until a bone
breaks, it is important to talk to your doctor about your
bone health. If your doctor feels that you are at risk for
osteoporosis, he or she may order a bone density test. A
bone density test measures how strong–or dense–your
bones are and whether you have osteoporosis. It can also
tell you what your chances are of breaking a bone. Bone
density tests are quick, safe, and painless.
What Can I Do to Make My Bones Healthier?
It is never too early or too late to take care of your
bones. The following steps can help you improve your bone
- Eat a well-balanced diet rich in calcium and vitamin D.
Good sources of calcium include low-fat dairy products,
and foods and drinks with added calcium. Good sources
of vitamin D include egg yolks, saltwater fish, liver,
and milk with vitamin D. Some people may
need to take nutritional supplements in order to get
enough calcium and vitamin D. The charts below show
how much calcium and vitamin D you need each day. Fruits
and vegetables also contribute other nutrients that are
important for bone health.
Sources of Calcium:
- Tofu (calcium fortified)
- Soy milk (calcium fortified)
- Green leafy vegetables (e.g., broccoli, brussels sprouts,
mustard greens, kale)
- Chinese cabbage or bok choy
- Sardines/salmon with edible bones
- Orange juice (calcium fortified)
- Dairy products (e.g., milk, cheese, yogurt)
Recommended Calcium and Vitamin D Intakes
||Vitamin D (IU/day)
|Infants 0 to 6 months
|Infants 6 to 12 months
|1 to 3 years old
|4 to 8 years old
|9 to 13 years old
|14 to 18 years old
|19 to 30 years old
|31 to 50 years old
|51- to 70-year-old males
|51- to 70-year-old females
|>70 years old
|14 to 18 years old, pregnant/lactating
|19 to 50 years old, pregnant/lactating
Definitions: mg = milligrams; IU = International Units
Source: Food and Nutrition Board, Institute of Medicine, National Academy of Sciences, 2010.
- Get plenty of physical activity. Like muscles, bones become
stronger with exercise. The best exercises for healthy bones
are strength-building and weight-bearing, like walking, climbing
stairs, lifting weights, and dancing. Try to get 30 minutes
of exercise each day.
- Live a healthy lifestyle. Don’t smoke, and, if you
choose to drink alcohol, don’t drink too much.
- Talk to your doctor about your bone health. Go over your
risk factors with your doctor and ask if you should get a bone
density test. If you need it, your doctor can order medicine
to help prevent bone loss and reduce your chances of breaking
- Prevent falls. Falling down can cause a bone to break, especially
in someone with osteoporosis. But most falls can be prevented.
Check your home for dangers like loose rugs and poor lighting.
Have your vision checked. Increase your balance and strength
by walking every day and taking classes like Tai Chi, yoga,
Will I Need to Take Medicine for My Bones?
There are medicines to help prevent and treat osteoporosis.
Your doctor may want you to take medicine if your bone density
test shows that your bones are weak and that you have a good
chance of breaking a bone in the future. Your doctor is more
likely to order medicine if you have other health concerns
that increase your risk for breaking a bone, such as a tendency
to fall or a low body weight.
How Can I Join a Research Study?
The National Institutes of Health (NIH) conducts research
studies all over the country in which people take part as
volunteers. These studies help uncover new risk factors and
treatments for osteoporosis and other diseases.
There are many benefits to being part of a research study,
such as getting related medical care at no charge and, in
some cases, help with travel and other costs. Also, study
volunteers are seen by a team of experts and are often among
the first to receive new treatments ahead of the general
public. Many volunteers take part in the research simply
because they want to help others with the same disease, both
today and in the future.
You can learn more about joining an osteoporosis research
study by going to the website www.ClinicalTrials.gov.
Where Else Can I Go for Help?
For more information on osteoporosis and bone health,
contact any of the following organizations:
NIH Osteoporosis and Related Bone Diseases ~ National Resource Center
Toll free: 800-624-BONE (2663)
National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)
National Institutes of Health
1 AMS Circle
Bethesda, MD 20892-3675
Toll Free: 877-22-NIAMS (877-226-4267)
National Osteoporosis Foundation (NOF)
For Your Information
This publication may contain information about medications used to treat the health condition discussed here. When this publication was produced, we included the most up-to-date (accurate) information available. Occasionally, new information on medication is released.
For updates and for any questions about any medications you are taking, please contact
U.S. Food and Drug Administration
Toll free: 888–INFO–FDA (888–463–6332)
For updates and questions about statistics, please contact:
Centers for Disease Control and Prevention's National Center for Health Statistics
Toll free: 800–232–4636
The mission of the National Institute of Arthritis and Musculoskeletal
and Skin Diseases (NIAMS), a part of the Department of Health
and Human Services’ National Institutes of Health (NIH),
is to support research into the causes, treatment, and prevention
of arthritis and musculoskeletal and skin diseases; the training
of basic and clinical scientists to carry out this research;
and the dissemination of information on research progress in
these diseases. The National Institute of Arthritis and Musculoskeletal
and Skin Diseases Information Clearinghouse is a public service
sponsored by NIAMS that provides health information and
information sources. Additional information can be found on
the NIAMS website at www.niams.nih.gov.
This booklet is not copyrighted. You can make copies of it
and give out as many as you want.
Additional copies of this booklet are available from the National Institute of Arthritis and Musculoskeletal and Skin Diseases, NIAMS/National Institutes of Health, 1 AMS Circle, Bethesda, MD 20892-3675, and on the NIAMS website at www.niams.nih.gov.
NIH Pub. No. 12-7847
NIH Osteoporosis and Related Bone Diseases ~ National Resource Center
2 AMS Circle
Bethesda, MD 20892-3676
Toll Free: 800-624-BONE (2663)
The NIH Osteoporosis and Related Bone Diseases ~ National Resource Center provides patients, health professionals, and the public with an important link to resources and information on metabolic bone diseases. The mission of NIH ORBD~NRC is to expand awareness and enhance knowledge and understanding of the prevention, early detection, and treatment of these diseases as well as strategies for coping with them.
The NIH Osteoporosis and Related Bone Diseases ~ National Resource Center is supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases with contributions from:
The National Institutes of Health (NIH) is a component of the U.S. Department of Health and Human Services (DHHS).
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