Physical changes and the occurrence of certain medical conditions can emerge as more birthdays go by. Some of these may be based on genetic predispositions and the natural aging process, but in most cases, lifestyle habits can still have a great impact on the risks. Although we cannot change our family medical history, we can take some action steps towards reducing possible negative outcomes. This tends to be true in the case of bone fractures and falls.

Maximizing bone strength is based on a lifetime of habits, not just something we should be doing as we get older. During our teens and early twenties, we reach peak bone mass the strongest our bones will be throughout our lifetime. After that, our job is to maintain this bone strength for as long as possible.

Bones are a lot more complex than most people think. Bone tissue is undergoing constant remodeling. This means the removal of old bone cells and replacement with new bone cells. Bones need the ingredients required to support the structure of bone and also those needed for the creation/repair of bone tissue.

When it comes to dietary intake, some nutrients are used as part of the structure of bone. Examples would be protein, calcium, potassium, phosphorus, magnesium, and many other minerals. Other nutrients are involved in the creation of bone. Vitamin C is one example. Some nutrients facilitate the uptake and transport of nutrients to bone, such as vitamin D.

Studies suggest prioritizing food sources of these nutrients when possible due to the wide range of nutrients food contains as compared to supplements. In some instances, however, one or more supplements in appropriate amounts may be warranted.

The amount of dietary calcium required for bone increases somewhat with increasing age. Postmenopausal women should try for 1200-1500mg/day, while men over age 70 should try for 1200mg/day. Persons who have been tested as deficient in vitamin D should consider a supplement that brings them up to and maintains the recommended blood levels.

Various amounts of calcium can be found in dairy products, dark leafy vegetables, beans/lentils, tofu, almonds/almond butter, and fortified foods/beverages. Vitamin D is in oily fish like salmon, eggs, and fortified foods/beverages. Fruits, vegetables, whole grains, nuts, seeds, and beans are good sources of bone-friendly minerals. Vitamin C is higher in citrus fruits/juices, berries, dark leafy greens, peppers, members of the cabbage family, with some available in other fruits and vegetables as well.

Bone also likes the gentle stimulus of movement and strength challenges. This means consistent exercise such as weight-bearing activities and strength exercises. Walking is an easy, low impact activity. Strength exercises are especially helpful for low or moderate-weight individuals. Hand and ankle weights can be a convenient way to do some strength exercises at home. Exercise bands, machines, and body weight exercises are other options. Persons with established osteoporosis should consult a physical therapist for safe exercise guidance.

When considering the reasons to maintain strong bones, the major goal is to reduce the risk of fracture. Fractures, especially in older adults, can lead to disability and lower quality of life. In addition, fractures in older individuals often take longer to heal than those in children and younger adults.

Falling is a frequent cause of fracture. Studies have shown that keeping up with exercise is the best way to reduce fall risk. Exercise should include those for strength and balance. Strength exercises not only help to sustain bone strength, but also improve muscle function. Adequate vitamin D has been studied for its possible benefit to muscle.

Tai Chi has been shown to significantly improve balance and can reduce falls. Some retirement facilities and nursing homes offer classes in Tai Chi for this reason.

Falling can also be caused by vision problems. Having regular eye exams is a good idea. Glasses should be worn for the purposes intended. This means taking off your magnifiers while walking around the house doing errands since otherwise, the resulting blurry vision may increase fall risk.

Inspecting the house for possible slips and trips is a good idea. Remove small areas rugs that can relocate under your feet. Wear non-slip foot ware (socks are an accident waiting to happen). Keep electric cords away from traffic areas. Wipe up spills/excess water on floors of the kitchen and bath. Add non-skid decals to the floor of the bathtub or shower. Add handrails in the home as needed.

Lack of sleep can reduce physical coordination and focus. Address any sleep issues as possible. Some medications can cause dizziness, fatigue, and other side effects that can increase fall risk. Discuss all these issues with your health care provider if you think they are a problem.

Bone health begins in the younger years and should be a priority as we age. As noted, numerous factors can contribute to the risk of falling, so attention to these is extremely important to reduce the risk of fractures and to sustain a high quality of life for many birthdays to come.

Pam Stuppy, MS, RD, CSSD, LD is a registered, licensed dietitian with nutrition counseling offices in York, ME and Portsmouth, NH. She is also the nutritionist for Phillips Exeter Academy, presents workshops nationally, and is Board Certified as a Specialist in Sports Dietetics. (See for more nutrition information, some healthy cooking tips, and recipe ideas).