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The ultimate guide to bone health

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Bone health is easy to take for granted until something changes. A minor fall leads to a fracture, you lose confidence moving around, or a scan shows your bone density is lower than expected. The good news is bones respond to what you do across life. Food and exercise can’t guarantee you won’t lose bone density, but they can help you build stronger bones early on and protect bone strength later.

This guide explains why bone health matters, what to prioritise at different life stages and the nutrition and movement habits that support strong bones over time. It is not only for people with osteoporosis, but it does cover the steps that matter most for people who are worried about osteoporosis risk.

From the mid-30s onwards, bone loss starts to outpace bone building. In women, bone loss becomes more rapid for several years after menopause due to the drop in oestrogen. In men, bone density also tends to decline with age, although the pattern is usually more gradual. That life-stage pattern is why the advice changes slightly depending on age.

What can negatively affect bone health?

In the same way that certain nutrients and activities can be considered bone builders, other things have the opposite effect, including:

Smoking and alcohol
Smoking cigarettes or vapes or drinking more than two standard alcoholic drinks a day are all classified as risk factors for osteoporosis
Some medications
Long-term use of corticosteroids, anti-seizure medications, medicines used to treat thyroid disease and depression, as well as hormone treatments for breast and prostate cancer may affect bone health
Menopause
On average, women lose up to 10 percent of their bone density in the first five years after menopause, due to a lack of oestrogen
Some health conditions
Living with a condition that impacts how well your body can absorb nutrients – for example coeliac disease or Crohn’s disease – may bump up the risk of osteoporosis. Rheumatoid arthritis and thyroid disease may also increase the risk of bone loss
A family history of osteoporosis
Poor bone health can also be inherited from your family. Consider whether your parents or your siblings have been diagnosed with osteoporosis.

Are you at risk of osteoporosis?

There’s no question your body needs an adequate calcium intake. But there are other factors that increase your risk of osteoporosis that you should be aware of.

They include:

➜ A family history of the condition
➜ Early menopause
➜ Long-term use of steroid medication or reflux medication
➜ Medical conditions that affect nutrient absorption — such as undiagnosed or poorly-managed coeliac disease, Crohn’s disease or ulcerative colitis
➜ Being 65 years or older for women, or 75 years or older for men
➜ Low vitamin D levels. Vitamin D helps with calcium absorption
➜ Smoking
➜ Excessive alcohol intake — more than 10–14 standard drinks a week
➜ A very high caffeine intake
➜ An excessive salt intake.

Prevention is always the best cure, but there are still ways to help maintain bone density and avoid accelerated bone loss. If you’re unsure of your risk, it’s best to speak to your GP to get the rundown on how you’re tracking.

Top nutrients for strong bones

We’ve all heard about the importance of calcium for bones, however supportive eating for bone health is less about one nutrient and more about having a varied, consistent healthy intake. That said, a few nutrients matter most when it comes to bone health.

Calcium
Calcium is essential for strong bones and one of the most important nutrients for bone density. If dietary calcium is consistently low, your body can draw calcium from bone to support other essential functions

Vitamin D
Vitamin D helps the body maintain calcium and phosphate balance and supports bone and muscle function. Vitamin D deficiency can lead to weak, softened bones in both children and adults. Most vitamin D comes from sunlight exposure, but food also provides small amounts

Protein
Protein supports muscle and overall strength, which matters for bone health because stronger muscles help protect against falls. Addtionally, muscle strengthening exercises signal to bones to become denser. A bone supportive eating pattern includes a mix of protein sources such as dairy, legumes, fish, eggs, nuts and seeds

Other supporting nutrients

Dietitians often highlight the importance of magnesium, which you can find in nuts, seeds, legumes and wholegrain cereals; Zinc which is found in meat, eggs, legumes, nuts and seeds; and vitamin K from leafy greens and some fermented foods. It’s not necessary to track these nutrients closely unless you have a deficiency. If your diet includes a range of whole foods, especially plant foods plus enough protein, you should have these covered by a varied healthy diet.

How much calcium and vitamin D do you need?

Calcium needs change across life stages, so knowing your starting point is helpful to build it into your usual eating pattern.

It’s recommended women consume 1000mg per day until 50 and 1300mg after 50. Men are recommended to consume 1000mg per day until 70 and 1300mg after 70.

Vitamin D is different. Most people get it from sunlight rather than food and deficiency is more likely in some situations. If you rarely get sun exposure, cover up most of the time, have darker skin, work indoors, are older, or have a medical reason for low vitamin D, you could be deficient. If you’re , it’s best to see your GP to find out if you are deficient and in need of supplementation.

Try our calcium calculator to see how much calcium is recommended for you.

How to boost your calcium intake

Dairy foods, such as milk, yoghurt and cheese, are convenient, bioavailable sources of calcium. Additionally fortified plant alternatives to milk, tinned fish with bones and calcium-set tofu are also good options.

Easy ways to add calcium

• yoghurt with fruit and nuts
• milk in coffee or tea, or as a drink with meals
• cheese in small amounts added to salads, soups or vegetables
• calcium-fortified plant milk if you avoid dairy
• tinned salmon or sardines with bones
• tofu made with calcium (check the label)

If you avoid dairy, it can still be done, but it’s vitalto choose calcium-fortified products and check that your total intake adds up across the day.

To help you achieve your daily recommended calcium, download our calcium in common foods chart here.

What a day’s calcium on a plate looks like

With a recommended daily intake (RDI) of 1000mg calcium per day for most adults — what does this actually look like?

Example 1

170g tub yoghurt (400mg) + 95g tin of red salmon (215mg) + 3 dried figs (114mg) + 2 tablespoons tahini (132mg) + 10 Brazil nuts (50mg) + 1 cup chickpeas (90mg) = 1001mg

Example 2

150g firm tofu (480mg) + 1 cup cooked bok choy (125mg) + 2 tablespoons almond butter (132mg) + 30g reduced-fat cheddar cheese (250mg) + 1 orange (50mg) = 1037mg

High-calcium recipes to try:

Exercises for strong bones

Bone cells respond to physical stress by forming bone, so activities that put weight through your skeleton and challenge your muscles are the most helpful for bone strength. Three areas crucial to building an exercise plan that supports strong bones are:

Weight-bearing exercises
Exercise like jogging, stair climbing, dancing, jumping and certain sports put stress on our bones which thicken in response, creating stronger bones. Walking is good exercise, especially for hips and legs, but it is often not enough on its own to strengthen bones.

Strength training
Strength exercises like weight training are fantastic to help build bone density and help maintain bone density and slow bone loss in older adults. Incorporating the following exercises is easy with home equipment, such as resistance bands or dumbbells, to build good all-round strength:

1. Squats
2. Lunges
3. Deadlifts
4. Chest presses
5. Overhead presses
6. Push-ups
7. Bent-over rows
8. Lat pulldowns
9. Planks.

Balance and coordination
Falls are a major cause of fractures in older adults, so balance work matters too. Yoga, Pilates and tai chi can help with balance and coordination and are good additions to your plan.

Try this simple weekly plan:

Monday Strength training & balance work

Tuesday Weight-bearing exercises

Wednesday Strength training & balance work

Thursday Exercise with impact

Friday Strength training & balance work

Saturday Exercise with impact

Sunday Rest day/gentle movement

What to focus on for each age group

Childhood and adolescence
Most people build the majority of their bone mass by around age 20, with around 50 per cent of bone mass laid down by adolescence. That makes childhood and adolescence a critical window for bone building.

What to prioritise:

• calcium-rich foods as everyday options
• regular weight-bearing play and sport, including running and jumping• enough protein for growth
• vitamin D support through safe sun exposure and advice if deficiency is a concern.

Your 20s and 30s
Bone density generally peaks by around 30. This stage is about building strong habits while life is busy.

What to prioritise:
• keep calcium intake steady, especially if dairy drops out of your routine
• include resistance training regularly
• avoid smoking and vaping and keep alcohol to a minimum.

Midlife: 40s and 50s
From around 35 to 40, bone density starts to decline. In midlife, the aim is slowing loss and protecting strength.

What to prioritise:
• keep calcium, vitamin D and protein consistent
• keep strength training in your week
• if activity has slipped, rebuild gradually and make it routine.

Menopause and post-menopause
For women, menopause is a key turning point. There is a five to 10 year phase of more rapid bone loss after menopause, due to the drop in oestrogen.

What to prioritise:
• meet calcium needs consistently (needs increase after 50)
• prioritise resistance training and weight-bearing activity
• include balance work
• discuss your risk factors with your GP if you have a family history, early menopause or a prior low-trauma fracture.

Older age
You cannot fully prevent age-related bone loss, but you can reduce risk and protect function. In older age, nutrition and exercise work together, including strength, balance and falls prevention.

What to prioritise:
• keep protein and calcium intake steady, even if appetite is lower
• keep strength and balance training going at a safe level. It’s never too late to start
• consider vitamin D status if you get little sun exposure or have other risk factors.

Men and bone health
Bone loss is not only a women’s issue, osteoporosis can affect men too. The same foundations apply: adequate calcium, vitamin D, protein and regular strength and weight-bearing activity.

FAQs

Is dairy the only way to get calcium?
No. Dairy is convenient and well absorbed, but fortified plant alternatives, calcium-set tofu, tinned fish with bones and some plant foods can all contribute. The key is total intake across the day.

If I avoid dairy, what should I look for on labels?
Choose calcium-fortified plant milks and yoghurt alternatives and check the nutrition panel for calcium. Calcium-set tofu can also help, but it is worth checking the ingredient list for added calcium.

Do I need a calcium supplement?
Not automatically. Food is usually the first option. If you consistently cannot meet your needs through food, or you have higher needs, speak with your GP or dietitian before starting supplements.

Is walking enough for bone health?
Walking helps, but it is often not enough on its own. Bones respond best to a mix of weight-bearing activity and resistance training. Balance work becomes more important with age too.

I do lots of cycling or swimming. Is that enough?
Cycling and swimming are great for fitness, but they are not weight-bearing, so they do not challenge bones in the same way. If these are your main activities, adding some weight-bearing movement and resistance work will give your bones more support.

Does coffee weaken bones?
Coffee is often blamed for bone loss, but the bigger picture matters most. If calcium intake is low overall, anything that nudges calcium balance in the wrong direction matters more. A practical approach is to keep caffeine moderate and make sure you are meeting your calcium needs regularly. If you are concerned, discuss it with your GP, especially if you have other risk factors.

Is it too late to start working on bone health after 50?
No. You cannot fully reverse age-related bone loss, but you can still slow loss and improve strength, balance and function. Starting now is worthwhile, especially with resistance training and meeting your calcium and vitamin D needs.

If I have osteoporosis, should I avoid exercise?
In most cases, movement is part of the solution, but the type and intensity matter. It is worth getting personalised advice if you have osteoporosis, have had a fracture, or feel unsure about safe exercise choices.

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