Learn About Bone Health and Research Options

Understanding Bone Basics and Why They Matter

Bones are living tissues that constantly change throughout your life. Your body breaks down old bone and creates new bone tissue in a process called bone remodeling. When you are young, new bone is created faster than old bone is removed, which increases your bone mass. Most people reach their peak bone mass around age 30. After that, bone remodeling continues, but you lose slightly more bone mass than you gain.

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Your bones serve many critical functions beyond just providing structure. They protect your vital organs, including your heart, lungs, and brain. Bones also store minerals like calcium and phosphorus, which your body needs for many functions. When your diet does not provide enough calcium, your body takes it from your bones to maintain blood calcium levels. Additionally, bone marrow inside your bones produces red blood cells, white blood cells, and platelets that your body needs to carry oxygen, fight infection, and stop bleeding.

Bone density refers to how much mineral content is packed into your bone tissue. Higher bone density means stronger bones that are less likely to break from falls or injuries. Lower bone density means bones are more fragile and break more easily. Two main types of bone tissue make up your skeleton: compact bone on the outside, which is dense and hard, and spongy bone on the inside, which has a honeycomb-like structure with spaces filled with bone marrow.

Several factors influence your bone health throughout life. Age plays a role—bone loss happens faster as you get older. Sex matters too, since women lose bone density more rapidly after menopause due to decreased estrogen levels. Family history influences your peak bone mass and how quickly you lose bone later. Physical activity, nutrition, hormones, and certain medications also affect bone strength. Understanding these factors helps you make informed choices about your bone health.

Practical takeaway: Learn your risk factors for bone loss by considering your age, sex, family history, and lifestyle habits. This knowledge helps you understand why bone health matters to you personally and motivates informed choices moving forward.

Nutrition and Lifestyle Choices That Support Bone Health

Calcium is the primary mineral that makes up bone tissue, so getting enough calcium is essential for building and maintaining strong bones. The recommended daily intake is 1,000 mg for adults aged 19-50 and 1,200 mg for women over 50 and men over 70. Good dietary sources of calcium include dairy products like milk, yogurt, and cheese. One cup of milk provides about 300 mg of calcium. Other sources include leafy green vegetables such as broccoli and collard greens, canned fish with bones like salmon and sardines, fortified plant-based milks, and fortified orange juice. If you cannot get enough calcium from food, your doctor may suggest a calcium supplement.

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Vitamin D works with calcium to build and maintain bone. Your body produces vitamin D when your skin is exposed to sunlight, and you can also get it from food. Fatty fish like salmon, mackerel, and sardines contain natural vitamin D. Egg yolks, mushrooms exposed to sunlight, and fortified milk and cereals are other sources. The recommended intake is 600 to 800 IU daily for most adults, though some people may need more. Your doctor can check your vitamin D level with a blood test if you are concerned about deficiency.

Physical activity is one of the most powerful ways to support bone health. Weight-bearing exercises like walking, jogging, dancing, and climbing stairs force your muscles to pull on bones, which stimulates bone-building cells. Resistance training with weights or resistance bands also strengthens bones by applying stress to them. Aim for at least 150 minutes of moderate-intensity aerobic activity and two days of strength training per week. Even small amounts of physical activity are better than none, and it is never too late to start moving more.

Other lifestyle factors matter for bone health too. Limiting caffeine intake to under 400 mg daily—roughly four cups of coffee—may help preserve bone. Avoiding smoking is critical since smoking reduces bone density and slows bone formation. Limiting alcohol to moderate amounts (one drink per day for women, two for men) also helps protect bones. Getting adequate sleep supports overall health and bone remodeling. Managing stress through relaxation techniques, hobbies, or social connection may indirectly support bone health by reducing cortisol levels that can interfere with calcium absorption.

Practical takeaway: Start a food diary for three days to track your calcium and vitamin D intake, then identify specific foods you can add to reach recommended levels. Choose one weight-bearing activity you enjoy and commit to doing it most days of the week.

Bone Health Screening and Measurement Methods

A DEXA scan (dual-energy x-ray absorptiometry) is the gold standard test for measuring bone density. This test uses low-dose x-rays to measure how much mineral is in your bones. During a DEXA scan, you lie on a table while a scanner arm moves over your body, taking images usually of your spine, hip, and forearm. The scan takes about 10 to 30 minutes and is painless and non-invasive. Results are reported as a T-score, which compares your bone density to that of a healthy young adult.

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T-scores are interpreted in these ranges: a T-score of -1.0 or higher is considered normal bone density, a score between -1.0 and -2.5 indicates low bone density called osteopenia, and a score below -2.5 indicates osteoporosis. A Z-score compares your bone density to others your age and sex, which may be more meaningful if you are younger. Your doctor interprets your results in the context of your age, sex, and other risk factors to determine whether treatment or monitoring is recommended.

Screening guidelines vary by age and sex. The U.S. Preventive Services Task Force recommends bone density screening for all women aged 65 and older and postmenopausal women aged 50-64 who have risk factors. For men, screening is generally recommended starting at age 70, though men with risk factors may be screened earlier. Examples of risk factors include a family history of osteoporosis, low body weight, smoking, excessive alcohol use, and certain medications like corticosteroids. Your doctor can assess whether screening is appropriate for you based on your individual situation.

Other bone health measurements exist beyond DEXA scans. Ultrasound tests measure bone density at the heel and take less than a minute, though they are not used for diagnosis. Blood and urine tests can measure bone turnover markers that show how quickly your body is breaking down and forming bone. These markers may help predict bone loss rate and response to treatment. Vertebral fracture assessment uses low-dose x-rays to look for spine fractures you might not know you have. Your doctor determines which tests, if any, are appropriate for your situation.

Practical takeaway: Discuss with your doctor whether bone density screening is right for you based on your age, sex, and risk factors. Understanding what test results mean helps you make informed decisions about next steps in your bone health journey.

Understanding Osteoporosis and Other Bone Conditions

Osteoporosis means your bones have become so weak that they fracture from minor falls or bumps that would not normally cause injury. According to the National Osteoporosis Foundation, about one in three women over age 50 will experience a fracture related to osteoporosis in her lifetime, as will about one in five men. Osteoporosis develops silently—there are no symptoms or pain—until a fracture occurs. This is why it is sometimes called a "silent disease." Common fracture sites include the hip, spine, and wrist.

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Hip fractures are particularly serious and often require surgery. Recovery can take months and may result in permanent disability or loss of independence. Spine fractures may go unnoticed initially but can cause loss of height, stooped posture, and chronic back pain over time. These vertebral fractures can happen without falling, just from the weight of daily activities. Wrist fractures typically occur when someone falls and tries to catch themselves. While these heal better than hip fractures, they still cause pain and temporary disability.

Osteopenia is the condition of having low bone density that is not yet low enough to be called osteoporosis. People with osteopenia have increased risk of developing osteoporosis later but have not reached that threshold yet. This condition provides an opportunity to take action through lifestyle changes and sometimes medication to slow bone loss and prevent