What are 'healthy' bones?

Healthy bones are bones that are dense, strong, and able to heal effectively.

Your bones are a living part of your body, and despite their strength, they are flexible. They can heal themselves when broken, and are constantly renewed by your body.

Your bones grow throughout childhood and adolescence. Bone renewal (known as 'remodelling') occurs throughout life.

Bones are made from:

• calcium
• collagen
• bone marrow

Your bones are affected by your diet and lifestyle. Looking after your general health will help to keep your bones healthy.

Why is bone health important?

Bone health is important as your bones support your body, help you to move around. They also protect sensitive organs like your heart and lungs.

As you get older, your bone strength slowly decreases. This can sometimes lead to osteoporosis. Osteoporosis is a chronic (long-term) disease in which your bones become hollow and fragile, so that even a minor injury or fall can result in a broken bone. This can lead to a lower quality of life.

What are the symptoms of poor bone health?

There are many symptoms of poor bone health, including:

• stooped posture
• loss of height
• unexplained back pain
• broken bones caused by a minor fall or injury

In extreme cases, damaged or fractured bones caused by everyday movement and pressure on your bones.

What factors put bone health at risk?

There are many things that can decrease your bone density and put your bone health at risk.

Medical conditions

Some medical conditions can increase your risk of poor bone health, such as:

• HIV
• diabetes
• rheumatoid arthritis

Medicines

Medicines, such as glucocorticoids and some cancer treatments, can negatively affect your bone health.

Other risk factors

Other risk factors for poor bone health are:

• having a family history of osteoporosis
• being a post-menopausal female
• being older

What happens to my bones as I get older?

Your bones continuously renew themselves. Your body breaks down and rebuilds bone tissue throughout your life. However, from your 30s onward, more bone is broken down than rebuilt. This leads to your bones becoming weaker over time.

Weaker bones are more likely to break even from a small injury. They may also develop tiny fractures, which can be painful.

Osteopaenia (osteopenia) is more common in older people. It means that your bones are less dense than normal, but not so fragile as to be diagnosed with osteoporosis.

If you have osteopaenia, you are at greater risk of developing osteoporosis. It's an early warning sign that you should take action to improve your bone health. This can lower your chance of breaking a bone in future.

Osteoporosis is a chronic (long-term) disease of your bones. They become porous and fragile, so that even a minor injury can damage the bone.

What can I do to improve my bone health?

You can improve your bone health by:

• having enough calcium, vitamin D and protein in your diet
• keeping active
• reducing or stopping smoking or vaping
• drinking alcohol in moderation
• doing regular weight bearing exercise

Calcium

Eating healthy foods is one of the most important things you can do for your bones. A healthy diet provides your body with all the nutrients it needs. The needs of your body change depending on your stage of life.

Your diet should include at least 3 servings every day of a calcium rich food such as:

• milk
• cheese
• yoghurt
• almonds
• firm tofu

Choosing low fat cheese and milk doesn't reduce the amount of calcium you get. It can help you keep a healthy weight.

Being underweight or overweight can increase your risk of broken bones. If you are not sure what is a healthy weight, you can:

• check using a BMI calculator
• speak to your doctor, dietitian or nurse

Getting enough Vitamin D

Vitamin D allows your body to absorb the calcium in your food. This keeps your bones from becoming weaker.

Getting enough vitamin D is important to keep your bones strong and healthy.

For many Australians the main source of vitamin D is from sunlight. How much sun you need will depend on many factors, including:

• your skin tone
• the climate you live in

If you have fair skin, spending 5 to 10 minutes in the summer sun will give you enough vitamin D. You will need to have your face, hands and arms exposed. Aim to be outside before 10am or after 3pm.

In the winter, try to spend up to half an hour in the sun in the middle of the day. If your skin is darker, or you are 70 years or older, you may need to spend longer in the sun to get enough vitamin D.

Vitamin D is found in foods such as:

• liver
• fatty fish
• egg yolks

If you don't spend much time outside, or are of an older age, vitamin D supplements can help you top up your vitamin D levels.

Getting enough protein

Protein is vital for bone and muscle health. Eating enough animal and plant proteins helps reduce your chance of fractures.

Exercise

Staying active helps keep your bones healthy. A combination of different exercises is important.

Weight bearing exercise uses your skeleton to support the weight of your body. This is an effective way to keep or increase bone density. Weight bearing exercise can include:

• brisk walking
• hiking
• stair climbing
• running
• skipping

Resistance training (strength training) places strain on your muscles and encourages strong bones.

Exercise classes that improve your balance and coordination can also strengthen your bones and lower your chance of falling.

You should try to do moderate to vigorous resistance training 2 or 3 times a week. Have at least one day off in between sessions. It's important to continue to progress your exercise.

Talk to your doctor before starting any new exercise activity to make sure it is right for you.

Reduce or stop smoking or vaping

Smoking, or having a history of smoking, increases your risk of broken bones. If you currently smoke, the best thing you can do is to stop smoking as soon as you can.

There are many programs that can help you quit smoking or vaping. Support is available. Speak with your doctor or pharmacist for advice.

Avoid drinking to excess

Drinking more than 10 alcoholic drinks a week or drinking every day increases your chance of fracturing or breaking a bone.

By drinking safely you can help keep your bones strong. You will also lower your chance of getting injured due to the effects of alcohol.

When should I see my doctor?

Speak to your doctor about your bone health if

• you have a family history of osteoporosis
• you are over 50 years of age and have signs of poor bone health
• you spend most of the day indoors and are mainly covered up when outdoors
• you have broken a bone from a minor injury or slight fall

Your doctor may complete an 'osteoporosis risk assessment' to help decide if you need treatment.

Your doctor will ask you about your symptoms and your medical history. They might ask you to take a bone density scan to check the strength and density of your bones.

Resources and support

Take the healthy bones assessment on the Know Your Bones website.

Find out more about Healthy Bones Australia or call 1800 2442 141.

Find an exercise physiologist near you who can help you build a safe exercise plan to strength your bones.

You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with you 24 hours a day, 7 days a week.