What are ‘healthy’ bones?

Healthy bones are bones that are dense and strong. 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 being renewed by your body.

Your bones grow throughout childhood and adolescence, and bone renewal (known as ‘remodeling’) occurs throughout life.

Key components of bones include calcium, collagen and bone marrow. Your bones are affected by the foods you eat and your lifestyle, so 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 and protect sensitive organs like your heart and lungs.

As you get older, you bone strength slowly decreases which 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.

What are the symptoms of poor bone health?

Signs of poor bone health include stooped posture and loss of height, and a common symptom is unexplained back pain.

Broken bones caused by a minor fall or small injury are also a sign of poor bone health.

If your bones are extremely weak, you may experience damaged or fractured bones caused by every-day movement and pressure on your bones.

What factors put bone health at risk?

There are many different factors that can put your bone health at risk. To keep your bones healthy, it’s important to have enough vitamin D and calcium in your diet, quit smoking, drink in moderation and exercise regularly.

Some medical conditions can increase your risk of poor bone health, such as HIV, diabetes or rheumatoid arthritis.

Medicines, such as glucocorticoids — which are sometimes used to treat asthma — and some cancer treatments, can also have a negative effect on your bone health.

Having a family history of osteoporosis, being a post-menopausal female, and being older are all risk factors for having weak bones.

What happens to my bones as I get older?

Your bones gradually decrease in strength and density from your 30s onwards. Your bones continuously renew themselves by breaking down and rebuilding bone tissue throughout your life.

As you get older, more bone is broken down than is rebuilt, so your bones become weaker over time. Weaker bones are more likely to break if you have even a small injury. They may also develop tiny fractures, which can be painful.

Osteopaenia (also spelled osteopenia) is a condition that is more common in older people. Osteopaenia means that your bones are less dense than normal, but not so porous as to have a diagnosis of osteoporosis.

If you have osteopaenia, you are at greater risk of developing osteoporosis. It is considered an early warning sign that you should be taking action to improve your bone health and reduce your risk of breaking a bone in future.

What can I do to improve my bone health?

You can improve your bone health by:

• eating healthy foods and keeping active with weight-bearing exercises
• reducing or stopping smoking
• drinking alcohol in moderation
• getting enough vitamin D from sunlight and calcium from food sources

Healthy diet

Eating healthy foods is one of the most important things you can do for your bones. A healthy diet is one that provides your body with all the nutrients it needs (without eating to excess), and this can change depending on your age and stage of life.

Your diet should include at least 3 servings every day of a calcium rich food such as milk, cheese, yoghurt, almonds or firm tofu. Choosing low fat cheese and milk doesn’t reduce the amount of calcium you are getting and can help you maintain a healthy weight.

Being underweight or overweight can increase your risk of broken bones. If you are not sure what a healthy weight would be for you, you can check using a BMI calculator or arrange to speak to your doctor, dietitian or nurse.

Keep active

Staying active helps to keep your bones healthy. A combination of weight bearing exercises (such as brisk walking, hiking, stair climbing, running or skipping) along with resistance training — also called strength training or weightlifting — can strengthen your muscles and bones. These exercises should be done at a moderately hard intensity to achieve the greatest benefit.

Short bursts of high intensity and/or high impact exercises such as jogging, jumping or skipping are more effective at improving bone health than longer bouts of lower impact activities like walking.

You should try to do moderate-intensity to vigorous resistance training 2 or 3 times each week, with at least one day off in between sessions.

Another option is to participate in exercise classes that improve your balance and coordination such as tai chi, which can also strengthen your bones and decrease your risk of falling.

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

Reduce or stop smoking

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

There are many programs and tools that can help you quit smoking, and support is available. Speak with your doctor or pharmacist for advice.

Avoid drinking to excess

Drinking more than 10 alcoholic drinks in a week or drinking every day has been proven to significantly increase your risk of fracturing or breaking a bone.

By not drinking alcohol to excess, you can help keep your bones strong as well as reduce your risk of falling over or getting injured due to the influence of alcohol.

Getting enough vitamin D

Getting enough vitamin D is important for keeping your bones strong and healthy. If you don’t have enough vitamin D, your body will not be able to absorb the calcium in your food and your bones will become weaker.

While vitamin D can be found in foods such as liver, fatty fish and egg yolks, for most Australians the main source of vitamin D is from exposure to sunlight.

Australia has a wide range of climates and a mixed population, and how much sun exposure you need will depends on many factors, including your skin tone and the climate you live in.

In the summer, spending 5 to 10 minutes in the sun most days will provide you with enough vitamin D if you have fair skin and your face, hands and arms are 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 or older, you may need to spend longer in the sun to get enough vitamin D.

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.

When should I see my doctor?

Speak to your doctor about your bone health if you have a family history of osteoporosis or if you are over 50 and experiencing any of the signs of poor bone health.

It is particularly important to speak to your doctor if 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 and what treatment would be best for you.

Many Australians spend a large part of the day indoors, and many are covered up when outdoors. If this sounds like you, ask your doctor if you need a bone health check. Your doctor may ask you about your symptoms and your medical history, and might ask you to take a bone mineral density test to check the strength and density of your bones.

Resources and support

• Take the healthy bones assessment on the Know Your Bones website.
• Speak to Healthy Bones Australia about bone health and osteoporosis on their toll-free helpline — 1800 2442 141
• Learn more about how exercise can improve your bone and overall health on the Jean Hailes website.
• Explore personal experiences of bone health on Healthy Bones Australia’s website.
• Find an exercise physiologist near you who can help you build a safe exercise plan to strength your bones.