Use a whole-person approach to strong, healthy bones as you age

There was a time when we thought osteoporosis was something that happened to everybody when they got old. Fragile bones and a humped back were just “inevitable.” We now know this isn’t true. We can hold onto strong bones with the right combination of nutrition, exercise, healthy habits, fall prevention and medication when needed: a whole-person bone-health action plan.

Broken bones in middle and old age are very common. Half of women and one quarter of men will break a bone after age 50. In fact, every 15 seconds, someone over the age of 50 in the U.S. breaks a bone due to osteoporosis. That broken wrist may be a red flag. A break caused by a fall from a standing height, no matter how “hard” the surface or how “bad” the fall, is considered low trauma and is almost always due to weak, brittle bones: osteoporosis. Normal bone doesn’t break when you fall at standing height.

Exercising, eating a healthy diet, getting the recommended amount of calcium and vitamin D, and taking an approved osteoporosis medication can help protect our bones from breaking — so we can age independently and continue doing the activities we love, like gardening, playing with grandchildren and traveling.

If you break a bone after age 50, you should talk to your health care provider and ask about a bone density test. Together you can assess your risk for more fractures and make decisions about the best ways to protect your bones in the years ahead. Whatever treatment plan you decide on, it must include fall prevention.

Help protect your bones from breaking by:

  • Exercising
  • Maintaining a healthy diet
  • Getting the recommended amount of vitamin D and calcium
  • Taking an approved osteoporosis medication

Falls are the leading cause of broken bones in older people. If you prevent falls, you prevent fractures. Lots of things contribute to falls: bad eyesight, poor balance, slippery shoes, weak legs, dizziness, slow reflexes, the list goes on. The good news is that a lot can be done to reduce your risk. Keep your eyeglass prescription up to date. Get yourself some grippy-soled, lace-up shoes that fit snugly and comfortably. Work with a physical therapist on muscle strengthening and balance training exercises. Stay as active as possible to build endurance and agility. And let your doctor know right away if you ever feel dizzy.

A strong adult skeleton starts in childhood with a healthy diet and exercise. Even if we don’t achieve our full skeletal potential or peak bone mass, we can keep our bones healthy and strong. There is no single “silver bullet” remedy. It takes a whole person approach. Get enough calcium (preferably through the diet), take vitamin D, participate in regular exercise, fall-proof your home and avoid smoking and excess alcohol. And, if you have had fractures or are diagnosed with osteoporosis, talk with your doctor about medication options. There are many choices. You and your doctor can work out a plan that keeps you on your feet and active throughout your long and healthy life.

Andrea J. Singer, M.D., FACP, CCD, is the director of Women’s Primary Care and the Bone Densitometry Department of Obstetrics and Gynecology at MedStar, Georgetown University Hospital. She is also the clinical director for the National Osteoporosis Foundation ( and a leading authority on bone loss in the aging.