How to eat and move for healthy bones (May 2025)
By Carrie Dennett, MPH, RDN
It’s estimated that 10 million Americans have osteoporosis, and another 44 million have low bone density, according to the Bone Health and Osteoporosis Foundation (BHOF). While 1 in 2 women and up to 1 in 4 men will break a bone due to osteoporosis after age 50, the stage is set before that. Fortunately, there’s a lot we can do to help prevent bone loss. And if you already know you have low bone density, these same recommendations can be an important part of an overall treatment plan.
Eat enough. While there are specific nutrients that are key for bone health, simply eating enough matters, too. When calorie intake is too low, this can directly contribute to bone loss, in part because intake of key nutrients drops, too. Inadequate calories can also cause bone loss indirectly via loss of estrogen (in females) or testosterone (in males). The greater the calorie deficit, the greater the risk, which is why the risk of bone loss in people with anorexia as well as in athletes who aren’t eating enough to fuel their activity is well established. But behaviors like chronic dieting, skipping meals, and overexercising also pose a risk.
Eat protein. Once you’re eating enough food, the focus shifts to protein, which provides important building blocks for bone. The recommended daily allowance (RDA) of 0.36 grams of protein per pound of body weight per day is not enough, as that’s the amount needed to avoid a protein deficiency. Aiming for 0.55 to 0.68 grams of protein per pound of body weight—or even a bit higher—each day is more optimal (if you never weigh yourself, use your best estimate). That would look like 81 to 102 grams per day for someone who weighs 150 pounds, or 109-136 grams for someone who weights 200 pounds.
Include bone-building nutrients. No bone-friendly diet would be complete without a few more specific nutrients that are key for bone health. Calcium is one of them, of course. Dairy milk, yogurt, kefir and cheese—except cottage cheese—are obvious sources of calcium. They’re also rich in other nutrients that support bone health, such as protein, potassium and vitamin D, which is essential for absorbing calcium. Plant-based sources of calcium include tofu made with calcium, tempeh, calcium-fortified plant milks and other foods, and some dark leafy vegetables—collard greens, broccoli rabe, turnip greens and kale are the best of the bunch.
It’s recommended that women get 1,000 milligrams (mg) of calcium per day up to age 50 and 1,200 mg per day after that. (Men need the same amounts, but their transition age is 70.) Calcium has an upper daily limit—2,000 mg for adults ages 51 and older, 2,500 mg for younger adults—so more isn’t better, and we can’t really absorb more than 500 to 600 mg per meal. It’s ideal to get your calcium from food, and getting calcium from dairy products or fortified plant milks can make it easy to spread your intake throughout the day for maximum absorption and minimum reliance on calcium supplements to bridge the gap.
Eat plants. There are many reasons why it’s a good idea to eat enough fruits and vegetables, and bone health is one of them. A diet rich in fruits and vegetables provides antioxidants, potassium, magnesium, vitamin K and vitamin C, each of which plays a role in bone health. Another benefit of plant-forward diets is that they are anti-inflammatory, and that benefit extends to bones. Osteoclasts—cells that degrade bone—are turned on by inflammation.
Add weight-bearing exercise. When exercising for bone health, weight-bearing, muscle-strengthening and balance exercises all play a role. Weight-bearing forms of physical activity such as running, hiking, jumping rope, tennis/pickleball, dancing or high- or low-impact aerobics stimulate bones. Stimulating bones is good for bone density, while keeping muscles strong with exercises such as lifting weights or using resistance bands makes it more likely that you can stop a fall—and prevent a fracture if you lose your balance.
A robust bone health plan should also include types of movement that help maintain balance, such as tai chi, yoga, Pilates, or simply practicing standing on one foot. Certain strength training exercises, such as lunges and one-legged deadlifts, build strength and balance. Keep in mind that while physical activity is good for bone health, as mentioned, overexercising can work against bone health if it creates a calorie deficit.
References:
Bone Health and Osteoporosis Foundation. What is osteoporosis and what causes it? https://www.bonehealthandosteoporosis.org/patients/what-is-osteoporosis/
NIH Osteoporosis and Related Bone Diseases National Resource Center. https://niams.nih.gov/Health_Info/Bone/
LeBoff MS, Greenspan SL, Insogna KL, et al. The clinician’s guide to prevention and treatment of osteoporosis. Osteoporos Int. 2022 Oct;33(10):2049-2102. https://pmc.ncbi.nlm.nih.gov/articles/PMC9546973/
Steinman J, Shibli-Rahhal A. Anorexia Nervosa and Osteoporosis: Pathophysiology and Treatment. J Bone Metab. 2019 Aug;26(3):133-143. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6746661/
Popp KL, Cooke LM, Bouxsein ML, Hughes JM. Impact of Low Energy Availability on Skeletal Health in Physically Active Adults. Calcif Tissue Int. 2022 May;110(5):605-614. https://pubmed.ncbi.nlm.nih.gov/35171303/
National Institutes of Health Office of Dietary Supplements. Calcium Fact Sheet for Consumers.
https://ods.od.nih.gov/factsheets/Calcium-Consumer
