We’ve been told that we need to drink milk to have strong bones, but for thousands of years the Chinese and Japanese have survived and thrived on a dairy-free diet.

Getting enough calcium is key (our diet should provide around 700mg) but it’s not the whole story.

Hormones, sunshine and marine minerals also play a role.

Keep reading for easy-to-follow insight on how to keep your bones strong and healthy.

What is good bone health?

Good bone health is the ideal and something we should all strive to have and maintain throughout our entire life because bone health impacts us at all ages, from when we’re young to when we’re older.¹

We store calcium in our skeleton, which we need in order for our bodies to function.

It also forms part of our bone tissue.

If we don’t get enough calcium from our diet, we don’t have enough of it stored within our skeleton, which can cause our bones to become weaker and more brittle, and prone to injuries.

Good bone health - i.e. giving our entire bone structure the minerals it needs to stay strong and healthy – can help prevent us from developing osteoporosis, which is a condition that causes our bones to become so fragile that they break more easily.

Older adults with osteoporosis are most vulnerable to breaks in their wrists, hips and spine.

These fractures can seriously reduce mobility and independence.

Summary

Good bone health relates to making sure our bones have the vitamins and minerals they need to stay strong and healthy.

The stronger our bones are when we’re younger, the more likely they are to become less frail as we age.

What is bone formation?

Bone formation is as it sounds; when our bones form.

It’s also referred to as osteogenesis and ossification, which are two terms that are used to describe the process of bone formation.

Parts of the skeleton form during the first few weeks after conception.

By the end of the eighth week after conception, the skeletal pattern is formed in cartilage and connective tissue membranes and ossification begins.²

Bone development continues throughout adulthood.

Even then, bone development continues to repair fractures and adapt in response to how we treat our bodies and our lifestyle.

Osteoblasts, osteocytes and osteoclasts are the three types of cells involved in the development, growth and remodelling of bones.

Osteoblasts are bone-forming cells, osteocytes are mature bone cells and osteoclasts break down and reabsorb bone.

Summary

Bone formation relates to bone development, which is also called osteogenesis and ossification. Osteoblasts, osteocytes and osteoclasts are the three types of cells involved in the development, growth and remodelling of bones.

What is bone density?

Bone density relates to how much bone mineral we have in our bone tissue and is based on the concept of mass of mineral per volume of bone.³

Bone density tests are used to identify if you have osteoporosis, which is a disorder that makes bones more fragile and more likely to break.

The test, which is typically carried out on the spine, hips or forearms, uses X-rays to measure how many grams of calcium and other bone minerals are present within a section of bone.

These tests are used to:

• Detect decreases in bone density before you break a bone
• Calculate your risk of getting broken bones
• Determine if you have osteoporosis or not
• Monitor osteoporosis (if you have it)

The higher your bone mineral content, the more dense your bones are.

And the denser your bones, the stronger they generally are and the less likely they are to break.

Summary

Bone density is a measure of how much bone mineral we have in our bone tissue and is based on the concept of mass of mineral per volume of bone.

You can calculate your bone density by having a bone density test on your spine, hips or forearms.

What is bone mass?

It’s another way of referring to our overall bone size and strength, which is determined by our genes.⁴

It’s not really possible to dramatically change our bone mass because it’s hereditary however, there are certain times in our life when we can influence it.

For instance, when we experience rapid growth, i.e. in adolescence and early adulthood.

This is when the ability to shape our bone mass is at its greatest and it's mainly achievable through diet and exercise.

Meanwhile, smoking, poor nutrition, minimal exercise and excessive alcohol intake can all lead to reduced bone mass.

Peak bone mass refers to our maximum bone size and strength and tends to be reached when people are between the age of 25 and 30.

From the age of 40 onwards, people’s bone mass starts to deteriorate.

However, this can be slowed down by eating a healthy, balanced diet and taking part in regular exercise.

Summary

Bone mass relates to overall bone size and strength and is determined by our genetic make-up.

From the age of 40 onwards, people’s bone mass starts to slowly deteriorate.

Can you build ‘bigger’ bones?

Quite possibly due to the fact our bones are living organs that grow and change shape throughout our life.

When we move, it impacts our bones, especially when we do certain exercises.

This impact causes our bones to squash, twist and bend, which can potentially change them.⁷

For example, our shin bones briefly become almost a millimetre shorter as our foot hits the ground when we’re running.

The bone senses these small changes and can grow dramatically – in the months after starting exercise – to reduce the risk of breaking.

This means that the racket arm bones of tennis players can be 20% wider and contain 40% more bone mineral than their other arm, while sprint runners have up to a third more bone in their shin bone than people who don’t exercise.

High impact exercise, such as landing on the floor post-jump or hitting a tennis ball, has been recognised as being more likely to produce larger muscles and make our bones change.

Whereas more cardio-based exercise, such as swimming or cycling, isn’t associated with having the same effect.

Our bones tend to get bigger and denser near the joints. Meanwhile, our bone shafts tend to get bigger and thicker with little change in bone density.

Summary

It’s possible to grow larger bones, especially through doing high-impact exercise, such as jumping or playing tennis.

Bones tend to get bigger and denser near the joints. Meanwhile, the bone shafts tend to get bigger and thicker with little change in bone density.

12 ways to maintain healthy bones

Below are 12 ways to maintain healthy bones.

1. Eat seaweed

Sea vegetables feature heavily in Asian diets and certain types of seaweed contain more calcium than cheese.

In Japan, you’ll find nori wrapped around sushi rolls, wakame floating in miso soup and kelp in seaweed salads.

If you don’t like the flavour of seaweed, try taking a sea kelp supplement instead.

2. Eat more greens

Leafy green vegetables are a great way to boost your calcium levels.

Excellent sources include spinach, kale and broccoli rabe and you can boost their absorption by combining them with a drizzle of extra-virgin olive oil or coconut oil.

3. Monitor magnesium

Increasing your magnesium intake boosts bone density and reduces the risk of osteoporosis.

It is magnesium that determines where potassium and calcium are deposited in the body, so what is the best way to up your dose?

Seaweed, raw cacao and pumpkin seeds are all rich in magnesium, but you might want to supplement if you don’t regularly consume these foods.

Having a magnesium bath, by soaking in magnesium or ‘marine’ salts, is an ideal way to absorb this mineral.

4. Get enough Vitamin D

Not only is Vitamin D vital for calcium absorption, but it also plays a fundamental role in supporting the immune system, regulating mood and protecting against chronic diseases.

Sunshine is the best source of Vitamin D, but many of us are not getting enough.

It’s difficult to get adequate levels through diet alone, so you may want to consider a supplement to support your bone health – especially if you aren't often exposed to the sun.

Vitamin D3 is the most natural form, and being a fat-soluble vitamin, it’s best absorbed when you take it with food.

Vitamin D foods include: Oily fish, shiitake mushrooms, eggs, liver and spreads and breakfast cereals fortified with Vitamin D.⁸

5. Balance with Vitamin K2

When you are taking supplements you need to make sure they are working in balance.

Vitamin K2 keeps calcium in its correct place and stops it from accumulating in the brain and soft tissue.

This fat-soluble vitamin also prevents toxicity from Vitamin D if you are taking very large doses.

Non-dairy foods rich in K2 include egg yolks, chicken liver, grass-fed beef and Natto, a fermented soy dish popular in Japan.

A recent study found that a specific form of K2 found in these foods increased the percentage of osteocalcin (a protein found in bone) three times more powerfully than Vitamin K1 did.

6. Eat more calcium-rich food

Calcium is crucial for overall good bone health.

It plays a key role in helping build bones and keeps our teeth healthy, and we should ideally have 700mg a day of it in order for it to effectively do these jobs.

Research, in which calcium food sources and calcium supplements were given to people over the age of 50, found that increasing calcium intake from dietary sources or by taking calcium supplements produces small non-progressive increases in bone mineral density.

They are unlikely to lead to a clinically significant reduction in the risk of bone fractures.⁹

Calcium-rich foods include: Milk, cheese and other dairy products, green leafy veg, soya drinks with added calcium, bread made with calcium-fortified flour, sardines and pilchards.¹⁰

7. Exercise regularly

Exercise works on bones in the same way that it works on our muscles – by making our bones stronger over time.

Physical exercise is essential for making our bones stronger when we are younger and making sure they stay as strong as possible as we get old.¹¹

Due to the fact bone is living tissue, it changes over time in response to how we treat it.

Regular exercise makes your bones adapt by creating more bones and becoming denser.

It’s also important you eat a healthy and balanced diet, which includes plenty of calcium and Vitamin D in order to make this happen.

Exercise also helps with balance and coordination, making us less likely to fall over and break our bones when we are older.

The best exercises for bone health are:

• Strength training exercises – including weight machines and free weights, which put stress on our bones and have bone-building capacity
• Non-impact exercises – such as yoga and Tai Chi, which improve flexibility and balance
• Weight-bearing exercises – such as brisk walking, jogging, tennis and dancing, which increase the weight that’s put on our bones, providing more bone-strengthening benefits in the process.

8. Stop smoking

Smoking has been linked to potentially significantly increasing bone loss.

Research carried out on pre-menopausal and post-menopausal men and women explored the effects of smoking on their overall bone health.

While it did conclude there was a connection between bone loss and smoking, the reasons behind smoking-associated bone loss and fracture risk remain poorly understood.

The effect appears dose-dependent and is thought to potentially be partially reversible. Further research is required to understand the connection between the two.¹²

9. Take a calcium supplement

If you aren’t taking on enough calcium through your diet every day, then you may want to consider boosting your calcium levels by taking a calcium supplement.

Calcium is a key contributing factor in bone health and strength, and is readily available in supplement form. 

10. Maintain your weight

Carrying extra weight or not carrying enough weight is unhealthy for bones.

In some circumstances, postmenopausal women who are underweight don’t produce enough of the hormone, oestrogen, which helps regulate bone mass and strength.

When oestrogen isn’t being produced, bones become brittle and are at an increased risk of fractures and breaks.¹³

11. Explore your genetics

As we mentioned at the start of this article, our bones are based on our genetics.

And while it’s not possible to change our genetic make-up, it is possible to forecast our potential bone health.

For example, osteoporosis might run in your family, so it may be possible for you to be screened for it sooner rather than later.

That way, you can take any precautionary measures and start giving your bones the extra TLC they need to help prevent osteoporosis, as well as any other bone-related conditions.¹⁴

12. Talk to your GP about your bone health

Having a clear picture of what your current bone health is like and if there is anything you can do now to maintain your bone health goes a long way in understanding the condition your bones are in and how you can look after them.

You may want to ask your GP if you need a bone density test or any other relevant tests. Once you’ve established your bone health, you can then take appropriate action based on what your health professional recommends.¹⁵

When to take vitamins for strong bones and joints

Unfortunately, our bones tend to naturally lose strength the older we get.

People over the age of 65, who tend to be less active, are advised to get at least 150 minutes of moderate-intensity exercise (e.g. walking, playing tennis or doing water aerobics) a week.

In doing so, it helps keep their bones and muscles as strong as possible for as long as possible.¹⁶

However, sometimes, especially if people already have osteoarthritis, and are struggling to get all the calcium, Vitamin D and protein they need for good bone health from their diet, they may want to consider taking a supplement.

In these instances, supplements that contain both calcium and Vitamin D are usually recommended.

People who are under the age of 65 may also choose to take calcium and/or Vitamin D supplement if they find they aren’t getting enough through their diet alone.

Your GP or pharmacist will be able to advise you on the best supplement to take based on your individual bone health, as well as recommend the right dosage for you.

Takeaway

We only get one set of bones that have to last us throughout our entire life.

But because we can’t actually see them, it can be easy to overlook the fact we need to look after them as much as we possibly can to give them a greater chance of looking after us as we get older.

Being tuned into the importance of bone health is the first step in the process (which you have now completed after reading this article), and fortunately, good bone health, in general, is something we can all work towards.

Eating more bone-supporting food that contains calcium and Vitamin D is one of the best things we can all do.

And if you suspect you may not be getting all of the minerals and vitamins you need to keep your bones in the best possible condition, you can always take a supplement.

Meanwhile, if you aren’t already doing so, it’s important you do regular exercise too; whether that’s strength training, non-impact or weight-bearing exercise.

The advice in this article is for information only and should not replace medical care. Please check with your GP or healthcare professional before trying any supplements, treatments or remedies. Food supplements must not be used as a substitute for a varied and balanced diet and a healthy lifestyle.

Last updated: 14 December 2021