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Bone Health

Bone health concerns vary for girls and women of different ages and backgrounds. Take action to build and maintain strong bones and reduce your risk of broken bones from osteoporosis.
Prevention

Building strong bones in your early years is important. Maintaining bone strength is important as you age. 

Your bones are your body’s support system. Bone constantly breaks down and new bone is built – like a road that gets potholes which are filled in on an ongoing basis. Your bones keep growing and are at their peak bone mass by about age 30. By the time you reach your mid-40s, you lose bone faster than new bone is built. This is when your risk begins to increase for osteoporosis.

Several risk factors for osteoporosis are in your control, such as your eating habits, physical activity, smoking or drinking alcohol, and calcium and vitamin D intake. However there are many risk factors you can do nothing about, like your genetics and family history, being female, your age, ethnicity and the need to take medications to manage other aspects of your health.

Genetics play an important role in your risk for osteoporosis: at least 70% of an individual’s risk for osteoporosis is determined by genetics. Keeping your bones strong and healthy may help to reduce your chance of getting osteoporosis later in life. Osteoporosis usually appears around the age of 60 but some types of the disease can develop as early as your 30s. 

Secondary osteoporosis is when medications or medical conditions increase the risk of developing osteoporosis or osteoporosis breaks either by causing thin bones, increasing risk of falls, or both. 

Protect your bones

Calcium builds and supports strong bones. Good sources of calcium include milk, cheese, yogurt and milk alternatives such as fortified soy beverage.


The calcium calculator at Osteoporosis Canada can help you find out how much calcium you need to protect your bones. Canada’s Food Guide is a good source for information on calcium and milk servings by age.

Talk with your health care provider about taking calcium supplements if you are having problems getting enough calcium in your diet.

Your body needs vitamin D to absorb the calcium. Only small amounts of vitamin D come from food like oily fish (salmon, sardines) or egg yolks. Our northern Canadian climate means we do not get the recommended amounts of vitamin D from the sun.
  • Women over 50 – take a daily 400 IU supplement (pill) of vitamin D and follow Canada’s Food Guide recommendations of 500 ml of milk or fortified soy beverage daily.
  • Women under 50 who do not drink 500 ml of milk or fortified soy drink daily – take a daily 400 IU vitamin D supplement.
  • Women who are at risk or living with osteoporosis - follow Osteoporosis Canada’s recommendations for vitamin D intake (800-2000 IU per day), unless under the supervision of a healthcare provider.
See Nutrition for Health Bones (PDF) for more about eating for osteoporosis. 
 

Research shows a physically active lifestyle reduces your risk of breaks by helping you maintain bone and muscle mass and improve your balance. Exercise can also reduce your risk of falls.


Examples of bone healthy exercises:
  • weight-bearing exercises that force you to work against gravity, like walking, hiking, jogging, stair-climbing, playing tennis, dancing
  • resistance training such as weight training or using exercise bands (long rubber strips)
  • balance training exercises like standing on one leg or movement-based exercises such as tai chi to improve your stability and dynamic balance
  • posture and core stability training
In addition to weight-bearing exercise, resistance, balance, and posture/core stability training, it is important to engage in activities of sufficient intensity each week to raise your heart rate. Activities, such as brisk walking contribute to cardiovascular (heart) health.

Watch the Osteoporosis Canada video series Too fit to fracture on exercise and osteoporosis.

Osteofit

Osteofit is a certified exercise program in BC for people at risk of bone breaks and falls. It was developed by clinicians and researchers at BC Women’s Hospital and is available in many communities throughout the province. Osteofit classes will introduce you to ways to safely exercise, build strength and balance, and reduce your risk of falling.

Find an Osteofit exercise program near you.
 

Drink alcohol in moderation. Drinking alcohol in large amounts reduces your bone density and increases your risk of breaking bones.  


Canada’s Low Risk Alcohol Drinking Guidelines recommend: 
  • women drink no more than 2 alcoholic drinks a day most days or 10 per week
  • men drink no more than 3 alcoholic drinks per day most days and 15 drinks a week 
Smoking tobacco weakens your bones. Stopping smoking can slow your rate of bone loss. Smoking is a real danger to your bone health; learn more about the impact of smoking on your bones from the International Osteoporosis Foundation.

For help to stop smoking, visit Quit Now.  Find a program in your area. It can be hard to stop smoking and take a number of tries but your bones are worth it.
 
Osteoporosis

Osteoporosis is a disease that decreases the quality and amount of your bone. It makes your bones weak and more likely to break.  Breaks occur most often in the wrist, spine and hip. 

Anyone can get osteoporosis, but the condition is most common in women over the age of 60. Osteoporosis has no visible signs and symptoms; many women have no idea their bones have become weak until they break a bone. 

Osteoporosis causes 1 in 3 women to break their bones some time in their life: 
  • women have a greater chance of getting osteoporosis than men because they have smaller bones and less bone tissue
  • women lose bone faster than men due to hormone changes that happen during and after menopause
Osteoporosis is a major health concern for women due to the silent nature of the disease. The pain, weakness and bone breaks from falls and injury impact a woman’s mobility, independence and quality of life.  

More women break their bones from osteoporosis than all of the women combined in one year who get breast cancer, have a heart attack or a stroke.
 
Men are also at risk for osteoporosis. Fewer men develop osteoporosis because men have denser bones and lose their bone mass slower than women. 

However, 1 in 5 men will break their bones due to osteoporosis. So men benefit as much as women from taking action to keep their bones strong throughout their life. 

Osteoporosis Canada provides more information about men and osteoporosis. 
 

Research is just beginning to be done on the bone health of trans people. No current evidence shows that trans people are at any increased risk for osteoporosis. 


If you are transgender, these factors may impact your risk for weak bones:
  • taking hormones changes the balance of estrogen and/or testosterone in your body, the two hormones that maintain healthy bones
  • removing testicles or ovaries changes your hormone levels; it is unclear how much hormone you need to keep your bones strong
  • smoking, heavy alcohol use and limited physical activity are general risk factors for osteoporosis you may face
  • you may face discrimination that makes it difficult to access medical care
For more information, please see: Trans people & osteoporosis (PDF).
 

Throughout your life

Take action at different stages of your life to help build and maintain strong, healthy bones.

These are your critical bone-building years. Between the ages of 9 and 30, you are building your bone mass. The bone mass you build now will determine your overall bone strength and density for the rest of your life.

While osteoporosis is typically a disease of older women, what you do now can help protect you from getting osteoporosis and fracturing or breaking your bones later in life. You can take the following actions to build healthy bones for life: 
  • Get enough calcium and vitamin D to help your bones grow strong. Canada’s Food Guide recommends adolescents between the ages of 9-18 have:
    • a minimum of 3 to 4 servings (1300 mg) of milk and milk alternatives.  
  • Get active. Regular exercise like biking, running, dancing or any physical activity you enjoy will build and strengthen your bones for life. The Canadian Physical Activity Guidelines recommend youth ages 12-17 years:
    • get a minimum of 60 minutes of moderate to vigorous intensity physical activity daily.
  • Get help if you have an eating disorder. Anorexia nervosa (refusing to eat or eating very little) and bulimia (throwing up food after eating) can weaken your bones and prevent you from achieving peak bone mass which may increase your risk of osteoporosis later in life.

Teen Pregnancy and Osteoporosis

Teen mothers may be high risk for bone loss during pregnancy and for osteoporosis later in life.

The baby's need to develop may compete with the young mother's need for calcium to build her own bones. This may lead the mother to not achieve optimal bone density which helps protect her from osteoporosis later in life. 

Pregnant teens should be especially careful to get enough calcium during pregnancy and breastfeeding.
Teen pregnancy and bone health. Teenage mothers may be at especially high risk for bone loss during pregnancy and for osteoporosis later in life. Unlike older women, teenage mothers are still building much of their own total bone mass. The unborn baby’s need to develop its skeleton may compete with the young mother’s need for calcium to build her own bones, compromising her ability to achieve optimal bone mass that will help protect her from osteoporosis later in life. To minimize any bone loss, pregnant teens should be especially careful to get enough calcium during pregnancy and breastfeeding.Teen pregnancy and bone health. Teenage mothers may be at especially high risk for bone loss during pregnancy and for osteoporosis later in life. Unlike older women, teenage mothers are still building much of their own total bone mass. The unborn baby’s need to develop its skeleton may compete with the young mother’s need for calcium to build her own bones, compromising her ability to achieve optimal bone mass that will help protect her from osteoporosis later in life. To minimize any bone loss, pregnant teens should be especially careful to get enough calcium during pregnancy and breastfeeding.TeeTee
Teen pregnancy and bone health. Teenage mothers may be at especially high risk for bone loss during pregnancy and for osteoporosis later in life. Unlike older women, teenage mothers are still building much of their own total bone mass. The unborn baby’s need to develop its skeleton may compete with the young mother’s need for calcium to build her own bones, compromising her ability to achieve optimal bone mass that will help protect her from osteoporosis later in life. To minimize any bone loss, pregnant teens should be especially careful to get enough calcium during pregnancy and breastfeeding.Teen pregnancy and bone health. Teenage mothers may be at especially high risk for bone loss during pregnancy and for osteoporosis later in life. Unlike older women, teenage mothers are still building much of their own total bone mass. The unborn baby’s need to develop its skeleton may compete with the young mother’s need for calcium to build her own bones, compromising her ability to achieve optimal bone mass that will help protect her from osteoporosis later in life. To minimize any bone loss, pregnant teens should be especially careful to get enough calcium during pregnancy and breast

Women start to lose bone mass in their mid-30s. It is important to take action now to maintain your bone strength and reduce your chances of developing osteoporosis later in life.

  • Eat well – follow Canada’s Food Guide on eating a healthy balanced diet. Get enough calcium and vitamin D to support your bones. Canada’s Food Guide recommends adult women have 2 servings of milk or milk alternatives:
  • Women under 50 who do not drink 500 ml of milk or fortified soy drink daily – take a daily 400 IU vitamin D supplement.
  • Women who are at risk or living with osteoporosis - follow Osteoporosis Canada’s recommendations for vitamin D intake (800-2000 IU per day), unless under the supervision of a healthcare provider. 
  • Be active - regular exercise like brisk walking, hiking, dancing or any weight-bearing activity you enjoy will build and strengthen your bones for life.
  • Follow the Canadian Physical Activity Guidelines recommendations for women between the ages of 18-64.

Pregnancy, Breastfeeding & Bone Health

Pregnancy and breastfeeding can impact your bones and that of your baby’s. If you are pregnant or breastfeeding, it is important that you get enough calcium and vitamin D in your diet.  

Canada’s Food Guide recommends pregnant and breastfeeding women get 2-3 servings of milk or milk alternatives (soy, tofu) daily in their diet.  Find out more about healthy eating, exercise and weight gain before and during pregnancy from the Society of Obstetricians & Gynecologists of Canada

While bone loss can occur during pregnancy, a woman gains her bone mass back after finishing breast feeding.  

Research shows having children does not increase a woman’s chance of developing osteoporosis later in life. Some studies suggest that additional pregnancies provide some protection from osteoporosis and broken bones.

It is rare but some women develop osteoporosis during pregnancy. Most often the bone loss is temporary and usually bones regain their mass after childbirth and breastfeeding. 

Learn more about pregnancy, breastfeeding and bone health from the National Institute of Health. 
 

As you approach menopause, your hormones change and estrogen levels drop. This causes your body to lose bone mass at a faster rate than when you were younger. Up to 2-3% of bone mass can be lost each year, putting you at a greater risk for developing osteoporosis. 


Genetics plays an important role in your risk for osteoporosis as about 70% of your bone strength is influenced by genetics. Other factors that affect your risk of developing osteoporosis are: 

  • bone mass at menopause - the higher your bone density is when you reach menopause, the lower your chance of developing osteoporosis
  • rate of bone loss after menopause - some women experience rapid bone loss during the 5 to 7 years following menopause. If you lose bone quickly, you have a greater chance of developing osteoporosis.
While you can’t prevent bone loss at this stage of life, you can take action to reduce your risk of osteoporosis.

  • Eat well – get enough calcium and vitamin D to support your bones. Canada’s Food Guide recommends women over 50 have 3 or more servings (1200 mg) of milk or milk alternatives.
  • Women under 50 who do not drink 500 ml of milk or fortified soy drink daily – take a daily 400 IU vitamin D supplement.
  • Women who are at risk or living with osteoporosis - follow Osteoporosis Canada’s recommendations for vitamin D intake (800-2000 IU per day), unless under the supervision of a healthcare provider. 
  • Be active - regular exercise like brisk walking, hiking, dancing or any weight-bearing activity you enjoy will build and strengthen your bones for life.  Follow the Canadian Physical Activity Guidelines for women between the ages of 18-64.
  • Get screened - talk to your healthcare provider about your risk for osteoporosis and whether you need a bone density screening test. Canadian osteoporosis guidelines recommend postmenopausal women, men over 50 and individuals over 50 years of age who have had a bone break get screened if they are at risk of or have osteoporosis. 
 

Women 60 years of age and older are at the greatest risk of bone breaks from osteoporosis. 


While you can’t prevent bone loss at this stage of life, you can take action to reduce your risk for osteoporosis: 

  • Get screened - have a bone density test. Canadian osteoporosis guidelines recommend you get tested if you are a postmenopausal woman over 50 or you are over 50 years of age and have had broken a bone.
  • Prevent falls - you can lower your risk for falling and breaking a bone by doing exercises to improve your balance. Make your home safe - remove area rugs, electrical cords or things on the floor or stairs that can cause you to slip. Use handrails, a cane or walker if you need balance support.
  •  Eat well – follow Canada’s Food Guide for a healthy, balanced diet. Get enough calcium and vitamin D to help your bones grow strong. Canada’s Food Guide recommends women and men over 50 years of age at low risk for osteoporosis get 3 to 4 servings of milk and alternatives daily.
  • women over 50 not at risk for osteoporosis – follow Health Canada’s recommendations to take 400 IU of vitamin D supplement (pills) and follow Canada’s Food Guide recommendations of 500 ml of milk or fortified soy beverage daily.
  • women who are at risk or living with osteoporosis - follow Osteoporosis Canada’s recommendations for vitamin D intake (800-2000 IU per day), unless under the supervision of a health care provider. 
  • be active - regular exercise reduces your risk of falls and breaks. Follow the Canadian Physical Activity Guidelines for women 65 years and older. Find exercise programs like BC Women’s Osteofit program for individuals at risk or living with osteoporosis.

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SOURCE: Bone Health ( )
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