Clinical Topic
Publication Date
February 16, 2021
Bone Health
Your bones are an important part of your body and store very important minerals. Did you know that your bones gain strength until you are 20-30 years of age and then at an older age you start losing bone strength? The amount of bone you gain during childhood can protect you from weak bones and fractures later in life. Your bone strength is like a bank account-the more money in the bank, the stronger the account becomes!
So how do you develop a good bone bank?
Bone strength is mostly determined by your genes, but you can still make a difference through healthy diet and exercise. Here are 3 important things that you could do to keep your bone bank account full:
- Calcium: Calcium is a very important mineral that strengthens bones. The recommended intake of calcium varies with age (Table 1). Dairy products and non-dairy foods (breads, cereals) fortified with calcium are good sources of calcium (Table 2). You can also get calcium through calcium supplements if you do not eat enough calcium-rich foods. Different calcium supplements have different amounts of calcium. We recommend you read the label to find out how much calcium is provided in each supplement and talk to your healthcare provider about how much is right for you. Too much calcium is not healthy either and can be harmful to the kidneys.
- Vitamin D: Vitamin D is a hormone that helps absorb calcium from the intestines and kidneys and store calcium in bones. It can be made by the body with sunlight exposure. However, in the winter season or with inadequate exposure to sunlight, your body may not be able to make enough vitamin D. In these situations, your doctor may recommend that you take supplements. Vitamin D supplements are available at various pharmacies and grocery stores without a prescription. Most multivitamins contain 400 units of vitamin D. Please read the label carefully and talk to your healthcare provider about the dose that is right for you. Some Vitamin D supplements are dosed in milliliters (mL) and some are dosed in drops. See Table 1 for the recommended daily intake of vitamin D.
- Physical Activity: Weight bearing exercises such as jump roping, basketball, soccer and gymnastics are good for your bones. So get out there and have some fun! Centers of Disease Control and prevention recommends 60 minutes of moderate to vigorous physical activity daily in an enjoyable setting for all children and young adults.
Other Factors important for bone health:
Hormones: Different hormones have a variable effect on bone. Growth hormone and puberty hormones have a positive impact, whereas steroids and excess thyroid hormones can hurt bone health. If you have any disorder of hormone production, be sure to talk to your doctor about ways to optimize bone health.
Medications: Certain medications like steroids are known to cause bone loss and decrease bone formation. If you have a disease that requires long-term steroid use, make sure you take the recommended dose of calcium and vitamin D to optimize your bone health. You may also benefit from formal testing of your bone health and certain medications that improve bone strength.
Table 1. Recommended daily calcium and vitamin D intake
| Age | Calcium (mg/day) | Vitamin D (IU/day) |
| 1-3 years | 700 | 600 |
| 4-8 years | 1,000 | 600 |
| 9-18 years | 1,300 | 600 |
| 19-50 years | 1,000 | 600 |
Ref: Institute of Medicine (IOM) recommendations Nov 2010
Table 2. Foods rich in calcium
| Food | Calcium (mg) |
| Fortified oatmeal, 1 packet | 350 |
| Sardines, canned in oil with edible bones, 3 oz | 324 |
| Cheddar cheese, 1 ½ oz | 306 |
| Milk nonfat, 1 cup | 300 |
| Milkshake, 1 cup | 300 |
| Yogurt plain, low-fat, 1cup | 300 |
| Soybeans cooked, 1 cup | 261 |
| Tofu, firm with calcium, 1/2cup | 204 |
| Orange juice fortified with calcium, 6oz | 200-260 |
| Salmon canned with edible bones, 3 oz | 181 |
| Pudding, instant made with 2% milk, 1/2 cup | 153 |
| Baked beans, 1cup | 142 |
| Cottage cheese, 1%milk fat, 1 cup | 138 |
| Spaghetti, lasagna, 1 cup | 125 |
| Frozen yogurt, vanilla, soft serve ½ cup | 103 |
| Ready to eat cereal, fortified with calcium 1cup | 100-1000 |
| Cheese pizza 1 slice | 100 |
| Fortified waffles, 2 | 100 |
| Turnip greens, boiled, ½ cup | 99 |
| Broccoli, raw, 1 cup | 90 |
| Ice cream, vanilla, ½ cup | 85 |
| Soy or rice mild fortified with calcium 1 cup | 80-500 |
Source: Surgeon General’s Report on Bone Health and Osteoporosis: What it Means to You. US Department of Health and Human Services, 2004, pages 12-13.
To learn more about bone health, you can use these excellent web resources.