The risk of osteoporosis for both sexes depends on the amount of bone mass attained between ages 25 and 35, and how rapidly the bone is lost later. Higher levels of bone mass earlier in life help accumulate a store of bone that takes longer to deteriorate during aging. Some experts have suggested that young people can increase their bone mass by as much as 20 percent, which builds a store of skeletal mass crucial to preventing osteoporosis.

About 34 million Americans have low bone mass, according to the National Osteoporosis Foundation (NOF). This condition is known as osteopenia. People can take several steps to increase their bone mass. Valuable tools in fighting osteoporosis throughout a person’s lifetime include:

• Regular exercise. Regular physical activity (about 30 minutes a day) can help build strong bones and slow bone loss, and the benefits can start at any age. Strength training exercises and weight-bearing activities can help build bone mass. Balance-improving exercise, such as tai chi, can help reduce the risk of falls. Older adults without a history of regular exercise can still increase bone density through exercise. Examples of weight–bearing activities include:
  
  
• Walking, hiking, running or jogging
• Aerobics, calisthenics or skipping
• Stair climbing
• Weight lifting
• Skiing or skating
• Tennis, racquetball, squash or handball
• Field hockey, soccer or other field sports
• Basketball
• Dancing
  
  
• Adequate amounts of dietary calcium. Calcium is particularly important while the skeleton is growing (in childhood and adolescence) and during pregnancy and breastfeeding. As people age, the body becomes less efficient at absorbing calcium. Chronic health problems and other medications can also interfere with absorption. Good sources of calcium include foods such as:
  
  
• Milk, low-fat yogurt and cheese
• Green vegetables such as spinach and broccoli
• Canned salmon
• Calcium-fortified orange juice
• Tofu fortified with calcium
• Soy beverages
• Nuts such as almonds
  
  
Generally, it is recommended that people consume 1,000 milligrams (mg) of calcium a day until age 50. After menopause, women should consume 1,000 mg daily if they are taking hormone replacement therapy (HRT) and 1,500 mg daily if they are not taking HRT. Men over age 50 should consume 1,200 mg of calcium daily.

The U.S. Centers for Disease Control and Prevention (CDC) recommends the following calcium levels by age:



Age	Calcium (milligrams per day)
Birth to 6 months	210
6 to 12 months	270
1 to 3 years	500
4 to 8	800
9 to 18	1,300
19 to 50	1,000
51 or older	1,200
Pregnant or lactating	1,000

For people who cannot eat dairy products, calcium supplements can help meet daily requirements. If side effects such as constipation occur, calcium citrate or phosphate formulas may be better tolerated than calcium carbonate.



• Adequate amounts of vitamin D, which is essential for absorbing calcium. Milk is the primary source of vitamin D in the diet, and one cup contains 100 International Units (IU) of vitamin D. People ages 51 to 70 are urged to get 400 IU of vitamin D each day, while those over 70 should get 600 IU each day. Vitamin D is also found in eggs, fatty fish and cereal. The skin also produces vitamin D from sunlight, and small amounts of daily sun exposure can help meet vitamin D requirements. An additional benefit of fatty fish is omega-3 fatty acids, which recent research suggests may also promote bone mineral density.
  
  
• Not smoking. Smoking increases bone loss, because it reduces the body’s ability to absorb calcium. It also decreases a woman’s production of estrogen.
  
  
• Limiting alcohol. Having more than two drinks a day may decrease bone formation and reduce the body’s ability to absorb calcium.
  
  
• Considering hormone therapy. Testosterone replacement therapy may reduce men’s risk of osteoporosis, decrease fatigue and improve mood. Yet it may increase the risk of prostate cancer. Short-term HRT can have several benefits for women undergoing menopause, but the serious health risks of longtime HRT have prompted many experts to warn women against taking HRT simply as a method of preventing osteoporosis.
  
  
• Limiting cola and other sources of caffeine. Consuming excess caffeine (e.g., more than three cups of coffee a day) may raise the risk of osteoporosis, although there is some dispute about this, especially for people who have adequate levels of calcium in their diets.
  
  
• Avoiding long-term use of corticosteroids, if possible. For patients who do take corticosteroids long term, the American College of Rheumatology recommends taking bisphosphonates.
  
  
• Treating eating disorders. Conditions such as anorexia nervosa raise the risk of osteoporosis. 

In addition, certain steps can be taken to prevent the likelihood of bone fractures in those with osteoporosis or who may be at risk for the disease. These measures include:

• Practicing good posture and ergonomics. Keeping the head held high, chin in, shoulders back, upper back flat and lower spine properly arched helps prevent stress on the spine. Tips for maintaining good posture include:
  
  
• Placing a rolled towel in the small of the back while sitting or driving.
  
  
• Not leaning over when reading or doing homework.
  
  
• Using proper lifting techniques. This involves bending at the knees rather than the waist and lifting with the legs while keeping the upper back straight.
  
  
• Preventing falls. Unexpected falls are the source of many fractures, especially those of the hip and wrist. People can take several steps to reduce the risk of falling. These include:
  
  
• Wear low-heeled shoes with nonslip soles.
  
  
• Eliminate potential sources of slipping in the home or workplace, such as poorly placed electrical cords and area rugs.
  
  
• Install adequate lighting in all areas inside and around the home.
  
  
• Avoid walking on ice, wet or polished floors, or other slippery surfaces.
  
  
• Avoid walking in unfamiliar areas.
  
  
• Beware of the effects of medicine. Certain drugs may cause drowsiness or otherwise impair a person’s coordination or mental alertness.
  
  
• Treat health conditions that may increase the risk of falling. These include poor or impaired vision, impaired arm or leg strength and gait disturbances.
  
  
• Control pain. Patients should not ignore chronic pain, as it can limit mobility and cause additional pain if left untreated.
  
  
• Considering wearing hip pads. Fat or muscle that pads the hips helps to reduce hip fractures. Researchers are investigating whether external hip pads may provide a cushion that lessens the risk of fracture when a person falls. Initial results in studies involving nursing home residents have been encouraging.

In addition, research shows that men who take the cholesterol-controlling drugs known as statins may be less likely to suffer osteoporotic fractures. Studies have produced mixed results on whether statins affect women’s risk of such fractures.