By Cristina Mutchler 

 Medically reviewed by Stella Bard, MD

Osteoporosis makes your bones more fragile over time, which can be challenging to cope with on a daily basis. Fortunately, treatment options like prescription medications and hormone therapy are available—and can be supplemented with lifestyle changes.

Certain diet and exercise modifications, along with taking steps to prevent bone fractures and injuries, can help improve osteoporosis symptoms and your quality of life. This article provides an overview of how exercising, eating healthy, and preventing falls help support bone health.

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Doucefleur / Getty Images

Risk Factors and Causes of Osteoporosis


Anyone can develop osteoporosis, which happens when bone mass and bone mineral density breaks down. But it’s more likely to occur in people with certain risk factors.

For example, your chances of developing osteoporosis increase with the following:1

  • Older age

  • Female sex assigned at birth

  • Thin-boned, slender body frame

  • Family history of osteoporosis 

  • Low levels of estrogen or testosterone

  • Consuming a diet low in calcium and vitamin D

  • Using certain medications, such as glucocorticoids, proton pump inhibitors, and more

  • Family history of osteoporosis

  • Certain medical conditions like rheumatoid arthritis, gastrointestinal diseases, and more

  • Smoking, heavy alcohol drinking, and low physical activity levels

Healthy Diet for Osteoporosis

Simply put, the food you eat affects your bone health. There are a few specific nutrients that are essential for an osteoporosis diet.

Calcium

Calcium is a mineral that your body needs to help maintain healthy bones. As you age or develop osteoporosis, calcium can be reabsorbed by the body.2 This makes your bones thinner and weaker instead of promoting good bone health.3

For this reason, your healthcare provider will likely recommend adding plenty of this nutrient to your diet with foods or a supplement, if needed.4

Office of Dietary Supplements. Calcium.

Vitamin D

Getting enough vitamin D in your diet helps your body absorb calcium. If you don't get enough of either, your bones become more fragile and likely to fracture.5

While vitamin D can also be created in the body through sun exposure, a healthcare provider will likely recommend a supplement or a diet bolstered with fish, eggs, cheese, and more.

Foods to Eat

If your diet is not providing your body with enough calcium and vitamin D, the first step is carefully adding in good sources of these key nutrients.

For example, calcium is found in:1

  • Dairy products

  • Dark leafy green vegetables

  • Broccoli

  • Salmon

  • Sardines

  • Calcium-fortified foods, like tofu, orange juice, cereals, breads, and soy milk

Foods that contain vitamin D include:

  • Fatty fish

  • Eggs

  • Liver

  • Vitamin D–fortified foods, like milk and cereals

Federal guidelines recommend that women over the age of 50 and men over the age of 70 get a daily calcium intake of 1,200 milligrams (mg) and a daily vitamin D intake of 800 international units (IU).6 A vitamin supplement may be recommended by your healthcare provider if you're not able to make dietary modifications.

(Note that when research and health authorities are cited, the terms for sex and gender from the source are used.)

Foods to Avoid

There also are foods that you'll want to stay away from. Experts recommend avoiding the following foods if you have osteoporosis:7

  • Salty foods (including processed or canned foods that often contain high amounts of sodium)

  • Colas

  • Wheat bran

  • Foods and drinks with added sugar8

  • Red meat and other sources of saturated fat9

To help manage your osteoporosis, include foods that support bone health and avoid added sugar, sodium, and saturated fat.

Exercise Regularly

While it may seem counterintuitive, exercising regularly is important for helping preserve bone density and reducing the risk of a bone fracture when you have osteoporosis. To see the benefits, experts recommend a mix of weight-bearing exercises that force the body to work against gravity roughly three times a week.2

Low-Impact Weight-Bearing Exercises

Incorporating low-impact weight-bearing and resistance exercises into your routine will place less strain on your joints and is a good place to start.

For example, you might consider including osteoporosis-safe physical activities like:10

  • Hiking

  • Walking

  • Climbing stairs

  • Tennis

  • Dancing

  • Lifting light weights

  • Light jogging

  • Swimming

  • Bicycling

High-Impact Weight-Bearing Exercises

High-impact or high-intensity exercises put stress on the joints, and typically involve activities like running or jumping. These types of activities are usually not recommended for people with osteoporosis because of the risk for fractures or other injuries.11

If you're interested in starting or continuing any high-impact exercises after being diagnosed with osteoporosis, ask your healthcare provider if you're cleared to do so.

Talk to Your Healthcare Provider About Exercise

An exercise routine is a key part of an osteoporosis treatment plan. Just be sure to discuss with your healthcare provider which exercises will be safest for you based on your specific osteoporosis case.

Limit Alcohol, Smoking, and Caffeine

As with food, people with osteoporosis should also be mindful of the other substances they consume—like alcohol, tobacco, and caffeine.

Here's what experts recommend:

  • Drinking alcohol in moderation or not at all, as it appears to block the body's ability to regenerate and strengthen bones.12

  • Avoiding secondhand smoke or quitting smoking, as research shows tobacco use can increase the risk of bone fractures.13

  • Limiting caffeine, which may interfere with bone metabolism and calcium absorption if consumed in larger amounts.14

Lifestyle Changes Plus Medication

Remember that incorporating these lifestyle changes is meant to supplement osteoporosis medication and become a part of your treatment plan—not replace any prescriptions or therapies that your healthcare provider has recommended.

Prevent Falls and Fractures

It's important to reduce the risk of breaking or fracturing a bone in the first place by preventing falls. For people with osteoporosis, a bone break might not be able to heal properly and can lead to additional pain.15

Improve Balance

Having good balance helps keep you steady, reducing the risk of a fall. To improve your balance, consider the following:15

  • Incorporate exercises that promote strength and balance, such as yoga, Pilates, tai chi, weight lifting, or using resistance bands.16

  • When standing up from sitting or lying down, do so slowly or with support.

  • Don't be afraid to use a cane or walker if it makes you feel steadier.

  • Take extra caution on stairs, particularly outside during wintry weather.

Remove Fall Hazards Around the House

It's a good idea to set up your house in a way that promotes open walkways and room to get around, if possible. In addition to arranging furniture so that items are not in your way, you might also do the following:17

  • Remove throw rugs, and replace them with nonskid mats or carpet strips.

  • Make sure carpets are securely fixed to the floor.

  • Keep electrical cords tucked away.

  • Ensure there is good lighting, particularly in hallways and by staircases.

  • Consider installing handrails on stairs and in the bathroom.

Assistive Devices

Tools are available to install or keep handy if you fall. These include:17

  • Using an emergency response system that involves pushing a button on a necklace or bracelet to alert 911

  • Setting up a smart home device or smartwatch that can quickly connect you to emergency assistance

  • Carrying a charged cell phone with you around the house

  • Using motion-activated lights that automatically turn on

Work With Your Healthcare Provider

Your healthcare provider is an important part of your osteoporosis treatment plan. Together, you can work to find the best methods for coping with osteoporosis—without sacrificing your quality of life.

In addition to visiting your healthcare provider for regular checkups, don't be afraid to ask a question if you're having an issue between visits. Many factors can affect bone health or increase fall risk, including medications, new or ongoing health conditions, and changes in your living environment.

Coping with osteoporosis can be a challenging journey, but know that there are many different treatment options and support mechanisms available along the way. In addition to incorporating lifestyle changes for physical improvement and ease, you might also consider resources for emotional support when navigating this life change.

Summary

Lifestyle changes like exercising, eating healthy, and preventing falls are important parts of an osteoporosis treatment plan. This includes eating a diet rich in vitamin D and calcium, starting a bone-strengthening exercise routine, and incorporating some tweaks around the house to reduce the likelihood of falling.

Always check with a healthcare provider first for the best options to safely manage your osteoporosis.

 Sources

National Institute of Arthritis and Musculoskeletal and Skin Diseases. Osteoporosis.

MedlinePlus. Osteoporosis.

National Institute of Aging. Osteoporosis.

Office of Dietary Supplements. Calcium.

Institute of Medicine of National Academies. Dietary reference intakes for calcium and vitamin D.

National Institute of Arthritis and Musculoskeletal and Skin Diseases. Calcium and vitamin D: important for bone health.

Bone Health and Osteoporosis Foundation. Food and your bones: Osteoporosis nutrition guidelines.

Tian L, Yu X. Fat, sugar, and bone health: a complex relationship. Nutrients. 2017;9(5):506. doi:10.3390/nu9050506

Mozaffari H, Djafarian K, Mofrad MD, Shab-Bidar S. Dietary fat, saturated fatty acid, and monounsaturated fatty acid intakes and risk of bone fracture: a systematic review and meta-analysis of observational studies. Osteoporos Int. 2018;29(9):1949-1961. doi:10.1007/s00198-018-4540-7

National Institute of Arthritis and Musculoskeletal and Skin Diseases. Exercise for your bone health.

National Institute of Arthritis and Musculoskeletal and Skin Diseases. Osteoporosis: diagnosis, treatment, and steps to take.

Cheraghi Z, Doosti-Irani A, Almasi-Hashiani A, et al. The effect of alcohol on osteoporosis: a systematic review and meta-analysis. Drug Alcohol Depend. 2019;197:197-202. doi:10.1016/j.drugalcdep.2019.01.025

Hernigou J, Schuind F. Tobacco and bone fractures. Bone Joint Res. 2019;8(6):255-265. doi:10.1302/2046-3758.86.BJR-2018-0344.R1

Antonioli L, Haskó G. Caffeine and bones: if less is good, more may not be better. J Caffeine Adenosine Res. 2019;9(2):38-39. doi:10.1089/caff.2019.29011.ah

National Institute on Aging. Osteoporosis.

National Institute on Aging. Falls and fractures in older adults: causes and prevention.

National Institute on Aging. Preventing falls at home: room by room.

Capozzi A, Scambia G, Lello S. Calcium, vitamin D, vitamin K2, and magnesium supplementation and skeletal health. Maturitas. 2020;140:55-63. doi:10.1016/j.maturitas.2020.05.020

Zheng X, Lee SK, Chun OK. Soy isoflavones and osteoporotic bone loss: a review with an emphasis on modulation of bone remodeling. J Med Food. 2016;19(1):1-14. doi:10.1089/jmf.2015.0045

Bartolozzi E. The natural approach to osteoporosis. Clin Cases Miner Bone Metab. 2015;12(2):111-115. doi:10.11138/ccmbm/2015.12.2.111

Benedetti MG, Furlini G, Zati A, Letizia Mauro G. The effectiveness of physical exercise on bone density in osteoporotic patients. Biomed Res Int. 2018;2018:4840531. doi:10.1155/2018/4840531


By Cristina Mutchler
Cristina Mutchler is an award-winning journalist with more than a decade of experience in national media, specializing in health and wellness content.