When you’re a healthy 20- or 30-something, your bone health seems like an issue you can safely put off until you’re older. But like saving for retirement and using an SPF to protect your skin every day, you really need to start preparing your bones now to make sure they’re as healthy as possible in the future. Here’s what’s going on with your skeleton and how to make sure you’re giving yourself a strong start.

woman eating yogurt

How do we measure bone health?

One key way to know that your bones are strong is by checking your bone density. Dr. Ricardo Cook, MD, an orthopedic surgeon with The Centers for Advanced Orthopaedics based in Maryland, explains, “Bone density looks at the mineral content of our bones. These minerals are laced between collagen — the organic component that gives bones elasticity — and it’s those minerals that make your bones rigid.”

To check your bone density, Dr. Clifford Stark, DO, an osteopathic sports medicine specialist and primary care physician in New York, recommends a DEXA scan (dual-energy X-ray absorptiometry). “This gives you a ‘T-score’ — a number that compares your bone density to that of a healthy 30-year-old. A T-score above -1.0 is considered normal, while a score between -1.0 and -2.5 suggests osteopenia (weaker-than-average bones), and a score below -2.5 represents osteoporosis.” This isn’t the only concern: Stark adds, “Other factors to consider include bone quality, which has many different components such as accumulated microscopic damage, the quality of collagen, the size of mineral crystals, and the rate of bone turnover.”

You only have a limited time to build up bone density

This is why it’s important to work on your bone health as early as possible. Stark explains, “Think of bone health like a bank account. For people assigned female at birth, bone (“money”) is being deposited throughout your 20s until about the age of 30. After that, you start the period of continuous withdrawals for the remainder of your life, which accelerates as the years go by, especially after menopause. This is why it’s extremely important to take advantage of those younger years: They set the stage for later in life.” No more putting this off; the clock is ticking!

Calcium is your first call

Dr. Victor Romano, MD, an orthopedic surgeon and author based in Chicago, IL, advises, “Calcium is what makes our bones strong and makes our muscles, nerves and brain function properly. If we don’t consume enough calcium in our daily diet, our body will rob our bones of the required amount, and eventually, our bones will weaken to a point where they will break spontaneously or with a minor injury.” So how much do we need every day? “The daily recommendation is 1,000 mg to 1,200 mg,” Romano says. “Our bodies can only absorb up to 1,500 mg of calcium in one day: Any more will just be eliminated in your urine and can lead to kidney stones.” Which means no cheat days: “There’s no making up for lost days of no calcium intake,” Romano warns. “Get calcium in your daily diet.”

Okay, but how? Rachel Fine, RD, CDN, a dietitian who owns To The Pointe Nutrition in New York City, says, “Dairy and fortified dairy alternatives, such as plant-based milks and yogurts; beans; and leafy greens are some of the best food sources of calcium and vitamin D.” As important as hitting your calcium target is, she recommends using your diet as the primary source: “Your body cannot absorb more than 500 mg of calcium from supplements at a time and excessive calcium from supplements can also increase your risk of heart attack and stroke. Generally, this occurs when supplemental intake is over 1,000mg per day, or if you’re also getting about 800mg a day from food sources in your diet.” Drink your fortified milk instead.

Think of vitamin D as calcium’s wingman

Even if you’re hitting your daily calcium intake, Romano adds, without enough vitamin D you won’t be able to absorb it. Adults aged 19 to 70 need 600IU a day, and most foods don’t naturally contain very much. Fatty fish like salmon and tuna are your best dietary source, in addition to specially fortified foods like certain cereals, yogurts, and margarine. Next time you’re grocery shopping, have a close look at the labels to see if you’re getting added vitamin D for your money. It is possible to get enough vitamin D from the sun in summer: About seven minutes in July without sunscreen should get you there. However, if you live somewhere that’s cold and cloudy in winter, you might need to take supplements to make sure you’re getting enough. “Check with a doctor before supplementing, as it’s best to not overdo your vitamin D intake,” advises Fine. “Taking your supplement with a meal that incorporates fat will help promote absorption.”

A few other factors to consider

So you’ve stocked up on tuna and spinach: Now what? Cut out the soda, advises Ricardo: “Eating a lot of fast food and drinking soda can affect your bone health, because those types of foods don’t have the proper nutrients and can wear your bones down.” Drinking too much alcohol and caffeine can also damage your bones, says Stark, as can some medications, “most notably steroids, and also hormonal medications such as those used for endometriosis.” If you’re physically able, one of the best things you can do for your bones is weight-bearing exercise: “Activities that load the skeletal system are crucial for maintaining and optimizing bone health,” Stark encourages. “I recommend a wide variety that incorporates balance with gravitational forces in multiple directions, thereby engaging the entire skeletal system.” Even if you’re not athletic, this covers a surprising number of activities: Dr. Kinjal Parikh, DO, physical medicine and rehabilitation specialist at OrthoCarolina Spine Center in Charlotte, NC, suggests: “Walking, running, hiking, dancing, tennis, basketball, gymnastics, and soccer.” But leave the bike at home: “Swimming and cycling are not weight-bearing.”

Knowing that you may already have missed some of your prime bone-loading years may sound worrying, but if you follow these steps you really can make a difference. “Don’t assume you’re doomed to failing bones,” Stark reassures us. “As with many other health factors that deteriorate with age, there are measures you can take to minimize this process — and the younger you start, the better the results.” Now you know what to do, show your bones some love, and you’ll be the strongest retiree in the residential home.

Share your weight-bearing workouts and calcium-packed recipes with us @BritandCo.

(Photo via Getty)