Looking After Your Bones Through Life

Bone looks inert and is not. It is living tissue, continuously broken down and rebuilt throughout your life. That constant turnover is why bone responds to what you do — and why neglect shows up decades later rather than immediately.

Why this matters

Bone density builds through childhood and adolescence, reaches a peak in early adulthood, and then gradually declines. Two things follow. Building a higher peak early gives you more to draw on. And slowing the later decline determines how much strength remains in older age.

The practical consequence of weak bone is fracture, most often at the hip, spine and wrist — and a hip fracture in an older person is a serious event affecting independence, not merely a broken bone. Bone loss itself causes no symptoms, which is why it is easy to ignore until a fracture happens.

What medical guidance says

What influences bone strength

Some factors cannot be changed — age, being female, family history, and body frame. Several can:

• Weight-bearing physical activity, which stimulates bone to maintain itself. Bone responds to load; inactivity accelerates loss.
• Adequate calcium and vitamin D, which are the raw material and the means of absorbing it.
• Tobacco use, which is associated with lower bone density.
• Heavy alcohol intake.
• Very low body weight and prolonged restrictive eating.
• Long-term use of certain medicines, notably oral steroids.
• Some medical conditions, including thyroid, parathyroid, kidney and coeliac disease.
• In women, the fall in oestrogen after menopause, which accelerates bone loss for several years.

The Indian picture

Low vitamin D is widely reported across Indian populations, including in sunny regions — sun avoidance, covering clothing, indoor work, air pollution and skin pigmentation all reduce how much is made in the skin. Dietary calcium intake also tends to fall short of recommendations in many Indian diets. Both are worth discussing with your doctor rather than self-supplementing on assumption.

Everyday nutrition for bone

• Milk, curd and paneer are the most concentrated everyday calcium sources for those who take dairy.
• Ragi is a notably calcium-rich millet and a traditional Indian staple worth using more often.
• Sesame seeds, particularly til, and almonds.
• Green leafy vegetables and drumstick leaves.
• Small fish eaten with the bones, for those who eat fish.
• Pulses, beans and tofu.
• Adequate protein across the day — protein is part of the bone matrix, not just muscle.

Do not begin high-dose calcium or vitamin D supplements on your own. Excess calcium supplementation is not harmless, and vitamin D dosing should be based on your circumstances and, where appropriate, a test. Ask your doctor.

Lifestyle

• Include weight-bearing activity most days — brisk walking, stair climbing, dancing. Swimming and cycling are good for the heart but load bone far less.
• Add simple resistance work two or three times a week; muscle pulling on bone is part of what maintains it.
• Get sensible sun exposure, discussed with your doctor if you have skin conditions or a history of skin cancer.
• Stop tobacco in all forms and moderate alcohol.
• Work on balance in later life — falls are what turn weak bone into a fracture. Simple standing balance practice and yoga help.
• Make the home safer: good lighting, secure rugs, bathroom grab rails, and a clear path to the bathroom at night.
• Have your vision and any dizziness-causing medicines reviewed, as both contribute to falls.

For anyone over sixty, preventing falls protects bone at least as much as anything you eat. The strongest skeleton still breaks if you land badly.

When to consult a doctor

Discuss bone health with your doctor if you have broken a bone from a minor fall, have lost height or developed a stooped posture, have a family history of hip fracture or osteoporosis, take long-term steroids, have had an early menopause, or have a condition affecting absorption or the thyroid.

Your doctor decides whether a bone density scan or blood tests are appropriate — these are not tests to arrange for yourself. Seek prompt care for sudden severe back pain in an older person, or any suspected fracture.