Twenty-somethings have a lot on their minds: finishing school, settling into a career, taking control of their finances. Bone health isn’t always top of mind. When we’re young, our bone tissue is constantly being created and destroyed, so it’s easy to take our rock-solid skeleton for granted. But as we age, this process slows down, and our bodies gradually lose bone faster than new bone is built. For some people, this deterioration causes their bones to become especially weak, brittle and porous, a condition called osteoporosis. People with this disease are more susceptible to bone breakage—particularly in the hip, spine, and wrist—and can also experience pain, limited mobility and stooped posture.
While osteoporosis can develop in both men and women at different ages, it most frequently affects older women who have gone through menopause. (Estrogen levels drop during menopause, and experts believe the hormone helps maintain bone density.) The good news, though, is that there’s a lot you can do in your 20s to strengthen your bones and reduce your risk of getting osteoporosis later on.
“Bone loss is inevitable in women,” says Deena Adimoolam, MD, assistant professor of diabetes, endocrinology and bone disease at the Icahn School of Medicine at Mount Sinai. “But there are plenty of lifestyle changes that can help slow down the process.”
Your bones are still being rebuilt in your 20s, she explains, which means you can continue to strengthen them during this time. Here, a few smart lifestyle strategies that can help offset your risk.
One of the very best things you can do for healthy bones in your 20s is establish an exercise routine you can stick to. But not all workouts are created equal.
“Physical activity has been shown to have beneficial effects on bone health, especially by adding weight-bearing activities into daily workouts,” says Dr. Adimoolam.
In other words, make sure you’re taking advantage of those free weights at the gym, as well as other forms of resistance training like yoga, running, tai chi and brisk walking. Even better, schedule a plyometrics workout: According to a study from Brigham Young University, exercises that involve jumping may significantly improve hip bone mineral density in premenopausal women.
The diet choices you make in your 20s can help build strong bones for life: “Calcium and vitamin D are very important for bone health,” says Dr. Adimoolam. She recommends filling your plate with three servings of calcium-rich foods every day. This can include both dairy and non-dairy sources—think milk and yogurt, as well as kale, edamame, almonds and oranges. Foods that are high in vitamin D include salmon and other fatty fish, eggs and fortified cereal.
Other bone-building foods to load up on: Bananas (potassium may help increase bone strength by reducing resorption), prunes (vitamin K may promote bone health) and olive oil (it contains a compound called oleuropein that may prevent bone loss).
In addition to eating well and exercising, Dr. Adimoolam stresses the importance of aiming for a healthy weight. “Women who are underweight are at risk of developing osteoporosis at an earlier age,” she says. Belly fat could also up your risk: Recent research from Harvard found that premenopausal women who had more visceral fat had decreased bone mineral density.
Some women have greater risk of developing osteoporosis than others. If these factors apply to you, consider discussing bone health with your doctor. He or she might recommend a bone density scan to start monitoring your bone mass from an earlier age.
If osteoporosis runs in your family—if your mother or grandmother has it, for example—you have an increased risk of developing it yourself. This is especially true if a family member had early-onset osteoporosis, meaning it started before age 60.
Because estrogen may be linked to bone density, a woman who isn’t having a regular period may not be benefiting from the hormone’s protective effects on bone health, Dr. Adimoolam explains. Similarly, if your period stops for more than a year and you’re not on birth control, let your doctor know. (Most birth control pills contain estrogen, so if you don’t have your period and you’re on the pill, you don’t have to be too concerned about your bone health, Dr. Adimoolam says.)
Women who have this condition, which occurs when the ovaries fail before age 40, have a higher risk of osteoporosis, Dr. Adimoolam says.
As if you needed another reason to quit: In addition to lung cancer, heart disease, and stroke, smoking cigarettes can also contribute to osteoporosis.