10/07/2026
BONE HEALTH: MAINTAINING BONE STRENGTH & MASS
Roughly 43 million American adults have low bone density, which significantly increases the risk of osteoporosis and bone fractures. Bone mass peaks around age 30 and then naturally declines. For women, bone loss accelerates during menopause, and men typically experience a more gradual bone loss beginning in their 50s. Common causes of bone loss include inadequate calcium and vitamin D intake, lack of bone-strengthening exercises, smoking, excessive alcohol consumption, certain medications like steroids and proton pump inhibitors (PPIs), and medical conditions such as hyperthyroidism.
The following tests are commonly used to identify and monitor bone health:
• Dual-energy X-ray absorptiometry (DEXA) scan: This is the gold standard for measuring bone mineral density. It is generally recommended for women over 65, men over 70, and younger individuals with certain risk factors. Results are typically measured in t-scores and z-scores:
⚬ T-Score: Compares your bone density to the average of a healthy 30-year-old
⚬ Z-Scores: Compares your bone density to the average of healthy people of your same age, ethnicity, and s*x
• Quantitative ultrasound: This radiation-free test assesses bone density, often at peripheral sites like the heel. However, this test has limitations and cannot diagnose osteoporosis.
• Peripheral dual-energy X-ray absorptiometry (pDXA): This test is often used to screen for osteoporosis by measuring bone density at peripheral sites like the forearm, wrist, finger, or heel.
Certain groups should consider testing earlier, including postmenopausal women under 65 with risk factors (e.g., physical inactivity, low body weight, a family history of osteoporosis or hip fractures, excessive alcohol use, and smoking), people with fractures after age 50, and those with conditions or medications that weaken bones. Regardless of
your age, there are some effective ways to preserve bone density and prevent bone loss. Diet plays a key role, and the following foods are known to support bone health:
• Dairy products such as milk, cheese, and yogurt
• Leafy green vegetables like kale, spinach, and collard greens
• Plant-based milks and cereals that are fortified with calcium and vitamin D
• Fatty fish such as salmon and mackerel
• Nuts and seeds, particularly almonds and chia seeds
Exercise is also a powerful tool for increasing or maintaining bone density. Weight-bearing activities such as walking, jogging, hiking, and dancing stimulate bone growth by stressing the skeleton. Weight training or resistance bands also help strengthen bones.
If you are under 30, focus on building bone mass by consuming adequate calcium and vitamin D. If you have already passed your bone density peak, focus on preserving bone mass with healthy lifestyle choices. Work with your healthcare provider to decide when and which tests may be right for you.