My grandmother, had one of those giant, Hunchback-of-Notre-Dame type humps on her back. Her neck hung forward like she had spent way too much time playing games on her cell phone, except she passed away at age 94 before she ever even owned a cell phone. At her tallest she was 5’2″. By the time she reached 75, she was 4’11”. 

Her mother, my great-grandmother, passed away from a broken hip at age 93. They both lived long, healthy lives, and I’m pretty sure my grandmother could not have cared less about the giant hump on her back, but these days, being in your seventies is still pretty young. Women in their seventies are not only playing their their grandchildren, they’re also getting remarried, traveling the world, and still working in corporate America. Why not do all that without a camel-like lump on your back?

Bones, although the appear to be hard and lifeless, are actually living, growing, flexible tissue made up of three things: collagen that makes them flexible, calcium-phosphate mineral complexes that make them hard, and living bone cells which continually replace weakened sections of bone. Bone tissue is constantly breaking down and rebuilding. From the time you are young until your bones have reached their peak (usually around age 30 for women), you make more bone tissue than you lose.  his is when your bones are nice and dense and healthy. Unfortunately, bone density, like everything else, does not stay at its peak forever. The good news, though, is the decline of bone density can be a very slow process and does not have to result in osteoporosis, which is what happened to Grandma Anna and Great-Granny Eva. 

Osteoporosis is a bone disease that occurs when you lose too much bone or re-make too little, or a combination of both. It causes bones to become weak and brittle, capable of breaking easily— and breaking a bone at an old age can be fatal. Women are at a much greater risk for osteoporosis than men because after menopause, when our estrogen, progesterone and collagen levels drop dramatically, our bone breakdown and repair system suffers. As estrogen levels drop, so does the vitamin K function, which is necessary for the formation of bone protein which provides the framework for our bones. In fact, one year prior to the start of menopause and up to seven years after, women can lose up to 20 percent of our bone density. That’s not good, but it isn’t inevitable, and the earlier you start protecting your bones, the better off you’ll be.

Below are the most important things you can incorporate into your daily life starting now, regardless of your age:

1. Feed your body with calcium and vitamin D.  

If you are under 50, you need about 1000 mg per day of calcium. If you are over 50, you need at least 1200 mg per day. When we don’t put enough calcium into our body, our body starts taking calcium from our bones.  

The best way to get calcium is from food or drinks. If you find you cannot possibly ingest enough calcium daily, a supplement can be taken. Make sure you are looking at the amount of elemental calcium, as this is the calcium your body will absorb. Do not take more than 500 or 600 mg at a time because that’s the maximum amount the body can absorb. If you need to take more to meet your daily requirements, split your dose in half and take each half at opposite ends of the day. The best foods for calcium are dairy products and dark, leafy greens like kale, collard greens, bok choy, and Chinese cabbage. 

Vitamin D is needed in lesser amounts for calcium absorption to occur, but it is also trickier to get, especially in the winter months. Under age 50, you need 400 to 800 mg per day. Over 50, the number goes up to between 800 and 1000 mg per day. Sunlight is your number one source for vitamin D. If you find you aren’t getting much sun, you can find vitamin D in some fatty fishes, like tuna, mackerel, and salmon. It is also often added to milk, orange juice, and some cereals. Here’s a real catch-22: when you wear SPF 8 or greater, you are preventing your body from absorbing 95 percent of the vitamin D it should be getting from the sun—but you need to wear a broad spectrum sunscreen daily to protect your skin from harmful UVA and UVB rays. You can always take a vitamin D supplement if needed, but if you’re taking a multivitamin, vitamin D is probably already in there—no need to double dose.

2. Bear weight and build muscle. 

We always hear how exercise is so important in maintaining optimal health. In terms of bone health, however, there are two specific types of exercise that count: weight-bearing and muscle-building exercises. 

Nearly any type of aerobic exercise is weight-bearing. Jogging, running, dancing, playing tennis, or soccer are all weight-bearing exercises. Plyometric training, or jump training, is a great way to maintain healthy bones, although this is an advanced move, and if practiced without proper form, can do more damage than good. But it is a great form of exercise to build up to and continue, as it improves muscle and joint strength, balance, flexibility, mobility, and metabolic rate.

Muscle-building, or muscle-strengthening exercises, are considered those that use body weight or added weight, such as push ups, pull ups and weight lifting, and resistance training. I’m not suggesting bulking up to a mini-Schwartzenegger or anything. Lifting light weights (4 to 7 pounds) and plenty of repetitions are fine for building upper body strength. For larger muscle groups like the back, legs, and bum, opt for something a little weightier (12 to 24 pounds). If you follow those numbers, you’ll be bulk-free and bone healthy. Pilates and yoga are also great body-weight training options.

3. Boost your vitamin K intake (K2 as MK-7, particularly).  

K2 can be found in aged cheeses (yum) and fermented foods, like tofu, kefir, kombucha, and sauerkraut. Fermented foods have so many other amazing health benefits too, from brain function to gene expression, that helping your bones is almost just a bonus. Wine, by the way, is a fermented food.  Just sayin’…  

While you munching on all those dark, leafy greens to boost your calcium levels, you can feel extra good in knowing they are chock-full of vitamin K1 as well.  The average supermarket is getting much better at offering up things like kefir, tofu, and kombucha, but if you’re searching for more options, hit up your local Whole Foods or health food store. They will have plenty. Kombucha may take some getting used to, depending on your palette, but kefir can be pretty darn delicious from the start, if you get the right one. My fave: Helios organic Greek kefir in vanilla. 

4. QUIT SMOKING! 

Do I even really need to write that? I know if you are a smoker, you don’t truly want to be as you know how harmful it is to your health on so many levels. But quitting is hard. I get it. New research suggests, however, that quitting cold turkey is the most successful way of stopping long term. Find something super healthy to replace your cigarettes with. Try something with a kick, like wasabi seaweed snacks or chipotle almonds or, hey, a bottle of kombucha. Smoking, in terms of bone health alone, promotes bone loss while simultaneously killing osteoblasts, the bone making cells. In other words, smoking attacks the bones from both ends. There’s no happy ending there.

In life, we age. As we age, maintaining our health becomes more challenging and requires more attention. The beautiful thing about it, though, is we have the choice to feed our body with goodness and our options are abundant. People often say that getting old’s a bitch. I say getting old is a gift. Feeling good while you get there is a choice. Make it yours.