A fall can change your life. In older adults, a hip fracture isn’t just “bad luck”: it’s linked to loss of independence and a real increase in mortality risk in the months that follow. The good news is that bone health isn’t a mystery. It can be measured, trained, and protected with concrete habits.
This article covers the essentials to improve bone mineral density, lower fracture risk, and—most importantly—prevent falls.
Know your risk: genetics, age, and context
Genetics matter. Having a parent with a history of hip fracture is a meaningful red flag. Still, genetics aren’t destiny: risk is shaped by training, nutrition, sleep, medications, and your environment.
Common risk amplifiers
- Menopause and lower estrogen
- Low body weight, restrictive dieting, or low protein intake
- Prolonged sedentary time
- Chronic use of certain medications (for example, steroids)
- Prior falls, dizziness, or vision issues
If several apply to you, there’s no need for panic—just a reason to act with a plan.
Measure what matters: bone density and fracture risk
The classic tool is a DXA scan. It’s not perfect, but it helps quantify risk and track trends over time. It’s often most useful when combined with context: age, family history, prior fractures, and fall risk.
When to consider an evaluation
- Family history of hip fracture
- Noticeable height loss or a developing stoop
- Fractures from low-impact events
- Persistent pain and functional limitation
Other tests that can add clarity
Depending on your situation, your clinician may consider:
- Vitamin D
- Calcium, phosphate, and kidney function
- Thyroid hormones (when relevant)
- A medication review for drugs that increase fall risk or affect bone
The goal isn’t to medicalize everything—it’s to remove avoidable “brakes.”
Training that strengthens bone (not just muscle)
Bone adapts to load. A practical approach combines:
- Progressive strength training
- Controlled impact (when appropriate)
- Balance and coordination work
Strength: the foundation
Aim for 2–3 sessions per week. Prioritize big patterns:
- Squats (to a chair if needed)
- Light Romanian deadlifts or a banded hip hinge
- Step-ups
- Pressing and rowing (for posture and upper-body strength)
A simple guideline: 2–4 sets per exercise, 6–12 reps, leaving 1–3 reps “in reserve.” If you’re new, start with less and build every 1–2 weeks.
Impact: the minimum effective dose
If it’s safe for you (and cleared by your professional), moderate impact can help:
- Gentle hops
- Stair climbing
- Walks with brief faster intervals
If you have advanced osteoporosis or pain, don’t improvise—poorly chosen impact can backfire.
Balance: the “insurance policy” against falls
Strong bones help, but many fractures are prevented by not falling. Spend 5–10 minutes per day on:
- Single-leg stands near a wall
- Heel-to-toe walking
- Ankle and foot drills
Rule of thumb: if it doesn’t challenge you a little, it won’t train balance. Challenge, yes—but always safely.
Nutrition for bones: simple, but not optional
Bone health needs building blocks and the right hormonal signals.
Prioritize enough protein
Protein supports muscle mass (fewer falls) and helps maintain metabolic “scaffolding.” Spread protein across 2–3 meals and include complete sources (eggs, dairy if tolerated, meat, fish, legumes combined).
Calcium, vitamin D, and beyond
- Calcium: ideally from foods (dairy, canned fish with bones, some vegetables)
- Vitamin D: depends on sun exposure, skin, season, and baseline levels—measure and adjust
- Magnesium and vitamin K: may contribute, but avoid supplementing blindly
If you already supplement, review dose, interactions, and actual need.
Habits that weaken bone (and how to fix them)
- Excess alcohol: increases fall risk and may harm bone
- Smoking: worsens bone quality and recovery
- Poor sleep: affects repair hormones and coordination
- Chronic crash dieting: promotes muscle and density loss
You don’t need perfection. Reduce what does the most harm and sustain what protects.
Fall prevention: the most underrated piece
Your home setup and daily habits can be decisive.
Quick checklist
- Night lights in hallways and bathrooms
- Remove slippery rugs
- Stable indoor footwear
- Keep vision and hearing up to date
- If you get dizzy when standing up, hydrate and consult
A 5-minute daily “protocol”
- 1 Minute single-leg stand per side
- 1 Minute heel-to-toe walking
- 1 Minute calf raises
- 2 Minutes sit-to-stand from a chair with control
If you’ve already fallen once, don’t ignore it—it’s a signal to adjust strength, balance, and environment.
One last point: the best program is the one you can keep doing. Small, consistent strength and balance work beats sporadic intense bursts, especially when the goal is staying independent.
Conclusion
Protecting your bones is not only about “taking calcium.” It’s a full plan: assess risk, train strength, practice balance, eat enough protein, and reduce hazards at home. The payoff is huge: more independence now and a lower chance that a fall becomes a life-changing event.
Knowledge offered by PeterAttia