When it comes to bone health, calcium has long been viewed as the star of the show. Though still important, it’s actually only one small piece of the puzzle—especially if you’re over 40 (your bone mass peaks around age 30). During perimenopause, estrogen levels begin to decline, speeding up bone loss and increasing the risk of osteoporosis (weakened bones).

“Some women lose up to 20% of their bone density in the first 10 years after menopause,” explains Melanie Haffner-Luntzer, the head of bone regeneration at Ulm University in Germany. That loss usually begins even earlier, she says, so it’s important to take steps to increase and maintain your bone density. Haffner-Luntzer’s number one tip? Strength training.

Why is strength training beneficial for bone health?

Haffner-Luntzer recommends that women over 40 strength-train two to three times a week, even if it’s just short, 15-minute sessions. More specifically, she encourages progressive strength training, which is also known as progressive overload. According to the Cleveland Clinic, this is “when you gradually increase the load or stress that’s placed on your muscles during strength training and workouts.” You can do this by increasing the weight you lift, adding more sets to your routine, or reducing the recovery time between exercises.

Strength training helps put stress on your bones that “can nudge bone-forming cells into action” and increase bone density and overall bone strength, Harvard Medical School reports. It can also improve muscle mass, posture, and reaction time, thus reducing the risk of falls and further protecting bone health. “Strength training isn’t about bodybuilding, but about preventative medicine,” Haffner-Luntzer says.

Do other exercises help maintain bone health?

Yes—see some below.

Vibration Training

Haffner-Luntzer explains, “Studies show that whole-body vibration has positive effects on bone density in postmenopausal women, especially with certain low-magnitude, high-frequency settings.”

Trampoline jumping

A 2019 study found that older women with osteopenia (the precursor to osteoporosis) who completed a 12-week mini-trampoline exercise program twice a week saw improvements in balance, mobility, strength, fear of falling, and more.

Walking

According to a 2022 study, “taking brisk walks for 30 minutes per day three or more times per week…is recommended to prevent bone loss in premenopausal women.” Walking, jogging, running, and other aerobic exercises are also good for your heart health, metabolism, and mood. If you really want to spice things up, try adding ankle or wrist weights or a weighted vest.

In addition to exercise, what other factors can influence bone health?

Unsurprisingly, nutrition—especially calcium, vitamin D, and protein—is incredibly important. The International Osteoporosis Foundation recommends that adults consume 1000 mg of calcium per day, increasing to 1200 mg for women aged 51 and older. (Some calcium-rich foods include yogurt, sardines, kale, and almonds.)

Vitamin D is also important for calcium absorption and, therefore, muscle and bone health. The National Institutes of Health recommends that adults consume between 600 and 800 international units (IU) of the vitamin daily. (Three ounces of rainbow trout, for example, has 645 IU of vitamin D, according to the NIH).

Sleep and recovery are crucial, too, as chronic stress can negatively affect bone health, Haffner-Luntzer says. She adds, “Smoking, excessive alcohol consumption, eating disorders, certain medications such as long-term [steroid] use, and family history play a major role.”

As always, it’s important to pay attention to your body and talk to your doctor about any concerns so a tailored treatment plan can be created if necessary.

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