Everything you need to know about bone health

Adults 20 to 40
Calcium – 1,000 mg per day
Aim for two or three full servings of calcium-rich foods every day. The operative word here is full; a bit of milk in your coffee and a splash on your cereal isn't enough. Many Canadian adults overestimate their calcium intake, says Dr. Diane Thériault, director of the Dartmouth Osteoporosis Multidisciplinary Education program in Nova Scotia. "Milk on your cereal usually isn't more than half a cup, which is only half a serving of calcium," she says. "That doesn't cut it."

Vitamin D – 400 IUs per day (some experts recommend 800 IUs)
You can try to get this requirement into your diet by including sources such as fortified foods, dairy products and fish such as tuna or salmon, and by getting more sun exposure. But even when taking these steps, adults won't get enough vitamin D, according to Thériault. "I would suggest a supplement for most Canadians, given our climate and typical diet," she says. (Women who are pregnant or lactating should talk to their doctors about upping their daily vitamin D intake to 2,000 IUs, especially in winter months, according to the Canadian Paediatric Society.)

Exercise
Staying active at age 35 is just as important as it was when you were 15 – but don't overdo it; elite female athletes can suffer from amenorrhea. So be active, but smart – four hours a week of moderate exercise should do it. (Brisk walking is fine, but try to add more strenuous activities that require your muscles to work against gravity, such as dancing or jogging; muscle pulling on bones results in a mechanical load on bones, which is important for bone growth.)

You might also consider including strength training in your fitness routine. Lifting weights for as little as 30 minutes, twice a week, also helps stimulate bones to increase in strength and density, and can even lessen the effects of osteoporosis if you already have it. You might want to consider starting with light weights (maybe two or three pounds) and building up from there. If you’re a novice, consult a trainer.

Prevention
The jury is still out on whether estrogen (as in the birth control pill) helps prevent osteoporosis in pre-menopausal women. If you're at high risk for osteoporosis, it's all the more important to take preventive measures. You're at increased risk if you:
• are slender;
• smoke;
• consume more than four cups of coffee a day;
• regularly drink one or more standard alcoholic drinks a day (for men it's more than two drinks);
• have a family history of osteoporosis;
• have already sustained a fracture after little or no trauma; or
• used corticosteroids for at least three months or have taken SSRIs (antidepressants).

Tip: Reaching the right balance of protein intake can be tricky. Eating too much can cause calcium to be excreted by the kidneys, but eating too little increases the risk of hip fractures.

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