Certain lifestyle factors can affect your bone health:
- diet (including how much calcium you get)
- physical activity
If you have already lost some bone density, or have osteoporosis, changes to lifestyle can’t cure or reverse the problem but may help stop it getting worse.
A varied, balanced diet will give you the nutrients that are important for strong, healthy bones.
Calcium is a vital mineral for teeth and bones because it gives them strength and hardness. Our bodies contain about 1kg of calcium and 99% of it is found in our bones.
Our main dietary source of calcium is dairy produce. Most people are able to get enough calcium through a healthy diet that includes dairy products. Three portions of dairy a day will give you the recommended amount of calcium if you do not already have osteoporosis.
If you don’t eat or drink any dairy products, it’s important to ensure you still get enough calcium in your diet from other non-dairy sources. Milk alternatives such soya, rice and almond milk do not naturally contain as much calcium as cow’s milk. Choosing dairy alternatives with added calcium can be helpful.
Good sources of calcium include:
- milk and dairy products (including low-fat varieties) such as yoghurt, fromage frais and cheese
- calcium-fortified breakfast cereals
- dried fruit such as apricots and figs
- fish with edible bones such as anchovies, sardines, pilchards and whitebait
- green leafy vegetables like broccoli, watercress and kale
- pulses, beans and seeds such as kidney beans, green beans, baked beans and tofu (a vegetable protein made from soya beans)
- nuts and seeds such as almonds, brazil nuts, hazelnuts and sesame seeds
The calcium content of drinking water varies greatly across the UK. Some bottled mineral waters are calcium enriched (and are healthier than fizzy drinks). You may need to take a calcium supplement if you don’t get enough calcium from diet alone.
How much calcium do I need?
Adults need around 700mg of calcium a day. Someone with or at risk of osteoporosis may be advised to have around 1,000–1,200mg a day. See the table below for a guide to the calcium values of some common foods (all figures are approximate).
|portion of food||calcium per portion|
|200ml milk (all types)||240mg|
|30g Cheddar cheese||220mg|
|100g sardines in oil||500mg|
|100g tinned salmon||91mg|
|20g (1/4 bunch) watercress||34mg|
|200g baked beans||106mg|
|100g (about 5) dried figs||250mg|
|50g (about 15) brazil nuts||80mg|
|one slice of white bread||53mg|
|One pitta bread/chapatti (65g)||60mg|
|Boiled broccoli (two spears)||34mg|
|One medium orange||75mg|
There are calculator tools available online that can tell you how much calcium is in the different foods you eat.
Vitamin D is needed to help your body absorb calcium. The main source is sunlight, which your body uses to make this vitamin in your skin.
From April to September, the ultraviolet light from the sun is strong enough that we can make vitamin D on exposed skin such as the face, legs, and arms, but it’s important to be safe in the sun. The body stores vitamin D for use during the winter months but it’s recommended that all adults take a vitamin D supplement especially in the winter months.
You can get some vitamin D from food. However, even if you have a healthy, well-balanced diet, that provides all the other vitamins and goodness you need, it’s unlikely to provide enough vitamin D. Good food sources of vitamin D include:
- egg yolks
- red meat
- oily fish such as herrings and sardines
- cod liver oil
- margarine, yoghurts and breakfast cereals that have added vitamin D (vitamin D-fortified)
Drinking too much alcohol can affect your bone density. Additionally, studies have shown drinking alcohol increases the risk of getting breast cancer, although it’s less clear if this affects the prognosis (outlook) for people who have had breast cancer. Therefore, NICE (National Institute for Health and Care Excellence) recommend people who’ve had breast cancer limit their alcohol intake to below five units per week.
You can find out how many units are in your drinks by using an online unit calculator. As a general guide:
- half a pint of average-strength (4%) beer = 1 unit
- a 175ml glass of wine (12.5%) = 2 units
- a single 25ml measure of spirits (40%) = 1 unit
Regular weight-bearing exercise or activities help stimulate growth and strength of the bones. Weight-bearing exercise is any exercise where you support the weight of your own body. Weight-bearing exercises can be high-impact or low-impact.
High-impact activities include:
Low-impact activities include:
- stair climbing
- cross training machines
The type of activity you do will depend on your individual needs and current abilities, such as your fitness levels, any effects of treatment or other health problems you might have.
If you have osteoporosis and are thought to have a high fracture risk you may need to avoid high-impact exercise and awkward or sudden bending and twisting because of a higher chance of injury. It might be useful to discuss this with your GP, treatment team or a physiotherapist to find out what is right for you.
In addition to helping strengthen bones, exercise during and after treatment for breast cancer may also improve some of the other side effects of treatment – such as cancer-related fatigue and weight gain.
Some studies have also shown that regular exercise after treatment may help reduce the risk of breast cancer coming back.
It’s recommended that adults should do at least 150 minutes (2 hours 30 minutes) of moderate-intensity activity a week. Moderate-intensity activity should make your heart beat faster. You’ll feel warmer and breathe slightly harder, but you should still be able to hold a conversation.
You may find it easier to do shorter periods of activity at first and build up to 30 minutes a day especially if you have fatigue or are new to exercise. If you choose an activity that you enjoy, you’re more likely to do it regularly. Any amount of activity is better than none, so try to minimise the time you are inactive as much as you can.
You should consult your doctor before starting any new exercise routine. They may refer you to a physiotherapist if you need extra guidance or support.
As well as activities like walking, aim to do muscle-strengthening activities at least twice a week. These activities can help strengthen your muscles after treatment, and include:
- sitting to standing
- press-ups against the wall
- lifting light weights (you could use tins of food or small bottles of water)
- activities that involve stepping and jumping such as dancing
- using fitness equipment such as a static bike or cross trainer
- yoga or Pilates
Talk to your GP before beginning a new muscle-strengthening activity.
Smoking has been linked to a higher risk of fractures, so it’s a good idea to stop or cut down if you smoke. If you need help to stop smoking, speak to your GP or visit the NHS Smokefree website.
Treatments to prevent or treat osteoporosis
Find out more about different ways to prevent or treat osteoporosis.