Looking after your bones

If you're worried about your risk of osteoporosis, certain lifestyle changes can help you look after your bones. For example:

• Eating a healthy diet that includes plenty of calcium and vitamin D
• Limiting your alcohol intake
• Being physically active
• Not smoking

If you’ve already lost some bone density or have osteoporosis, lifestyle changes cannot cure or reverse this but may stop it getting worse.

Find out more about osteoporosis and breast cancer treatment.

A varied and balanced diet can give you the nutrients that are important for strong, healthy bones.

Calcium

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 get enough calcium through a healthy diet that includes dairy products, such as:

• Milk
• Yoghurt
• Cheese

Having 3 portions of dairy a day will give you the recommended amount of calcium.

If you do not eat or drink any dairy products, it’s important to make sure you still get enough calcium in your diet from other non-dairy sources such as:

• Leafy green vegetables (such as broccoli, watercress and kale)
• Oily fish (such as sardines and mackerel)
• Some types of fruit (such as oranges, satsumas and dried figs)

Some dairy-free milks or meat alternatives like tofu are also fortified with calcium.

The Royal Osteoporosis Society has more information on getting enough calcium in your diet.

The Eatwell Guide has information about good sources of calcium. Alternative versions are also available for vegetarian and vegan diets.

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 to 1,200mg a day.

You may need to take a calcium supplement if you do not get enough calcium from your diet. You can speak to your GP or treatment team for advice about calcium supplements and increasing your calcium intake through your diet.

Vitamin D

Your body needs vitamin D to help it absorb calcium. You can get vitamin D from:

• Sunlight
• Food
• Supplements

Sunlight is the main source of vitamin D. Your body uses it to make vitamin D in your skin.

From April to September, sunlight is strong enough for our bodies to make vitamin D on exposed skin such as the face, legs and arms. However, it’s still important to stay safe in the sun and wear a high sun protection factor (SPF) suncream.

The NHS recommends all adults in the UK take a vitamin D supplement during autumn and winter.

Some people may not get enough vitamin D from sunlight because of little or no exposure to the sun, for example if they wear clothing that covers most of their skin or are housebound. If this is the case, your GP or treatment team may recommend you take a vitamin D supplement throughout the year.

You can get some vitamin D from food. But even if you have a healthy and well-balanced diet that provides all the other vitamins you need, it’s unlikely to provide enough vitamin D.

You can find information about good vitamin D sources on the NHS website.

Drinking too much alcohol can affect your bone strength and thickness (density). The National Institute for Health and Care Excellence (NICE) recommends people who have had breast cancer limit their alcohol intake to below 5 units per week.

You can find out how many units are in your drinks by using an online unit calculator. As a general guide:

• A can of beer, lager or cider (440ml, 5.5%) = 2.4 units
• A standard glass of wine (175ml, 12.5%) = 2.1 units
• A single shot of spirits (25ml, 40%) = 1 unit

Regular physical activity and exercise are important for maintaining bone health.

Types of activity

Regular weight-bearing exercise or activities help stimulate growth and maintain bone and muscle strength.

Weight-bearing exercise is any exercise where you support the weight of your own body.

Weight-bearing exercises can be moderate-impact or low-impact.

Moderate-impact activities include:

• Running
• Skipping
• Aerobics
• Tennis

Low-impact activities include:

• Walking
• Dancing
• Stair climbing
• Cross training machines

It’s also good to do muscle-strengthening exercise or activities, using either your own body weight or resistance to make your muscles work harder. As your muscles get stronger, they pull harder on your bones, which helps your bones get stronger too. Examples of muscle strengthening exercises include:

• Lifting weights
• Using resistance bands
• Squats
• Heavy gardening, like digging
• Hill walking

The type of activity you do will depend on your individual needs and current abilities, such as your fitness level, any effects of treatment or other health problems you might have.

Getting advice about physical activity 

If you have osteoporosis and have a high fracture risk, you may need to change your exercises and avoid any awkward or sudden bending and twisting because of a higher chance of injury.

Speak to your GP or treatment team before starting any new exercise routine. They may refer you to a physiotherapist if you need extra guidance or support.

The Royal Osteoporosis Society has information on exercise for bone health.

The NHS website also has information on exercise for strong bones and building strength and flexibility.

Watch our Facebook Live about exercise interventions for people with breast cancer.

Smoking has been linked to increased bone loss and a higher risk of fractures, so it’s important to stop or cut down if you smoke. If you need help to stop smoking, speak to your GP or visit the NHS Better Health website.

For more information and support on looking after your bones during treatment, you can call our free helpline – see below for ways to get in touch.

You can also see more information about osteoporosis and bone health on the Royal Osteoporosis Society website.

They also have an osteoporosis risk checker tool where you can get personalised bone health recommendations.