The Reason You Should Be Thinking About Bone Health by Your 20s May Surprise You

It may be the last thing on your mind, but starting good habits early is critical for good health now and mobility later

Taking care of your bone health isn’t on the minds of most people in their 20s, 30s, and even 40s.. Sure, we know our bodies can begin to get slower as we age—our hearing deteriorates, perfect eyesight dwindles, and endurance takes a hit. But these are changes we expect to happen in middle age or even later.

What many don’t realize is that bone mass reaches its peak in our 20s, according to board-certified pediatric rheumatologist Jennifer Weiss, MD. Antonia F. Chen, MD., MBA, the chair of the Department of Orthopaedic Surgery at UT Southwestern Medical Center, agrees, adding that our bone health starts declining in our late thirties and early forties. 

“Typically, it happens gradually and only becomes possible to detect if you lose some height, develop a stooped posture, or break bones,” Chen says. “If you break, or fracture, one bone, that is an indication of poor bone health and increases the likelihood of breaking other bones.” 

But what if you don’t show any obvious signs of bone deterioration? Does that mean your bone health is in the clear? Not necessarily. Bone mass naturally declines over time—that’s just part of aging. However, how quickly it declines depends on how well you take care of your bones, especially in your younger years.

“Ensuring a healthy, nutritious diet including adequate calcium, vitamin D, and protein intake, alongside high-impact weight-bearing exercises, are key to maximizing bone growth,” rheumatologist Nicole Leung, MD, explains. “A high peak bone mass will help to decrease risk for osteoporosis in older age.” 

Ready to start prioritizing your bone health? Read on. 

How to Take Care of Your Bone Health 

Taking care of your bones now can help prevent problems later in life. Here are some key ways to keep them strong and healthy.

Diet 

As the saying goes, everything starts with your diet—and that includes bone health. Your body needs plenty of calcium to maintain strong bones. Dairy-based foods like yogurt, cheese, and milk are great sources, as well as fish such as sardines and salmon. For vegans and vegetarians, seeds, legumes, and leafy greens such as bok choy and kale provide solid calcium options.

Calcium alone isn’t enough; vitamin D is essential for helping your body absorb it. Dr. Leung recommends supplements, as few foods naturally contain high levels of vitamin D. However, if you prefer a natural approach, Dr. Chen suggests spending time in the sun as an alternative source.

Exercise

Diet alone won’t cut it—regular exercise is just as important. But not all workouts are equally beneficial for your bones.

Dr. Chen recommends weight-bearing exercises to slow bone loss. “Activities like walking, stair climbing, and playing sports like pickleball are great for both bone and muscle health,” she says. Strength training, including resistance bands and weightlifting, also helps maintain bone density by keeping muscles strong and engaged.

Lifestyle Factors

We know excessive alcohol consumption can harm the body, increasing the risk of cancer and other health issues. But it also affects the growth (and deterioration) of your bone cells. “Smoking cigarettes and excessive alcohol consumption—three or more drinks per day—can kill bone cells and worsen bone density,” says Dr. Leung. 

Stress is another factor, too. Dr. Weiss says our bones form and strengthen depending on our body’s response to stress. The more stress we have, the weaker our bones become. Healthily manage stress through mindfulness, meditation, exercise, or talk therapy with a licensed professional.

Similarly, Dr. Chen warns that women need to be especially mindful of their bone health, as hormonal changes play a significant role in bone density. Breastfeeding mothers and individuals in perimenopause should increase their intake of vitamins and minerals to support bone strength during these transitional phases 

Why Should You Care About Your Bone Health 

You’re probably wondering: why does bone health matter if it’s going to deteriorate anyway? Poor bone health comes with a decline in quality of life and an array of health risks, including osteoporosis.

Most people don’t realize they have osteoporosis until it’s too late. It’s “a silent disease because there is no pain with bone loss,” Dr. Leung says. Osteoporosis weakens bones, making them fragile and more likely to break. Weak bones can lead to significant mobility issues and long-term health complications.

Dr. Leung adds that recent fractures due to low bone mass (even if you are young) increase the risk of another fracture, especially in the first few years after a break. And the more fractures you have, the harder it is to regain all the bone mass you’ve lost.

So, while taking care of your bones might not feel particularly urgent now, it will pay off by way of preventing complications later in life. 

Take a Bone Density Test

If you’re concerned about your bone health, consider taking a bone density test. “[It] tells you about how much bone you have and is one of the determinants of future risk for fracture,” Dr. Leung says. While most people get tested in their 50s, Dr. Weiss emphasizes that it’s never too early, especially if you have a family history or other risk factors for low bone mass.

Certain medical conditions and medications can also impact bone health. “Medical conditions such as rheumatoid arthritis, or medications such as steroids, antidepressants, and hormone deprivation therapies for cancer treatment can affect bone health,” explains Dr. Leung. If you fall into any of these categories, talking to your doctor about a bone density test may be a proactive step toward maintaining strong bones. 

Keep in Mind 

All of this might sound a bit overwhelming, particularly if you’re young and focused on other aspects of your health at the moment. But here’s the thing: while it may seem like keeping your bones healthy requires a complicated routine, it’s actually simpler than you might think. It’s really about making small changes that you should already be doing to improve your overall quality of life.

As Dr. Weiss puts it, “Bone health is a habit, just like brushing your teeth. A healthy diet and weight-bearing exercises throughout life are the most important ways to build and maintain strong bones.”