Your Bone Health as You Age

From Childhood to Young Adulthood, Middle Age, 50 and Beyond

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You probably don’t think about your bone health as often as you should especially if you are a young adult or in middle age. But your bone health is important regardless of your age.

Whether you are a teenager, a young adult, in middle age, or an older adult, you still need to eat right, keep moving, and get enough calcium and vitamin D to keep your bones strong and minimize bone loss. Here is what you need to know about bone health at every stage of life.

How Bone Health Develops With Age

Laura Porter / Verywell


Childhood and adolescence are the most important years for bone building in the human skeleton. The greatest gains in bone size and strength occur when the hormones of puberty start to speed up bone growth. During this time, bones will get longer, wider, and thicker.

The adolescent bone-building period will continue until the largest and densest peak bone mass has been reached, which is by the late teens or early 20s. And by age 30, most bones have already started to slowly lose mass.

Peak bone mass, according to the National Osteoporosis Foundation, is the greatest amount of bone a person can attain. Children and adolescents who have higher peak bone mass will when they are older have a reduced risk of osteoporosis—a bone disease where bones become weak, brittle, and vulnerable to breaks.

The bone mass accumulated during childhood and adolescence is the best protection you have against bone loss, osteoporosis, and fractures later in life.

Childhood bone health is influenced by inherited genes, hormones, environment, and lifestyle. Genetic factors seem to have the strongest influence on bone mass. And researchers think 60% to 80% of peak bone mass contribution is genetically determined.

But for a child to achieve optimal peak bone mass, genes simply aren’t enough. Other factors come into play like hormones, a healthy diet, and an active lifestyle.

Young Adulthood

Young adulthood is the time where most people achieve their peak bone mass. By age 30, your bones will be at maximum strength and bone density.

People in their 20s often think they don’t need to worry about their bone health or osteoporosis but this isn't true. Even though osteoporosis tends to affect older adults, it can still affect young people in their 20s and 30s. It can even affect children.

And while it is true you will eventually be older and might develop osteoporosis, you are never too young to reduce your risk of developing the condition. Make sure you are making smart lifestyle choices—like being active, eating healthy, not smoking, and reducing your alcohol consumption—to keep your bones strong and healthy for life.

Research shows physical activity is the most important thing you to can do throughout your life to improve bone mass. Being active during this high bone peak period and into middle adulthood can bring about the most important improvements in peak bone density.

You should aim to get 1,000 milligrams (mg) of calcium daily. You might also consider a daily vitamin D supplement because it can be hard to get the recommended 600 IUs (international units) from your diet alone.

Middle Adulthood

After reaching peak bone mass, you will gradually begin to lose bone. And up until this point in your life, your body has been continually shedding old bone and replacing it with new bone through a process called bone remodeling. After reaching peak bone, the bone remodeling process starts to slow down.

Women who have entered menopause will experience significant bone resorption (shedding) and less new bone formation. Most women in North America will experience natural menopause between ages 40 and 58, according to The North American Menopause Society.

Once estrogen levels start to dramatically drop—which is what happens when you hit menopause, women will experience rapid bone loss that leads to reduced bone strength and increased fracture risk. This explains why osteoporosis is more common in women, and why women are affected by the condition at younger ages than men.

When you are in your 30s and 40s, bone loss can affect you regardless of your sex. According to a study reported in 2019 by The Journal of the American Osteopathic Association, 1 in 4 middle-aged adults have weakened bones.

The study looked at 173 men and women between the ages of 35 and 50. Researchers found that 25% of the study participants already had osteopenia, a condition where bones start to weaken. Osteopenia increases your risk of osteoporosis later in life.

Middle adulthood is an important time to manage modifiable risk factors. Modifiable risk factors are the ones you have control over like not smoking or drinking alcohol in excess, increasing dairy intake, being active, eating healthy, and keeping a healthy weight.

Getting enough exercise, calcium, and vitamin D are the best ways to minimize bone loss. Exercise can also help you to keep muscle mass, which will protect and strengthen the surrounding bones and reduce your risk for fractures.

Over Age 50

The calcium intake requirement after age 50 increases for women to 1,200 mg. It remains at 1,000 mg for men. The amount of vitamin D you need daily is still 600 IUs. It will increase to 800 IUs a day from age 71 on. 

Women are four times more likely than men to develop osteoporosis. In fact, they make up 80% of all people with osteoporosis. And after age 50, women will have more fractures than men. Before that, men under 50 have higher incidences of trauma injuries from sports activities than do women under age 50.

According to the National Osteoporosis Foundation, 1 in 4 men over age 50 will break a bone due to osteoporosis. And each year, 80,000 men with osteoporosis will break a hip. Men who break a hip are more likely than women to die within a year after the break due to problems that arise from the break (i.e. infectious conditions like sepsis).

It is never too late to prioritize your bone health even after age 50. If you smoke, you will want to quit. According to the National Osteoporosis Foundation, smoking is a major risk factor for osteoporosis. Excessive alcohol consumption can also adversely affect your bone health, so it makes sense for you to limit your alcohol intake to one or two drinks per day. 

Talk to your healthcare provider about what changes you can make to support your bone health and overall well-being. This is especially important if osteoporosis runs in your family. Because even if you do everything throughout your life to keep your bones strong and healthy, heredity may not be in your favor.

If you are concerned about your bone health or osteoporosis runs in your family, ask your healthcare provider about getting a dual-energy X-ray absorptiometry (DEXA) scan. These scans can be helpful in determining early signs of bone loss or, if you have already been diagnosed with osteoporosis, they can help your practitioner to know if and when they need to prescribe medicines to strengthen your bones.

70 and Beyond

Preventing falls is important when you reach your 70s. According to the National Council on Aging, falls are the leading cause of fatal injuries and the most common cause of trauma requiring hospitalization in older adults.

Falls cause many older people to lose their independence, which includes having to leave their homes and move into nursing homes or assisted living facilities.

The good news is that most fractures can be prevented and having strong bones can reduce your fracture risk even after age 70. Both men and women should aim to get 1,200 mg of calcium and 800 IUs of vitamin D daily to help them maintain bone strength and prevent bone breaks.

A Word From Verywell

If you are worried about your bone health or risk factors for osteoporosis, talk to your healthcare provider. They may recommend a DEXA scan. Those results can help your practitioner determine where your bone density is and the rate of bone loss.

Having this information and knowing your risk factors can help your healthcare provider determine whether you might need medications to slow down bone loss and strengthen your bones.

15 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Soliman A, De Sanctis V, Elalaily R, et al. Advances in pubertal growth and factors influencing it: Can we increase pubertal growth?. Indian J Endocrinol Metab. 2014;18(Suppl 1):S53-S62. doi:10.4103/2230-8210.145075

  2. National Osteoporosis Foundation. Peak bone mass.

  3. Levine MA. Assessing bone health in children and adolescents. Indian J Endocrinol Metab. 2012;16(Suppl 2):S205-S212. doi:10.4103/2230-8210.104040

  4. Bielemann RM, Martinez-Mesa J, Gigante DP. Physical activity during life course and bone mass: a systematic review of methods and findings from cohort studies with young adults. BMC Musculoskelet Disord. 2013;14:77. doi:10.1186/1471-2474-14-77

  5. National Osteoporosis Foundation. Get the facts on calcium and vitamin D.

  6. National Institutes of Health. Vitamin D fact sheet for consumers.

  7. Demontiero O, Vidal C, Duque G. Aging and bone loss: new insights for the clinician. Ther Adv Musculoskelet Dis. 2012;4(2):61-76. doi:10.1177/1759720X11430858

  8. The North American Menopause Society. Are we there yet? Navigate now with our guided menopause tour.

  9. Manolagas SC, O'Brien CA, Almeida M. The role of estrogen and androgen receptors in bone health and disease. Nat Rev Endocrinol. 2013;9(12):699-712. doi:10.1038/nrendo.2013.179

  10. Bass MA, Sharma A, Nahar VK, et al. Bone mineral density among men and women aged 35 to 50 years. J Am Osteopath Assoc. 2019;119(6):357-363. doi:10.7556/jaoa.2019.064 

  11. Dietary reference intakes for adequacy: calcium and vitamin D. In: Dietary Reference Intakes for Calcium and Vitamin D. Ross AC, Taylor CL, Yaktin Al, et al., editors.

  12. Alswat KA. Gender disparities in osteoporosis. J Clin Med Res. 2017;9(5):382-387. doi:10.14740/jocmr2970w

  13. National Osteoporosis Foundation. Just for men

  14. National Osteoporosis Foundation. Smoking and bone health.

  15. National Council on Aging. Falls prevention facts.

By Lana Barhum
Lana Barhum has been a freelance medical writer since 2009. She shares advice on living well with chronic disease.