What You Can Do to Protect Your Bones at Every Age

Osteoporosis is a chronic condition where bone mineral density drops low enough that bones become fragile and break more easily. The word literally means “porous bone.” Bones lose minerals — especially calcium — and the internal structure deteriorates, increasing the risk of fractures from falls or even everyday movements.
Osteopenia is the stage before osteoporosis. Bone mineral density is lower than normal but hasn’t reached the osteoporosis threshold. Osteopenia can progress to osteoporosis if left unmanaged — but with the right nutrition and lifestyle changes, that progression can be slowed or prevented.
In 2022, an estimated 3.4% of Australians were living with osteopenia or osteoporosis. Falls linked to low bone mineral density accounted for 29% of fall-related injuries. When a fracture occurs due to osteoporosis, it can result in chronic pain, reduced independence, and — in some cases — premature death. Hip fractures in older adults carry a particularly high mortality risk within the first 12 months.
The good news? Bone health is something you can actively support — through food, movement, and the right professional guidance.

Who Is Most at Risk?

Reduced bone mass is more common in certain groups. Understanding your risk factors helps you and your dietitian focus on the right strategies.
Postmenopausal women face the highest risk. The drop in oestrogen after menopause accelerates bone mineral loss. Women can lose up to 10% of their total bone mass in the first five years after menopause.
Older adults of all genders experience gradual bone loss from around age 35 onward. The rate increases with age, particularly after 70.
Other risk factors include low vitamin D levels, long-term corticosteroid use (for conditions like asthma, rheumatoid arthritis, or inflammatory bowel disease), smoking, excessive alcohol intake, a sedentary lifestyle, and low body weight.
People living with certain disabilities also face increased risk. Research shows higher rates of low bone mineral density in people with schizophrenia (Stubbs et al., 2014), people taking certain anti-epileptic medications, people with Down syndrome (Geijer et al., 2014), and people with limited or no mobility. If you’re an NDIS participant or carer supporting someone in these groups, bone health is worth discussing with a dietitian.

How Osteoporosis Is Diagnosed

Osteoporosis diagnosis requires a bone mineral density test. A DXA scan (dual-energy X-ray absorptiometry) measures bone density — usually at the hip and spine — and produces a T-score.
A T-score of -1.0 or above is considered normal. A T-score between -1.0 and -2.5 indicates osteopenia. A T-score of -2.5 or below indicates osteoporosis.
Your GP can refer you for a DXA scan. Medicare covers the scan for people over 70, postmenopausal women with risk factors, and anyone with a history of minimal trauma fracture. Healthy Bones Australia provides a risk assessment tool on their website to help you decide whether to discuss screening with your doctor.

Calcium — The Most Important Nutrient for Bone Health

Calcium is the primary mineral in bone tissue. Adequate calcium intake supports bone mineral density at every age. The body cannot manufacture calcium — it must come from food or supplements.

How Much Calcium Do You Need?

Recommended daily calcium intakes vary by age and sex:

  • Children 1–3 years: 500mg per day
  • Children 4–8 years: 700mg per day
  • Children 9–11 years: 1,000mg per day
  • Teenagers 12–18 years: 1,300mg per day
  • Adults 19–50 years: 1,000mg per day
  • Women over 50 years: 1,300mg per day
  • Men over 70 years: 1,300mg per day

Calcium-Rich Foods — A Practical Guide

You don’t need to rely on supplements to meet your calcium targets. Many everyday foods provide meaningful amounts of calcium.

  • Cow’s milk — 240mg per 200ml glass
  • Calcium-fortified plant milks (soy, almond, oat) — 240mg per 200ml (check the label — not all plant milks are fortified)
  • Dairy yoghurt — 200mg per 150g tub
  • Hard cheese (cheddar, parmesan) — 240mg per 30g slice
  • Soft cheese (brie, feta, mozzarella) — 120–180mg per 30g
  • Sardines with edible bones — 240mg per 60g (canned in oil)
  • Tinned salmon with bones — 200mg per 90g (small tin)
  • Tofu (calcium-set) — 126mg per 120g
  • Bok choy — 84mg per ½ cup (cooked)
  • Broccoli — 110mg per 120g (raw weight)
  • Chickpeas — 99mg per 200g (cooked)
  • Almonds — 75mg per 30g (a small handful)
  • Oranges — 60mg per medium orange
  • Dried figs — 96mg per 60g
  • Calcium-fortified breakfast cereals — 200mg per cup

Three serves of dairy (or calcium-fortified alternatives) per day typically provides around 700–800mg of calcium. Adding a serve of leafy greens, tinned fish with bones, or almonds can bring you close to or above your daily target.
If you’re unsure whether you’re meeting your calcium needs, an Accredited Practising Dietitian (APD) can assess your dietary intake and recommend specific food changes — or supplements if needed. If you’re weighing up whether supplements or real food is the better approach, our guide covers the differences.

Vitamin D — Essential for Calcium Absorption

Calcium can’t do its job without vitamin D. Vitamin D helps the intestines absorb calcium from food. Without adequate vitamin D, even a high-calcium diet won’t fully protect your bones.
The body produces vitamin D when skin is exposed to ultraviolet B (UVB) radiation from sunlight. In Melbourne, UVB levels are sufficient for vitamin D production during spring and summer — but drop significantly during autumn and winter. Many Melburnians develop vitamin D insufficiency over the colder months, particularly people with darker skin, people who cover most of their body for cultural or medical reasons, and people who spend most of their time indoors.
Food sources of vitamin D include oily fish (salmon, sardines, mackerel), eggs, and fortified foods like some milks and margarines. However, food alone rarely provides enough vitamin D to maintain optimal levels. Your GP can check your vitamin D status with a blood test, and supplementation is commonly recommended — particularly for older adults, NDIS participants with limited outdoor access, and people in residential care.
The recommended daily intake of vitamin D for adults is 600 IU (15 micrograms), increasing to 800 IU (20 micrograms) for adults over 70. Your GP or dietitian can advise on the right dose for your situation.

Exercise — Building and Maintaining Bone Strength

Weight-bearing exercise stimulates bone-forming cells (osteoblasts) and helps maintain bone mineral density. Exercise also improves balance and muscle strength — reducing your risk of falls, which is the primary cause of osteoporotic fractures.

Effective exercise types for bone health include:

  • Weight-bearing activities: walking, jogging, dancing, stair climbing, tennis
  • Resistance training: lifting weights, using resistance bands, bodyweight exercises like squats and lunges
  • Balance and coordination exercises: tai chi, yoga, standing on one leg

The Australian Government physical activity guidelines recommend at least 30 minutes of moderate-intensity physical activity on most days of the week for adults. For bone health specifically, resistance training at least 2–3 times per week provides the most benefit.
If you have existing osteoporosis or mobility limitations, an exercise physiologist or physiotherapist can design a safe programme tailored to your ability. Exercise doesn’t treat established osteoporosis on its own — but combined with good nutrition, it plays an important role in reducing fracture risk.

Other Factors That Affect Bone Health

Smoking accelerates bone loss. Excessive alcohol intake (more than two standard drinks per day) reduces calcium absorption and increases fracture risk.
Certain medications affect bone density over time. Long-term corticosteroids, some anti-epileptic medications, proton pump inhibitors (used for reflux), and some cancer treatments can all contribute to bone loss. If you’re on any of these medications, discuss bone health monitoring with your GP.
Protein intake also matters. Adequate dietary protein supports bone mineral density — particularly in older adults. Research shows that higher protein intake, when combined with sufficient calcium, is associated with lower fracture risk. Good protein sources include dairy, eggs, lean meat, fish, legumes, tofu, and nuts.

What a Dietitian Can Help With

A clinical dietitian at Accelerate Nutrition can assess your dietary calcium and vitamin D intake, identify gaps, and build a practical nutrition plan that fits your lifestyle and preferences.

Your dietitian can also help with:

  • Reviewing your overall diet for bone-supporting nutrients — calcium, vitamin D, protein, magnesium, and vitamin K
  • Navigating food choices when you have multiple health conditions (for example, managing calcium intake alongside a low-sodium diet for high blood pressure)
  • Coordinating with your GP around supplementation and medication interactions
  • Supporting NDIS participants and older adults who may face additional barriers to eating well

If you’re managing other chronic conditions alongside bone health, our guide on managing health conditions with nutrition covers how a dietitian supports the bigger picture. For older adults navigating nutrition and aged care, our post on dietitian support for adults explores home visits, aged care packages, and what a first appointment looks like.
Appointments are available via home visit, telehealth, or in clinic at Dandenong and Glenroy. Medicare-funded sessions are accessible through a Chronic Disease Management (CDM) plan from your GP. NDIS, DSOA, and Support at Home funding may also cover dietetic support.