More than half of Americans age 50 or older have osteoporosis or low bone mass (osteopenia). In osteoporosis, the bone gradually demineralizes until it becomes porous and lace-like, brittle, and breaks easily. Most of us don’t think about bone health until we hit 50+, but the choices we make every day have a tremendous influence on the ability of our bones to hold us up.

Osteoporosis affects five times more women than men, triggered by the rapid fluctuation and drop of estrogen in menopause and compounded by the fact that most women typically have less dense bones than men to begin with. That said, one third of hip fractures occur in men, who usually suffer worse outcomes and greater mortality than women.

Basics to Build Bones

The core formula for bone density starts with this trifecta. It takes all three together to ensure strong bones. Skimp on one, and you don’t get the impact.

• calcium intake
• vitamin D
• weight-bearing exercise

Nutrients for Bone Health

Magnesium, boron, vitamin K, and silica all help to build strong bones. You need a healthy digestive system to absorb those nutrients.

Start with a nutrient-rich diet, and not just from dairy (which gets mixed reviews) but also from leafy greens, cruciferous vegetables, beans, and bones like bone broth, bones-in simmered dishes, sardines, and canned salmon.

Supplements help fill in the gaps.

Recipes for Strong Bones

Knowing these nutrients, we can create delicious ways to make our body stronger. “Let food be your medicine and medicine be your food,” to paraphrase Hippocrates.

Exercise for Bone Strength

Weight-bearing exercise tells your body to build bone for the perceived future need, using calcium and other nutrients from the diet, which it can’t use without enough vitamin D.

What Chews at Your Bones?

Estrogen protects bones, but when it begins to wane in perimenopause, the balance shifts quickly. In addition, two overarching themes encourage the body to break down bone or impair its ability to build it: inflammation and acidity. That’s partly because your body uses calcium ions (which often get pulled from bones) to buffer acidity in the body to keep your pH stable. Increased risk of osteoporosis is linked to smoking, inactivity, stress, inadequate sleep, diabetes, etc. Too much caffeine, salt, red meat, soda, and sugar also wear away at bones.

Strong Bones by the Decade

• In Your 20s

  You build bone primarily during youth, so enjoy a healthy, plant-focused diet and regular activity. Consider digestive bitters and bitter salad greens that encourage healthy digestion.

  Avoid soda, smoking, excessive drinking, salt, and extreme dieting. Excessive red meat (sorry, Paleo peeps) is one of the worst foods for bone density. Strict vegan diets can miss important nutrients, but if carefully followed and supplemented, legume-rich vegetarian and vegan diets tend to benefit bones.

• In Your 30s

  Consider adding a calcium and vitamin D supplement alongside diet. Aim for 1,000 milligrams (mg) of calcium and a minimum 600 mg vitamin D daily. Calcium carbonate is cheap and dense (which means fewer pills), but calcium citrate, hydroxyapatite, or calcium chelated to amino acids are all better absorbed. Whatever form of calcium you choose, divide it up morning and night and take it with food for optimal absorption.

  Protect your bones during pregnancy. Your developing baby pulls from your calcium stores (your bones) if you’re not consuming enough. Eat healthfully and take a prenatal multivitamin plus a calcium supplement, ensuring optimal calcium intake.

  Carve out time for stress management, adequate sleep, exercise, and nutritious food.

  Watch caffeine and alcohol consumption; find better ways to energize and relax.

• In Your 40s

  Scrutinize medications that accelerate bone loss, such as antacids and proton-pump inhibitors as well as glucocorticoids and steroids. Work with your doctor and naturopathic doctor or herbalist to seek natural alternatives whenever possible.

  In perimenopause, consider hormone balancing, boneprotecting herbs like black cohosh or red clover. Talk to your natural practitioner first if you have a risk of estrogen-dependent cancers.

  Boost your daily intake of beans and legumes, which contain plant estrogens that may help prevent bone loss.

  Get out hiking, running, or walking regularly, and do regular strength-training exercises.

  Add strong-brewed nutritive herbal teas like nettle leaf, red clover blossom, oat straw, and horsetail as well as bone broth to your routine.

  Don’t ignore chronic inflammatory diseases, including prediabetes, thyroid conditions, and chronic pain.

• 50s and Beyond

  Start regular bone density DEXA screenings with your primary care practitioner at age 65, but talk to your doctor when you turn 50 to see if you have risk factors that warrant earlier testing.

  Boost your calcium intake to 1,200 mg daily with 800 mg or more vitamin D, and consider a formula with additional nutrients like boron, vitamin K, magnesium, and silica. Yes, you’ll have to take several pills to get this in! Those herbal teas and bone broths help too.

  Keep up the strength training and weight-bearing routines.

  Don’t stop moving. Mind your mobility with gentle, regular exercises like walking and yoga. Seek professional guidance and physical therapy if pain impinges on your ability to move comfortably.

  Support your balance and reduce falls with yoga, t’ai chi, and sensible footwear.

Diet can play a significant role in controlling the symptoms and progression of rheumatoid arthritis (RA). A recent study in the journal Frontiers in Nutrition lists blueberries, ginger, olive oil, and green tea among the beneficial foods.

Foods for Rheumatoid Arthritis (RA) Relief

RA causes pain, swelling, and stiffness in the joints. The authors of the study determined that certain foods can help reduce inflammation brought on by the disease. They also specified dried plums, pomegranates, whole grains, and turmeric, among others.

“Regular consumption of specific dietary fibers, vegetables, fruits, and spices, as well as the elimination of components that cause inflammation and damage, can help patients manage the effects of rheumatoid arthritis,” said researcher Bhawna Gupta, PhD. “Incorporating probiotics into the diet can also reduce the progression and symptoms of this disease.” Yogurt, kefir, and sauerkraut are rich in probiotic bacteria.

It’s an astounding number: 54 million American adults report receiving a diagnosis of arthritis or similar joint disorder from their doctors. That’s about one in four Americans, “making arthritis one of the most common, if not most common, chronic medical condition,” says rheumatologist Nathan Wei, MD, director of the Arthritis Treatment Center, in Frederick, MD.  

Collagen & Joint Health

Collagen hydrolysate may help lessen joint pain. Collagen supplements supply a rich source of peptides and amino acids that the body needs to make collagen in joint cartilage. Studies show that collagen hydrolysate taken orally accumulates in cartilage. Other research indicates that statistically significant results start to occur after three months of supplementation, but not before.

These joint problems range from osteoarthritis and rheumatoid arthritis to gout, lupus, and fibromyalgia. It’s not just older people who suffer, as Dr. Wei points out: “Approximately 60 percent of those affected by arthritis are under the age of 65.”

Glucosamine/Chondroitin

People seeking relief from joint pain often take glucosamine- and chondroitin-containing supplements: Both ingredients rebuild joint cartilage. These heavy hitters are what Dr. Wei recommends to his patients who have osteoarthritis, and he takes them himself. The compounds have similar and complementary roles in the body.

“While the studies are in conflict, I believe there’s enough evidence to recommend it. The dosage I recommend is glucosamine 500 milligrams (mg)/chondroitin 400 mg, three capsules daily for one month, and then one capsule twice dai-ly,” he explains.

In a recent study, adults with knee osteoarthritis who supplemented with a combination including both glucosamine and chondroitin experienced improved walking speed (which is tied to a decrease in knee pain). It’s clear that these supplements, as a combination, reduced pain since those with knee osteoarthritis who started supplementing needed fewer NSAIDs (nonsteroidal anti-inflammatory drugs). NSAID use dropped by 7 percent in the first month of glucosamine/chondroitin supplementation and went down by 37 percent after three months of supplement use.

NSAIDs, such as aspirin, Celebrex, and Advil, ease joint pain while also reducing inflammation of joints and soft tissues, which is why so many people rely on them. But they do have downsides, which makes natural alternatives desirable.

NSAIDs work by blocking the production of prostaglandins (hormonelike substances that can trigger inflammation). But blocking these inflammation-promoting prostaglandins is also the source of NSAID side effects. Prostaglandins play other roles in the body. For example, they control the secretion of gastric juices and the mucus that lines the stomach. This is why NSAIDs are linked to ulcers and life-threatening gastric bleeding when used long term.

Fish Oil

Osteoarthritis is known as the wear-and-tear disease, since pain and disability stem from a wearing away of cartilage in the joint. Rheumatoid arthritis, however, relates to underlying inflammation as the core problem. Inflammation is a complex biological response that, under normal circumstances, initiates healing. In rheumatoid arthritis, however, the inflammation is without cause and becomes chronic. It is this chronic nature of the inflammation that becomes destructive to afflicted joints.

For patients experiencing inflammation-related joint issues, Dr. Wei recommends fish oil. Omega-3 fatty acids in fish oil fight inflammation, which helps in three key ways: decreased joint pain, less morning stiffness, and reduced reliance on NSAID medications for pain relief.

“Fish oil generally comes as a 360 mg capsule, and I recommend at least two a day,” says Dr. Wei. “Fish oil has also been shown to be valuable for patients with heart disease,” which makes this supplement valuable for multiple reasons.

Turmeric

The spice turmeric contains the active ingredient curcumin, which is a well-established antioxidant and an-ti-inflammatory. Joint function improves and pain is reduced when turmeric supplements are used.

A large body of research backs up the use of curcumin for healthier joints.

Turmeric comes in different forms, so Dr. Wei recommends following the manufacturers’ suggested dosing.

Additional Joint-Friendly Supplements

Consider these additional dietary supplements and herbs that Nathan Wei, MD, recommends for joint relief:

• Boswellia
• Bromelain
• Garlic
• Ginger

Slather It On

Arnica creams and gels can provide topical relief for sore joints. You simply rub the herb-based cream/gel onto your sore area to relieve pain and minimize swelling. When arnica gel went head to head with an ibuprofen gel in a group of 204 adults with osteoarthritis pain, the arnica alleviated symptoms and improved joint function as well as the ibuprofen. Considering that arnica comes with far fewer side effects than the conventional pain reliever, it’s certainly worth a try (except in those allergic to arnica or related plants, such as chamomile or marigolds).

Creak, pop! One in five American adults experiences painful joints (mostly due to osteoarthritis or rheumatoid arthritis), and when sore joints from sports injuries, overuse, and strain associated with being overweight get added in, that’s a whole lot of achiness nationwide.

Joints are complicated structures that “rely on bone, muscle, and ligaments all working together to provide a full range of motion,” says Holly Lucille, a Los Angeles-based naturopath. Understanding the source of your joint pain or inflammation is important, she adds, in order to pinpoint the most effective remedy. It could be an autoimmune disease such as rheumatoid arthritis, but in other cases, food sensitivities can be the culprit.

Supplements to Ease Joint Pain

Natural remedies offer a powerful and safe way to ease symptoms and promote joint healing. “Multiple studies demonstrate that natural remedies can be more effective than their pharmaceutical counterparts,” says Jacob Teitelbaum, MD, author of From Fatigued to Fantastic!

The exciting part of giving a natural remedy a go, he adds, is that, unlike conventional medications that come with side effects, herbal healers tend to give “side benefits.” For example, while you might try an herb like turmeric for a swollen knee, while taking this multipurpose herb, you could end up also soothing your heartburn.

Remember: you should always consult your healthcare practitioner before adding supplements to your regimen.

1. Turmeric

   The Indian spice turmeric contains an active ingredient called curcumin that reduces inflammation in a variety of ways, including the down-regulation of COX-2 enzymes; suppressing COX-2 enzymes is also the way NSAIDs like aspirin and ibuprofen work. When inflammation quiets down, joints feel less painful and stiffness fades away.

   Dr. Teitelbaum likes combining curcumin with the herb boswellia. “This combination was shown in a head-on study to be more effective than the commonly prescribed drug Celebrex,” he says.

   Although it is fine to try these herbs while also taking a prescription arthritis or pain medication, if you go that route, Dr. Teitelbaum suggests using both the herb and medication for six weeks to reach the full effect of the herb. Then try tapering off the conventional pain medication to see if the herb alone can do the trick. Skip turmeric if you have gallstones.

2. Comfrey

   Studies confirm that comfrey cream outperforms conventional medications when it comes to ankle sprains and brings the added benefit of stimulating tissue repair. “Comfrey cream excels when it comes to all sorts of joint pain, but especially any pain traced back to osteoarthritis,” says Dr. Lucille.

   She recommends trying it alone or combined with other herbs. “Many of my patients get even better results when they pair comfrey cream with an oral curcumin supplement. I consider this my one-two punch for joint pain.”

3. Collagen

   Collagen is a protein found throughout your body, especially in your connective tissue. Collagen supplements, in a form called collagen hydrolysate, can improve symptoms for those with osteoarthritis and other joint problems.

   In one study, 80 people with aching knees or hips due to osteoarthritis took either 2 grams of collagen or a placebo every day for 70 days. By the end of the study, those taking the collagen reported less pain and were able to do more physical activities.

4. Andrographis

   Andrographis has a long history of use in both Ayurvedic and traditional Chinese medicine. It’s better known as an immune-booster, but it is gaining recognition for its anti-inflammatory powers and potential healing of rheumatoid arthritis.

   People with rheumatoid arthritis who supplemented with andrographis in a recent study experienced fewer tender or swollen joints. A key way that andrographis serves as an anti-inflammatory is by reducing the expression of several pro-inflammatory proteins.

Side Benefits of Natural Joint Pain Relief

With conventional joint pain medications, you open yourself up to the potential for harmful side effects. It’s a different story with natural remedies, which can improve health in multiple ways, giving you “side benefits.” Here are some examples.

They hold us up, they help us move around, they keep our organs safe, and they store important minerals. Bones: The human adult has 206 of them, from the penny-sized ossicles of the inner ear, without which we could not hear, to the femur, also known as the thighbone, the longest and strongest. They’re the basis of the body’s infrastructure, and keeping them healthy will help keep us healthy as we age.

Start Now to Strengthen Bones

Bones change and grow throughout life—our bodies break down the old bone and manufacture new bone. But we do a better job of it when we’re young. Up to about age 30, when we reach optimum bone mass, the body is faster at producing new bone than at dismantling old bone. After that, the process reverses, meaning bones are still renewed and regenerated, but we lose more bone mass than we gain.

This means the best time to shore up the bones is in childhood, adolescence, and young adulthood. The stronger they are when we hit peak bone mass, the more bone our bodies will have to draw on as we get older—and the less likely we are to develop a bone disease like osteoporosis, which weakens the bones and makes them more likely to break. That said, it’s never too late to take action to keep bones healthy and strong. 

Bone Strength Is All About Calcium

Most of us know that the mineral calcium is needed for strong bones and teeth. But it plays other important roles in the body as well. It helps with blood clotting, transmitting nerve signals, squeezing and relaxing muscles, releasing hormones, and regulating the heartbeat. Calcium is found in nerve cells, body tissue, blood, and other bodily fluids in addition to bones and teeth.

The body can’t make calcium. If it needs more to help with nerve, muscle, or circulatory system function, it leaches it from the bones, which is why it’s important to get your daily requirement of calcium through diet—and supplements, if needed. 

How much calcium do you need per day? Here’s a quick run-down. Children: ages 1 to 3, 700 milligrams (mg); 4 to 8, 1,000 mg; 9 to 18, 1,300 mg. Adults: ages 19 to 50, 1,000 mg; men ages 50 to 70, 1,000 mg; women 50 to 70, 1,200 mg; adults over 71, 1,200 mg. 

Just eating calcium-rich foods or taking calcium supplements won’t guarantee that your bones are protected. The body needs vitamin D to absorb and use calcium, so be sure you’re getting enough through exposure to sun, foods such as oily fish and egg yolks, fortified foods, and supplements. Phosphorus and magnesium also help with calcium absorption.

Bone-Healthy Living

Getting enough calcium is the lynchpin to bone health, but it’s not the only factor that affects skeletal strength. To ensure strong bones:

• Get Moving!

  Strength-building and weight-bearing exercises—walking, weightlifting, climbing stairs—will increase bone mass. Aim for 30 minutes a day.

• Minimize Falling Hazards

  Falling puts you at risk for breaking a bone, especially if you have osteoporosis. Do what you can to prevent falls. Make your home “fall-free” by removing loose rugs, moving furniture that impedes walking, and installing good lighting. Then consider incorporating balance-building activities like yoga, t’ai chi, and dancing into your routine.

• Live Clean

  Don’t smoke, and limit alcohol intake.

• Sleep Well

  A study published in the Journal of Bone and Mineral Research suggests that the sleep disruption caused by sleep apnea can negatively affect bone metabolism.

• Check Risk Factors

  Talk to your healthcare practitioner about your risk factors for bone disease.

Make no bones about it—the stronger our skeletons, the more active we can be as we age. Take steps (both literal and figurative) now to keep your bones as strong and healthy as possible.

Dairy-free calcium

Dairy products are practically synonymous with calcium. How can you be sure to get enough calcium in your diet if you don’t eat dairy? No worries; there are plenty of alternatives. Here are a few:

• Fortified tofu
• Fortified soy milk (calcium fortified)
• Dark green, leafy vegetables
  • broccoli
  • Brussels sprouts
  • mustard greens
  • kale 
• Chinese cabbage or bok choy
• Beans/legumes
• Sardines/salmon with edible bones
• Shrimp
• Almonds and Brazil nuts
• Sunflower seeds
• Tahini
• Blackstrap molasses