There are a number of wonderful things about aging: We gain wisdom and perspective, enjoy decades-long friendships, and have more time for hobbies. Unfortunately, there are also some downsides to aging that can have serious consequences if we don’t address them — and at the top of that list is diminishing bone health.
Bone density and bone quality both decline as we age, especially if we aren’t actively working to combat the drop-off. But the good news is, it’s never too late to start — and with a little bit of work you can rebuild some of the bone you’ve lost over time. To help us figure out where to start, we asked Christina Chen, MD, a geriatrician in the Division of Community Internal Medicine, Geriatrics and Palliative Care at the Mayo Clinic and medical ambassador for The Good Feet Store, to share what you should know about bone health at every stage of life.
Bone Density vs. Bone Quality
When most people think about bone health, they think about bone density — but that’s only half the picture. “Bone density tells us how much bone you have,” explains Dr. Chen. “It’s essentially how much mineral content, mostly calcium, is packed into your bones.”
Bone quality, on the other hand, measures how well the bone is built and how it functions. This includes the bone’s architecture: the collagen fibers, structure, and ability to absorb stress. That means someone can have high bone density but still be at risk for fractures if the bone is brittle or poorly structured. “You can have great bone density but poor bone quality,” Dr. Chen notes. “Both are very important.”
When Bone Loss Begins
Bone loss starts earlier than many people realize. “We reach our peak bone mass — essentially the strongest bones we’ll ever have — in our late twenties to early thirties,” says Dr. Chen. After that, we gradually begin to lose bone. For women, the decline accelerates sharply at menopause.
“Estrogen is the key hormone that helps maintain the balance between breaking down and building new bone,” she explains. “When estrogen drops during menopause, that protective effect disappears.” And this drop-off is steep — women can lose up to 20–25 percent of their bone mass in the first 5 to 10 years after menopause.
Men also experience bone loss with age, but since their hormones decline more slowly, it’s a more gradual process. “Midlife is such an important window for prevention for anyone,” Dr. Chen says. “Building strong bones early sets the foundation for healthy aging.”
The Best Exercises for Bone Strength
Not all exercise benefits bone health equally. “The strongest evidence supports a combination of weight-bearing impact exercises and resistance training,” says Dr. Chen. Impact activities — like brisk walking, hiking, stair climbing, or gentle jumping — put healthy stress on the skeleton, stimulating bone-strengthening, especially in the hips and legs where fractures are most common.
Resistance training using free weights or resistance bands builds muscle, improves balance, and reduces fall risk. “This kind of training helps with more than just your bones,” Dr. Chen explains. “It also protects your joints, enhances energy, and helps with stability.”
While cardio exercises like swimming and cycling are great for heart health, they don’t load the bones the same way high-impact exercise and resistance training do. “The key takeaway is to focus on exercises that challenge the bones in a healthy way,” she says. “That stress signals them to remodel, which makes them stronger.”
The overall takeaway is that staying active is critical: “The worst thing you can do for bone health is to be sedentary.” Adapt workouts as needed — try lower-impact moves, chair exercises, or gentle walking. “Movement, in any form,” says Dr. Chen, “helps protect your bones.”
The Role of Foot Alignment and Support
Our feet are the foundation of the body — and they can make or break our ability to stay active and build bone. As Dr. Chen explains, “Our feet take a lot of beating every single day, yet we rarely think about how much they influence everything above them.” When foot mechanics are off — whether from flat arches, neuropathy, or simply poor footwear — it can throw off alignment all the way up the body.
“If the arch collapses or rolls inward, or if the muscles of the feet become weak, that changes the architecture of the foot,” says Dr Chen. “When the impact forces of walking or standing aren’t distributed evenly, they travel upward toward the legs, knees, hips, and spine.” Over time, that misalignment can cause pain, instability, and poor posture — all of which discourage movement. “I’ve seen patients whose hip or back pain improved just by giving them better foot support,” she notes. Properly aligned feet distribute weight evenly, strengthen posture, and help maintain balance, reducing strain and lowering the risk of falls.
Personalized arch supports, like those from The Good Feet Store, can make a huge difference in restoring that natural alignment and giving your body the foundation it needs to move confidently. “Personalized arch supports from The Good Feet Store act like shock absorbers,” Dr. Chen explains. “They help guide the force of each step through the bones and joints properly, so our bodies can handle it.” That means the pressure that once caused discomfort now travels efficiently through the body, protecting vulnerable joints while encouraging healthy, bone-strengthening movement. “When you feel more secure on your feet, you’re more likely to move,” she says. “Those small adjustments ripple upward, improving stability, reducing pain, and supporting good balance and bone health for the long run.” With proper support, even simple activities — walking, climbing stairs, or standing for long periods — become opportunities to safely stimulate bone growth and maintain strength over time.
Nutrition and Supplements for Strong Bones
Good nutrition is essential not only for overall well-being but for bone density. “Bones are living tissue,” explains Dr. Chen. They need a variety of nutrients to renew themselves over time.” Calcium and vitamin D are the cornerstones of bone health, and adults generally need 1,200–1,500 mg of calcium per day, ideally from foods like dairy, fortified plant milks, leafy greens, and salmon. Vitamin D helps the body absorb calcium, so sunlight exposure — or supplements in darker months — are key. “Those of us who live in colder climates can spend up to six months in darkness,” she notes. “Supplements can help maintain healthy nutrient levels when we can’t get them from natural sunlight.”
Protein is another key building block for bone, and adequate protein intake reduces fracture risk and supports muscle strength. Other nutrients like magnesium, vitamin K, and phosphorus also aid bone metabolism.
While Dr. Chen supports supplement use when necessary, she believes food should come first, with supplements filling in the gaps. “Bone health comes from a balance of good nutrition, regular movement, and healthy lifestyle choices,” she explains, noting that habits like smoking can “destroy bone over time.”
Preventing Falls and Fractures
Dr. Chen breaks fall prevention into three key areas: environment, medical awareness, and physical readiness. Here’s some of her tips for staying healthy and stable:
Create a safe environment
“Live in a home that’s safe for you,” she says. Improve lighting, remove clutter, cords, and loose rugs, and install grab bars where needed. And footwear matters: “A lot of people walk around barefoot, but well-fitting shoes provide traction and stability.” Avoid loose slippers or socks on smooth floors.
Manage medical risks
Low blood pressure, vision problems, or certain medications can affect balance. “If you’re dizzy or disoriented from medications, it increases your fall risk,” Dr. Chen says. Work with your healthcare team to ensure your prescriptions and dosages support stability.
Build physical strength and balance
From your thirties onward, focus on balance training to build a firm foundation — and you can begin at any time. “Even in your seventies and eighties, practices like tai chi or yoga can improve coordination and reflexes to help you catch yourself when you stumble,” she says. Ensuring proper foot alignment by using personalized arch supports from The Good Feet Store can also make it much easier to improve balance and coordination.
Together, these habits — safe environments, medical management, and movement — help maintain confidence, independence, and bone protection as we age.
Aging may be inevitable, but frailty doesn’t have to be. By nourishing our bones with the right nutrients, doing the right exercise, and using tools like personalized arch supports from The Good Feet Store, we can stay strong and independent well into our later years. Small, intentional steps make it possible not only to preserve bone health but to rebuild confidence — one strong stride at a time.
