There’s a lot we can do during this phase of life to slow the rate of bone loss, reduce fracture risk, and maintain mobility and independence well into our later years.
As we enter our senior years, bone loss accelerates and the risk of fractures rises—but there’s still plenty we can do. In this final episode of our special series "Stronger Bones at Every Age," we share practical nutrition, lifestyle, and exercise strategies to preserve bone density, reduce fall risk, and maintain mobility and independence in later life.
"Stronger Bones at Every Age" is a special limited series made possible in part by the National Cattlemen's Beef Association, a contractor to the Beef Checkoff. This series is dedicated to providing the same evidence-based, unbiased information you've come to expect from the Nutrition Diva, reflecting the editorial integrity and professional expertise of our host.
For more information on the topics discussed in this episode, visit https://www.quickanddirtytips.com/bones.
You can also find citations for the entire series at https://www.quickanddirtytips.com/bones#citations.
Welcome back to the last installment of our special series on building healthy bones throughout the lifespan in observation of Osteoporosis Awareness Month. The entire series is also available on our website at https://quickanddirtytips.com/bones.
Ou thanks to the National Cattlemen’s Beef Association for helping to make this special series possible. The NCBA is a contractor to the beef checkoff program, a USDA-supervised program that funds research into human nutrition, food safety, environmental impacts, and other topics, and also support efforts (such as this one) to make that information more widely available.
Just like every other episode of this podcast, my goal in this series is to provide you with balanced, accurate, and useful information and what I’m choosing to share reflects my own independent assessment of the evidence.
For any of you listening who may be registered dietitians, this entire podcast series has been approved by the Commission on Dietetic Registration for 1.5 hours of continuing education credits! You can access those credits (as well as the episodes themselves) by going to the Beef Nutrition Education Hub at https://beefnutritioneducation.org.
In the first episode of this series, we focused on the unique opportunities and challenges to building healthy bones during childhood, looking at diet and nutrition as well as other aspects of lifestyle. Our second episode focused on teens and young adults and the unique challenges and opportunities that this time of life presents in terms of bone health. The third episode looked at the period between ages 30 and 60. And this final episode will focus on strategies to help preserve bone health and maintain mobility, independence and quality of life throughout our senior years.
By the time we reach our 60s, the balance between bone breakdown and bone building has shifted decisively. As we’ve heard throughout this special series, the process of bone remodeling—where old bone is broken down and new bone is built in its place–goes on throughout our entire lives. But as we age, that remodeling process slows down and the balance tips toward bone loss.
We’ve talked about how bone loss begins to speed up in mid-life due to hormonal changes. And for many people, this process continues to accelerate as they get into their 60s and beyond—due to other physiological changes that often come with this phase of life. Perhaps the most significant of these is the gradual loss of muscle tissue (a condition known as age-related sarcopenia), That loss of strength and stability not only contributes to the loss of bone density, but also increases the risk of falls and fractures–in both men and women. In fact, by the time they are in their 80s, men’s risk of hip fractures approaches that of women the same age.
Indeed, these factures (and not simply the bone loss itself) are one of the biggest concerns during this phase of life, because the loss of mobility and independence that they often lead to–hip fractures, in particular–can be devastating. They’re not only painful and disabling but are also associated with an increased risk of hospitalization, long-term care placement, and even mortality.
Fortunately, there’s a lot we can do during this phase of life to slow the rate of bone loss, reduce fracture risk, and maintain mobility and independence well into our later years. Some of these strategies are nutritional, others are lifestyle-based, and many are interconnected.
One of the biggest nutritional challenges as we age—particularly into our 70s, 80s, and beyond—is that appetite and food intake often decline. This may be due to reduced sense of taste and smell, medications, digestive issues, or simply lower activity levels. But regardless of the cause, it can lead to an unintended consequence: inadequate intake of key nutrients that help maintain both bone and muscle mass.
Several nutrients tend to fall short in older adults’ diets, including calcium, vitamin D, magnesium, and potassium. For adults over 70, the recommended intake of calcium is 1,200 milligrams per day Good dietary sources of calcium include:
Vitamin D needs also increase in later life, as the body becomes less efficient at producing it from sun exposure. The recommended intake for adults over 70 is 800 IU (20 mcg) per day. Vitamin D can be found in:
But perhaps the most important and most consistently under-consumed nutrient is protein. As with calcium and vitamin D, our need for protein increases as we age. As we age, our bodies become less efficient at using dietary protein to stimulate muscle protein synthesis—a phenomenon that researchers have dubbed anabolic resistance. Simply put, when we are older, it takes more protein to get the same muscle-building benefit that we may have gotten from protein when we were younger.
In fact, research suggests that older adults may need to consume significantly more protein than the current Recommended Dietary Allowance (0.8 g/kg/day) in order to preserve muscle mass, support bone health, and maintain mobility. A systematic review commissioned by the National Osteoporosis Foundation in 2017 found that higher protein intakes were associated with less bone loss and lower fracture risk in older adults, without adverse effects. Other researchers have proposed protein intake targets of 1.2 to 1.5 grams per kilogram of body weight per day for older adults to help preserve muscle mass and bone strength. For a 150-pound person, that works out to about 80 to 100 grams per day—well above the current minimum recommendation.
Unfortunately, one of the most persistent nutrition myths is that higher protein diets might actually weaken bones. In fact, multiple systematic reviews—including the one commissioned by the National Osteoporosis Foundation that I just mentioned—have found that higher protein intakes may help reduce bone loss and fracture risk, particularly in the lumbar spine.
Now, it is true that higher protein diets increase the amount of calcium that is excreted in the urine. However, when we take in more protein, our body actually ramps up the amount of calcium that it absorbs from our food. So, the total amount of calcium available for bone remodeling is only negatively affected if there is not enough calcium in the diet.
The quality and source of protein also matter. Animal proteins—such as lean beef, poultry, fish, eggs, and dairy— provide all of the essential amino acids in the proportions needed by the body, and are particularly rich in leucine, a key amino acid that stimulates muscle protein synthesis. They also tend to be more protein-dense, delivering more protein per serving and per calorie than most plant-based protein sources. This can be especially helpful when appetite and total calorie intakes are lower.
Dietary intake data shows that seniors who include beef in their diet are more likely to meet the recommended intake of calcium than those who don’t. In addition, beef also provides an excellent source of vitamin B12, a nutrient that people in this age group are often deficient in.
Plant-based proteins—like beans, lentils, nuts, tofu, and whole grains—can also contribute meaningfully to total protein intake and overall diet quality. However, they tend to be lower in one or more essential amino acids and are less protein-dense, meaning you often need to consume larger portions and a variety of sources to meet protein needs. That’s not always easy, especially for seniors with smaller appetites.
In a meta-analysis of studies looking at frailty in older adults published in 2023, higher protein intake over time was associated with a significantly lower risk of developing frailty. But in addition, those who consumed more animal-derived protein experienced less frailty than those who consumed less. This suggests that it’s not only the quantity of protein that matters, but also the quality and consistency of your protein intake.
Here once again are some reflections from Dr. Taylor Wallace, professor of nutrition at Tufts and George Washington Universities. He previously served as a senior staff member at the National Osteoporosis Foundation, where he spearheaded a number of research initiatives. I asked Taylor to talk a bit more about this link between protein intake and frailty.
Dr. Wallace: It comes as no surprise that higher protein intakes over time are associated with a significantly lower risk of frailty in older adults. Protein intake begins to decline in older adulthood, as does intake of many other important nutrients for a number of reasons. And this is not only detrimental to maintaining bone density, but also muscle and musculoskeletal health, which is not as easily recovered as we age. Older adulthood is another example of where mixing adequate calcium and protein intake with physical activity, particularly strength training, under conditions of Vitamin D adequacy can have a marked impact. Recent studies of hospitalized older adults are among the most noteworthy to highlight how adequate protein can substantially prevent muscle breakdown, for example, after surgery. Lean meats, poultry, and low- and non-fat dairy are complete, protein-packed options to help older adults maintain adequacy.
I’m certainly not suggesting that plant proteins should be avoided—far from it. In fact, legumes and whole grains provide other important nutrients like fiber, magnesium, and phytonutrients. And fiber deserves special mention here. Researcher Connie Weaver has explored the connection between dietary fiber and bone health. She explains that prebiotic fibers may increase the body’s ability to absorb calcium and improve bone strength—likely through their effects on gut bacteria and the production of short-chain fatty acids.
Although more research is needed–particularly in older adults– to fully understand how these microbiome shifts translate to bone outcomes, increasing dietary fiber intake has a lot of benefits, including alleviating constipation, which is a common complaint among seniors. Incorporating fiber-rich foods like beans, lentils, vegetables, fruits, and whole grains may therefore offer a double benefit: supporting digestion and potentially contributing to bone health.
In short, the goal in this stage of life is to maximize the nutritional quality of every bite. Prioritizing high-quality, protein-rich foods—particularly animal sources—and adequate calcium, vitamin D, and fiber can help preserve both bone and muscle, support mobility, and reduce the risk of falls and fractures.
Of course, diet is only part of the equation when it comes to protecting bone health and mobility in later life. Physical activity—and the kind of activity you do—also plays a critical role.
Weight-bearing and resistance exercises help stimulate bone remodeling and maintain bone density, even in older adults. But as we get older, many of us experience physical limitations that can make high-impact exercise—like running or jumping—less feasible or even risky. Fortunately, there are still plenty of ways to load the bones and keep muscles strong without high impact.
For younger seniors—those in their 60s and 70s who are still relatively active—strength training, walking, dancing, stair climbing, yoga, and tai chi can all provide the kind of mechanical stress that helps preserve bone and muscle. Simple additions like carrying groceries, doing yardwork, or taking the stairs instead of the elevator can also contribute to that mechanical load.
For older seniors—or those with mobility challenges—the focus may shift to balance training, flexibility, and maintaining mobility. Exercises like chair yoga, seated strength exercises, and supported standing exercises can help maintain strength and stability while reducing the risk of falls.
And fall prevention is key. Because at this stage, the greatest threat to bone health isn’t just the slow loss of density—it’s the increased risk of a fractured bone if you do fall. That’s why experts recommend that older adults include exercises specifically designed to improve balance, flexibility, and lower body strength. Things like standing on one foot while holding onto a countertop, or working with a physical therapist on fall prevention strategies can all make a difference.
In addition to exercise, it’s worth considering the role of our daily routines and environments. Minimizing tripping hazards (such as uneven thresholds or throw rugs), using assistive devices when needed, and ensuring adequate lighting can all help reduce fall risk.
And finally, as we discussed in the last episode, I’d be remiss if we didn’t at least mention the role of sleep and stress. Although the research is still emerging, there’s evidence that chronic stress and poor sleep quality may contribute to bone loss over time—likely through hormonal pathways that increase bone resorption. So prioritizing rest, managing stress, and creating safe, active environments are all part of a comprehensive strategy to protect bone health in later life.
As with every other phase of life that we’ve looked at in this special series, our senior years present some unique challenges but also plenty of opportunities. Although our bone building years are behind us, there is still a lot we can do to slow the rate of bone loss, reduce the risk of fractures, and maintain mobility and independence well into our later years. Let’s sum up some of the most impactful strategies.
Enormous thanks again to the National Cattlemen’s Beef Association, a contractor to the beef checkoff, for making this special series possible. I hope you will continue to share it widely and refer to it in the future as we all strive to build Stronger Bones at Every Age.
This entire series will be available at quickanddirtytips.com/bones, where you can also check out a complete list of the scientific reference for this series. And a reminder to any registered dietitians who have been listening that this series has also been approved for 1.5 continuing education credits, which you can access at beefnutritioneducation.org.
If you’re a new listener who has joined us for this special series, I hope you’ll also subscribe to our regular weekly podcast, where we take a closer look at the latest nutrition news, research, and trends, sort fact from fiction, and answer your food and nutrition questions!
Nutrition Diva is a Quick and Dirty Tips podcast. Steve Riekeberg is our audio engineer, Brannan Goetschius provides script editing. Holly Hutchings is the Digital Operations Specialist and Morgan Christianson heads up Podcast Operations & Advertising. We get also get indispensable support from Nat Hoopes. Thanks to all of them and thanks to you for listening!