A friend once expressed frustration that her mother would no longer sit or stand erect. She attributed her mom’s slouch to laziness, but in truth osteoporosis had caused compression fractures that collapsed the front of her mom’s vertebrae.

When osteoporosis weakens the vertebrae, they gradually become wedge-shaped, creating the pronounced curve in the upper back that’s often called a “dowager’s hump.” Once that happens, neither starch nor willpower will straighten your spine.

Osteoporosis is common, occurring in upwards of 10 percent of adults over age 50, according to a study published in 2014 in the Journal of Bone and Mineral Research. But it isn’t an inevitable part of aging.

Bones are dynamic structures, constantly remodeling themselves through the addition and subtraction of material. During the third decade of your life, your bone mass peaks. After that, it’s a downhill process — one that accelerates in women after menopause as their estrogen levels drop.

Older men can also develop osteoporosis, though bone loss starts later in men — around age 65 or 70 — than in women. Aside from age, risk factors include having a family history of the condition, being small and thin, smoking, drinking too much alcohol, and being physically inactive.

Calcium, Vitamin D, and Your Bones

Another risk factor for osteoporosis is not getting enough dietary calcium, the mineral that makes bones strong and also aids myriad bodily functions, such as muscle contractions and nerve signal transmission. When blood levels of calcium fall, your bones “give up” calcium to restore normal levels. Bones are like a mineral savings account: If you keep withdrawing calcium and other minerals, your bones weaken.

For years, doctors have advised older people to take calcium and vitamin D supplements to maintain bone density. The Institute of Medicine recommends 1,200 milligrams (mg) of calcium daily for women over 50 and men over 70, and 600 international units (IU) of vitamin D.

The big question is: Do these supplements help maintain bone density?

Possibly not, according to two papers published in September 2015 in the British Medical Journal. The first paper examined 59 studies on the impact of getting additional calcium in food or supplements (calcium plus or minus vitamin D) on bone mineral density. The extra calcium produced small increases in bone mineral density for the first year or two, but this change was found to be unlikely to reduce bone fracture risk (the most dreaded consequence of osteoporosis).

The second BMJ article directly addressed the issue of bone fracture prevention. Researchers analyzed studies investigating the impact of dietary calcium, milk and other dairy products, and calcium supplements on fracture risk in women over 50. Their conclusion? None of these interventions provided appreciable protection against bone breaks. Furthermore, calcium supplements can cause undesirable effects, including constipation, cardiovascular events (including heart attacks, stroke, and angina), and kidney stones.

So what can you do to protect your bones and avoid the pain and disability of fragile, broken bones? As it turns out, behaviors that preserve bone also help prevent other major diseases, such as heart disease and cancer. In addition to staying away from tobacco and heavy drinking, here are a few things you can do to preserve your bones.

1. Engage in Weight-Bearing Exercise

Weight-bearing and muscle-strengthening exercises stimulate bone formation and slow age-related bone loss.

Some weight-bearing activities include:

  • Walking
  • Jogging
  • Jumping rope
  • Climbing stairs
  • Skiing

Muscle-strengthening exercises (also called resistance training) require you to work against additional weight, such as free weights, weight machines, elastic bands, and your own body (push-ups and chin-ups, for example). If you’re a yoga enthusiast, you’ll be pleased to know that a 10-year-long study published in Topics in Geriatric Rehabilitation showed that a 12-minute daily yoga routine increased bone mineral density in the spine, femur (thigh bone), and possibly the hips.

For more information on bone-preserving exercises, check the National Osteoporosis Foundation website. In addition, the Centers for Disease Control and Prevention provides instructional videos for exercises you can do at home and in the gym.

If you already have osteoporosis or any other chronic condition, check with your doctor before jumping on the treadmill.

If you have osteoporosis in your spine, avoid heavy lifting, sit-ups, abdominal “crunches,” and any activities that involve extreme bending or twisting.

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