Once bone mass is lost, it is difficult or impossible to replace. For this reason, preventing osteoporosis is vital. It is important to do everything you can to build peak bone mass by age 25 and then to ensure that the inevitable loss of bone occurs as slowly as possible.

Prevention entails a variety of measures, including the following:
 
Monitoring Calcium and Vitamin D Intake. Calcium requirements depend primarily on age. The Institute of Medicine offers the following guidelines for daily calcium intake:

• Children (4-8 years old): 800 milligrams (mg)
  
  
• Children (9-18 years old): 1,300 mg
  
  
• Men and women (19-50 years old) (including pregnant and nursing women): 1,000 mg
  
  
• Pregnant and nursing women (under 18 years old): 1,300 mg
  
  
• Men and women (over 50 years old): 1,200 mg

Dairy products, especially those low in fat such as skim milk and low-fat yogurt, are an excellent source of calcium. An eight-ounce glass of skim milk provides 300 mg of calcium and only 90 calories. 
 
Women who are lactose intolerant and vegans, as well as anyone who wants a varied, calcium-rich diet, can turn to dark-green leafy vegetables such as kale, broccoli, and mustard greens; soy milk and other soy products such as tofu; salmon (with edible bones); and calcium-fortified fruit juices and breakfast cereals. 
 
Vitamin D Is Essential for Calcium Absorption and for Muscle Strength. There is, moreover, increasing evidence that a vitamin D deficiency may increase fracture risk. The skin manufactures vitamin D when exposed to the sun; however, widespread use of sunscreens has reduced the role of natural light in preventing vitamin D deficiency. In addition, older people who are rarely out of doors need a supplemental source of this essential vitamin.
 
Overall Nutrition. A high protein intake has been shown to be associated with a lower risk of hip fracture in men and women between age50 and 69, although not in older individuals. Contrary to earlier reports, there is no conclusive evidence that the carbonation in beverages has an adverse effect on bone health. It is possible, however, that the caffeine in some carbonated beverages increases calcium excretion. Drinking large quantities of carbonated beverages rather than milk also deprives the body of a major calcium source. Finally, recent research has indicated that vitamin B12 may be an important link in preventing osteoporosis. Good sources of this vitamin include low-fat dairy products, fish and lean meat, and eggs. The ability to absorb B12 from food decreases with age, so a vitamin supplement may be advisable for older women. 
 
Exercising. Women of all ages should engage in regular weight-bearing exercise. Walking is one of the best methods ways to maintain bone strength. Other weight-bearing exercises include jogging, hiking, tennis, bicycling, dancing, aquatic exercises (but not swimming), and weight training. Choose an exercise that combines movement with impact on the limbs. Start exercising slowly, especially if you have been inactive. Because falls are the most common cause of fractures, do some balance activities to reduce your risk. The benefits of tai chi in particular have been documented. Consult your doctor before beginning any exercise program. 
 
Cutting Out Smoking and Reducing Alcohol Intake. Eliminate smoking and excessive alcohol use; these cause bone loss and increase your risk of a fracture. 
 
  
You can download the entire "Savvy Woman Patient" chapter on Bone and Muscle Health as a PDF.

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