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Healthy lifestyle habits, including adequate intake of calcium and vitamin D, are important for preventing osteoporosis and are also a useful accompaniment to medical treatment.
A combination of calcium and vitamin D can reduce the risk of osteoporosis. (For strong bones, people need enough of both calcium and vitamin D.) The National Osteoporosis Foundation (NOF) recommends:
Dietary Sources. Good dietary sources of calcium include:
Certain types of foods can interfere with calcium absorption. These include foods high in oxalate (such as spinach and beet greens) or phytate (peas, pinto beans, navy beans, wheat bran). Diets high in animal protein, sodium, or caffeine may also interfere with calcium absorption.
Dietary sources of vitamin D include:
However, many Americans do not get the vitamin D they need from diet or exposure to sunlight.
Supplements. Adults who consume adequate amounts of calcium through dietary sources may not need to take a supplement. Many require vitamin D, particularly if they do not get enough exposure to sunlight. Vitamin D is made in the skin using energy from the ultra-violet rays in sunlight. Because sun exposure increases the risk for skin cancer and premature skin aging, many Americans restrict their sunlight exposure. People's vitamin D levels decline as they age.
Calcium and vitamin D supplements can be taken as separate supplements or as a combination supplement. If taken separately, the supplements do not need to be taken at the same time.
Both calcium and vitamin D supplements can increase the risks for kidney stones. If you have a history of kidney stones, discuss with your doctor whether these supplements are appropriate for you.
Calcium supplements can also have other side effects and drug interactions:
Exercise is very important for slowing the progression of osteoporosis. Although mild exercise does not protect bones, moderate exercise (more than 3 days a week for more than a total of 90 minutes a week) reduces the risk for osteoporosis and fracture in both older men and women. Exercise should be regular and life-long. Before beginning any strenuous exercise program, older patients or those who have serious medical conditions should talk to their doctors.
Specific exercises may be better than others:

Other lifestyle changes that can help prevent osteoporosis include:
An important component in reducing the risk for fractures is preventing falls. Risk factors for falling include:
Recommendations for preventing falls or fractures from falls in elderly people include:
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National Osteoporosis Foundation. Clinician's Guide to Prevention and Treatment of Osteoporosis -- 2008. Washington, DC.
Qaseem A, Snow V, Shekelle P, Hopkins R Jr., Forciea MA and Owens DK. Pharmacologic treatment of low bone density or osteoporosis to prevent fractures: a clinical practice guideline from the American College of Physicians. Ann Intern Med. 2008;149(6): 404-15.
Tang BM, Eslick GD, Nowson C, Smith C, Bensoussan A. Use of calcium or calcium in combination with vitamin D supplementation to prevent fractures and bone loss in people aged 50 years and older: a meta-analysis. Lancet. 2007 Aug 25;370(9588):657-66.
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