1. Eat calcium-rich foods Besides dairy products, choose fish with bones (such as salmon, sardines or whitebait), and serve them with a side of dark leafy green vegetables or broccoli. Fortified tofu and soy milk are other calcium-rich choices. For a calcium boost, snack on almonds or dried figs.

2. Take calcium supplements The recommended daily allowance for calcium is 1,000 mg a day during our 20s, 30s and 40s. But our need for calcium rises as we age. After menopause, women need 1,500 mg a day unless they take hormone therapy. “Remember to factor in the calcium from your multivitamin,”. Your body only absorbs 500 mg of calcium at a time, so spread the amounts you consume over the course of the day for the greatest benefit, and take calcium with meals to maximize absorption. (Check with your doctor first before starting supplements.)

3. Add some D to your day To help absorb calcium, most adults need 1,000 to 2,000 IU of vitamin D daily. (Combined calcium-vitamin D pills usually do not contain enough D to meet this requirement.) “Vitamin D deficiency is far more common than previously thought, and affects everyone, young and old”. For a vitamin D boost, enjoy 15 to 20 minutes of mid-day sunshine without sunscreen. (If you are at high risk for skin cancer, avoid the sun and choose vitamin D supplements instead.)

4. Start weight-bearing exercises For bone strength and new bone cell formation, try strength training plus exercises that “load” or compress your bones. “Running, jogging, high-impact aerobics, repetitive stair climbing, dancing, tennis and basketball are best for building bones. But if you have osteopenia, osteoporosis or arthritis, try walking or using an elliptical trainer or stair stepper.” (Clear any exercise plans with your doctor first.)

5. Avoid smoking and drinking to excess Loss of bone mineral density is associated with tobacco use and excessive alcohol intake. If you smoke, look into a smoking cessation program, and if you drink, stick to no more than one glass of wine or beer a day.

6. Get your bone mineral density tested Doctors can get a quick and painless “snapshot” of bone health using a simple X-ray test called DXA. This test measures bone mineral density (BMD) and helps determine risks of osteoporosis and fracture. “Most women lose bone at an accelerated rate for four to seven years after menopause, so they may wish to start BMD testing within two years of menopause.” Younger women who skip periods or suffer unexplained fractures should start testing sooner. Earlier BMD tests are recommended for men and women with certain diseases and for those taking medications that increase risk, such as long-term steroid therapy.

7. If necessary, consider medication Pre-menopausal women at high risk of osteoporosis may consider hormone therapy to boost the waning estrogen levels linked to bone loss. Women and men diagnosed with osteopenia or osteoporosis can take various medications to prevent dangerous hip and spine fractures. Bisphosphonates prevent further bone loss and are taken by mouth once a week or once a month or, if side effects occur, once a year by IV infusion. Teriparatide, a medication similar to a natural human hormone, rebuilds bone when given by daily injection but can be taken safely for just two years. “None of these medications works without calcium and vitamin D as building blocks.”