Improving bone health

There are some things about bone health that you cannot control. These include your natural bone structure, your family health history, and some breast cancer treatments, such as hormonal therapy, that can cause bone loss. However, there are many things you can do to improve your bone health on your own.

Exercise and nutrition are a big part of keeping your bones stable and strong. Even if your bones are healthy now, exercise and good nutrition can reduce some side effects of treatment and help you stay as healthy as possible over your lifetime.

On this page, we’ll share ways that exercise and nutrition can improve your bone health.

Exercise for bone health

Exercise helps your bones in many ways, especially when your diet includes foods that contain calcium and vitamin D — two important nutrients for bone health.

If you are in breast cancer treatment and feeling tired, the idea of exercise may feel overwhelming. But when you gradually start to exercise on a regular basis, it can give you more energy over time.

How exercise helps your bones — and more

Regular exercise:

• Triggers your body to build more bone
• Makes bones stronger
• Increases bone mineral density, a measure of minerals (such as calcium) in your bones
• Increases coordination and balance, reducing the risk of falls and bone fractures
• Helps you maintain a healthy weight
• Helps keep blood pressure and blood sugar stable
• Lowers high cholesterol
• Improves sleep quality
• Improves memory and thinking
• Reduces anxiety and depression
• Helps your overall physical well-being

Weight-bearing exercise for bone health

For improving bone health, the most effective exercises are weight-bearing exercises. These exercises strengthen bones by making your body work against gravity.

Examples include:

• Lifting weights
• Walking
• Yoga
• Dancing
• Stair climbing
• Using an elliptical machine for a low-impact, full-body workout
• Gardening and yard work

Like muscles, your bones are made stronger through use. Moving and resisting weight signals your body to make those areas stronger.

It’s important to exercise safely. Some soreness is common when you first start working out, but you should stop if you experience pain that lasts more than 48 hours after your workout.

If you’re not able to start on weight-bearing exercises at first, non-weight-bearing exercises can help you build up your fitness. These include bicycling and swimming. While these exercises are less beneficial for bones, they offer significant cardiovascular and overall health benefits.

Consider working with an exercise trainer

It is important to exercise in a way that’s safe and helps you avoid injury — especially when you begin an exercise program for the first time.

Think about working with a certified cancer exercise trainer or physical therapist if:

• You’ve never exercised regularly before
• You have been diagnosed with a bone health condition such as low bone mineral density (osteopenia or osteoporosis)
• You have concerns about managing exercise with breast cancer treatment and/or other health issues

A qualified trainer can help by showing you exercises suited to your abilities and your goals. They can also show you exercises you can safely do at home.

If you are looking for a qualified exercise trainer, ask your care team for recommendations. You can learn more about finding a trainer on the Exercise page.

Exercise and metastatic breast cancer

Many types of exercise are safe for people diagnosed with metastatic breast cancer (breast cancer that has spread to other parts of the body, such as the bones).

Still, each situation is unique. Sometimes, adjustments are needed. If you have metastatic breast cancer, ask your care team if there are any exercise precautions to consider. Learn more.

Explore LBBC exercise resources

Learn more about exercise for people diagnosed with breast cancer, including:

• How exercise reduces the risk of recurrence and improves survival
• How exercise can reduce treatment side effects
• Tips for starting or restarting an exercise routine
• Learning how much exercise you need
• Understanding aerobic and resistance exercise
• Ways to increase activity
• How to find a qualified exercise trainer

You can also learn about our BeACTIVE exercise video series.

Nutrition for bone health

Eating well can help you maintain healthy bones, a healthy weight, and a good quality of life.

Talk with your care team about ways to include foods with two nutrients that play a special role in bone health: calcium and vitamin D.

Calcium and bone health

Calcium is important for rebuilding bone. Not getting enough calcium in your diet increases the risk of low bone density and fractures.

The best way to get more calcium is through certain foods and drinks. Here are some calcium-rich foods and drinks to consider:

• Low-fat or non-fat yogurt, milk, and cheeses
• Dark-green vegetables such as collard greens, kale, bok choy, broccoli, broccoli rabe, and spinach*
• Canned sardines, canned salmon, and canned mackerel; these contain soft bones that you can eat
• Beans, such as garbanzo beans (chickpeas), pinto beans, soybeans, white beans, and edamame
• Amaranth, a type of grain
• Foods and drinks that are labeled “fortified” or “prepared” with calcium, such as tofu, soy or almond milk, orange juice, waffles, breads, English muffins, oatmeal, and cereals
• Almonds, sesame seeds, and sunflower seeds
• Dried figs

*While spinach has high calcium content, the calcium is not absorbed as well as it is with other leafy greens, such as collard greens and kale.

What about calcium supplements?

Doctors used to recommend calcium supplements to reduce the risk of bone loss.

But research shows that taking calcium in supplement form (such as calcium capsules, gummies, or chews) can increase the risk of kidney stones and heart attack.

The good news: Calcium in foods and beverages does not increase this risk. If you’re not sure where to start with calcium in your diet, ask your care team. You can also ask for a referral to see a nutritionist.

Vitamin D and bone health

Vitamin D is just as important as calcium when it comes to protecting your bones. Vitamin D helps your body absorb calcium.

How much vitamin D do you need? Start by asking your care team for a blood test that can check your vitamin D levels. After you discuss the results, they can recommend ways to keep your levels healthy.

A person can get vitamin D through:

• Certain foods
• Sunlight
• Vitamin D supplements

Vitamin D in foods

There are some foods, but not many, that contain vitamin D. They include:

• Fatty fish such as salmon, tuna, mackerel, trout, swordfish, and sardines
• Egg yolks
• Beef liver
• Mushrooms such as shiitake, oyster, and chanterelle

Some foods and drinks are labeled as “fortified with vitamin D,” including:

• Fortified cheeses, yogurt, oatmeal, and cereals
• Fortified milk, soymilk, oat milk, almond milk, and orange juice

Still, it’s important to know that too much vitamin D from fortified foods or supplements can cause symptoms such as fatigue, frequent urination, dehydration, and constipation. Talk with your care team before adding fortified products or supplements.

Vitamin D and sunlight exposure

When your skin is exposed to sunlight, it makes vitamin D. Then, your liver and kidneys help change the vitamin D into a form your body can use.

It’s important to wear sunscreen when you are out in the sun. Even while wearing sunscreen, some sunlight is still absorbed into the skin, and your skin can still make vitamin D.

There are reasons some people get less sunlight exposure than others, such as:

• Living in a part of the world that doesn’t get much sunshine
• Working night shifts and sleeping most of the day
• Spending a lot of time indoors
• Having a health condition that causes you to be homebound or to live in a long-term nursing care facility

Talk with your care team about how much regular time in the sun you’re getting now and if it would be helpful for you to increase your daily time outdoors.

If you are not able to get outdoors more, ask about getting vitamin D through nutrition and/or supplements.

Vitamin D supplements

Certain foods and sunlight can help you maintain a healthy vitamin D level. Still, some people may also need to take vitamin D supplements.

After your care team has performed a blood test to check your vitamin D level, ask them if taking a supplement is a good idea for you. Two kinds of vitamin D supplements are available: vitamin D2 and vitamin D3. Both support bone health. Talk with your team about what’s best for your situation.

More information about bone health

While exercise and nutrition can do a lot to support healthy bones, some people can also benefit from medicines that can protect bones.

Your care team might recommend additional treatments to protect your bones if you:

• Are undergoing breast cancer treatment that increases the risk of bone loss, such as hormonal therapy
• Have been diagnosed with metastatic breast cancer in the bones

Visit Medicines to protect bones to learn about options.

On the Bone health page, you can learn about:

• Bone mineral density
• DEXA scans to check your bone health
• Osteopenia and osteoporosis
• Bone loss risk factors
• How some treatments can cause bone loss
• How metastatic breast cancer in the bones can cause bone loss
• Ways to protect your bones

Visit Nutrition and exercise for more information on lifestyle changes that can improve your overall health and well-being, including bone health.