People are often surprised to discover the bones that they were born with go through a constant process of change throughout their lives. We build bone in our childhood to young adult lives, with peak bone mass reached by our early 20s. After that, our bones slowly begin to weaken, as we begin to lose bone faster than we build new bone. The fastest bone loss occurs after menopause in women, when the loss of estrogen causes significant bone resorption.

While some bone loss is a common result of growing older, if too much bone is broken down it can become weak and fragile, leaving individuals more susceptible to painful and even debilitating fractures. This condition — osteoporosis — is often called the “silent disease” because many people don’t know they have it until they break a bone.

Luckily, there are steps you can take to prevent and lower your chances of developing osteoporosis.

Get moving

Exercise does wonders for the entire body — it strengthens your heart, muscles and your bones, and even improves flexibility and balance so you’re less likely to hurt yourself if you do fall.

Try weight-bearing exercises, such as jogging or walking, yoga, dancing, tai chi or water aerobics. These types of activities force your body to work against gravity, which promotes new bone growth.

Strength training, such as lifting weights or using resistant bands, makes your bones stronger, just as it does your muscles. A healthy mix of weight-bearing and strength-training exercises are key to preventing osteoporosis — just check with your doctor before beginning a new exercise routine.

Eat for strong bones

The old saying is true: milk does a body good. So does other calcium-rich food, such as yogurt, cheese, broccoli, sardines, salmon, edamame, tofu, kale, beans and dairy. If you aren’t getting enough calcium, ask your doctor if you should be taking a supplement.

Vitamin D is another important nutrient that supports bone health, but it can be difficult to get enough of it in food. Many foods such as milk, orange juice, soy milk and certain cereals are fortified with vitamin D, so look at the labels to check nutrition levels.

Limit your vices

Tobacco and alcohol use have many negative effects on your health, but if you are at risk of developing osteoporosis, it is even more important to limit drinking and smoking. Smoking has been shown to increase bone loss and the chance of fractures. Excessive alcohol use is also linked to bone loss. The Hawaii Tobacco Quitline offers free resources to help Hawaii residents quit tobacco use.

Some studies have shown that drinking soda — specifically cola — in excess could be linked to lower bone density. If you’re a soda junkie, try replacing one or two cans of soda a day with a glass of fat-free milk or fortified orange juice to get more calcium and vitamin D.

Prevent falls

Whether or not you’ve been diagnosed with osteoporosis, it’s always a good idea for older adults to practice fall prevention. Wear proper footwear, use handrails at home and outside, keep floors free of clutter or loose wires and make sure hallways and stairs at home are brightly lit.

It’s never too late — even if you have osteoporosis or low bone density, you can still make a difference in your bone health by being proactive with your diet and exercise. Take the right steps today to build healthy bones for life.

Dr. Jennifer Loh, endocrinologist at Kaiser Permanente Honolulu Medical Office.