Instead of worrying about your weight, focus on avoiding fragility

Shift Your Mindset is an occasional series from CNN's Life, But Better team. We talk to experts about how to do things differently to live a better life.
Anti-aging aspirations have turned longevity products and services into a wellness-industry gold mine. But who wants to add on years only to spend them struggling to move, dependent on others and unable to enjoy basic activities?
What's the point of sticking around longer if you can't actually live life? Building and maintaining strength and mobility helps preserve the independence you need to age with dignity — and the actions you take now make all the difference.
In their new book 'The Complete Bone and Joint Health Plan: Help Prevent and Treat Osteoporosis and Arthritis,' dietitian and personal trainer Sydney Nitzkorski and orthopedic surgeon and sports medicine specialist Dr. Jocelyn Wittstein share the strategic diet and exercise choices you can make now to help maintain your quality of life well into your later years. Nitzkorski is a sports dietitian at Marist University in Poughkeepsie, New York, and she runs a private fitness and nutrition practice. Wittstein is an associate professor at Duke University School of Medicine in Durham, North Carolina.
This conversation has been edited and condensed for clarity.
CNN: What's the biggest misconception about bone and joint health?
Dr. Jocelyn Wittstein: Most people don't realize that bone mineral density (BMD) peaks at around age 30. After that, your goal is to maintain your BMD and try to slow down bone loss. For women, bone density decreases about 1% annually until menopause and then accelerates to 2% a year. Men experience a roughly 1% annual decline. The key is to build a strong foundation early and continue supporting your bone and joint health throughout your life.
Another misconception is that cardiovascular exercise alone is enough to preserve mobility, but strength training and light impact exercises are critical, too. These activities can elevate the peak bone density of people in their teens and 20s, while people older than 30 need those same exercises to minimize loss.
This is important considering that 1 in 4 adults will get osteoarthritis, and anyone older than age 50 has a heightened risk for both arthritis and osteoporosis, women in particular. A full 77% of postmenopausal women reported joint pain in a randomized study.
Sydney Nitzkorski: As a dietitian, I find that people don't think enough about how much calcium they're taking in, and most people are not getting enough. Your body can't make the calcium it needs, not just for bones and teeth but also heart, muscle and nerve function. If you're not consuming enough, your body will raid the reserves in your skeleton to meet its requirements.
This is why everybody, at every age, needs to get enough calcium. If you have kids, make sure they're consuming enough now, because this is when they're building bone mass. But sufficient calcium is still important even if you're 60 or beyond. Boosting your bone health is incredibly important at every age, and it's never too late to start taking proactive steps.
CNN: Are calcium supplements necessary?
Nitzkorski: Whole foods are the best sources for calcium, with supplementation as a secondary option. I recommend that people track their intake for a typical week and then adjust accordingly. Adults need 1,000 to 1,200 milligrams of calcium daily. Good sources include milk, fortified plant milks, broccoli and kale, as well as sardines and anchovies because you eat the bones.
Wittstein: Plus bok choy, which I consider a superfood. It's the green vegetable with the highest bioavailability of calcium. The calcium your body gets from a food depends on two factors: the total calcium the food contains and the bioavailability of that calcium, or how well the body absorbs and uses the mineral. A cup of milk has 300 milligrams of calcium that is 30% bioavailable, while a cup of bok choy has 160 milligrams that is 55% bioavailable. Yet, each one provides the body with an equivalent amount of calcium: about 87.5 milligrams. Along with bok choy's excellent calcium bioavailability, it also provides fiber and vitamins A and C. I love to prepare this green vegetable superfood with garlic, ginger and olive oil, making it an excellent anti-inflammatory food for joints and overall health.
CNN: Pressing question: Can we count the calcium from milk in coffee?
Nitzkorski: Yes! In the book, Jocelyn and I share that we both nail our calcium targets by drinking a lot of milk with a little bit of coffee. It's true that consuming more than 300 milligrams per day of caffeine lowers your body's calcium absorption — but that's a high bar when you consider an 8-ounce cup of coffee contains around 100 milligrams and a double shot of espresso contains about 140 milligrams.
Wittstein: Milk, whether it's from cows or a plant-based type that's been supplemented, is a good source of vitamin D, too. We know that consuming 2,000 IU of vitamin D a day can benefit bone health and . When it comes to coffee, people are often glad to learn that it is rich in anti-inflammatory antioxidants. It contains the polyphenol quercetin, which nd has anti-inflammatory properties.
I like to add cinnamon to my coffee for added anti-inflammatory effect and glucose control. You can also add whey protein — which provides amino acids that your body uses to build muscle — and/or collagen supplements, which can improve both bone density and joint pain, depending on the type.
CNN: What's the connection between inflammation and joint health?
Wittstein: Inflammation can break down cartilage and contribute to joint pain. Chronic inflammation accelerates joint deterioration. Anti-inflammatory nutrition taken in through diet and supplements like omega-3 fatty acids and curcumin, for example, can help ease symptoms like pain and swelling.
CNN: What does an anti-inflammatory diet look like?
Nitzkorski: What I love about recommending anti-inflammatory foods is that they provide so many other benefits, too, such as decreasing heart attack risk, increasing longevity, improving digestion and giving you more energy.
An anti-inflammatory diet is rich in lean proteins, which could be animal-based — such as non- or low-fat dairy, eggs, fish, chicken or turkey — or plant-based like beans, lentils and soy as well as pea proteins, which are found in a lot of protein powders. An anti-inflammatory diet also includes healthy fats, such as olive oil and foods containing omega-3 fatty acids like fish as well as walnuts and flax, chia and basil seeds.
Alliums — including garlic, onion, leeks and shallots — are flavorful plants that have multiple anti-inflammatory properties. And there's a whole spectrum of spices including turmeric, cayenne, black pepper and ginger.
Wittstein: Also important is dietary fiber from fruits, vegetables, beans and whole grains that provides short-chain fatty acids, higher levels of which are associated with lower levels of inflammation. Fruits and vegetables also contain myriad anti-inflammatory phytochemicals — naturally occurring compounds that provide an array of health benefits.
Avoiding or limiting inflammatory ingredients like processed meats, red meat, fried foods, saturated fats and processed carbohydrates is also important.
CNN: What types of exercise promote bone and joint health?
Wittstein: It's critical to incorporate resistance training and impact exercises. The goal is to work into your 150 minutes of weekly activity a combination of the following: three days of weight-bearing aerobic exercise, two days of resistance training, and two days of balance work and light-impact exercises.
That might sound like a lot, but these don't have to be long, intense sessions, and several of these types of conditioning can be combined. Standing on one leg and doing an overhead press counts as resistance training as well as balance work, for example. There are multiple things we want you to do to stimulate your bones and your muscles in different ways, but some of these activities can count as two.
Nitzkorski: You can also integrate little exercises into your daily life. Just as we lose muscle and bone mass with age, we also lose our ability to balance. Practice intentionally throwing yourself off balance a little bit so your body must work to find its equilibrium again.
Stand on one foot while brushing your teeth. Instead of sitting while watching TV, stand on one leg. Pretend a paintbrush is strapped to your toe and try to write your name or the alphabet. Write A through M on your right leg, and then switch and do N through Z on your left. To work on muscular endurance, do little arm circles. These start out super easy, but if you do them for two or three minutes it becomes exhausting.
CNN: What do you mean by light-impact exercises?
Wittstein: These include small jumps, jumping jacks or jumping rope. Studies show that doing 10 to 50 jumps three times a week is enough to stimulate your bone density. I encourage people to weave them into their day. By doing a little bit of hopping while you're waiting for the bus, you're getting your heart rate up and getting in some light-impact conditioning.
CNN: Do you recommend jumping if it causes knee pain?
Nitzkorski: No, people should listen to their joint pain! If jumping hurts your knees, focus on other kinds of conditioning like shallow squats, for example. You can also spread out your jumps over the course of the day or a week so you are not doing too many in a row. Or you can modify jumping exercises by using the back of a chair, or something else, for balance.
Wittstein: Or try modifications like pool jumping, which adds resistance and partly reduces impact. Water-based exercises are not as effective as land-based jumping exercises, but they are definitely beneficial for bone mineral density.
Although the gains from some of these exercise-based interventions may seem small, they actually translate to big risk reductions. We know from studies of pharmaceutical interventions that a 2% increase in lumbar-spine-bone density reduces spine fracture risk by 28%. A 4% improvement in hip-bone density decreases hip fracture risk by 32%. So even small improvements matter significantly.
CNN: Is it ever too late to start boosting your bone and joint health?
Nitzkorski: Absolutely not. While it's ideal to start early, you can always benefit from improving your diet and exercise routine. Start small — even 10 minutes of activity is better than nothing. Over time, small dietary changes can become a habit that sticks. The goal is consistency and gradual improvement so you can enjoy the life you live for that much longer.
Editor's note: Sign up for CNN's Fitness, But Better newsletter series. Our seven-part guide will help you ease into a healthy routine, backed by experts.
Jessica DuLong is a Brooklyn, New York-based journalist, book collaborator, writing coach and the author of 'Saved at the Seawall: Stories From the September 11 Boat Lift' and 'My River Chronicles: Rediscovering the Work That Built America.'

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