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APCO members celebrate World Osteoporosis Day 2024 by emphasizing on ‘Say No to Fragile Bones’

November 5, 2024/
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Last Sunday, October 20, 2024, members of the Asia Pacific Consortium on Osteoporosis (APCO) celebrated World Osteoporosis Day (WOD). This annual global campaign, coordinated by the International Osteoporosis Foundation (IOF), aims to raise much-needed awareness of the prevention, diagnosis, and treatment of osteoporosis and fragility fractures.

This year’s IOF World Osteoporosis Day (WOD) campaign, “Say No to Fragile Bones” unites patients and healthcare professionals in the fight against osteoporosis. With the Asia Pacific’s ageing population, urbanization, and sedentary trends, 319 million people over 50 are projected to be at high risk of fractures by 2044. WOD offers a vital platform to drive awareness and promote early action against this growing health crisis. It was truly inspiring to see APCO members actively championing the critical need for early osteoporosis detection and treatment was truly inspiring.

Keep reading to learn how some of our APCO members representing 23 countries and regions throughout the Asia Pacific, celebrated this important occasion – namely Australia, Hong Kong, India, Indonesia, Japan, Mongolia, Pakistan, Philippines, Singapore and Sri Lanka.

Australia
To celebrate WOD 2024, Healthy Bones Australia, led by APCO Executive Committee member, Dr Greg Lyubomirsky, released a new Burden of Disease report at a special event hosted at Parliament House in Canberra on October 10, 2024. The report outlines the prevalence and cost of osteoporosis In Australia for the coming decade and highlights the urgent need for early diagnosis and funding for prevention strategies.

Left to right: Prof Peter Wong, Dr Greg Lyubomirsky, Ms Carole David , The Hon Kate Thwaites MP, Ms Sally Pearson OAM, Senator Helen Polly, Prof Peter Ebeling
Dr Greg Lyubomirsky, CEO Healthy Bones Australia releasing the report

The report launch event was attended by federal politicians including The Hon Kate Thwaites MP, Assistant Minister for Ageing and Women, former Olympic and World Champion Sally Pearson OAM, patient advocate Carole David and leading experts Professor Peter Ebeling AO and Professor Peter Wong. It was also covered broadly by media coverage on television news networks, online news and radio reports. Healthy Bones Australia’s new Burden of Disease report included below key findings;

 

  • 6.2 million (67 per cent) Australians aged 50+ years are living with poor bone health
  • In 2023 in Australia, a fracture was sustained every 2.7 minutes resulting in more than 193,000 fractures, by 2033 this will increase to a fracture every 30 seconds
  • The total cost of osteopenia and osteoporosis equated to AUD $4.8 billion (2023) and is estimated to climb to AUD $8.3 billion per year (by 2033)

Hong Kong
In Hong Kong, the Osteoporosis Society of Hong Kong organised the 24th Regional Osteoporosis Conference (ROC 2024) to commemorate WOD 2024. Conference included talks discussing osteoporosis in children, multidisciplinary care of an osteoporotic patient including recent updates in osteoporosis management.

APCO member, Dr Lui Tak Wai David, was invited to deliver on the topic ‘Bone Fragility in Diabetes’ which aimed to improve clinicians’ awareness to assess and optimize bone health in people with type 2 diabetes. Dr Lui discussed the scope of the problem about fragility fractures in type 2 diabetes, including local and global epidemiology of fragility fractures related to type 2 diabetes and their clinical consequences, diabetes-specific risk factors, pathophysiology, and management of bone fragility in type 2 diabetes. Dr Lui emphasized the need for concerted efforts to close the gap in the fracture risk related to diabetes.

Dr Lui Tak Wai David, delivering his talk at ROC 2024.

India
In commemoration of WOD, the Department of Endocrinology at PGIMER, in collaboration with the Indian Society of Bone Mineral Research, successfully organized a free osteoporosis screening camp at Sector 22 Dispensary. APCO Executive Committee member, Prof. Sanjay Bhadada, who also heads the Department of Endocrinology, at the Post Graduate Institute of Medical Education & Research (PGIMER), remarked, “Osteoporosis is a silent disease, but its consequences can be severe. Our goal through such camps is to increase awareness, encourage early diagnosis, and guide patients in preventive measures to maintain bone health.”

Prof Bhadada participating actively in the camp.

The initiative, supported by Mr Prince Bandola, aimed to raise awareness and provide crucial diagnostic services to the community. Approximately 100 individuals underwent DEXA scans to assess bone health, with a few patients also availing mammography services. The results revealed that 10 percent of the screened population were found to have osteoporosis, underscoring the need for early detection and intervention. All patients received personalized medical consultations from the PGIMER Endocrinology team. Following the screenings, around 150 individuals attended a health talk focused on the importance of fall prevention, a critical factor in reducing the risk of fractures in osteoporosis patients. The event reflects PGIMER’s ongoing commitment to promoting public health and preventive care.

Media coverage by Indian newspapers for the event organised in India.

India
On October 30, 2024,  APCO member Dr. Lakshmi Nagendra, led a vibrant celebration of World Osteoporosis Day at JSS Hospital, Mysore, India. This year’s theme, “Say No to Fragile Bones,” highlighted the importance of raising awareness about osteoporosis to reduce fracture risks and improve quality of life. In a significant initiative, JSS Hospital launched its Fracture Liaison Services in partnership with the departments of Endocrinology, Geriatrics and Orthopedics, aiming to improve care and clinical outcomes for patients with osteoporotic fractures. This collaboration marks a strong commitment to combating osteoporosis and promoting better bone health across the community.

This collage includes snippets of the event organized at JSS Hospital, Mysore to celebrate WOD 2024.

Indonesia
The Ministry of Health of Indonesia and the Indonesian Osteoporosis Association, who are also known as Perhimpunan Osteoporosis Indonesia (PEROSI), will be organising 2 nationwide events in November and December 2024. APCO member, Dr Paulus Rahardjo, who is on PEROSI’s Multidisciplinary Expert Team, is optimistic about the positive impact on osteoporosis awareness and prevention in Indonesia.

The first event which will be held on November 10, 2024, is a virtual national seminar of National Osteoporosis Day. The virtual seminar will bring together healthcare professionals, including general practitioners, specialists, and subspecialists, to discuss advancements and strategies in osteoporosis care. This collaboration with the Ministry of Health underscores the national commitment to osteoporosis awareness and education. The second event is a National Osteoporosis Day 2024 Celebration which will invite over 10,000 members on the public on a fun walk while educating them through seminars. It will also include free bone health checks for members of the public.

These events are designed to engage both the medical community and the general public in Indonesia, fostering a culture of osteoporosis prevention and bone health awareness. By scheduling the National Osteoporosis Day (HON) activities in alignment with World Osteoporosis Day, PEROSI hopes to contribute to global efforts while respecting the national political landscape.

On the left is the poster for the nationwide Seminar and on the right is the poster inviting the Indonesian public to celebrate National Osteoporosis Day.

Japan
In Japan, our APCO member Professor Atsushi Suzuki decorated the rotary within Fujita Health University School of Medicine premises with blue LED ornaments. On October 20th, they held a half-day seminar for osteoporosis liaison service (OLS) coordinators in Tokyo, with over 300 participants attending. An additional public lecture for citizens is scheduled to be held in Nagoya in December 2024.

Mongolia
In Mongolia, Dr Myadagmaa Jaalkhorol, APCO Committee member and President Mongolian Naran Society of Osteoarthritis and Musculoskeletal Health, joined Dr Yanjmaa S, Head of the Diabetes Center of the First Central Hospital of Mongolia joined Dr Myadagmaa in welcoming everyone. The event organised by the Mongolian Naran Society for Osteoarthritis and Musculoskeletal Health, the First Central Hospital of Mongolia, the Department of Health Research, Graduate School, MNUMS and the School of Public Health, MNUMS, as part of the efforts to celebrate WOD 2024.

The top left picture depicts Dr Myadagmaa while in the top right, Dr Yanjmaa delivering the welcome speech. The bottom 2 pictures capture members of the event organising team.

Dr Myadagmaa educated the public about Osteoporosis and its risk factors. She also shared about some preventive measures that can be taken such as including milk and dairy products in a person’s diet. The organising team evaluated the knowledge and risk factors of 380 ambulatory clients about osteoporosis. The International Osteoporosis Foundation’s osteoporosis risk assessment and health improvement recommendations were translated from English to Mongolian and questionnaires were collected from outpatient clients. Ambulatory clients who were diagnosed with osteoporosis were encouraged to consume osteoporosis-preventing milk and dairy products. The event’s golden sponsor Suu JSC, provided 16,000 milk and dairy products which were distributed to the patients.

This collage includes snippets of the event organised in Mongolia to celebrate WOD 2024.

Pakistan
The 1st International Osteoporosis and Bone Health Summit titled “Redefining Osteoporosis: From Prevention to Treatment,” was held on October 22, 2024, was a landmark event dedicated to discussing the latest developments in osteoporosis management and bone health. The conference was organized by the Vitamin D Academy and Fragility Fracture Network-Pakistan (FFN-Pak) in collaboration with PharmEvo, as part of celebrating WOD 2024. The event featured interactive presentations from both national and international experts, spanning diverse fields such as orthopedics, medicine, endocrinology, chemical pathology, rheumatology and family physicians. The event was structured into three scientific sessions, each concluding with expert opinions from leading physicians and surgeons.

This collage includes snippets of the 1st International Osteoporosis and Bone Health Summit held in Pakistan.

Dr Aysha Habib Khan, APCO Executive Committee member and the founding member of FFN-Pak, discussed implementing the FRAX tool in Pakistan, highlighting its importance for assessing fracture risk and integrating it into primary care. Dr Khan shared the Asia Pacific Consortium on Osteoporosis (APCO) framework highlighting 5IQ model in the management of osteoporosis. Renowned surgeons gave their expert opinions on improving the lifestyle focusing on exercise, sun exposure, and a healthy diet.

Experts delivered enlightening presentations on Vitamin D’s critical roles in bone health and osteoporosis prevention, the synergistic role of Vitamin K2, Vitamin D, and calcium, and the importance of maintaining a balance between these nutrients for optimal bone and cardiovascular health. Experts further opine to enhance and standardize supplementation programs at the community level, focusing on practical approaches to improve bone health outcomes.

The day concluded with a powerful presentation by Prof. Masood Umer, who shared the journey of FFN-Pak. He discussed the network’s efforts in raising awareness and improving care for fragility fractures, outlining future goals for the organization and its contributions to the global FFN community.

This collage includes the speakers at the 1st International Osteoporosis and Bone Health Summit held in Pakistan.

Philippines
Prof Julie Tan Li-Yu, an associate professor at the University of Santo Tomas Faculty of Medicine and Surgery in Manila, Philippines and an APCO member was involved in the event organised by the Rheumatology department at the University of Santo Tomas Hospital to commemorate WOD 2024.

The World Arthritis and Osteoporosis Day forum included talks such as the ‘Understanding Arthritis & Osteoporosis: Every type, every bite – Empowering lives through knowledge and nutrition’, ‘Understanding Osteoporosis: What you need to know’ and ‘Nutrition with Arthritis and Osteoporosis’. The forum emphasized that while arthritis is common, it can be managed with early intervention, medication and lifestyle changes. Similarly, experts reminded the participants that osteoporosis does not have to be an inevitable part of aging if preventive steps are taken early on.

The event concluded with gratitude extended to the patient participants and sponsors for making the forum successful. The key takeaway of the day was reiterated: ‘Knowledge is power, and with the right information, patients can take control of their health through early detection, treatment, and proper nutrition.’ The forum also highlighted the importance of awareness and self-care, providing participants with essential knowledge about arthritis and osteoporosis as diseases. It served as a reminder that these conditions, while common can be addressed through a proactive approach to health – on that combines medical treatment with lifestyle changes for a better quality of life.

This collage includes snippets of the World Arthritis and Osteoporosis Day forum in Philippines.

Singapore

Poster of the webinar on Osteoporosis and Bone Health which will be organised by the Osteoporosis and Bone Metabolism Unit at SGH.

The Osteoporosis and Bone Metabolism Unit at Singapore General Hospital (SGH) will be commemorating World Osteoporosis Day with 2 educational events that will be held in November 2024. The first one is a unique webinar on Osteoporosis and Bone Health for Staff at SGH. The unit believes that “Education” begins at home and so this webinar in contrast to the public forums they have been holding for the last 17 years, aims to educate SGH staff, who themselves form part of the larger Singaporean community. The webinar inspired by the International Osteoporosis Foundation’s 2024 WOD theme will be a strong call to action by Health Care Providers saying “No to Fragile Bones”. It will feature talks by APCO Chairperson Prof Manju Chandran -Senior Consultant and Director of the Osteoporosis and Bone Metabolism Unit, Ms Nicole Ong Huiyi – Physiotherapist and Ms Benita –Loh Shu Ning- Dietitian.

On November 23, 2024, there will be another unique educational event- this time a first of its kind in the Asia Pacific region- a Hands On DXA BMD workshop organized by the Osteoporosis and Bone Metabolism Unit in collaboration with the Department of Nuclear Medicine and Molecular Imaging and funded by the International Society for Clinical Densitometry. This workshop which will be helmed by DXA expert trainers- Ms Joy Thorpe from the UK and Ms Susan van der Kamp from Ireland and facilitated by Ms May Ann Delos Santos, aims to bridge the gap between theoretical knowledge and clinical practice so that quality densitometry which is critical to good osteoporosis management and research can be learned.

Poster of the Hands On DXA BMD workshop.

Sri Lanka
Sri Lanka College of Endocrinologists in collaboration with the Galle Medical Association celebrated the WOD 2024 on October 22nd with two educational programs focusing on allied health personnel and doctors. APCO Executive member Prof Sarath Lekamwasam, Chair Professor at the Department of Medicine, Faculty of Medicine, Galle, Sri Lanka was invited to deliver opening lectures in both programs highlighting the need for a country-specific management protocol.

Nearly 50 people from diverse allied health fields participated in the first program which addressed non-pharmacologic interventions. The second program which was dedicated to clinical care was attended by nearly 75 doctors. The initial feedback from the participants was positive and its success indicated a demand for such events in the future.

A snippet of the event organised in Sri Lanka to celebrate WOD 2024.

WOD presents an annual opportunity for APCO members to unite, highlight this essential cause, and celebrate their achievements. It’s uplifting to see the variety of cultural approaches and creative initiatives from our member nations and regions supporting this global health mission.

To learn more about APCO’s commitment to developing tangible solutions to the substantive challenges involving osteoporosis management and fracture prevention in the world’s most populated and fastest-growing region, head to apcobonehealth.org and follow us on LinkedIn.

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Low Calcium Intake

Reference 1: This review examined calcium intake among adults around the world and found that many populations do not consume enough calcium to support good bone health. The authors highlight that low calcium intake is particularly common in many Asian countries, where average intakes are often well below recommended levels. Because calcium is essential for building and maintaining strong bones, inadequate intake may increase the risk of osteoporosis and fractures. The study emphasises the importance of promoting calcium rich foods and other practical ways to help people meet their daily calcium needs.

Citation: Balk EM, Adam GP, Langberg VN, et al. “Global dietary calcium intake among adults: a systematic review.” Osteoporos Int. 2017 Dec;28(12):3315-3324. doi: 10.1007/s00198-017-4230-x. Epub 2017 Oct 12. Erratum in: Osteoporos Int. 2018 May;29(5):1223. doi: 10.1007/s00198-018-4447-3. PMID: 29026938; PMCID: PMC5684325.

Reference 2: This review explores the important role of calcium in maintaining healthy bones throughout life. The authors explain that adequate calcium intake helps build and maintain bone strength, while long term low intake may contribute to bone loss and increase the risk of fractures. The paper also discusses the importance of obtaining calcium from a balanced diet, with supplements considered when dietary intake is insufficient. Overall, the review reinforces that meeting daily calcium needs is an important part of supporting lifelong bone health.

Citation: Cormick G, Belizan JM. “Calcium Intake and Health.” Nutrients. 2019 Jul 15;11(7):1606. doi: 10.3390/nu11071606. PMID: 31311164; PMCID: PMC6683260.

Reference 3: This review explores how common calcium deficiency is around the world and the impact it can have on health. The authors explain that many people do not consume enough calcium, particularly in low and middle income countries, increasing the risk of poor bone health and fractures. The paper highlights the importance of consuming enough calcium throughout life to help build and maintain strong bones. It also emphasises the need for practical strategies, such as improving access to calcium rich foods, fortified foods, and nutrition education, to help people meet their daily calcium needs.

Citation: Shlisky J, Mandlik R, Askari S, et al. “Calcium deficiency worldwide: prevalence of inadequate intakes and associated health outcomes.” Ann N Y Acad Sci. 2022 Jun;1512(1):10-28. doi: 10.1111/nyas.14758. Epub 2022 Mar 5. PMID: 35247225; PMCID: PMC9311836.

High Sodium Intake

Reference 1: This review explored whether eating too much salt affects bone health in postmenopausal women. The authors found that while high salt intake may increase calcium loss from the body, there is currently not enough high quality evidence to clearly determine its long term effects on bone mineral density or fracture risk. The paper highlights the need for more research to better understand this relationship. In the meantime, following general recommendations to limit excessive salt intake remains an important part of maintaining overall health.

Citation: Imash D, Gusmanov A, Chan MY. “High salt intake and bone health in postmenopausal women: exposing the lack of studies – a systematic review and meta-analysis.” Front Endocrinol (Lausanne). 2025 Nov 19;16:1694539. doi: 10.3389/fendo.2025.1694539. PMID: 41347127; PMCID: PMC12672310.

Reference 2: This study explored whether salt intake was linked to bone health in postmenopausal women in southern India. The authors found that women who consumed more salt were more likely to have weaker bones, poorer bone structure, osteoporosis, and vertebral fractures. These findings suggest that excessive salt intake may be associated with poorer bone health in this population. The study adds to growing evidence that a balanced diet, including limiting excess salt, may help support healthy bones.

Citation: John R, Cherian KE, Kapoor N, et al. “Excess dietary salt is associated with an altered bone strain index, degraded bone microarchitecture, vertebral fractures, and increased prevalence of osteoporosis in postmenopausal women – A study from a teaching hospital in southern India.” Aging Med (Milton). 2024 Oct 10;7(5):606-613. doi: 10.1002/agm2.12360. PMID: 39507226; PMCID: PMC11535168.

Lower Protein Intake Among Older Adults

Reference 1: This review explored how protein intake and regular exercise can help slow the progression of age-related muscle loss in older adults living in the community. The authors found that combining adequate protein with strength or resistance exercise was more effective than either approach alone in helping to maintain muscle strength and physical function. The paper highlights that preserving muscle health is important for reducing the risk of falls, fractures, and loss of independence. It also reinforces the value of healthy lifestyle habits in supporting active and healthy ageing.

Citation: Li L, He Y, Jin N, Li H, Liu X. “Effects of protein supplementation and exercise on delaying sarcopenia progression in Asian community-dwelling older adults.” Food Chem X. 2022 Jan 20;13:100210. doi: 10.1016/j.fochx.2022.100210. PMID: 35128383; PMCID: PMC8808080.

Reference 2: This consensus paper encourages a broader focus on maintaining muscle health throughout life rather than only identifying or treating sarcopenia after it develops. The authors explain that healthy muscles are essential for mobility, balance, independence, and overall wellbeing, especially as people age. The paper highlights the importance of regular physical activity, good nutrition, and early action to help preserve muscle strength and function. It also encourages healthcare professionals and the public to view muscle health as an important part of healthy ageing alongside bone health.

Citation: Chen LK, Hsiao FY, Akishita M, et al. “A focus shift from sarcopenia to muscle health in the Asian Working Group for Sarcopenia 2025 Consensus Update.” Nat Aging. 2025 Nov;5(11):2164-2175. doi: 10.1038/s43587-025-01004-y. Epub 2025 Nov 4. PMID: 41188603.

High Prevalence of Lactose Intolerance

Reference 1: This review explores how lactose intolerance may affect bone health. The authors explain that people who avoid dairy because of lactose intolerance may miss out on important nutrients, particularly calcium, if these nutrients are not replaced from other foods. The paper highlights that getting enough calcium is important for maintaining strong bones and reducing the risk of fractures. It also emphasises that there are many ways to meet calcium needs, including lactose free dairy products and other calcium rich foods.

Citation: Hodges JK, Cao S, Cladis DP, Weaver CM. “Lactose Intolerance and Bone Health: The Challenge of Ensuring Adequate Calcium Intake.” Nutrients. 2019 Mar 28;11(4):718. doi: 10.3390/nu11040718. PMID: 30925689; PMCID: PMC6521087.

Reference 2: This review explores whether drinking milk can help support bone health in Asian populations, particularly those at higher risk of osteoporosis. The authors highlight that many people in Asia consume less milk than recommended, which may contribute to lower calcium intake and poorer bone health. The paper explains that milk provides important nutrients for strong bones and discusses practical options for people who cannot tolerate regular milk, such as lactose free milk and yoghurt. Overall, the review suggests that finding suitable ways to include dairy or alternative calcium rich foods in the diet may help support lifelong bone health.

Citation: Jiao H, Xu Y, Zhang Y, et al. “Is it advisable for Asians to drink milk, especially those at risk of osteoporosis?” Front Nutr. 2025 Jun 25;12:1586623. doi: 10.3389/fnut.2025.1586623. PMID: 40635901; PMCID: PMC12239142.

Reference 3: This review explores ways to protect bone health in populations where calcium and vitamin D intake is often too low. The authors explain that getting enough of these nutrients is essential for building and maintaining strong bones, yet deficiencies remain common in many parts of the world. The paper highlights that healthy eating, safe sun exposure, regular physical activity, and, where needed, fortified foods or supplements can all help support bone health. It also emphasises the importance of public health efforts to improve awareness and make nutritious foods more accessible, particularly for people at greater risk of osteoporosis.

Citation: Yeum KJ, Ju S, Choe U. “Strategies for preventing bone loss in populations with inadequate calcium and vitamin D intake.” Nutr Res Pract. 2025 Apr;19(2):155-169. doi: 10.4162/nrp.2025.19.2.155. Epub 2025 Mar 13. PMID: 40226767; PMCID: PMC11982687.

Vitamin D Deficiency Despite Sunshine

Reference 1: This review examined how common vitamin D deficiency is around the world and found that it remains a widespread public health concern. The authors explain that many people do not get enough vitamin D because of factors such as limited sun exposure, diet, and lifestyle. As vitamin D plays an important role in maintaining strong bones and muscles, low levels may increase the risk of poor bone health. The study highlights the importance of improving awareness and ensuring people have adequate vitamin D through safe sun exposure, diet, fortified foods, or supplements when needed.

Citation: Cui A, Zhang T, Xiao P, Fan Z, Wang H, Zhuang Y. “Global and regional prevalence of vitamin D deficiency in population-based studies from 2000 to 2022: A pooled analysis of 7.9 million participants.” Front Nutr. 2023 Mar 17;10:1070808. doi: 10.3389/fnut.2023.1070808. PMID: 37006940; PMCID: PMC10064807.

Reference 2: This review examined vitamin D levels among adults living in South Asia and found that vitamin D deficiency is very common across the region. The authors explain that factors such as limited sun exposure, lifestyle, skin pigmentation, and diet may all contribute to low vitamin D levels. Because vitamin D is essential for maintaining healthy bones and muscles, addressing this deficiency is an important part of supporting lifelong bone health. The study highlights the need for greater awareness and practical strategies to help people achieve adequate vitamin D levels.

Citation: Siddiqee MH, Bhattacharjee B, Siddiqi UR, MeshbahurRahman M. “High prevalence of vitamin D deficiency among the South Asian adults: a systematic review and meta-analysis.” BMC Public Health. 2021 Oct 9;21(1):1823. doi: 10.1186/s12889-021-11888-1. PMID: 34627207; PMCID: PMC8501935.

Vegetarian and Plant-Based Diets

Reference 1: This review explores how vegetarian diets may affect bone health. The authors explain that while well planned vegetarian diets can provide many health benefits, they may also be lower in important nutrients such as calcium, vitamin D, protein, and vitamin B12 if not carefully balanced. The paper highlights that these nutrients play an important role in maintaining strong bones and reducing the risk of fractures. It also emphasises that people following vegetarian diets can support their bone health by choosing a varied, nutrient-rich diet and including fortified foods or supplements when needed.

Citation: Falchetti A, Cavati G, Valenti R, et al. “The effects of vegetarian diets on bone health: A literature review.” Front Endocrinol (Lausanne). 2022 Aug 5;13:899375. doi: 10.3389/fendo.2022.899375. PMID: 35992115; PMCID: PMC9388819.

Reference 2: This review examines how vegetarian diets may influence bone mineral density, a measure of bone strength. The authors explain that people following vegetarian diets may have lower bone mineral density if they do not consume enough nutrients that are important for healthy bones, such as calcium, vitamin D, and protein. However, the paper also highlights that a well planned vegetarian diet can support good bone health when these nutritional needs are met. The review emphasises the importance of choosing a balanced diet to help maintain strong bones throughout life.

Citation: Chuang TL, Lin CH, Wang YF. “Effects of vegetarian diet on bone mineral density.” Tzu Chi Med J. 2020 Sep 16;33(2):128-134. doi: 10.4103/tcmj.tcmj_84_20. PMID: 33912409; PMCID: PMC8059457.

Reference 3: This review examined how vegan and vegetarian diets may affect bone mineral density and fracture risk. The authors found that people following plant based diets, particularly vegan diets, may have lower bone mineral density and a higher risk of fractures if they do not get enough nutrients that support bone health. The paper highlights the importance of consuming adequate calcium, vitamin D, protein, and other key nutrients when following a plant based diet. It also emphasises that well planned vegetarian and vegan diets can support healthy bones when nutritional needs are carefully met.

Citation: Iguacel I, Miguel-Berges ML, Gomez-Bruton A, Moreno LA, Julian C. “Veganism, vegetarianism, bone mineral density, and fracture risk: a systematic review and meta-analysis.” Nutr Rev. 2019 Jan 1;77(1):1-18. doi: 10.1093/nutrit/nuy045. PMID: 30376075.

I Think I Might Be at Risk of Osteoporosis

Why should I ask?

Osteoporosis is often called the “silent disease” because there are usually no symptoms until a fracture occurs. If you have risk factors, it is important to discuss your bone health before a fracture happens. Some common risk factors include but not limited to: Family history, Smoking, Alcohol, Low Body Weight, Age and Previous Falls.

Questions to ask your Doctor

1Am I at risk of osteoporosis?
2Should I have a bone health assessment?
3Should I have a DXA scan?
4What are my personal risk factors for osteoporosis and fractures?
5Are any of my medications affecting my bone health?
6What lifestyle changes can help protect my bones?

I am experiencing Height Loss, Stooped Posture, or Bone Pain

Why should I ask?

Losing height, developing a stooped posture or experiencing persistent back pain may not simply be part of ageing. These symptoms can sometimes be caused by vertebral fractures that happen without a major injury.

Questions to ask your Doctor

1Could my symptoms be caused by osteoporosis?
2Should I have spinal imaging or a VFA?
3Could I have had a spinal fracture without realising it?
4What treatments are available if I have vertebral fractures?
5How can I reduce my risk of future fractures?

I have Risk Factors but my DXA Scan was Normal

Why should I ask?

A normal bone density result does not always mean your bones are healthy. Some people may still be at increased fracture risk because of other risk factors or underlying conditions that affect bone quality.

Questions to ask your Doctor

1Does a normal DXA scan mean I cannot have osteoporosis?
2Why am I still at risk of fractures?
3Should my fracture risk be assessed using other tools?
4Are there additional tests I should have?
5How often should my bone health be reviewed?

I am worried about being on an Osteoporosis Medication

Why should I ask?

Many people are concerned about possible side effects of osteoporosis medicines. Understanding both the benefits and risks can help you make an informed decision with your doctor.

Questions to ask your Doctor

1Why are you recommending this medication?
2What are the common side effects?
3How common are the serious side effects?
4What happens if I decide not to take treatment?
5Are there other treatment options that may be suitable for me?

I am going through Menopause

Why should I ask?

Bone loss accelerates during and after menopause because of declining oestrogen levels. Acting early can help maintain bone strength and reduce future fracture risk.

Questions to ask your Doctor

1Does menopause increase my risk of osteoporosis?
2Should I have a DXA scan?
3Am I getting enough calcium and vitamin D?
4Would hormone therapy or another treatment benefit me?
5What lifestyle changes can help protect my bones?

I Have Another Medical Condition That May Affect My Bones

Why should I ask?

Some medical conditions can weaken bones, affect bone quality or interfere with the body’s ability to absorb important nutrients. Others may increase your risk of falls and thus fractures. These include diabetes, rheumatoid arthritis, thyroid disease, kidney disease, celiac disease among others.

Questions to ask your Doctor

1Does my medical condition increase my risk of osteoporosis or fractures?
2Should I have a DXA scan or other bone health tests?
3Are there treatments that can help protect my bones?
4Do I need to see a bone specialist?
5How often should my bone health be monitored?

I take Long-Term Medicines

Why should I ask?

Some medicines can reduce bone strength or increase fracture risk, particularly if they are taken over a long period. Your doctor can help determine whether you need additional monitoring or treatment.

Questions to ask your Doctor

1Could this medication affect my bones?
2Should I have a DXA scan?
3Do I need calcium or vitamin D supplements?
4Should I take medication to help protect my bones?
5How often should my bone health be reviewed while taking this medication?

I am Falling More Often and am Worried about my Balance

Why should I ask?

Most fragility fractures occur after a fall. Identifying the causes of falls and improving balance and strength can significantly reduce your fracture risk.

Questions to ask your Doctor

1Why might I be falling more often?
2Could my medications be contributing?
3Should my vision or hearing be checked?
4Would physiotherapy or balance training help?
5Can I be referred to a falls prevention programme?

I am an Older Man

Why should I ask?

Although osteoporosis is often thought of as a women’s disease, men can also develop osteoporosis and experience serious fractures. Unfortunately, osteoporosis in men is frequently under-recognised and underdiagnosed.

Questions to ask your Doctor

1Can men develop osteoporosis?
2Should I have a bone density test?
3What are my personal risk factors?
4Do I need treatment to reduce my fracture risk?
5Are there lifestyle changes I should make?

My Blood Tests show Low Vitamin D and/or Low Calcium

Why should I ask?

Vitamin D and calcium play essential roles in maintaining healthy bones. Low levels may contribute to bone loss and increase the risk of fractures if left untreated.

Questions to ask your Doctor

1What may have caused my low vitamin D and/or calcium levels?
2Do I need supplements?
3How much calcium and vitamin D should I be taking?
4Should my levels be checked again?
5Are there other tests needed to identify the underlying cause of my my low vitamin D and/or calcium levels?