Bone Health Risk & Lifestyle Checklist Guide — References

This page lists the academic and web-based sources that informed the Bone Health Risk & Lifestyle Checklist Guide. It is provided for those who wish to review the references used within the guide.

Cleveland Clinic: Osteoporosis — Explains how osteoporosis can silently weaken bones until a fracture occurs, while covering common fracture sites, height loss, posture change, back pain, diagnosis, bone density testing, medicines, diet, exercise, and fall prevention.
NIAMS: Osteoporosis — Presents osteoporosis as reduced bone strength and lower bone mineral density, with hip, spine, and wrist fractures highlighted as common clinical concerns.
NHS Inform: Osteoporosis — Covers UK-facing guidance on osteoporosis and osteopenia, including assessment routes, fracture risk assessment, DXA scans, T-scores, diagnosis, lifestyle factors linked with bone health, and the role of clinical review.
Royal Osteoporosis Society: Osteoporosis Risk Checker — Uses a UK-facing checklist to review osteoporosis risk across age, BMI, menopause, low-trauma and repeated fractures, parent hip fracture, falls, medical conditions, medicines, calcium intake, vitamin D, smoking, alcohol, physical activity, and other personal risk factors.
International Osteoporosis Foundation: Risk Factors — Explains both changeable and non-changeable osteoporosis risk factors, including age, sex hormone changes, low body weight, family history, smoking, alcohol, nutrition, and physical inactivity. It also highlights warning signs such as height loss and a curved upper back, which may suggest underlying vertebral fractures.
Mayo Clinic: Osteoporosis Symptoms and Causes — Breaks down osteoporosis risk across age, sex, family history, hormone levels, diet, medical conditions, medicines, smoking, alcohol, sedentary behaviour, and other lifestyle factors, organising these into medical, hormonal, dietary, medicine-related, lifestyle, and family history categories.
NIAMS: Osteoporosis Diagnosis, Treatment, and Steps to Take — Explains osteoporosis diagnosis, bone density testing (DXA), fracture risk assessment, treatment options, medicines, lifestyle measures, nutrition, physical activity, fall prevention, and follow-up care. It also outlines the key topics to discuss during clinical review, including fracture history, family history, medical conditions, medicines, smoking, alcohol, and other factors that influence bone health.
Royal Osteoporosis Society: Causes of Osteoporosis — Covers hormone-related causes, family history, low body weight, eating disorders, medical conditions, medicines, smoking, alcohol, and low activity as contributors to weaker bones.
UC San Diego Health: Osteoporosis Risk Factors — Reviews osteoporosis risk through medical history, medicine use, lifestyle factors, sex hormone changes, body frame, and family background.
World Health Organization: Fragility Fractures — Defines fragility fractures as low-energy injuries and places fracture risk within the wider clinical picture of ageing, previous fracture, parental fracture history, menopause, and risk scoring.
Know Your Bones: Self Assess Your Bone Health Now — Clarifies the link between fracture history and bone health review, including clear patient wording around fractures, broken bones, and when assessment may be needed.
Royal Osteoporosis Society: Bone Health Checklist — Frames everyday bone health around calcium, vitamin D, body weight, physical activity, balance, coordination, smoking, alcohol, and bone health risk awareness, providing a practical checklist for reviewing lifestyle factors that influence bone strength.
Mayo Clinic: Bone Health Tips to Keep Your Bones Healthy — Explains how calcium, vitamin D, weight-bearing physical activity, smoking, alcohol, age, sex, body size, hormone levels, adult bone remodelling, and other medical risk factors influence long-term bone health, while outlining the key daily habits that support stronger bones across adulthood.
Bone Health and Osteoporosis Foundation: Nutrition — Covers calcium-rich foods, vitamin D, fortified foods, protein, fruit and vegetables, beans, alcohol, caffeine, sodium, and everyday dietary choices that support long-term bone health.
Royal Osteoporosis Society: Exercise and Physical Activity for Osteoporosis — Explains how safe movement, muscle strengthening, balance, posture, confidence, and everyday physical activity support bone health, daily function, and reducing fall risk.
American Academy of Orthopaedic Surgeons: Exercise and Bone Health — Covers weight-bearing activity, strength training, balance, posture, and other bone-friendly exercise choices that help support bone strength and safer movement.
International Osteoporosis Foundation: Exercise for Individuals with Osteoporosis — Reviews muscle strength, balance, posture, functional movement, and safe exercise choices for people with osteoporosis or an increased fracture risk. Explains how exercise can support everyday function while helping reduce the risk of falls and fractures.
MedlinePlus: Fall Risk Assessment — Explains patient fall risk screening, including previous falls, steadiness, mobility, gait, balance, strength, vision, medicines, footwear, and home hazards that may increase the likelihood of falling.
Cleveland Clinic: Fall Risk Assessment — Explains how fall risk screening considers previous falls, unsteadiness, fear of falling, daily activities, medicines, vision, home hazards, balance, walking pattern, and overall mobility to identify people who may be at greater risk of falling.
International Osteoporosis Foundation: Falls Prevention — Reviews the role of falls in fragility fractures and osteoporosis care, covering intrinsic and environmental risk factors such as muscle weakness, poor balance, medicines, vision problems, footwear, and home hazards, alongside practical fall-reduction strategies including home safety, weight-bearing and muscle-strengthening exercise, balance training, and vision checks.
APTA: Osteoporosis Self-Assessment Tool — Places the Osteoporosis Self-Assessment Tool in the context of recognised screening measures, helping distinguish this workbook score from formal clinical tools.
MDCalc: Osteoporosis Self-Assessment Tool — Shows the OST formula and risk categories, giving useful contrast between a validated screening calculation and this guide’s reflective workbook score.
Osteoporosis New Zealand: Checklist for Early Detection — Presents early detection prompts around fracture history, age, menopause, family history, steroid use, medical conditions, and lifestyle risk factors.
Mayo Clinic: Bone Density Test — Explains how bone density testing is used to measure bone strength and guide osteoporosis diagnosis or fracture risk review.
Royal Osteoporosis Society: Exercise for Bones — Explains weight-bearing impact activity, muscle-strengthening exercise, balance training, low-impact alternatives, movement breaks during prolonged sitting, gradual progression, goal setting, activity tracking, and safer exercise choices for people with osteoporosis, spinal fractures, higher fracture risk, or other medical considerations.
NIAMS: Exercise for Your Bone Health — Explains the role of weight-bearing exercise, resistance training, balance practice, muscle strengthening, fall reduction, and weekly activity patterns in supporting bone health. It also advises speaking with a healthcare professional before starting or progressing exercise if you have osteoporosis, low bone density, physical limitations, or other medical concerns.
Bone Health and Osteoporosis Foundation: Be Bone Strong — Exercise and Safe Movement — Explains weight-bearing and muscle-strengthening exercise, including high-impact and low-impact activities, bodyweight and resistance exercises, functional strengthening, balance training, walking-based movement, and practical guidance on exercising safely with osteoporosis or increased fracture risk.
International Osteoporosis Foundation: Exercise — Outlines the main types of exercise for bone health, including weight-bearing activity, resistance training, and balance work. It also discusses choosing activities based on personal capability, enjoyment, fracture history, and fall risk, while highlighting when professional advice is appropriate, particularly after a spinal fracture or when bending and higher-impact movements may not be suitable.
NHS: Osteoporosis Prevention — Sets out UK guidance on preventing osteoporosis through regular physical activity, including weight-bearing and resistance exercise, alongside balanced nutrition, calcium, vitamin D, sunlight exposure, smoking cessation, sensible alcohol intake, and seeking advice from a GP or specialist before starting a new exercise programme after an osteoporosis diagnosis. It also outlines the lifestyle measures used to support bone health planning, habit tracking, and long-term prevention.
Royal Osteoporosis Society: Nutrition for Bones — Explains bone-supportive eating through balanced meals, calcium, vitamin D, protein, fruit and vegetables, carbohydrates, dairy or fortified alternatives, and the wider dietary pattern that supports bone health.
International Osteoporosis Foundation: Nutrition — Reviews adult and older-adult nutrition needs, including calcium, vitamin D, protein, micronutrients, muscle function, and fracture risk in later life.
Royal Osteoporosis Society: How to Sleep More Comfortably with Osteoporosis or Fractures — Offers practical guidance for improving sleep comfort in people with osteoporosis or fractures, including advice on fracture pain, kyphosis, mattress choice, pressure relief, night-time positioning, and managing discomfort that may affect sleep quality.
MDPI: What Are the Barriers to Adoption of a Lifestyle Associated with Optimal Peak Bone Mass Acquisition? — Examines the real-world barriers that can make bone-protective habits difficult to maintain, including time, cost, food preferences, social and cultural influences, medical conditions, peer pressure, and the absence of early symptoms. These findings help explain why realistic planning, habit tracking, and barrier identification are important for long-term bone health.
NYU Langone Health: Lifestyle Changes for Osteoporosis and Low Bone Mass — Covers lifestyle changes for people with low bone mass or osteoporosis, including dietary choices, smoking, alcohol, and practical day-to-day habits that support bone health.
International Osteoporosis Foundation: Prevention — Presents lifelong bone health prevention through nutrition, calcium, protein, vitamin D, physical activity, healthy body weight, smoking cessation, limiting alcohol, risk awareness, early diagnosis, and fracture prevention across adulthood and older age.
UAB Tone Your Bones: Your Osteoporosis Treatment Worksheet — Presents a patient-facing worksheet that shows how to turn bone health care into practical treatment actions, personal goals, questions for healthcare professionals, and ongoing care planning. It also provides a clear framework for organising goal-setting and action-planning pages within a patient workbook.
Bone Health and Osteoporosis Foundation: Prevention and Healthy Living — Covers everyday bone health through nutrition, calcium, vitamin D, exercise, safe movement, fall prevention, smoking, alcohol, and other healthy lifestyle habits that support long-term bone strength and reduce fracture risk.
RACGP: Ongoing Monitoring — Outlines ongoing clinical monitoring for osteoporosis, including new fractures, falls, treatment adherence, treatment response, medicine review, risk reassessment, and bone mineral density follow-up where appropriate.
Mayo Clinic: Osteoporosis Diagnosis and Treatment — Explains diagnostic testing, bone density assessment, treatment pathways, medicines, lifestyle measures, fall prevention, and follow-up considerations for monitoring osteoporosis and reviewing progress over time.
NHS: Osteoporosis — Explains osteoporosis as a slowly developing condition that may only be diagnosed after a fall or sudden impact causes a fracture, with wrist, hip, and spinal fractures listed as common injury sites.
Royal Osteoporosis Society: Scans, Tests and Results — Sets out UK-facing guidance on fracture risk assessment, DXA scans, scan results, blood tests, and review points such as easy fractures, spinal fracture symptoms, risk factors, and treatment review.
Royal Osteoporosis Society: Fracture Risk Assessment — Defines fracture risk assessment and explains its role in estimating a person’s chance of breaking a bone, including use of FRAX in clinical settings.
MedlinePlus: Bone Density Scan — Explains how bone density scans measure bone strength, how scan results relate to fracture risk, and why further testing or repeat scans may be discussed.
NHS: Keep Bones Healthy Over 65 — Sets out practical bone health steps around exercise, diet, falls prevention, medicines advice, and fracture liaison services after a broken bone.
NHS Inform: Bone Health and Falls — Links bone health with fall outcomes and lists everyday steps such as calcium-rich eating, vitamin D from time outdoors, weight-bearing and muscle-strengthening exercise, stopping smoking, and limiting alcohol.
Royal Osteoporosis Society: Bone Density Scan DXA — Explains how a DXA scan can assess bone strength, osteoporosis likelihood, and future fracture risk.