New research highlights critical role of movement in lifelong bone health

A new review by the International Osteoporosis Foundation (IOF) Rehabilitation Working Group underscores the powerful impact of lifestyle behaviours—specifically physical activity and sedentary behaviour —on bone health across the human lifespan. 

While exercise has long been recognized for its role in strengthening bones and reducing fracture risk, emerging evidence reveals that prolonged sitting and inactivity can harm skeletal health, even among individuals who engage in regular physical activity. 

The study 'The Impact of Sedentary Behavior and Physical Activity on Bone Health: A Narrative Review from the Rehabilitation Working Group of the International Osteoporosis Foundation' synthesizes findings from epidemiological studies, systematic reviews, and meta-analyses, examining how physical activity and sedentary behaviour influence bone mineral density (BMD) and fracture risk in children, adolescents, adults, and older populations.

Key findings include:

• Physical activity – especially weight-bearing and resistance training – improves bone mineral density and helps reduce fracture risk in both younger and older populations.
• Sedentary behaviour – independent of overall activity levels – has harmful effects on bone health, increasing fracture risk, particularly in frail or pre-frail individuals.
• Even light-intensity activity can yield measurable benefits when it replaces sedentary time, especially in older adults and postmenopausal women.
• Early and continuous promotion of physical activity, aligned with World Health Organization (WHO) guidelines, provides an effective strategy for maintaining skeletal health and preventing osteoporotic fractures.

The evidence demonstrates that physical activity and sedentary behaviour are independent, modifiable factors influencing skeletal health. Clinical practice and public health policy should address both — not only encouraging physical activity, but also actively reducing prolonged sedentary time.

Professor Olivier Bruyère, Co-chair of the IOF Rehabilitation Working Group and Lead Author of the publication, stated:  

“This review highlights a critical message for populations worldwide: bone health depends not only on engaging in regular physical activity, but also on reducing the hours we spend in sedentary behaviour. In children and adolescents, too much sitting time can undermine bone development, while in adults and older individuals, inactivity accelerates bone loss and fracture risk. Importantly, even light daily activity—such as walking—can provide measurable benefits, particularly for older adults and postmenopausal women.”

IOF President Professor Nicholas Harvey and IOF CSA Chairman Professor Eugene McCloskey jointly underscore the significance of the study’s clinical and policy implications: 

“The findings highlight the imperative for early intervention and sustained promotion of physical activity throughout the life course, in alignment with WHO recommendations. We therefore urge governments, healthcare providers, and policymakers to implement comprehensive public health strategies that not only encourage active lifestyles but also systematically reduce sedentary behaviours across all populations and age groups, in order to ensure optimal skeletal health and fracture prevention.”

###

Reference: Bruyère, O., Scott, D., Papaioannou, A. et al. The Impact of Sedentary Behavior and Physical Activity on Bone Health: A Narrative Review from the Rehabilitation Working Group of the International Osteoporosis Foundation. Calcif Tissue Int 116, 109 (2025). https://doi.org/10.1007/s00223-025-01421-6
 

About IOF
The International Osteoporosis Foundation (IOF) is the world’s largest nongovernmental organization dedicated to the prevention, diagnosis, and treatment of osteoporosis and related musculoskeletal diseases. IOF’s membership committees include leading scientific experts, 340 patient organizations and medical societies in more than 150 countries, as well as universities worldwide. The IOF Capture the Fracture® initiative counts over 1,200 Fracture Liaison Services across all regions of the world. Together, this global network works to prioritize bone health and fracture prevention, sharing a vision of a world free from fragility fractures, where healthy mobility is a reality for all. @iofbonehealth
Websites: www.osteoporosis.foundation ; www.capturethefracture.org ; www.worldosteoporosisday.org ; www.buildbetterbones.org ; https://www.iofacademy.org/