Lifestyle advice

Calcium supplementation has been shown to increase the risk of gastrointestinal side-effects and has been linked to other adverse outcomes such as an increased risk of cardiovascular disease, so the recommendation is for OP patients to try and achieve a daily calcium intake of 700-1,200mg through diet.

A vitamin D intake of 400IU per day is advised for all adults, but for postmenopausal women and older men at risk of fractures, evidence supports the use of greater doses: 800IU or higher has been shown to protect against fractures and reduce fall risk.

Reducing the risk of falls cuts the risk of fracture so steps should be taken to improve safety and introduce exercise programmes, both of which may be components of local fall prevention programmes. Other steps which can improve bone health include increasing physical activity, stopping smoking, ensuring sufficient protein intake (using nutritional supplements if necessary) and reducing alcohol intake to under two units per day.