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How to Prevent Osteoporosis — An Evidence-Based Approach

Osteoporosis is not inevitable. The majority of fragility fractures are preventable — but prevention requires knowing your risk before the first fracture occurs.

Osteoporosis develops silently, over years or decades, without pain or symptoms. For most people, the first clinical sign that something is wrong is a fracture — a wrist broken in a minor fall, a vertebral crush fracture from bending to lift something, a hip fracture that changes the trajectory of an older person’s life entirely. By that point, significant bone loss has already occurred.

The central argument for prevention is straightforward: bone density can be measured before a fracture occurs. Risk can be calculated. Loss can be identified at the stage when intervention is most effective and least burdensome. The question is not whether prevention is possible — it is whether it is sought early enough.

Effective osteoporosis prevention operates across four interconnected areas: knowing your risk, building and preserving bone density through appropriate exercise, optimising the nutritional conditions bone remodelling requires, and — where indicated — pharmacological support. The London Osteoporosis Clinic’s clinical approach integrates all four within a consultant-led, monitored pathway.

Know Your Risk

A formal bone health assessment — including DXA scan, FRAX fracture risk score, and clinical history — is the only reliable way to know whether bone loss is occurring. Symptoms are not a reliable guide.

Exercise for Bone

Weight-bearing and resistance exercise provide the mechanical stimulus bone remodelling requires. The type, intensity, and progression of exercise matters far more than frequency alone.

Clinical Nutrition

Calcium, Vitamin D, protein, and magnesium are bone’s raw materials. Deficiency in any of these limits the efficacy of all other interventions, including pharmacological treatment.

Treatment Where Indicated

For patients with confirmed low bone density or high fracture risk, pharmacological treatment significantly reduces future fracture probability. The right drug, at the right time, is a prevention tool — not a last resort.

Avoid Depleting Factors

Smoking, excess alcohol, prolonged corticosteroid use, and low body weight all accelerate bone loss. Addressing modifiable risk factors is part of every prevention strategy at LOC.

Monitor Regularly

Prevention is not a one-time action. Regular DXA monitoring at appropriate intervals confirms that bone density is stable or improving — and allows the clinical strategy to be adjusted if it is not.

Who Should Be Assessed?

Prevention begins with knowing whether intervention is needed. A bone health assessment is appropriate for anyone with one or more of the following clinical indicators.

Consider assessment if you:

Are a woman approaching or past menopause
Have a family history of osteoporosis or hip fracture
Have used corticosteroids (e.g. prednisolone) for more than 3 months
Have experienced a fracture from a minor fall or impact
Have been told you have low bone density
Have an inflammatory condition such as rheumatoid arthritis or AS
Are a man over 50 with known risk factors

Also consider assessment if you:

Have noticed a loss of height over time
Have had an early menopause (before age 45)
Have a low body weight or BMI below 19
Smoke or consume more than 14 units of alcohol per week
Have coeliac disease or another malabsorption condition
Are concerned about your bone health even without a formal diagnosis
Have had significant weight loss or an eating disorder

A formal assessment at the London Osteoporosis Clinic includes a detailed clinical history, fracture risk stratification using the FRAX tool, DXA bone density measurement, trabecular bone score where indicated, and an individualised prevention or treatment plan. No GP referral is required.

What Does Prevention Look Like in Practice?

Prevention is not a single intervention — it is a sustained clinical strategy. At the London Osteoporosis Clinic, patients on the BoneRevive® Programme achieve an average 8–12% annual improvement in bone mineral density under consultant supervision. For patients who do not yet have osteoporosis, the goal is to preserve and build bone density during the years when that is most achievable, and to ensure that if bone loss is occurring, it is identified and addressed before a fracture happens.

Before any diagnosis	Identify risk factors. Establish baseline DXA if risk factors present. Optimise nutrition, exercise, and lifestyle. Annual monitoring if any risk factors identified.
Osteopenia confirmed	Increase exercise stimulus. Address all modifiable risk factors. Nutritional optimisation. Consider pharmacological prevention for high-risk subgroups. 12–18 month DXA monitoring.
Osteoporosis confirmed	Full clinical assessment and personalised treatment plan. Pharmacological treatment in most cases. Structured therapeutic exercise. Regular monitoring. Fracture risk recalculation at each review.
Post-fracture	Fracture Liaison Service principles apply. Urgent assessment and treatment initiation. Secondary fracture prevention is the immediate clinical priority.

How to Access a Bone Health Assessment

The London Osteoporosis Clinic operates on a self-referral basis — no GP letter is required. Appointments are available at HCA Healthcare at The Shard (London SE1) and The Nuffield Hospital (Tunbridge Wells). Phone and video consultations are also available.

Self-funding patients: Book directly online or by telephone — no GP referral required.
GP / clinician referral: GPs and healthcare professionals may refer patients directly. Please contact the clinic to arrange.
Private medical insurance: Most major insurers are accepted. Contact your insurer to confirm cover before booking. Some, including AXA Health, will arrange your appointment directly.
NHS patients: The clinic does not accept NHS referrals. Patients requiring NHS-funded treatment should ask their GP for a local NHS rheumatology or metabolic bone referral.

Prevention Begins With a Single Assessment.

A consultant-led bone health assessment at the London Osteoporosis Clinic provides a clear picture of your current bone density, fracture risk, and the most effective clinical pathway for your situation. No GP referral required. Results and a personalised plan within the first appointment.

Book a Bone Health Assessment →

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