g. step aerobics and intermittent jogging) is more appropriate for those not used to exercising and those over

50 years of age. In patients with osteoporosis, it is advised that any form of strength training should be site specific (i.e. targeting areas such as the muscle groups Linsitinib price around the hip, quadriceps, dorsi/plantar flexors, wrist extensors and back extensors). Weight-bearing exercises should be targeted to loading bone sites predominantly affected by osteoporotic fracture. In all patients, these exercise programmes should start at an easy level and be progressive in terms of intensity and impact. Obviously, the persistence to regular exercise and physical activity is of primary importance.   Lifestyle Epidemiological

studies have identified a large number of risk factors for osteoporotic fracture. XMU-MP-1 clinical trial These can be risk factors related to bone strength, i.e. bone density, geometry and/or quality, or factors independent of bone strength, essentially related to risk for falls (one for review). Amongst the identified risk factors only some are potentially modifiable. Such risk factors that can be Wnt inhibitor considered as somehow related to lifestyle are listed in Table 1. Table 1 Risk factors for osteoporotic fractures related to lifestyle Risk factor Related to bone strength, falls, other? Dietary  Low body weight Bone strength  Overweight, obesity (?) Bone strength, (other?)  Low calcium intake Bone strength, (falls?)  High sodium intake Bone strength  Excess caffeine intake Bone strength  Excessive use of cola drinks Bone strength Others  Excessive alcohol intake Bone strength, falls  Smoking Bone strength, other (?)  Low sun exposure Bone strength, falls  Use of hypnotic and sedative drugs Falls  Inappropriate housing conditions Falls  Physical inactivity Bone strength, falls Low body weight or low BMI is a well-recognized

risk factor for fracture, whereas overweight and obesity have generally been considered as protective [79, 80]. However, recent evidence tends to challenge this view and suggests that increased adiposity and obesity, which has been associated with higher prevalence of vitamin D insufficiency and in some GBA3 studies also of secondary hyperparathyroidism [81, 82], can have a negative impact on indices of bone strength and possibly on fracture risk [83–87]. Albeit the available evidence thus suggests that a lifestyle that helps maintaining a more ideal body weight is beneficial for bone health, presently there is no evidence that interventions aimed at gaining or losing weight in thin and obese persons, respectively, can reduce fracture risk. In fact, weight loss in obese subjects has been associated with increased bone loss [88].