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A new review by the International Osteoporosis Foundation (IOF) Rehabilitation Working Group underscores the powerful impact of lifestyle behaviors—specifically physical activity and sedentary behavior—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 titled "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 behavior influence bone mineral density (BMD) and fracture risk in children, adolescents, adults, and older populations.

The paper is published in the journal Calcified Tissue International.

Key findings include:

The evidence demonstrates that physical activity and sedentary behavior 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 behavior.

"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, health care providers, and policymakers to implement comprehensive public health strategies that not only encourage active lifestyles but also systematically reduce sedentary behaviors across all populations and age groups, in order to ensure optimal skeletal health and fracture prevention."

More information: Olivier Bruyère 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, Calcified Tissue International (2025). DOI: 10.1007/s00223-025-01421-6