Strong bones aren’t just built in childhood—they need care and attention throughout life.
A new review from the International Osteoporosis Foundation (IOF) Rehabilitation Working Group shows that both regular movement and reduced sitting time play a critical role in keeping bones healthy from childhood through old age.
The review, published in Calcified Tissue International, looked at decades of research on how physical activity and sedentary behavior affect bone mineral density (BMD) and fracture risk.
While it’s long been known that exercise strengthens bones and lowers the chance of fractures, the review highlights another important finding: sitting for long periods may harm bone health, even in people who exercise regularly.
The strongest benefits come from weight-bearing and resistance exercises, such as walking, running, dancing, or lifting weights.
These activities help stimulate bone growth in children and teens and slow bone loss in adults and older people.
But the review also found that even lighter activity, like walking or gentle movement around the home, can improve bone health if it replaces sitting time. This is particularly important for older adults and postmenopausal women, who face a higher risk of osteoporosis and fractures.
Professor Olivier Bruyère, co-chair of the IOF Rehabilitation Working Group and lead author of the review, emphasized that bone health relies on two equally important actions: moving more and sitting less.
“In children and adolescents, too much sitting can interfere with proper bone development,” he explained.
“In adults and older individuals, inactivity speeds up bone loss and raises the risk of fractures. Even light activity—like walking every day—can provide real benefits.”
The review also noted that frail or pre-frail older adults are especially vulnerable to the negative effects of long sitting times. For them, finding ways to reduce sedentary behavior and include even small bursts of movement can make a measurable difference.
IOF leaders say the findings have major implications for health care and public policy. Professor Nicholas Harvey, IOF President, and Professor Eugene McCloskey, IOF CSA Chairman, stressed that governments and health systems should take action.
“We urge policymakers to create strategies that promote active lifestyles and reduce sedentary time at every age,” they said in a joint statement. “Following World Health Organization guidelines for physical activity across the life course is one of the best ways to prevent osteoporosis and fractures later in life.”
The message is clear: bone health is shaped not only by how much we move, but also by how much we sit. Choosing daily movement—whether it’s structured exercise or light activity—combined with less sedentary time offers a powerful, lifelong strategy to build and maintain strong bones.
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