Since 2009, our FORE Fracture Risk Calculator has been available and we have been collecting feedback from people who are using it. A common question that people have is why we do not consider diet and exercise in the fracture risk calculation.

Over the years, researchers studying the risks that contribute to fractures use very large databases of people from around the world. They examined how well a variety of risk factors correlate with fractures. Using this very comprehensive method, they identified several factors that could be strongly linked to fracture risk. Each factor needed to be easily measured and also an independent contributor to the risk calculation. While there are a number of factors that can impact bone health, only a hand full of them by themselves contribute in a meaningful way to the fracture risk formula. Risks such as certain medical conditions and medications are included, but the most important risk factors are age, having suffered a fracture, having a close family member having a hip fracture. Neither diet nor exercise contributed to the risk calculation once all the other factors were included. So, although diet and exercise are VERY important prevention strategies, they do not have a measurable impact on immediate 10-year fracture risk–and they are hard to quantify.

This is not to say that we shouldn’t do everything we can to minimize risks and maximize bone health. Exercise and diet are critically important to the whole bone health picture. Fracture risk screening can help people who have an increased risk of fracture to consider ways to reduce that risk–the risk number can be the first step in motivating change.