Influencing exercise and diet to prevent osteoporosis: lessons from three studies.

Osteoporosis is a major public health problem, causing fractures of wrist, back and hip with high associated morbidity and mortality. Particularly at risk are postmenopausal women. Recent moves away from hormone replacement therapy as a preventative measure have focused attention on exercise and dietary supplementation with calcium for prevention and treatment. This article reports three studies of women screened for osteoporosis - an outpatient sample (n = 129), a GP sample (n = 25) of women before and after bone mineral density screening, and a sample of women diagnosed with osteoporosis in the past 5 years (n = 26). Only 57% in the outpatient sample consume the recommended amount of calcium (1500 mg calcium daily); 65% in primary care consume 1200 mg five times per week, although 90% intend to do so. For bone-loading exercise, the recommendation is three 20-minute periods per week. Most women thought they were undertaking enough exercise, and diaries showed that 74% of the women undertook 60 minutes per week, and 44% undertook 30 minutes five times per week. Women were more willing to change diet than exercise. Suggestions are made to help primary care teams to motivate women to make sustained changes in diet and exercise.