A team of 62 bone health experts from India created new guidelines to help doctors prevent and treat osteoporosis, a condition where bones become weak and break easily. Using a special method where experts answered questions in multiple rounds until they agreed on the best practices, they developed recommendations covering everything from preventing bone loss to treating it with medicine. These guidelines cover different situations like menopause, kidney disease, and long-term steroid use. The guidelines are designed to help all types of healthcare workers—from surgeons to nurses—give their patients the best care for bone health.

The Quick Take

  • What they studied: What are the best ways for doctors to prevent, find, and treat weak bones (osteoporosis)?
  • Who participated: 62 bone health experts from India, including doctors who specialize in bones, general doctors, researchers, and nurses with experience treating bone problems
  • Key finding: Experts agreed on 13 main areas of bone health care, from preventing weak bones to treating them with medicine and watching how well the treatment works
  • What it means for you: If you’re worried about bone health or your doctor mentioned osteoporosis, these new guidelines mean your healthcare team has clear, expert-approved steps to follow for your care. However, these are guidelines for doctors—you should talk to your own doctor about what’s right for your specific situation.

The Research Details

Experts created these guidelines using a special method called the Delphi technique. This method works like this: experts answer questions in rounds, see what others answered, then answer again. This continues until most experts agree on the answers. In this case, 62 bone health experts answered questions across six rounds. The experts included doctors who treat bones, researchers who study bones, and teachers at medical schools. This back-and-forth process helps make sure the final guidelines represent what most experts believe is the best approach based on current research.

Using expert agreement helps create guidelines that doctors will actually use in real life. Instead of just looking at research papers, this method combines research with practical experience from doctors who treat patients every day. The guidelines cover many different situations—like bone loss after menopause, bone problems from kidney disease, and bone weakness from steroid medicines—so they’re useful for many different patients.

These guidelines are based on expert consensus, which is a strong approach. The fact that 62 different experts from the field agreed on these recommendations makes them more reliable. However, these are guidelines, not absolute rules—individual patients may need different approaches based on their specific health situation. The experts plan to update these guidelines in 5-6 years as new research becomes available, which shows they’re committed to keeping the information current.

What the Results Show

The expert panel reached agreement on 13 major areas of bone health: preventing osteoporosis before it starts, screening people to find who’s at risk, diagnosing weak bones, using calcium and vitamin D, understanding gut bacteria’s role in bone health, how weight affects bones, bone loss after menopause, bone loss in men, bone problems from kidney disease, bone weakness from steroid medicines, medicines that treat osteoporosis, how to monitor if treatment is working, and a condition called osteosarcopenia (weak bones and weak muscles together). Each of these areas now has clear recommendations that doctors can follow. The guidelines emphasize that preventing bone loss is better than trying to fix it after it happens, and that different groups of people (women after menopause, men, people with kidney disease) may need different approaches.

The guidelines highlight several important connections: gut bacteria may play a role in bone health, obesity affects how bones develop, and certain medicines (like steroids) can weaken bones as a side effect. The experts also emphasized that bone health isn’t just about bones—it’s connected to overall health, nutrition, exercise, and other medical conditions. They noted that monitoring patients over time is important to make sure treatments are actually working.

These Indian guidelines add to existing bone health guidelines from other countries by focusing on issues that are particularly important in India and South Asia. They use the same expert consensus approach that other major medical organizations use, making them consistent with international standards while addressing local health needs and populations.

These are guidelines based on expert opinion, not results from a single large research study. While expert opinion is valuable, it’s not the same as testing a treatment on thousands of patients. The guidelines will need to be updated as new research comes out. Also, these guidelines are designed for healthcare professionals, not for patients to use directly—you should always talk to your own doctor about what’s right for you. The guidelines may not apply equally to all populations or healthcare settings.

The Bottom Line

If you’re at risk for osteoporosis (especially if you’re a woman over 50, a man over 70, or have certain health conditions), talk to your doctor about screening. Make sure you get enough calcium and vitamin D, exercise regularly, and avoid smoking and excess alcohol. If you’re diagnosed with weak bones, your doctor now has clear guidelines to help decide on the best treatment for your situation. These recommendations have high confidence because they come from expert agreement, but they should be personalized to your individual health needs.

These guidelines are most important for healthcare workers treating patients with bone problems. However, anyone concerned about bone health—especially older adults, women after menopause, people taking steroids long-term, or those with kidney disease—should be aware that their doctor now has updated guidance. People with strong, healthy bones and no risk factors may not need to worry about these guidelines right now, but prevention is always good.

Preventing bone loss is an ongoing process, not something that happens quickly. If you start taking calcium and vitamin D and exercising, it may take several months to see improvements in bone strength. If your doctor prescribes medicine for osteoporosis, it typically takes 1-2 years to see meaningful improvements in bone density. Your doctor will likely check your bone health periodically to see how you’re doing.

Want to Apply This Research?

  • Track daily calcium intake (target 1000-1200mg for adults), vitamin D supplementation, and weight-bearing exercise minutes. Log these weekly to see patterns and ensure you’re meeting recommendations.
  • Set reminders for calcium-rich foods or supplements at meals, schedule 30 minutes of weight-bearing exercise (walking, dancing, strength training) most days of the week, and track these activities in the app to build consistency.
  • Use the app to monitor calcium and vitamin D intake monthly, track exercise patterns, and set goals for bone-healthy behaviors. If prescribed osteoporosis medicine, use the app to remember doses and note any side effects to discuss with your doctor at follow-up appointments.

These guidelines are designed for healthcare professionals and should not replace personalized medical advice from your doctor. Osteoporosis diagnosis and treatment should always be based on your individual health situation, medical history, and test results. If you think you may have weak bones or are at risk for osteoporosis, consult with your healthcare provider before starting any new supplements, exercises, or treatments. These guidelines will be updated as new research becomes available, and your doctor will have the most current information for your care.