Are there dietary patterns that have been proven to reduce bone fractures?

Fermented dairy products such as yoghurt and cheese have been most consistently linked to a lower risk of hip fractures. They provide both calcium and high-quality protein, and the gut microbiome may also play a role. This effect appears across multiple observational studies, although that does not prove cause and effect. Eating at least five portions of vegetables and fruit per day is likewise associated with fewer hip fractures; people who fall below that threshold face a higher risk.

The Mediterranean diet, with its mix of fibre, polyphenols, legumes, fish and fermented dairy, scores favourably in observational studies. A higher protein intake also helps, but only when the diet contains sufficient calcium at the same time. Without that calcium anchor, the protective effect of extra protein is uncertain.

Eating a fully plant-based diet increases fracture risk, presumably due to a shortage of calcium and animal protein. People who eat vegan and do not actively supplement are at greater risk of bone fractures. On the other hand, a large Chinese study (nearly 18,000 participants) indicates that a dietary pattern rich in meat, eggs, dairy, vegetables and fruit reduced the risk of vertebral fractures in older women by 34 to 39 percent compared with people who ate little meat. This is observational evidence; other factors may be involved.

Soft drinks and fried foods are associated with lower bone density; drinking soft drinks daily and consuming alcohol regularly are explicitly discouraged in French guidelines because of their negative effect on bone health.

Calcium and vitamin D obtained through food are indispensable, but supplements in tablet or capsule form are a subject of doubt. Recent studies question whether supplements actually reduce fracture risk. If you want to know whether you have a deficiency, discuss this with your doctor before you start supplementing.