Adequate physical activity is highly promoted as a general health measure and controlled clinical trials suggest that load-bearing exercises are most effective in preserving skeletal mass. Adequate calcium intake is the cornerstone of any osteoporosis prevention (or treatment) plan. The effectiveness of dietary calcium and vitamin D supplementation for increasing bone mass in older adults and decreasing fracture risk has been demonstrated in controlled clinical trials. The recommended daily calcium intake for patients over the age of 50 is 1200 mg. However, optimal daily calcium intake may be higher (i.e., 1500 mg) in men and women over the age of 65. In postmenopausal women not receiving hormone therapy, the optimal daily calcium intake is 1500 mg. The NOF recommends 800 IU/d of vitamin D for older adults, as well as for chronically ill, housebound, or institutionalized individuals.

Patients who smoke should be encouraged to quit because age-related bone loss is accelerated after the fifth decade of life in smokers. In terms of reducing fracture risk, adequate physical activity reduces the risk of falls in elderly patients by increasing muscle balance and tone. Weight-bearing exercise, in which the bones and muscles carry the body's weight, is most effective. Examples include walking, jogging, tai-chi, stair climbing, dancing, and tennis. The value of assessing the risk of falling, and intervening in those at high risk (e.g., those with preexisting fragility fractures), is supported by randomized clinical trials in elderly patients.