Millions of Thais may be unaware they are living with what experts call a “silent disease,” as fragile bones and osteoporosis continue to threaten global health—including here in Thailand. The latest research and expert consensus, highlighted in a recent ABC News report, underscores the urgent need for both preventive and proactive measures to maintain bone health and decrease the risk of osteoporotic fractures across all age groups.
Osteoporosis, often only recognized after a fracture occurs, is particularly insidious because it can progress without symptoms for years. Traditionally, it has been associated with elderly women, but new evidence shows that men and younger people are also at considerable risk. According to the Royal Australian College of General Practitioners (RACGP), one in two women and one in three men will experience an osteoporosis-related fracture over their lifetimes, a trend mirrored in many Asian populations, including Thailand’s rapidly aging society.
The metaphor of viewing the skeleton as a “bone bank” highlights both the opportunity and urgency of bone health management. During youth—especially adolescence—a “deposit” of new bone reaches its peak. From around the age of 30 in women and somewhat later in men, withdrawals begin to outpace deposits, accelerating after menopause due to hormonal changes. The concern voiced by experts such as a Deakin University exercise scientist is that sedentary lifestyles in childhood may leave young people entering adulthood with dangerously low reserves, raising the possibility of earlier and more frequent fractures later in life.
Modern risk factors for weak bones—especially relevant in urban Thailand—include a family history of osteoporosis, low calcium or vitamin D intake, hormonal imbalances, the use of certain medications, smoking, excessive alcohol consumption, and lack of physical activity. As Thai society urbanizes, more youth and adults are constrained to indoor lifestyles and diets high in processed foods, echoing global trends that disadvantage bone health.
When it comes to prevention and management, the latest evidence emphasizes that regular, targeted exercise is crucial. While aerobic activities such as walking benefit general health, bone cells only respond to mechanical stress generated by impactful, weight-bearing movements: running, jumping, hopping, and similar activities that “shock” the skeleton. In fact, Australian researchers found in a longitudinal study that hopping on one leg significantly increased bone strength in that leg after just a year.
Muscle strengthening activities—such as squats, push-ups, resistance bands, and free weights—are also essential, as muscle mass helps prevent falls and maintains bone density. Experts now recommend “exercise snacking”: short, intense bouts of physical activity spaced throughout the day. This might include climbing stairs instead of taking the lift, squatting while picking items off the ground, or performing a few jumps or stretches during television commercials. However, older adults are advised to consult a qualified healthcare provider before starting high-impact exercises to reduce the risk of injury.
A professor of musculoskeletal health at the University of Sydney highlighted that while some may fear injury from exercise, appropriate, supervised routines can make exercise not only safe but also highly beneficial for older adults. In Thailand, many hospitals offer bone mineral density scans—an important screening tool for osteoporosis—and public health policies increasingly promote exercise programs for seniors.
Even those without a clinical diagnosis of osteoporosis are not entirely safe from fractures. A Monash University endocrinologist pointed out that only one third of fragility fractures occur in those meeting clinical criteria for osteoporosis (extremely low bone density). Many fractures occur in those with “osteopenia” (mildly reduced bone density) or even normal levels, as factors such as bone shape and micro-architecture, as well as balance and coordination, play significant roles. Therefore, activities that boost balance and mobility—such as tai chi, dancing, and gardening—are widely recommended. Early research also points to a potential benefit from yoga, and all forms of physical activity that enhance stability can help prevent falls, a leading cause of serious injury in older Thais.
Diet is the other major pillar in bone health. Vitamin D, essential for calcium absorption, is primarily generated through sunlight exposure, with fatty fish and fortified dairy as secondary sources. But with up to 25% of Australians—mirroring deficiencies increasingly found in Thailand’s urban populations—lacking sufficient vitamin D, supplements are sometimes necessary, but should be taken in medically recommended doses. Too much vitamin D can lead to kidney stones and other issues.
Calcium and protein intake are often suboptimal in both Australia and Thailand. Recommendations call for 1,000 mg of calcium daily for adults, with heightened needs for women over 50 and men over 70. Protein targets for older adults are 1.0–1.2 grams per kilogram of body weight per day, essential for both muscle and bone maintenance. The RACGP and comparable Thai nutritional guidelines suggest three servings of dairy foods daily, such as milk, yoghurt, or cheese, increasing to four for women over 50. Alternate sources include tofu, almonds, sesame seeds, tinned fish, leafy greens, beans, and calcium-fortified non-dairy beverages—options readily available in Thai markets. Traditional Thai cuisine, rich in bone-boosting ingredients like leafy greens, fish, and sesame, can be adapted to support strong bones if consumed with awareness of recommended servings.
As urbanization and modernization change Thai lifestyles, incorporating global best practices with traditional knowledge becomes crucial. Public health campaigns and community action—such as school-based exercise programs and senior activity clubs—could help reverse disturbing trends in inactivity and undernutrition, especially in cities like Bangkok and Chiang Mai.
Looking ahead, experts warn that, with Southeast Asian populations rapidly aging, the burden of bone disease and fractures is set to rise sharply without intervention. Thailand’s Ministry of Public Health, in collaboration with hospitals and community health centers, is ramping up screening and education campaigns, but both personal and community-level commitment is needed. A practical action plan for Thai readers includes: scheduling regular bone density scans if you are over 50 or have risk factors; incorporating weight-bearing and balance-focused activities into daily routines; ensuring sufficient intake of calcium, vitamin D, and protein; and consulting healthcare professionals for personalized advice.
For more information and tailored advice, Thais are encouraged to consult national health agencies and the local equivalents of organizations such as Healthy Bones Australia, and to access screening and exercise programs at community hospitals.
By making proactive choices today, Thais of all ages can help strengthen their “bone banks” and safeguard themselves against the pain, disability, and loss of independence that osteoporosis and related fractures can bring.
Sources: ABC News, Healthy Bones Australia, Royal Australian College of GPs, World Health Organization Osteoporosis Fact Sheet