What lifestyle modifications should I advise to a patient at high risk of developing osteoporosis?

Advise the patient to take regular, tailored exercise to improve muscle strength, including walking (preferably outdoors to increase vitamin D production), strength training targeting key muscle groups such as hip, wrist, and spine, and a combination of balance, flexibility, stretching, endurance, and progressive strengthening exercises.

Encourage a balanced diet to support bone health.

Advise stopping smoking if applicable, as smoking is a risk factor for fragility fractures.

Recommend drinking alcohol within the recommended limits because alcohol intake is a dose-dependent risk factor for fragility fractures.

Ensure adequate vitamin D and calcium intake, either through diet or supplementation, especially if dietary calcium is inadequate or if the patient has limited sunlight exposure.

Provide information and support resources such as the Royal Osteoporosis Society and NHS health encyclopaedia for further patient education.