NEW DELHI: For decades, osteoporosis has been framed in India almost exclusively as a woman's illness, something postmenopausal mothers and grandmothers were told to watch for. New research on Indian men is now dismantling that assumption — and prompting doctors in the national capital to urge men, especially older adults, to take their bone health seriously long before the first fracture strikes.
A systematic review and meta-analysis published in the Indian Journal of Medical Research in 2026 estimated that 14.6 per cent of the healthy adult Indian men covered by the studies analysed had osteoporosis, while 50.3 per cent had osteopenia, a condition in which bone mineral density falls below normal levels.
In plain terms, roughly one in seven apparently healthy men in the studied groups had bones fragile enough to be classified as osteoporotic, and about half had bones showing the early stages of weakening.
The findings have been described by Delhi-based physicians as a wake-up call. Osteoporosis weakens bones gradually and silently, thinning their internal architecture until even a minor fall, a stumble on the stairs, or an everyday injury can cause a fracture that would not have happened in healthy bone. Because the process usually unfolds without pain or visible symptoms, the first sign is often the fracture itself.
The review drew together 21 studies. Six of them, covering 1,569 men, fed into the pooled estimate for osteoporosis, while seven studies involving 1,585 men contributed to the osteopenia figure. The researchers were careful to flag an important caveat: the studies varied substantially from one another, so the percentages cannot be read as exact estimates for every Indian man across the country.
But even as indicative numbers, doctors say, they point to a large and largely unrecognised burden of weak bones among men who consider themselves fit.
"This is not a condition that announces itself," say doctors familiar with the research. "Osteoporosis often goes unnoticed until a fracture occurs," says Dr Sushil Sharma, Senior Consultant, Joint and Knee Replacement Surgeon at Kailash Hospital in Noida, who has been advising people in Delhi-NCR to pay closer attention to nutrition, physical activity and individual risk factors.
The timing of the warning is not accidental. As winter approaches the Delhi-NCR region, the capital's notorious air quality begins its seasonal decline, and doctors note that smoggy months can keep people indoors, disrupting the outdoor exercise routines that help preserve bone strength.
Dr Sharma's team cautions that poor air quality should not be blamed as a direct cause of osteoporosis — scientists are still investigating possible links between long-term exposure to fine particulate matter such as PM2.5 and lower bone mineral density, and this remains an area of ongoing research rather than an established fact.
The practical advice, doctors say, is to shift workouts indoors when pollution spikes, follow local air-quality advisories, and take regular movement breaks during desk-bound working hours.
Ageing is the single biggest driver of bone loss in both sexes, but it is far from the only one. Inadequate calcium and vitamin D intake, too little weight-bearing physical activity, smoking, excessive alcohol consumption, hormonal shifts and certain long-term medications can all erode bone density over the years.
Men who have spent decades at desks, getting little sunlight and less exercise, can arrive at their fifties and sixties with bones far more fragile than they imagine.
Dr Aakar Kapoor, Founder, Partner and Consultant Radiologist at City Imaging & Clinical Labs in Delhi, highlights how hormonal changes and prolonged inactivity should factor into any assessment of bone-health risk. Modern working professionals who sit for ten or more hours a day, he notes, may be quietly losing the physical stimulus their skeletons need to stay dense.
That does not mean every sedentary person has osteoporosis, doctors stress — age, medical history, fracture history and other individual risk factors must guide any clinical judgement.
Women do face a higher baseline risk, particularly around menopause, when falling oestrogen levels accelerate bone loss. Women who reach menopause early, especially before the age of 45, may need assessment sooner. But the new data makes clear that men cannot afford the comforting belief that osteoporosis is someone else's disease.
International data from the International Osteoporosis Foundation estimates that globally, one in five men over 50 will experience an osteoporotic fracture — and men who break a hip often face worse outcomes than women in the same situation.
So how does a man know whether his bones are in trouble? The warning signs, doctors say, are subtle. A fracture after a minor fall is the classic red flag. Other clues include unexplained loss of height over the years, persistent back pain that will not settle, or a progressively stooped posture. Any of these warrants a medical evaluation rather than being dismissed as ordinary ageing.
The standard test is a dual-energy X-ray absorptiometry scan, known as a DXA or DEXA scan, which measures bone mineral density at the hip and spine. The procedure is quick, painless and uses a very low dose of radiation. Doctors decide whether it is appropriate based on a person's age, medical history, previous fractures and risk profile; it is not routinely recommended for every healthy young adult.
"Older adults, postmenopausal women and those with risk factors, including early menopause or a previous fracture, should consult their doctor about bone mineral density testing," says Dr Sharma.
Prevention, as with most silent diseases, is far better than treatment. The building blocks are familiar: adequate calcium, protein and vitamin D. Doctors suggest a balanced diet that includes milk, curd, paneer, calcium-set tofu, pulses, green leafy vegetables and other nutrient-rich foods, along with safe sun exposure to support the body's vitamin D production.
Regular weight-bearing exercise — even brisk walking — combined with muscle-strengthening activities helps bones maintain their density, provided the routine is adapted to each person's fitness level and medical conditions.
Lifestyle habits matter as well. Not smoking, limiting alcohol, correcting nutritional deficiencies and staying active through the day all contribute to stronger bones. For older adults and anyone at heightened fracture risk, fall prevention at home — clear walkways, adequate lighting, supportive footwear — can be the difference between a stumble and a broken hip.
The 2026 review's headline numbers should not be treated as a national census of fragile bones, but as something arguably more useful: proof that the disease is hiding in plain sight among Indian men. The researchers themselves caution against reading the figures as nationally representative, given how much the underlying studies differed.
What the evidence does establish is that osteoporosis in men is far more common than public perception admits — and that screening, when guided by a doctor's assessment of individual risk, can catch it in time.
For a condition that reveals itself only when something breaks, that early knowledge is everything. A DXA scan today can prevent the hip fracture that robs a man of his mobility, his independence and his confidence tomorrow. The message from Delhi's doctors is simple: men should stop assuming their bones are fine and start treating bone health the way they treat blood pressure and blood sugar — as something worth measuring before trouble arrives.
(Reporting based on NDTV and News9live.)