Metabolic HealthHigher BMI Lowers Fracture Risk — New Meta-Analysis Rewrites FRAX Calculations
A large international meta-analysis pooling data from 25 prospective cohorts found that higher body mass index (BMI) is associated with progressively lower risk of major osteoporotic fractures and hip fractures. Using individual patient data from over 300,000 individuals, the study quantified the graded inverse relationship between BMI and fracture risk after adjusting for age, sex, and bone mineral density. These findings directly inform updates to the FRAX fracture risk assessment tool, which is used globally by clinicians to guide osteoporosis treatment decisions. The results confirm that low BMI remains a meaningful independent risk factor for fracture, while obesity confers a degree of skeletal protection — though this protection does not apply equally to all fracture sites.
