ANZBMS Position Statements
Trabecular Bone Score in the Assessment and Management of Osteoporosis in Australia: A Position Statement from ANZBMS (Endorsed by HBA).
Download the ANZBMS TBS Position Statement.
Standards for Clinical Bone Densitometry Practice
Download Standards for Clinical Bone Densitometry Practice Version 01 Dec 2024
Standard DXA Report: 2023 Minimum Requirements AANMS ANZBMS ESA
Australia & New Zealand Position Statements on Primary Hyperparathyroidism
Currently available as online, early view versions published by Wiley Publishing in Clinical Endocrinology:
Milat, F, Ramchand, SK, Herath, M, et al. Primary hyperparathyroidism in adults—(Part I) assessment and medical management: Position statement of the endocrine society of Australia, the Australian & New Zealand endocrine surgeons, and the Australian & New Zealand bone and mineral society. Clinical Endocrinology. 2021; 1- 16. doi:10.1111/cen.14659
Download position paper part 1
Miller, JA, Gundara, J, Harper, S, et al. Primary hyperparathyroidism in adults—(Part II) surgical management and postoperative follow-up: Position statement of the Endocrine Society of Australia, The Australian & New Zealand Endocrine Surgeons, and The Australian & New Zealand Bone and Mineral Society. Clinical Endocrinology. 2021; 1- 15. doi:10.1111/cen.14650
Download position paper part 2
Healthy Bones Australia/ RACGP Position Statement on the Management of Osteoporosis 2024
Click on the links below to the Executive Summary and Position statement for the Management of Osteoporosis:
Calcium and Vitamin D position Statement 2017
Download/p>
Updated Calcium and D statement December 2018
ESA/ANZBMS/MSA/COSA Position Statement: "Optimising bone health in women with breast cancer on endocrine therapy" now published in Clin Endo
Benefits of Dietary Calcium
The Australian and New Zealand Bone and Mineral Society, Osteoporosis Australia and Endocrine Society of Australia collectively reject the suggestion of Mr Pete Evans (reported in the Sydney Morning Herald1, ABC2and recently on the programme Sunday Night3, 26th March 2017) that “calcium from dairy can remove the calcium from your bones" or that calcium obtained from dairy foods can cause or contribute to osteoporosis.
Ensuring sufficient calcium intake is an important component for bone health across the entire lifespan. Dairy foods are an important and inexpensive source of calcium for many individuals, and most Australians obtain the majority of their calcium intake from dairy sources. Dairy foods also represent an important source of protein and calories for many frail older people.
Men and women with osteopaenia or osteoporosis should be reassured and confident that a good dairy intake does not have adverse effects upon skeletal health.
1http://www.smh.com.au/entertainment/doctor-criticises-chef-pete-evans-for-giving-potentially-deadly-diet-advice-20160829-gr3ydb.html
2http://www.abc.net.au/news/2016-08-29/pete-evans-slammed-for-advice-to-osteoporosis-sufferer/7793572
ANZBMS, OA and ESA issue joint response to Pete Evans
Calcium and Bone Health
The final version of the "Calcium and Bone Health" position paper was accepted in 2007 and is endorsed by ANZBMS, Osteoporosis Australia (OA) and the Endocrine Society of Australia (ESA).
Download the Position Statement
Vitamin D and adult bone health in Australia and New Zealand
A position statement by a working group of the ANZBMS, ESA and OA.
Published MJA 2005; 182: 281–285.
A significant number of Australians are deficient in vitamin D. Indeed, it is a fallacy that Australians receive adequate vitamin D from casual exposure to sunlight. Here, we outline the causes and outcomes of vitamin D deficiency, the people who are at risk, and recommendations for management of deficiency.
Download the Position Statement
Exercise and Osteoporosis
Download the position statement on Exercise and Osteoporosis.
Jaw osteonecrosis with bisphosphonates
Download the HBA MRONJ Guideline (Updated June 2026)
Osteoporosis New Zealand publishes Fracture Liaison Service Resource Pack
Osteoporosis New Zealand has published a Fracture Liaison Services (FLS) Resource Pack, which was endorsed by the Health Quality & Safety Commission New Zealand:
http://osteoporosis.org.nz/resources/health-professionals/fracture-liaison-services/
Fragility Fracture Network launches new website
The Fragility Fracture Network’s mission is to promote globally the optimal multidisciplinary management of the patients with a fragility fracture, including secondary prevention. FFN is a fast growing organisation with global reach and a multidisciplinary membership, which is particularly well represented in Australia and New Zealand. Professor David Marsh (orthopaedics) from the UK is the current FFN President and Professor Maria Crotty (Rehabilitation Physician) from Adelaide is President-Elect.
The FFN is focused on 6 themes:
- Peri-operative care: Improving the peri-operative care of fragility fracture sufferers has, and will continue to be a major focus for FFN members and a theme of FFN Congresses.
- Surgical treatment: A key challenge facing surgeons is how to obtain secure fixation of an implant to osteoporotic bone.
- Rehabilitation: Provision of effective rehabilitation is a vital component of any system of care for fragility fracture sufferers.
- Secondary prevention: Effective secondary prevention must urgently be established as a standard part of post-fracture care throughout the world.
- Research and education: FFN Special Interest Groups are active in establishing a minimum dataset for hip fracture audit, developing evidence-based pathways for vertebral fracture patients and defining key questions in rehabilitation research.
- Changing healthcare policy: Driving policy change that will raise fragility fracture care up the healthcare agenda across the world is a major aim of the FFN.
The new website can be visited at www.fragilityfracturenetwork.org. Please take a look, and if you find the site useful, share it with colleagues who are also interested in the care of fragility fracture sufferers.
Osteoporosis Australia Medical and Scientific Advisory Committee Position statements:
- Building Healthy Bones throughout life - an evidence-informed strategy to prevent osteoporosis in Australia’ MJA OPEN - full paper
- Calcium Supplementation Statement (reviewed 06/2015)
- Vitamin D Position Statement (10/2013)
- Vitamin D and health in adults in Australia & New Zealand: A position statement. MJA (June 18, 2012)
- Clinical guideline for the prevention and treatment of osteoporosis in postmenopausal women and older men(RACGP, 2010)
- Hormone replacement therapy and osteoporosis(August, 2012)
Other Downloads
- Clinical guidelines for the prevention and treatment of osteoporosis in postmenopausal women and older men
- Algorithm for the prevention and treatment of osteoporosis in postmenopausal women and older men
New Osteoporosis National Action Plan 2016
A new Osteoporosis National Action Plan, the result of a 12 month collaboration among a national alliance of stakeholder groups, launched on 20 October 2016 - World Osteoporosis Day. The plan presents a joint vision to address this major health issue as a matter of urgency.
Download a copy of the Osteoporosis National Action Plan here
Australian and New Zealand Bone and Mineral Society releases widely endorsed Position Paper on Secondary Fracture Prevention: A Call to Action.
On 11 May 2015, the Australian and New Zealand Bone and Mineral Society (ANZBMS) launched its pivotal Position Paper on Secondary Fracture Prevention, calling for radical change in how people who have suffered a fragility fracture are being managed.
Know Your Bones
Osteoporosis Australia and Garvan Institute of Medical Research launched Know Your Bones on Thursday 16 June. An Australian-first bone health self-assessment tool designed to help consumers understand their bone fracture risk, is now available to all adults, including the 7.5 million Australians living with brittle bones.
The Know Your Bones online tool helps adults assess their likelihood of fractures, including those diagnosed with osteopenia and osteoporosis – two common bone conditions that, together with fractures, will cost the nation more than $3 billion this year.
Further information: http://www.osteoporosis.org.au/experts-launch-know-your-bones
Information about the launch event: http://www.osteoporosis.org.au/minister-ley-attends-launch
Calcium Supplements and Vascular Disease
Updated: 10 September 2010
A recent publication by Bolland et al published in the British Medical Journal suggests that calcium supplements may increase the relative risk of ischaemic heart disease by 30%.1
While it is important to investigate possible harm caused by dietary supplements, it is difficult to know how much weight to put on this meta-analysis for several reasons. Firstly, a similar study – i.e. a pooled analysis of several randomized controlled trials where calcium supplements were given, funded by the American Heart Association did not detect any statistically significant increased risk of cardiovascular disease or other negative effects of calcium supplements.2 Secondly, none of the individual randomized trials analysed reported a statistically significant increased risk of ischaemic heart disease. Thirdly, new data from Lewis et al also reported no increase in atherosclerotic vascular disease related events in elderly women receiving calcium supplements (1200mg per day) followed for a total of 9.5 years (5 years on calcium supplements and a further 4.5 years). Importantly, records in this study, but not in most others, were validated through hospital admission data linkage although data for myocardial infarction events were not reported separately3. Fourthly, previous observational studies examining data from very large numbers of people have shown no adverse effect of high calcium intakes. As pointed out by Bolland et al, the effect of high dietary calcium intakes from diet were not studied in their recent meta-analysis.
While these studies were negative, it is important to recognise that methodological issues in the individual trials would have resulted in lack of power to detect a deleterious effect of calcium supplementation if there really was one present. For example, compliance in most, if not all the large trials, was around 50% so that a deleterious effect of calcium might have been missed. In post hoc analysis, the reduction in sample size when only compliers are examined, reduces the power of the study. Furthermore, none of the trials with calcium supplements were designed to investigate vascular events, so that randomization may have produced an uneven distribution of risk factors for cardiovascular disease, which could produce spurious results in either direction. In most of the studies, the subjects were not dietary calcium deficient, so supplements were given to people who already had adequate calcium intakes from dietary sources. In some studies, total calcium intakes were above 2000mg/day.
Given these uncertainties, ANZBMS recommends achieving a total calcium intake of 1000-1300mg, depending on age and sex, where possible through dietary intake of calcium rich foods. Similar recommendations come from the National Health and Medical Research Council. If dietary intake is not feasible and the treating doctor believes calcium supplements are needed for fracture risk reduction, then calcium supplements in doses of 500-600mg can be considered after a discussion of their benefits vs risks.
1. Bolland MJ, Avenell A, Baron JA, Grey A, MacLennan GS, Gamble GD, Reid IR. Effect of calcium supplements on risk of myocardial infarction and cardiovascular events: meta-analysis. BMJ 2010; 341:c3691.
2. Wang L, Manson JE, Song Y, Sesso HD. Systematic review: Vitamin D and calcium supplementation in prevention of cardiovascular events. Ann Intern Med. 2010 Mar 2;152(5):315-23.
3. Lewis JR, Calver J, Zhu K, Flicker L, Prince RL. Calcium supplementation and the risks of atherosclerotic vascular disease in older women: results of a 5-year RCT and a 4.5-year follow-up. J Bone Miner Res. 2010 Jul 7. [Epub ahead of print].