Doctors used to think a good, calcium-rich diet was enough to avoid the crippling bone disease known as osteoporosis, but it is now clear that regular exercise is just as important, a new report released stated.

"One of the best ways to build and maintain healthy bones is through exercise," Dr Helmut Minne, a leading German osteopath and board member of the International Osteoporosis Foundation (IOF) said in the IOF's new report, "Move it or Lose it."

The IOF is a non-governmental organization of scientific experts and national societies which focus on the disease.

Osteoporosis, in which the bones become fragile and break easily, is one of the world's most common chronic diseases. It strikes one in three women over 50 worldwide -- more than breast cancer -- and one in five men -- more than prostate cancer, the the report said.

Because bone is living tissue which renews itself continuously, it requires regular stimulation from physical activity. Like muscles, bones should be used regularly or they will deteriorate, the report said.

People develop a peak bone mass during their adulthood, which eventually begins to decline.

"Physicians once thought that reaching this peak depended primarily on diet, including sufficient calcium intake and exposure to vitamin D in the skin," the report said.

"But recent studies have (shown) that in laying down the bone foundation that will serve for a lifetime, exercise is just as important as diet," it added.

The report, which was released in Berlin for "International Osteoporosis Day" on Thursday, says women who sit for more than nine hours a day are 50 percent more likely to have a hip fracture than those who sit less than six hours a day.

Exercising the back during middle-age can help prevent vertebrae from weakening or fracturing when people get older, the report said.

Not all types of exercise stimulate bone mass growth. Weight-bearing and high-impact exercise like running or dancing are best for stimulating bone formation.

"Exercise builds strong muscles, which in turn builds strong bones," Minne said. "Exercise also improves muscle control, balance and coordination, and reduces the risk of falling or suffering a fracture during a fall."

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