{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T22:29:28Z","timestamp":1782858568604,"version":"3.54.5"},"reference-count":74,"publisher":"MDPI AG","issue":"23","license":[{"start":{"date-parts":[[2025,11,29]],"date-time":"2025-11-29T00:00:00Z","timestamp":1764374400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"\u201cVictor Babes\u201d University of Medicine and Pharmacy of Timisoara"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Background\/Objectives: Osteoporosis represents a major yet underdiagnosed public health concern in developing countries, including Tunisia. Limited awareness, delayed diagnosis, and suboptimal adoption of preventive strategies contribute to increased risk of fragility fractures in aging populations. This study aimed to assess post-pandemic knowledge, attitudes, and preventive practices regarding osteoporosis in the Tunisian general population. Methods: A cross-sectional survey was conducted between February and April 2024 in six randomly selected community pharmacies in Tunis. Adults \u2265 40 years old completed a validated 31-item questionnaire assessing socio-demographic factors, osteoporosis knowledge, risk factors, screening practices, and preventive behaviors. A total of 160 fully completed questionnaires were analyzed using SPSS v22. Results: Only 60.6% of respondents reported awareness of osteoporosis. Knowledge levels were significantly higher in men (8.37 vs. 7.40; p = 0.043), urban residents (8.22 vs. 7.21; p = 0.036), participants with higher education (8.73 vs. 7.00; p &lt; 0.001), those with a family history (8.58 vs. 7.49; p = 0.033), and individuals already diagnosed (9.19 vs. 7.63; p = 0.025). Screening rates were low: only 11.3% had ever undergone DXA testing, despite 18.8% reporting prior fractures. Preventive behaviors were inadequate: 80% did not supplement calcium, 88.1% did not use vitamin D, and 58.8% did not engage in &lt;30 min of daily activity. Osteoporosis was reported by 13.1% of participants and 95.2% of diagnosed cases received treatment, predominantly bisphosphonates (75%). Comorbidities were significantly associated with osteoporosis (24.5% vs. 7.5%; p = 0.003). Conclusions: This study reveals suboptimal awareness, limited access to screening, and insufficient preventive behaviors regarding osteoporosis in Tunisia. Targeted educational initiatives, expansion of DXA availability, adoption of national osteoporosis guidelines, and multidisciplinary stakeholder involvement are critical to improve early detection, prevention, and management in the aging Tunisian population. Furthermore, promoting balanced nutrition that includes calcium- and vitamin D-rich foods, along with appropriate dietary supplementation when needed, is an essential preventive strategy to support optimal bone health and reduce osteoporosis risk in the general population.<\/jats:p>","DOI":"10.3390\/nu17233759","type":"journal-article","created":{"date-parts":[[2025,12,3]],"date-time":"2025-12-03T10:34:01Z","timestamp":1764758041000},"page":"3759","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Knowledge, Beliefs and Preventive Practices Regarding Osteoporosis: A Cross-Sectional Study in Community Pharmacies in Tunis"],"prefix":"10.3390","volume":"17","author":[{"given":"Cristina","family":"Merlan","sequence":"first","affiliation":[{"name":"Faculty of Pharmacy, \u201cVictor Babe\u015f\u201d University of Medicine and Pharmacy, 2 Eftimie Murgu Street, 300041 Timisoara, Romania"},{"name":"Doctoral School, \u201cVictor Babe\u015f\u201d University of Medicine and Pharmacy, 300041 Timisoara, Romania"},{"name":"Research Center for Pharmaco-Toxicological Evaluation, \u201cVictor Babe\u015f\u201d University of Medicine and Pharmacy, Eftimie Murgu Sq. No. 2, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simona","family":"Buda","sequence":"additional","affiliation":[{"name":"Doctoral School, \u201cVictor Babe\u015f\u201d University of Medicine and Pharmacy, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandru","family":"Oancea","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, \u201cVasile Goldi\u0219\u201d Western University of Arad, 81 Revolution Boulevard, 2900, 310025 Arad, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-9617-8488","authenticated-orcid":false,"given":"Narcisa","family":"Jianu","sequence":"additional","affiliation":[{"name":"Doctoral School, \u201cVictor Babe\u015f\u201d University of Medicine and Pharmacy, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teodor Nicolae","family":"Onea","sequence":"additional","affiliation":[{"name":"Politehnica University of Timi\u015foara, Victoriei Square 2, 300006 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bianca","family":"Tot","sequence":"additional","affiliation":[{"name":"Faculty of Pharmacy, \u201cVictor Babe\u015f\u201d University of Medicine and Pharmacy, 2 Eftimie Murgu Street, 300041 Timisoara, Romania"},{"name":"Doctoral School, \u201cVictor Babe\u015f\u201d University of Medicine and Pharmacy, 300041 Timisoara, Romania"},{"name":"Research Center for Pharmaco-Toxicological Evaluation, \u201cVictor Babe\u015f\u201d University of Medicine and Pharmacy, Eftimie Murgu Sq. No. 2, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3084-6301","authenticated-orcid":false,"given":"Lucre\u021bia","family":"Udrescu","sequence":"additional","affiliation":[{"name":"Faculty of Pharmacy, \u201cVictor Babe\u015f\u201d University of Medicine and Pharmacy, 2 Eftimie Murgu Street, 300041 Timisoara, Romania"},{"name":"Center for Drug Data Analysis, Cheminformatics, and the Internet of Medical Things, \u201cVictor Babe\u015f\u201d University of Medicine and Pharmacy, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2704-8541","authenticated-orcid":false,"given":"Vlad","family":"Groza","sequence":"additional","affiliation":[{"name":"Department of Computer and Information Technology, University Politehnica of Timi\u015foara, 300223 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mihai","family":"Udrescu","sequence":"additional","affiliation":[{"name":"Department of Computer and Information Technology, University Politehnica of Timi\u015foara, 300223 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6576-965X","authenticated-orcid":false,"given":"Adelina","family":"Lombrea","sequence":"additional","affiliation":[{"name":"Faculty of Pharmacy, \u201cVictor Babe\u015f\u201d University of Medicine and Pharmacy, 2 Eftimie Murgu Street, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Denisa Maria","family":"Ni\u021bu","sequence":"additional","affiliation":[{"name":"Faculty of Pharmacy, \u201cVictor Babe\u015f\u201d University of Medicine and Pharmacy, 2 Eftimie Murgu Street, 300041 Timisoara, Romania"},{"name":"Doctoral School, \u201cVictor Babe\u015f\u201d University of Medicine and Pharmacy, 300041 Timisoara, Romania"},{"name":"Research Center for Pharmaco-Toxicological Evaluation, \u201cVictor Babe\u015f\u201d University of Medicine and Pharmacy, Eftimie Murgu Sq. No. 2, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-4923-2371","authenticated-orcid":false,"given":"Alexandru","family":"Ciolofan","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, \u201cVictor Babe\u015f\u201d University of Medicine and Pharmacy, 2 Eftimie Murgu Street, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Farah Ben","family":"Jabeur","sequence":"additional","affiliation":[{"name":"Faculty of Pharmacy, \u201cVictor Babe\u015f\u201d University of Medicine and Pharmacy, 2 Eftimie Murgu Street, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina Adriana","family":"Dehelean","sequence":"additional","affiliation":[{"name":"Faculty of Pharmacy, \u201cVictor Babe\u015f\u201d University of Medicine and Pharmacy, 2 Eftimie Murgu Street, 300041 Timisoara, Romania"},{"name":"Research Center for Pharmaco-Toxicological Evaluation, \u201cVictor Babe\u015f\u201d University of Medicine and Pharmacy, Eftimie Murgu Sq. No. 2, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3194-2012","authenticated-orcid":false,"given":"Valentina Oana","family":"Buda","sequence":"additional","affiliation":[{"name":"Faculty of Pharmacy, \u201cVictor Babe\u015f\u201d University of Medicine and Pharmacy, 2 Eftimie Murgu Street, 300041 Timisoara, Romania"},{"name":"Research Center for Pharmaco-Toxicological Evaluation, \u201cVictor Babe\u015f\u201d University of Medicine and Pharmacy, Eftimie Murgu Sq. No. 2, 300041 Timisoara, Romania"},{"name":"Institute of Cardiovascular Diseases Timisoara, 13A Gheorghe Adam Street, 300310 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,11,29]]},"reference":[{"key":"ref_1","first-page":"105","article-title":"The Epidemiology of Osteoporosis","volume":"133","author":"Clynes","year":"2020","journal-title":"Br. Med. 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