Bone Fit Exercise Physiology

5 META-ANALYSES ON EXERCISE & BONE

WALKING HELPS HEALTH. LOADING HELPS BONE.

If your goal is to preserve bone, do not hang your hat on walking alone. Lift. Do weight-bearing work. Better yet, combine them. Across 5 meta-analyses and network meta-analyses in peri/postmenopausal or postmenopausal women, the pattern is pretty consistent: resistance training helps, weight-bearing loading helps, mixed programmes often do best, and walking alone is a weaker primary option if bone is the target.

This is not one cherry-picked study. These papers together include 257 studies or trials and at least 16,943 women. That total is a summed total across reviews, not a unique headcount, so there is overlap between papers.

My read of the evidence is simple. Resistance training should be the anchor. Add weight-bearing or impact work if appropriate. Multimodal training keeps floating to the top.

Walking is good for health, but if bone is the actual goal, it is usually not enough on its own. And this is a months-to-a-year adaptation, not a 2-week project.

If bone is the target, walking is a start, not a finish line!

[1] https://pubmed.ncbi.nlm.nih.gov/36749350/ "Exercise training and bone mineral density in postmenopausal women: an updated systematic review and meta-analysis of intervention studies with emphasis on potential moderators"
[2] https://pubmed.ncbi.nlm.nih.gov/32785775/ "Effects of Different Types of Exercise on Bone Mineral Density in Postmenopausal Women: A Systematic Review and Meta-analysis"
[3] https://pubmed.ncbi.nlm.nih.gov/36824476/ "Comparative efficacy different resistance training protocols on bone mineral density in postmenopausal women: A systematic review and network meta-analysis"
[4] https://pubmed.ncbi.nlm.nih.gov/24149921/ "Effects of walking on the preservation of bone mineral density in perimenopausal and postmenopausal women: a systematic review and meta-analysis"
[5] https://pubmed.ncbi.nlm.nih.gov/41617082/ "Effects of different types of exercise over 24 weeks on bone mineral density in postmenopausal women: A systematic review with pairwise and network meta-analysis of randomized controlled trials"

P.S. Adequate calcium, vitamin D, and protein (1.6 g/kg/d or less) and in that order, are also a big part of supporting this.

Bone Density Myths: Why DEXA Scores Aren’t Everything — Physio Network Osteoporosis myths debunked: Find out why DEXA scans tell only part of the story—and what truly matters for your patients.

AND …. OR? Which one?! Medical management is a cornerstone of osteoporosis management but with the rise of evidence in exercise for management of bone mineral density issues … can one replace the other? There appears to be an ADDITIVE effect of meds + exercise so we should be locking shields with medicine and educating our clients appropriately! DOI: 10.1002/jbmr.4334 #osteoporosis

Turning Back Time: Moving Like a 20-Year-Old When You're Almost 70!

Older adults can maintain youth-like levels of physical function—if they lift weights. A new study compared older adults (~69 yr) who resistance trained to young adults (~24 yrs) who did not. The result? On key measures like:

• Chair-stand performance
• 6-minute walk test
• Timed up-and-go

➡️ Older lifters performed as well as (or better than) young non-lifters.
No gimmicks.
No biohacks.
No pre-exercise protein.
No creatine.
No fancy pixie dust…
Just consistency and resistance training—2x/week following ACSM guidelines. How simple is that?

Flip the script on aging: muscle loss and functional decline aren't inevitable. Resistance training is powerful, accessible, and proven to maintain independence and quality of life as we age.

Older adults can maintain youth-like levels of physical function—if they engage in weightlifting.

📚 Reference: Kendall H, Kipp LE, Mettler JA. Transl J ACSM. 2025;10(3):e000312.
https://journals.lww.com/acsm-tj/fulltext/2025/07180/resistance_training_preserves_physical_function_in.6.aspx
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Associations of Habitual Skeletal Loading with Bone Changes During the Menopausal Transition: A Follow-up Study - PubMed We observed a rather uniform skeletal response to the menopausal transition at all measured bone sites. Positive associations were found between medium and high-intensity impacts and bone characteristics at the femoral and tibial shafts. However, habitual skeletal loading did not seem to counteract....

There's a tendency for women to lift light weights for high repetitions, like picking up five-pound dumbbells and lifting them 20 times. This is often called "body sculpting" by trainers, who promise women that they can "tone up" without "getting bulky muscles." This mindset needs to go because it's misleading, misguided, and honestly not helpful for women whose s*x hormones, lean muscle mass, and strength are on a precipitous decline in perimenopause. This type of lifting will build muscle endurance, but that's not what you're looking for at this stage of the game. You need muscle STRENGTH.

Read more for science-backed research links and information >>> https://www.drstacysims.com/newsletters/articles/posts/Resistance_Training_Getting_the_Respect_It_Deserves

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Falls prevention interventions for community-dwelling older adults: systematic review and meta-analysis of benefits, harms, and patient values and preferences - Systematic Reviews Background About 20–30% of older adults (≥ 65 years old) experience one or more falls each year, and falls are associated with substantial burden to the health care system, individuals, and families from resulting injuries, fractures, and reduced functioning and quality of life. Many intervent...

We've been chatting a little bit in some classes about how the hips respond to Onero - Belinda goes into some details here, around the 17 minute mark which may be of interest. Some interesting information in here, especially first half of the interview. Have a listen!

How to Increase Bone Density Through the Onero™ Osteoporosis Exercise Program With Dr. Belinda Beck Just because you have Osteoporosis doesn’t mean you can no longer lead an active lifestyle or you have to stay indoors to minimize the risk of falls and frac...

Onero in the news again! Very proud to be running these classes.

The weights program doing heavy lifting in fight against osteoporosis | 7 News Australia A revolutionary weights program is doing the heavy lifting in the fight against osteoporosis. The unique exercise class prevents fractures years before they ...

Most of us think that aerobic exercise (swimming, cycling...anything that gets your heart rate up for a while) is the best way to reduce blood pressure. Turns out...not! Resistance training (like Onero) is more effective than aerobic exercise, a combination of the 2 is better still, and, biggest surprise of all, isometric exercise is best! Weird. The take home for all our Onero devotees is that you're getting bonus benefit for your blood pressure. 🙌🤛💪 https://pubmed.ncbi.nlm.nih.gov/37491419/