When it comes to bone health, it’s use it or lose it.
The Best Exercise Type and Frequency for Bone Density
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Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.
When it comes to bone health, it’s use it or lose it. Physical activity is considered a widely accessible, low-cost, and highly modifiable contributor to bone health. Exercise transmits forces through the skeleton, generating signals that are detected by your bone-building cells. This is why the National Osteoporosis Foundation, International Osteoporosis Foundation, and other agencies recommend weight-bearing exercises for the prevention of osteoporosis. These include high-impact exercises such as jumping, aerobics, and running, as well as lower impact exercises like walking and weight training to create those mechanical signals that spark bone growth, but sufficient intensity and frequency are critical. The large variation in bone benefit across different studies, from negligible changes to substantial improvements in bone mineral density, has been attributed to the adequacy of the exercise regime.
To improve measures of bone strength at the spine and hip, the most effective exercise training protocol appears to be a combination of progressive resistance and impact training at moderate to high intensity. Low intensity exercise does not appear to be sufficient. For example, while regular walking is often prescribed to prevent osteoporosis, it appears to offer limited benefit for bone loss prevention. On its own, walking has no significant effect on bone mineral density in the spine, wrist, or overall skeleton, but it has been shown to significantly improve hip bone density in studies that have lasted more than 6 months. More effective would be brisk walking, walking with a weighted vest, or combining walking with more vigorous exercises such as jogging, stepping, or stair-climbing. Non-impact activities such as cycling or swimming have been shown to have little or no effect.
An elegant study to determine the optimum frequency of high-impact exercise for bone health involved hopping on one randomly chosen foot, with the person’s other leg acting as the control. Women were randomized to hop 50 times on that one, same leg either seven days a week, four days a week, two days a week, or not at all for six months. And the brief, daily hopping increased hip bone density, but less frequent hopping was not effective. The only group who built significantly more bone in their hip on the jumping compared to non-jumping side within those 6 months was the seven-day-a-week group. If you jump 50 times with about a 10 pound (4.5 kg) weighted vest on, however, you may be able to preserve your hip bone density with just three sessions a week instead of every day.
Note, weight-bearing impact exercise may be contraindicated, meaning not advisable, in those with severe osteoporosis or recent history of fracture, so make sure you check in with your medical professional before you get going.
Please consider volunteering to help out on the site.
- Troy KL, Mancuso ME, Butler TA, Johnson JE. Exercise Early and Often: Effects of Physical Activity and Exercise on Women's Bone Health. Int J Environ Res Public Health. 2018;15(5):878.
- Shojaa M, Von Stengel S, Schoene D, et al. Effect of Exercise Training on Bone Mineral Density in Post-menopausal Women: A Systematic Review and Meta-Analysis of Intervention Studies. Front Physiol. 2020;11:652.
- Kistler-Fischbacher M, Weeks BK, Beck BR. The effect of exercise intensity on bone in postmenopausal women (part 1): A systematic review. Bone. 2021;143:115696.
- Daly RM. Exercise and nutritional approaches to prevent frail bones, falls and fractures: an update. Climacteric. 2017;20(2):119-124.
- Ma D, Wu L, He Z. Effects of walking on the preservation of bone mineral density in perimenopausal and postmenopausal women: a systematic review and meta-analysis. Menopause. 2013;20(11):1216-1226.
- Daly RM, Dalla Via J, Duckham RL, Fraser SF, Helge EW. Exercise for the prevention of osteoporosis in postmenopausal women: an evidence-based guide to the optimal prescription. Braz J Phys Ther. 2019;23(2):170-180.
- Bailey CA, Brooke-Wavell K. Optimum frequency of exercise for bone health: randomised controlled trial of a high-impact unilateral intervention. Bone. 2010;46(4):1043-1049.
- Snow CM, Shaw JM, Winters KM, Witzke KA. Long-term exercise using weighted vests prevents hip bone loss in postmenopausal women. J Gerontol A Biol Sci Med Sci. 2000;55(9):M489-M491.
Motion graphics by Avo Media
Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.
When it comes to bone health, it’s use it or lose it. Physical activity is considered a widely accessible, low-cost, and highly modifiable contributor to bone health. Exercise transmits forces through the skeleton, generating signals that are detected by your bone-building cells. This is why the National Osteoporosis Foundation, International Osteoporosis Foundation, and other agencies recommend weight-bearing exercises for the prevention of osteoporosis. These include high-impact exercises such as jumping, aerobics, and running, as well as lower impact exercises like walking and weight training to create those mechanical signals that spark bone growth, but sufficient intensity and frequency are critical. The large variation in bone benefit across different studies, from negligible changes to substantial improvements in bone mineral density, has been attributed to the adequacy of the exercise regime.
To improve measures of bone strength at the spine and hip, the most effective exercise training protocol appears to be a combination of progressive resistance and impact training at moderate to high intensity. Low intensity exercise does not appear to be sufficient. For example, while regular walking is often prescribed to prevent osteoporosis, it appears to offer limited benefit for bone loss prevention. On its own, walking has no significant effect on bone mineral density in the spine, wrist, or overall skeleton, but it has been shown to significantly improve hip bone density in studies that have lasted more than 6 months. More effective would be brisk walking, walking with a weighted vest, or combining walking with more vigorous exercises such as jogging, stepping, or stair-climbing. Non-impact activities such as cycling or swimming have been shown to have little or no effect.
An elegant study to determine the optimum frequency of high-impact exercise for bone health involved hopping on one randomly chosen foot, with the person’s other leg acting as the control. Women were randomized to hop 50 times on that one, same leg either seven days a week, four days a week, two days a week, or not at all for six months. And the brief, daily hopping increased hip bone density, but less frequent hopping was not effective. The only group who built significantly more bone in their hip on the jumping compared to non-jumping side within those 6 months was the seven-day-a-week group. If you jump 50 times with about a 10 pound (4.5 kg) weighted vest on, however, you may be able to preserve your hip bone density with just three sessions a week instead of every day.
Note, weight-bearing impact exercise may be contraindicated, meaning not advisable, in those with severe osteoporosis or recent history of fracture, so make sure you check in with your medical professional before you get going.
Please consider volunteering to help out on the site.
- Troy KL, Mancuso ME, Butler TA, Johnson JE. Exercise Early and Often: Effects of Physical Activity and Exercise on Women's Bone Health. Int J Environ Res Public Health. 2018;15(5):878.
- Shojaa M, Von Stengel S, Schoene D, et al. Effect of Exercise Training on Bone Mineral Density in Post-menopausal Women: A Systematic Review and Meta-Analysis of Intervention Studies. Front Physiol. 2020;11:652.
- Kistler-Fischbacher M, Weeks BK, Beck BR. The effect of exercise intensity on bone in postmenopausal women (part 1): A systematic review. Bone. 2021;143:115696.
- Daly RM. Exercise and nutritional approaches to prevent frail bones, falls and fractures: an update. Climacteric. 2017;20(2):119-124.
- Ma D, Wu L, He Z. Effects of walking on the preservation of bone mineral density in perimenopausal and postmenopausal women: a systematic review and meta-analysis. Menopause. 2013;20(11):1216-1226.
- Daly RM, Dalla Via J, Duckham RL, Fraser SF, Helge EW. Exercise for the prevention of osteoporosis in postmenopausal women: an evidence-based guide to the optimal prescription. Braz J Phys Ther. 2019;23(2):170-180.
- Bailey CA, Brooke-Wavell K. Optimum frequency of exercise for bone health: randomised controlled trial of a high-impact unilateral intervention. Bone. 2010;46(4):1043-1049.
- Snow CM, Shaw JM, Winters KM, Witzke KA. Long-term exercise using weighted vests prevents hip bone loss in postmenopausal women. J Gerontol A Biol Sci Med Sci. 2000;55(9):M489-M491.
Motion graphics by Avo Media
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Title
The Best Exercise Type and Frequency for Bone Density
LicenseCreative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0)
Content URLDoctor's Note
When it comes to fractures, one thing stands out: Fall Prevention Is the Most Important Thing for Preventing Osteoporosis Bone Fractures.
Can diet improve bone health? See Three Reasons Fruits and Vegetables May Reduce Osteoporosis Risk and Onions and Tomatoes Put to the Test for Osteoporosis.
What about medications that treat osteoporosis? See How Well Do Medicines Like Fosamax Work to Treat Osteoporosis? and Side Effects of Osteoporosis Medications Like Fosamax, Boniva, and Reclast.
Should we be concerned about a common class of medications causing osteoporosis? Check out Acid Reflux Medicine May Cause Osteoporosis for more.
This video was originally part of my webinar all about osteoporosis. You can watch that full recording, including a great Q&A.
How Much Exercise Does It Take to Boost Immunity? Check out the video.
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