Osteoporosis Prevention: Why Aren’t We Talking About Exercise First?

Despite good intentions and sometimes good outcomes I commonly see our approach to osteoporosis in medicine fall short. This is typically what we see: wait until 65, diagnose it, start a drug, and casually suggest “exercise” without real guidance on what that means. This is a missed opportunity. At Mission Metabolic Health, we believe exercise is one of the most powerful tools to prevent and slow osteoporosis, yet it’s rarely emphasized the way it should be.

Exercise: A Proven Strategy to Strengthen Bones

Bones are living tissue, and they respond to stress—just like muscles. The right types of exercise can slow or even reverse bone loss. Resistance training and high-impact activities have been shown to improve bone mineral density (BMD) in multiple studies. But the message most people get is vague: “stay active” or “try weight-bearing exercise.” How can we expect patients to even know where to start?

What the Research Shows

1.     The LIFTMOR Trial (Watson et al., 2017): This groundbreaking study showed that high-intensity resistance and impact training significantly improved BMD in postmenopausal women with low bone mass. Participants lifted heavy weights, performed jumps, and saw measurable bone gains—proving that frail bones don’t need frail exercise.

2.     Kistler-Fischbacher et al., 2021: This study reinforced that resistance training, particularly progressive overload, leads to increases in BMD and reductions in fracture risk, especially in aging adults.

3.     Zhao et al., 2015: A meta-analysis of over 50 studies found that high-impact exercise, such as jumping and sprinting, improved hip and spine BMD, reducing the likelihood of osteoporotic fractures.

Impact and Resistance: The Missing Pieces

It’s not just about “staying active”—walking and light yoga won’t cut it for osteoporosis prevention. What works? Heavy resistance training, plyometrics, and activities that stimulate bone growth. At Mission Metabolic Health, we design exercise programs that focus on:

●   Lifting Heavy: Squats, deadlifts, overhead presses—properly programmed strength training is essential.

●  Jumping & Impact: Plyometrics, jump training, and even brisk stair climbing can improve BMD.

●  Balance & Core Training: Reducing fall risk is just as important as improving bone density.

Pharmacologic Treatments Have Their Place, But…

Yes, medications like bisphosphonates, denosumab and anabolic agents can help, but we don't need to use them in isolation without the exercise component. The added benefit of fall prevention through posture, core and leg strength, foot speed and coordination are not available through any drug. Exercise is the only approach that delivers on all these fronts.

A Better Approach to Osteoporosis Prevention

At Mission Metabolic Health, we always consider exercise a meaningful intervention, not an afterthought. The research is clear: resistance and impact training can significantly improve bone health, and it’s time for a shift in how we approach osteoporosis prevention and treatment.

The resistance and impact exercises are best when carried out in a safe and supervised environment especially when starting out. We use a gradual and supervised approach in our osteoporosis program. Please reach out to us to find out how to get started.

If you’re concerned about osteoporosis, you have osteopenia, osteoporosis or a fracture, let's do something about it.