Osteoporosis and Resistance Training

Training Q&A [Moderated]
1

Hello,

Love your work at BB Medicine. It has helped me personally and informs my practice with clients as a physiotherapist working with over 55’s.

Great article on Osteoporosis. I wondered if you could provide the references used for this article?

I am particularly interested in the research that shows increases in BMD with resistance training in addition to the LiftMor trial?

I know a lot of women that engage in pilates, which is great if they enjoy it and it keeps them moving. However in terms of BMD and muscle mass development I would imagine weight training provides greater stimulus in these regards due to the progressive loading potential. Do you think this is fair to say? Would you classify Pilates as “resistance” training?

Cheers for your time!

2

I not consider pilates to be “resistance” training, and especially for the purposes of bone mineral density improvements. Muscle hypertrophy can be achieved across a wide range of loading intensities, but bone seems to more uniquely require higher loads to stimulate adaptation. This is a major limitation of much of the osteoporosis literature, where low- or moderate-intensity interventions show little to know effect, but the few higher-intensity interventions we see in intervention trials show larger effects, in addition to observational data from individuals who subject themselves to very high loading (such as habitual resistance training individuals, weightlifters/powerlifters, etc.).

That article was intended to be exclusively geared towards the lay public, and was not heavily scientifically referenced. Outside of the LIFTMOR trial, there is also the LIFTMOR-M trial (done in men), the FRoST trial, and a few other potentially useful resources can be found here: The effect of exercise intensity on bone in postmenopausal women (part 1): A systematic review - PubMed and The effect of exercise intensity on bone in postmenopausal women (part 2): A meta-analysis - PubMed . PubMed will be a useful resource to identify other data in this space, but it is important to focus on actual high-intensity interventions, given what we know about bone remodeling and adaptation.

3

Thanks Austin,

Appreciate it!

4

sorry for hijacking, but when you say “bone seems to more uniquely require higher loads to stimulate adaptation”, is there a minimum load a person should be aiming for (e.g. a 1xbody weight squat, or 1.5xbodyweight deadlift)?

Also, do you have any minimum recommendations for calcium intake? It’s never something I’ve thought of tracking.

thanks

5

No, there is no evidence for an absolute weight threshold. Our current programming recommendations for strength training would suffice, typically spending most of your training time in the 60-90% 1RM intensity range as a general ballpark.

I don’t think most people need to bother tracking this in particular, but current dietary guidelines are appropriate.

Following our general dietary advice and/or the general dietary guidelines would likely be sufficient; a diet rich in fruits, vegetables, legumes (like lentils, beans, chickpeas), whole grain sources (like oats, barley), nuts, fish, and other lean proteins, with dairy intake (excluding butter) based on individual preferences.

1 Like
6

Nice one thank you Austin