Does strength training help against bone loss (osteoporosis)?
Strength training helps to increase or maintain bone density, but the effect is modest and a reduction in fractures has not yet been demonstrated. Train at high intensity and under supervision for the best results.
Strength training increases bone density at multiple sites, but the effect is modest. A Cochrane review of 43 randomised studies involving 4,320 participants concluded that leg strength training is the most effective form of exercise for hip-neck bone density in postmenopausal women. For the spine, combination programmes, in which strength is combined with other forms of exercise, perform even better.
How hard you train makes a big difference. A randomised study in 101 postmenopausal women with low bone mass showed that intensively supervised strength training, twice a week at high intensity, increased spinal bone density by 2.9%. In the control group it actually declined by 1.2%. At the hip neck the difference was comparable: +0.3% versus -1.9%. Side effects were rare: one participant experienced a mild back spasm. This did, however, apply under strictly supervised conditions.
The Cochrane review mentioned above found no effect on the number of fractures. That is the hard outcome that ultimately matters, and the evidence is therefore not yet conclusive on that point. Walking alone probably does not help to build bone mass, although it may limit the loss. Vibration platform training yields contradictory results for bone density and may be better used for balance and fall prevention.
Starting early pays off. Physical activity during childhood and puberty is one of the most strongly supported lifestyle factors for building a good peak bone mass in adulthood. That judgement is based on a systematic literature review by the National Osteoporosis Foundation and is considered grade A evidence.
Creatine supplementation on top of strength training slowed the loss of hip-neck bone density in a small randomised double-blind study: the creatine group lost -1.2% (not significant), while the placebo group lost -3.9% (significant). That difference was statistically significant, but the study analysed only 33 of the 47 participants after dropout. This is therefore a preliminary finding.
Based on a Cochrane review (4,320 participants, 43 RCTs), a meta-analysis of 17 studies, the LIFTMOR RCT (101 women), a small RCT (n=16 after dropout), a small creatine RCT (33 analysed), and a NOF report based on a systematic literature review. PMIDs: 9927006, 21735380, 23287836, 28975661, 25386713, 32399891, 26856587, 30671455.
Stronger bones and strength training: does it help?
Strength training measurably improves bone density, although the effect remains modest. For the strongest results, high-intensity training under supervision is recommended, even if you already have low bone mass.
Do calcium and vitamin D supplements really help against bone loss?
Calcium and vitamin D together can improve bone density and slightly reduce the risk of hip fractures when a deficiency has been demonstrated. Vitamin D as a standalone supplement does little if your blood levels are already adequate.
Does strength training work as well as medication for osteoporosis?
Strength training demonstrably improves bone density and offers additional benefits that medication does not provide, but the two are not alternatives to each other: when fracture risk is seriously elevated, medication has stronger evidence behind it and cannot be replaced by exercise.
Do people with darker skin have a higher risk of osteoporosis (bone loss)?
People with darker skin have a greater chance of vitamin D deficiency, but that does not automatically mean greater bone loss. Whether you are actually at risk depends strongly on your age, eating habits, and how often you spend time outdoors.
Does strength training help against insulin resistance?
Strength training probably helps against insulin resistance, although the effect is most strongly demonstrated in combination with endurance training and, for additional weight loss, changes in diet.
Does strength training help with healthy ageing?
Strength training is one of the best-supported interventions for healthy ageing: training two to three times per week with progressive resistance demonstrably improves muscle strength, mobility and independence, even at an advanced age.