Which type of training has the best-proven track record against bone loss in later life?

High-intensity resistance training has the strongest backing for bone preservation in later life. The LIFTMOR study examined this in 101 postmenopausal women (average age 65) with osteopenia or osteoporosis. Training at more than 85% of maximum load, twice a week for eight months, improved lumbar spine bone density by nearly 3%. In the control group it actually declined by 1.2%. Hip bone density also improved. Side effects were minimal: one participant experienced a minor back spasm. The study is relatively small and lasted eight months, so some caution remains warranted¹.

A summary of seventeen studies (690 participants) confirms this picture: resistance training improves bone density at the lumbar spine, femoral neck and total hip in postmenopausal women. Three factors make the difference: using at least 70% of maximum load, training three times per week and sustaining the programme for at least 48 weeks. The effects were medium to large. One caveat: the individual studies differed considerably from one another, so the combined outcome calls for some caution².

Do you also want to address your fall risk and muscle strength at the same time? Then a combined programme of strength, aerobics, balance and flexibility is a good choice. A summary of fourteen studies (544 participants, average age 68) showed improvements in bone density, muscle strength, balance, quality of life and a lower fall risk. The advantage: you tackle multiple risk factors for bone fractures simultaneously³.

In people aged 80 or older the goal appears to shift towards slowing further decline rather than achieving genuine bone gains. In a small study (30 participants, 24 weeks of training) bone density did not improve significantly in the training group, but it did decline in the control group. Muscle strength and mobility did increase noticeably. Halting bone loss is therefore already a meaningful result at an advanced age⁴.

Creatine supplementation most likely adds nothing extra for your bones on top of resistance training. Most studies in older adults show no significant improvement in bone mass with creatine. There is some evidence for muscle strength, but for bone the evidence is not convincing⁵. Guidelines also emphasise that training is part of a broader package: adequate calcium, vitamin D and, where necessary, medication belong in it too. The direct evidence that training on its own prevents bone fractures remains limited^6,7.