Bone loss can have debilitating consequences. As your bones weaken over time, you risk having a debilitating fracture.

Years ago, I remember what happened after my Grandma Lois (she had been an amazing walker all of her life) fell and fractured her pelvis. At age 92, her bones were unfortunately weak and they couldn’t do surgery to fix her. Instead, she was transferred to a facility with round the clock care. It was awful to watch first hand. Sadly, my grandmother never got out of bed again and this ended her life. She was not alone, a disability from a debilitating fracture is a common way for people to end their lives.

Up until now, we have been taught that weight-bearing exercise (walking, jogging, using an elliptical machine) and weightlifting (using moderate weights) will help “maintain” bone mass, but we don’t think of it as a way to “boost” bone density.

Yet, what happens if older people weight lift intensively?

Recently, an Australian bone oriented medical center published an article on women that were doing high-intensity weightlifting; these investigators produced some amazing results!

The clinic studied 101 postmenopausal women, about half had osteoporosis and half were considered to have osteopenia. More than a quarter of them had already suffered from a fracture.

The women were divided into two groups, intervention and control; they exercised twice a week for at least 8 and up to 12 months, but the kinds of exercise they did were different.

For the control group, a low-intensity, home-based exercise regimen that emphasized balance and mobility, but not heavy-weight loading, was used. They did lunges, calf raises, and stretches with no more than 3-kg (6.6lb) weights in their hands — common types of exercises recommended for older women seeking to maintain fitness and bone strength.

The intervention group had supervised, 30-minute sessions of high-intensity resistance training at 80–85% of the “1 rep max” weight — that being the weight they could lift only once with maximum effort. The exercises included deadlift, overhead press, and back squat along with jumping chin-ups with drop landings.

Out of fear that these high-intensity exercises might cause an injury, these types of exercises are not usually recommended for older women, and prior studies of weight-bearing exercise for bone mass improvement used moderate loads rather than high loads.

The study’s results were fantastic:

• The high-intensity group gained an average of 2.9% bone mineral density in the lumbar spine, while the control group lost an average of 1.2%.
• The high-intensity group gained on average 0.3% bone mineral density in the femoral neck, while the control group lost on average 1.9%.
• The high-intensity group gained 13.6% femoral neck cortical thickness, while the control group lost 6.3%.

One 59-year-old-woman who trained for a total of 12 months saw an increase of 10.5% in the hip and 8.8% in the lumbar spine!

Unfortunately, there has been a common misconception that women with low bone mass risk developing spinal fractures if they use heavy weights or free-weight exercises — but this study shows that this just isn’t true. Only one woman in the study had any sort of injury — a mild muscle strain in her lower back that likely occurred from an error in technique.

Keep in mind, these women did not do initial weightlifting on their own as they were supervised with a professional trainer who taught the proper form for lifting.

If you are concerned about bone loss and the risk of a debilitating fracture, consider signing up with a certified trainer (such as the American College of Sports Medicine) to try high-intensity weightlifting.

Data published at the Masley Optimal Health Center has shown that strength training isn’t just good for your bones, but that those with greater muscle strength (measured with push up and sit up strength) had less arterial plaque and better brain processing speed too. We also showed that those who improved their strength enhanced their brain processing speed.  In a separately published study, we showed that weight lifting helped with weight control.

If you worry about getting too bulky with weight lifting—fear not. This type of weight lifting twice per week isn’t going to add abnormal muscle mass to your frame, although it very likely will help you look more shapely and sexy, and there is nothing wrong with that!

For the best bone-boosting results, in addition to weight lifting, you should also add weight-bearing activity (20-30 minutes of walking, jogging, dancing, or using an elliptical machine) on most days of the week. I also recommend stretching after each exercise session, so that you don’t end up stiff and inflexible. A 5-10 minute stretch after each session, plus a yoga session 1-2 times per week would provide an optimal workout routine.

Of course, if you are bone nutrient deficient, you won’t build bone mass very well. The key nutrients for your bones are vitamins D and K, plus calcium and magnesium.

Aim to get:

• 2000 to 5000 IU of vitamin D3 daily, enough to give you a 25-OH vitamin D blood level in the 40-60 range.
• Vitamin K, preferably 500 to 1000 mcg of vitamin K1 daily, plus 200 mcg of vitamin K2 daily. Even higher dosages of K2 have been studied for women with bone loss. (See my blog article on vitamin K for more details)
• Calcium, 800-1200 mg daily depending upon your activity level and bone mass. Preferably use protein bound sources of calcium, such as a calcium chelate, malate, or similar. As calcium blocks magnesium intake, you also must have magnesium if you are taking calcium.
• Magnesium 400-800 mg daily, preferably from a protein bound source, such as protein malate, glycinate, or a chelate.

I wish you the best of health!

Steven Masley, MD, FAHA, FACN, FAAFP, CNS

Reference

Watson SL, et al. High-intensity resistance and impact training improves bone mineral density and physical function in postmenopausal women with osteopenia and osteoporosis: The LIFTMOR Randomized Controlled Trial. Journal of Bone and Mineral Research 2018; 33(2): 211–220. DOI: 10.1002/jbmr.3284