Couch potatoes everywhere surely rejoiced when the New York Times published an article that ostensibly “debunked” the notion that exercise builds strong bones.
The article concludes that prescription drugs are the only hope for staving off osteoporosis. In fact, the author suggests that the soon-to-be-approved daily injectable and transdermal patch drug abaloparatide will be the most effective way to “rescue” your bones from osteoporosis.
Is there any merit to these statements? Is all that exercising and walking for naught, and you can just kick back and build strong bones while watching television, provided you take osteoporosis drugs?
Let’s analyze the article for its veracity, but first, here’s…
What The NYT Article Says About Exercise And Bone Health
The article, entitled “Exercise Is Not the Path to Strong Bones,” states that “Exercise has little or no effect on bone strength.”1 It then goes on to further this point by making the following statements:
- “…osteoporosis researchers know the advice [to exercise] is not backed up by rigorous studies.”
- Citing studies where exercise produced miniscule improvements in bone density as per DXA scans, “…if exercise builds bone, it does not build much bone.”
- “At this point, nothing except…perhaps, a new injectable drug called abaloparatide now being tested in clinical trials, make bone denser and stronger.”
- “…exercise might make bones healthier in terms of a mysterious property called bone quality. No one knows exactly what it is…”
Let’s analyze in detail these four statements.
#1: The benefits of exercising for bone health are not backed up by rigorous studies.
This is a sweeping statement that is not only ridiculously broad; it is simply untrue. If someone decides to exercise in order to build their bone strength, they can rest assured that many, many studies support them in their choice. Here are just a few.
Bone Strength Analysis
Savers know that bone is a dynamic tissue that responds to mechanical stimulation. Quoting from a very detailed analysis of the nature of bone strength:
“Bone adapts to mechanical stresses largely by changing its size and shape, which are major determinants of its resistance to fracture. Tissue is added in regions of high mechanical stress providing an efficient means for improving bone strength. Experiments have shown that small additions of bone mineral density (BMD) (5–8%) caused by mechanical loading can improve bone strength by over 60% and extend bone fatigue life by 100-fold.”2
The analysis discusses the biomechanics of bone, the importance of both mineralization (hardness) and collagen (flexibility), the mechanics of fracture, why bones break, a detailed look at the process of bone remodeling at the cellular level, and much more. This extremely thorough look at bone, inside and out, states in its conclusion that:
“The most effective way to strengthen bone is by adding new bone tissue where bone stresses are greatest. This occurs when bone adapts to mechanical loading.” 2
The next study is a review that looks specifically at the effect of “weighted exercises” in postmenopausal women.
A Systematic Review Of Weight-Bearing Exercise In Postmenopausal Women
Researchers reviewed data on exercise and bone density from 1990 to 2005:
“The review revealed evidence to support the effectiveness of weight training exercises to increase BMD [bone mineral density] in postmenopausal women. …Weighted exercises can help in maintaining BMD…and increasing BMD of the spine and hip in women with osteopenia and osteoporosis.”3
They further point out the importance of adopting exercise as part of an overall bone-healthy lifestyle, noting that “Exercise sessions should be…incorporated into long-standing lifestyle change.”5 In other words, exercise needs to be practiced on a regular basis in order to reap the full benefits.
The exercises shown to increase BMD were all weight-bearing, ranging from stair-climbing with weighted vests to back extension exercises with weighted backpacks. Participants also performed moves like rowing, wrist curls, and squats. These (and many more) are just the sorts of exercises recommended in the Osteoporosis Reversal Program and the Densercise™ Epidensity Training System. There’s a good reason for this: these exercises work!
Yet another study shows the importance of exercise, this time aerobic.
Aerobic Exercise Increases BMD And Key Trace Minerals In Blood
Nearly 100 healthy participants were followed in this 2015 study – 47 men and 53 women, all between the ages of 30 and 60. They performed aerobic exercise for one hour, three days a week, for 12 weeks.
When the participants were evaluated at the end of the 12 weeks, researchers observed increased levels of BAP, or bone-specific alkaline phosphatase, as well as:
- Increased BMD
- Elevated T-scores
- Increased serum levels of key bone-building minerals calcium and manganese, and a decrease in serum copper and zinc. The changes in these mineral levels “…were shown to be positively correlated with improved bone mass density among control and osteoporosis subjects of both sexes.”4
The study’s final conclusive statement lines up perfectly with what Savers already know:
“These results demonstrate that aerobic exercise of moderate intensity might protect bone and cartilage by regulation of body trace elements which are involved in the biosynthesis of bone matrix structures and inhibition of bone resorption process via a proposed anti-free radical mechanism.”4
Some others include a 2015 study on premenopausal women aged 25 to 50, whose bone density improved markedly following a series of jumping exercises over the course of four weeks.5 And a 2013 report published in the prestigious British Medical Journal showed that targeted exercise results in fewer falls and increased fracture resistance due to greater bone strength.6 These are just a few of the myriad of studies that confirm how vital exercise of all types is for bone strength.
And finally, the NYT article makes absolutely no mention of Wolff’s Law, which has been an accepted explanation of how bones are formed since the 1890s.
As explained in the Osteoporosis Reversal Program:
“[Wolff’s] theory was based on the now proven fact that bone is living and active tissue, and therefore, it adjusts to the stress it receives by increasing and decreasing in size as muscles do.
Scientists have confirmed that bone growth is stimulated by an applied force, and therefore, increasing muscular stress can increase bone tissue. Muscles help bone growth in two ways: when they apply stress on bones, the latter develop their size to support the stress. Secondly, muscles also apply their weight on bones causing an increase in bone mass.”
Now on to the article’s second point…
#2: Exercise builds little bone, if any
Here we have a blatant disregard for the nature of bone remodeling, and the crucial difference between bone quantity and bone quality. We’re going to look at this topic in more detail in a moment, but the point here is that exercise does not have to build large amounts of bone to be effective at rejuvenating bones to resist fracture.
#3: Only a drug called abaloparatide can save us now
This point reveals the true intention of the New York Times article. This is a classic tactic of Big Pharma – create fear about a health condition, demonize non-pharmaceutical treatments, and then ride in on the pharmaceutical white horse to save the day with the latest drug.
The case of this new drug, abaloparatide, is no different. It’s a synthetic form of human parathyroid hormone, similar to teriparatide, marketed under the name Forteo. Essentially, abaloparatide is Forteo with a makeover.
Introducing synthetic hormones of this nature is the perfect setup for increasing cancer risk. Taking such a risk makes no sense whatsoever when there are nutrition-based, safe alternatives to building bone available.
And that brings us to the fourth point in the article, which reveals its complete ignorance as to the nature of bone structure.
#4 Exercise may enhance bone “quality,” but this is too mysterious and unknown a concept to be valid
The concept of bone quality is not at all mysterious, nor is it true that “no one knows exactly what it is.” In fact, Savers most definitely know!
Bone quality has to do with the bone’s ability to bend and flex under pressure. This is known as tensile strength, and it’s the key to bone’s ability to resist fracture. And exercise does indeed enhance bone quality – which is far more important that bone quantity that simply denotes the presence of more bone.
In fact, this explains the apparent ability of osteoporosis drugs to increase bone density, which brings me to the one statement in the NYT article that I agree with:
“Popular osteoporosis drugs like Fosamax slow the rate of bone loss, but they do not build bone.”
That’s absolutely correct. Osteoporosis drugs like Fosamax do not induce the formation of new bone, and new bone must be formed to build tensile strength. This has much to do with the distinction between bone formation (modeling) and bone remodeling, and the importance of the quality of the bone matrix, or microarchitecture.
Microarchitecture: The Essence Of Bone Quality
“Bone tissue is a composite of both flexible and rigid components,”7 states a 2009 report published in Rheumatology. This concept is at the heart of bone microarchitecture, which is the measure of bone texture, not just the amount of bone present.
Bone is able to adapt its shape and size “in response to mechanical loads.”7 This adaptation takes place via both bone modeling and bone remodeling, which are actually different processes.
A Detailed Look At Bone Remodeling
Bone remodeling is the process by which old bone is replaced with new bone. Osteoclast cells remove old bone so osteoblasts, in charge of bone deposition, can replace them with younger, healthier cells. This occurs in four basic phases.
First is the quiescence/activation phase. The quiescent (dormant) surface of the bone needs to be transformed into a permeable surface, and this is accomplished with osteoclast precursors that, once they’ve penetrated the superficial bone layer, are fused with other cells to form osteoclasts.
Next is the resorption phase, which is regulated by cytokines and hormones. It’s really quite fascinating how proton pumps and ion channels work together to transfer hydrogen ions into an acidic solution, which then literally dissolves the minerals of the bone matrix. Enzymes are secreted that literally digest the organic, collagen-based part of the matrix, which creates saucer-shaped cavities (lacunae) and corresponding “tunnels” within the cortical bone (the outermost bone layer). At the end of this phase, the osteoclasts undergo apoptosis (cell death).
Then comes the third phase, the reversal phase, where the lacunae are populated by various mononuclear cells: monocytes, osteocytes, and pre-osteoblasts. At this point, balance and efficiency are crucial:
“In the absence of efficient coupling and bone balance, each remodeling transaction would result in a net loss of bone.”7
This phase produces a positive balance, so the periosteal (outermost) circumference of the bone actually increases.
The fourth and final phase of remodeling is the formation phase, where osteoblasts regulate the mineralization of the collagenous bone matrix. Some osteoblasts end up in the bone matrix itself, closely connected to each other and the periosteal bone cells. They are then called osteocytes. Other osteoblasts form a sort of lining on the bone’s surface.
This same process occurs in both cancellous (spongy) and cortical bone.
What Is Bone Modeling?
Bone modeling is a bit different. Modeling refers specifically to bone’s ability to adapt in response to mechanical load. Modeling is the formation of new bone without being preceded by bone resorption. It does not happen as often as bone remodeling, but it does occur, as in the example below:
“Modeling occurs vigorously not only during growth, but also, in the adult, in response to a mechanical load such as in tennis players in whom the radius of the playing arm has a thicker cortex and a larger external diameter than the contralateral radius.”7
Going back to what was mentioned earlier, bone is a composite of rigid and flexible components. Low bone density is defined as having holes or gaps in the bone microarchitecture, the result of decreased osteoblast function and increased osteoclast activity.
The microarchitecture is the bone matrix composed largely of collagen, a type of connective tissue that is responsible for bone’s tensile strength and flexibility. The state of the microarchitecture reveals the bone’s ability to resist fracture.
But bone density scans do not measure the microarchitecture of bone at all. They measure bone mineral density (BMD), which is only part of the picture, as researchers explain:
“Recent clinical investigations indicate that BMD only partly explains bone strength and show limitations of BMD measurements in assessing fracture risk and monitoring the response to therapy.”7
After our detailed analysis, it is clear that the New York Times article is flawed. And it basically attempts to convince the unknowing public that they should not bother exercising for their bones and instead, they should take the latest and newest osteoporosis drugs.
Bone Health Is Not A Bone Density “Pageant”
If you’re following the Osteoporosis Reversal Program, then you know that bone density test scores are only a part of the whole bone health picture. Improved DXA scores are certainly something to strive for, but it’s important to bear in mind that such tests measure quantity of bone, not quality.
And that brings us back to the New York Times article, which describes bone quality as some sort of elusive concept that cannot be measured and therefore, must not be valid. But new techniques for measuring bone quality are being developed, as the Rheumatology review states:
“…assessment of the trabecular bone microstructure may be obtained by high-resolution CT (hrCT), microCT, high-resolution MR (hrMR) and microMR.”7
These techniques are in their infancy, though, and the Medical Establishment does not like to deal with concepts that can’t be measured (and therefore used as a “threshold” to prescribe drugs). So they discount concepts like bone quality because it does not get them the numbers they need to prescribe.
Regardless of whether or not we can measure it, bone quality is key to optimal bone health. In fact, the health of your bones involves all sorts of immeasurable components, from hormones to antioxidants to nutrients. This is what sets the Osteoporosis Reversal Program apart from conventional medicine: the Program takes into account the non-quantifiable aspects of bone health rather than isolating one aspect of it that can be measured, and then attempting to influence it artificially with pharmaceuticals.
Take Exercising For Your Bones to the Next Level!
Learn the 52 exercise moves that jumpstart bone-building – all backed by the latest in epigenetics research.
When you follow the dietary and lifestyle recommendations in the Osteoporosis Reversal Program, you are helping your whole body, promoting a more healthful immune system, less inflammation, better gut health, a healthy weight, and so much more. And of course, you’re giving your bones the nutrients and exercise they need to thrive and rejuvenate…because exercise is absolutely essential for your bones to resist fracture.
Till next time,
2 Turner, Charles H. “Bone Strength: Current Concepts.” Ann. N.Y. Acad. Sci. 1068. (2006): 429–446. doi: 10.1196/annals.1346.039. PDF. http://www.fields.utoronto.ca/programs/scientific/08-09/biomedical/proposed_problems/Turner_bone_strength.pdf
3 Zehnacker, Carol Hamilton, T, DPT, MS; Bemis-Dougherty, Anita, PT, DPT, MAS. “Effect of Weighted Exercises on Bone mineral Density in Post Menopausal Women A Systematic Review.” Journal of Geriatric Physical Therapy. 30.2:07. 79-86. PDF. http://web.missouri.edu/~brownmb/pt415/case/nunez/osteo/Zehnacker-BMD-WBex-SR-JGPT-2007no.2.pdf
4 Alghadir, H.H., et al. “Correlation between bone mineral density and serum trace elements in response to supervised aerobic training in older adults.” 2016:11. (2016): 265-273. Web. http://www.dovepress.com/correlation-between-bone-mineral-density-and-serum-trace-elements-in-r-peer-reviewed-article-CIA
5 Tucker, L.A., et al. “Effect of two jumping programs on hip bone mineral density in premenopausal women: a randomized controlled trial.” Am J Health Promot. Jan-Feb 2015. 29(3): 158-64. DOI: 10.4278/ajhp.130430-QUAN-200. Web. http://www.ncbi.nlm.nih.gov/pubmed/24460005
6 El-Khoury, Fabienne, et al. “The effect of fall prevention exercise programmes on fall induced injuries in community dwelling older adults: systematic review and meta-analysis of randomised controlled trials.” BMJ. 2013. 347: f6234. Web. http://www.bmj.com/content/347/bmj.f6234
7 “Microarchtecture, the key to bone quality.” Rheumatology. 4.48. (2009): iv3-iv8. Doi: 10.1096/rheumatology/kep273. Web. http://rheumatology.oxfordjournals.org/content/48/suppl_4/iv3.full