Prevent And Avoid Physical Frailty By Following This Study’s Protocols - Save Our Bones

One of the most frightening aspects of aging is the prospect of physical frailty and mental decline. Sadly, these outcomes are common among elderly people and often lead to disability, hospitalization, and untimely death.

But don’t despair! Not only are these specters of aging avoidable, but they are also reversible after onset. It’s never too late to make changes to your diet, physical activity levels, and lifestyle that can radically improve your health, quality of life, and even your longevity.

Today we’ll look at a remarkable study that outlines a course of action to successfully reverse physical frailty in the elderly. And Savers will be glad to know that the practices researchers describe are very similar to the actionable steps in the Osteoporosis Reversal Program.

Risks Of Physical Frailty

Physical frailty is commonly defined as a combination of weakness, slowness, weight loss, exhaustion, and reduced physical activity. This state, common among the elderly, has numerous negative effects, since it greatly increases the chances of hospitalization, functional disability, and earlier death.1

Cognitive impairment paired with physical frailty is unfortunately common, because physical frailty greatly increases the probability of cognitive impairment.1

These hard truths make the search for ways to prevent and reverse physical frailty pressing. Thankfully, the research has proved fruitful.

Study Shows How To Reverse Physical Frailty

A study led by Associate Professor Ng Tze Pin of the Department of Psychological Medicine at the National University of Singapore compared the effects of nutritional, physical, and cognitive interventions- both individually and combined- on frailty reversal among older adults in a randomized controlled trial.1

This scientifically rigorous study included five parallel groups of 246 prefrail and frail Singaporeans in community living with a mean age of 70 years. Each of the five groups underwent a six-month intervention consisting of:

  • Nutritional supplementation
  • Cognitive training
  • Physical training
  • Combination treatment
  • Usual care control

At month 0, 3, 6, and 12 every participant was assessed for their frailty score, body mass index, knee extension strength, gait speed, energy/vitality, physical activity levels, and secondary outcomes like daily living dependency, hospitalizations, and falls.

Dr. Tze Pin Ng found that all groups saw an improvement in frailty score and status over the year, including the control group, but the results were significantly more positive in groups that received supplementation or training. The most significant improvement was found in the combination treatment group.1


This study found that nutritional supplementation, cognitive training, physical training, and especially the combination of all three significantly decreases frailty in older adults.

How To Reduce And Prevent Frailty

The outcomes were good, so now let’s look at the protocols followed by the participants that successfully and consistently created those positive results.

Nutritional Supplementation was given daily for 24 weeks. It was designed to augment caloric intake by 20% and provide about a third of the daily allowance of essential vitamins and minerals. The supplements included:

All of these nutrients except iron are Foundation Supplements. If you took this list out of context, you might think it was specifically formulated for bone health! That’s indicative of how important bone health is for overall health, and how interlinked our body systems are.

Physical Intervention in the study consisted of exercises of moderate, gradually increasing intensity tailored to each participant's abilities. Here are some detailed descriptions of their exercise routine:

  • 90 minutes in duration
  • 2 days per week for 12 weeks with a professional trainer
  • Then 2 days per week for 12 weeks at home
  • Performed in groups of 8-10
  • Designed to improve strength and balance
  • 8-15 maximum repetitions of exercises

Regular exercise that builds strength and balance is a core tenet of the Osteoporosis Reversal Program. Leading experts, including the authors of this study, concur that weekly exercise can be concentrated into big sessions (like the 90-minute workouts in this study) or spread out over multiple days. Either way, the results are clear: increased strength, improved balance, and reduced frailty- all of which are common sense ways to avoid fracture.

Cognitive Training consisted of 12 weeks attending 2-hour weekly sessions where participants “engaged in cognitive-enhancing activities designed to stimulate short-term memory, and enhance attention and information-processing skills, and reasoning and problem-solving abilities.”1 For the following 12 weeks, they attended 2-hour “booster” sessions every other week where they reviewed the skills from the first 12 weeks.

These activities included:

  • Learning strategies used to recall verbal and visual information
  • “Spot the differences” puzzles
  • Categorical naming tasks
  • Coding used to enhance attention and processing speed
  • Matrix reasoning exercises
  • Mazes
  • Tangram-like games that enhance reasoning and problem-solving abilities

This intervention effectively reduced frailty, and interestingly, also increased lower limb strength. Both of those outcomes are positive for bone health, and keeping a sharp mind is definitely essential when it comes to making smart choices about your health.

If the mental component of reducing frailty at first seems less related to bone health, consider this: a study from the University of Nebraska has established a relationship between bone loss and depression. 2 Our mind is a part of our body too, and its health impacts the health of our whole being.


Study researchers enhanced participants’ diets with nutrients that are Foundation Supplements, provided them with physical training that resembles the Save Institute’s exercise recommendations, and engaged them in cognitive training to improve memory, reasoning, processing and problem-solving. Together and separately, these interventions prevented and reversed frailty.

Don’t Fear Aging: Take Action To Make Your Late Years Strong Ones

Instead of worrying about the effects of aging, put what you’ve learned today into practice. Follow a healthy pH-balanced nutritional plan and take bone-healthy supplements. Call up a friend and start exercising together- pick a weight-bearing activity and practice moves that increase bone density. And get in the habit of playing puzzle games or join a game group.

Stop Worrying About Your Bone Loss

Join thousands of Savers from around the world who have reversed or prevented their bone loss naturally and scientifically with the Osteoporosis Reversal Program.

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There are so many ways to improve your health and your quality of life! Don’t forget that when you’re doing good for your body, the benefits are widespread and compounding. We have enormous power to shape our future, no matter what our present looks like.

Till next time,


1 Ng TP. et al, “Nutritional, Physical, Cognitive, and Combination Interventions and Frailty Reversal Among Older Adults: A Randomized Controlled Trial.” Am J Med. 2015 Nov;128(11):1225-1236.e1. Web. PDF:

2 Mollard E, Bilek L, Waltman N. “Emerging evidence on the link between depressive symptoms and bone loss in postmenopausal women.” International Journal of Women’s Health. 28 December 2017 Volume 2018:10 Pages 1—9. Web.

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Comments on this article are closed.

  1. Cococat

    Can you get a print copy of “Bone Appe’tit?

  2. Maria

    Vivian….Is bulging discs in the back a result of severe osteoporosis?
    Please reply. Thank you.

  3. bobbie

    made the mistake of taking biphosnates in pill form then broke my hip ,so they put me on reclast shot yearly, both medications caused many and serious side effects fr me,dr would not listen when i told him, so i quit going. it has been almost 4 yrs, im careful w/diet exercise. no smoking ,but i worry , as soon as ican i will go on your program.i have not had any more broken bones,and am 71 vry active and work pt,

    • Vivian Goldschmidt, MA

      I’m glad you’re part of the Save Our Bones community, Bobbie. I am sorry you suffered side effects from Reclast, but it’s wonderful to read that you’re on a drug-free track now. 🙂

  4. Nan

    Great articles…very informative and reassuring

    • Vivian Goldschmidt, MA

      Thank you, Nan. 🙂

  5. Jean Oldenburg

    I recently went to my Rheumatologist, at the end of the visit I was given a report on the visit, I looked at it when I returned home, on there was a suggestion that I have a Bone Density Test every year, and a DEXA Scan every 12 months, I was under the impression that these test were the same, could you explain the difference?

  6. Rosaline Corcoran

    I was wondering if you have heard of serrapeptase or Nattokinase. My daughter has been researching about these enzymes to help my husband who has IPF but I am wondering if they are helpful in preventing bone loss. I would appreiate your thoughts on these supplements?

    • Vivian Goldschmidt, MA

      Hi Rosaline,

      While those two enzymes have not been studied for their direct effects on bone health, they are both anti-inflammatory, which is an essential aspect of building healthy bone. Nattokinase is derived from natto, a fermented soybean paste that’s popular in Japan. Natto is rich in Vitamin K2, a Foundation Supplement on the Osteoporosis Reversal Program. But nattokinase does not contain Vitamin K2. You can read more about Vitamin K2 and its role in bone health here:

  7. Lisa

    I thought calcium supplementation was as no no in the Savers protocol

    • Vivian Goldschmidt, MA

      Not at all, Lisa. 🙂 You are probably thinking of calcium carbonate and other unhealthy forms of calcium supplements. But plant-derived calcium is highly recommended on the Save Our Bones plan. You can read more about calcium supplementation here:

      • Andrea Mazerik

        Vivian, what is your take on a calcium product and company name
        Called Algaecal?

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