There are two traits in research that are needed to evaluate if treatment can be effective.  A treatment needs to be qualified and quantified.  Qualified delineates if a particular treatment works or has an effect on a disease.  Quantified determines how much is needed for a positive effect.

Many studies have qualified exercise as an effective treatment for osteoporosis.  Broadly, these studies have found that exercise which repeats weightbearing stress through the spine and hips improves bone mineral density by 1-3%.  While that is not enough as a standalone treatment, it is helpful when combined with other treatments such as diet, nutrients and therapies like pulsed electromagnetic frequency (PEMF).

A key question many patients have is “so how much exercise is needed”?   A recent study using the National Health and Nutrition Examination Survey (NHANES) data provided some answers to that question.(1)  NHANES is an ongoing study of data from 15 countries looking at health examining extensive data.  The study set up by CDC is in its 16^th year and has answered many health questions.

The study looked at the relationship between bone mineral density (BMD) and exercise levels in 9339 post-menopausal women.  Exercise levels were based on MET hours/week.  A MET is a unit of energy expenditure.  A MET hour is the energy expenditure in 1 hour.  The point at which the level of exercise was associated with higher BMD was 32 MET hours per week.  Put into plain terms that it would be about 1 hour of exercise at 5 METS 6 days each week.

The chart below helps to translate that to specific activity. Walking vigorously (5 METS) for an hour 6 days/week would meet that level.  Walking more moderately

wearing a weight vest (5 METS) for an hour 6 days/week would also meet that level.  There is yet another advantage to walking using a weight vest – it increased the loading down through the spine and hips which is important given that those are the primary areas osteoporosis fractures occur in.

Different weight vests target different situations.  The one shown is 4 ½ lbs., so reasonable for most older patients. 

It also comes with additional ¾ lb. weight which can be added to the vest pockets as exercise tolerance increases.

Again, an important point is that exercise helps BMD but not enough as a stand alone treatment.  Exercise will increase BMD by 1-3%.  At a T score of -2.5 about 20% of BMD has been lost.  Adding the 1-3% gain with exercise can be helpful added to a coordinated program with PEMF therapy which shows higher gains in BMD.

Osteoporosis is a complex disease with many pieces.  A well-matched treatment program needs several helpful pieces.

1. Wang et al. Does adding physical activity improve spinal bone mineral density in postmenopausal women?: A cross-sectional analysis of NHANES 2011 to 2018. Medicine (Baltimore). 2026 Jan 23;105(4):e47348.