A meta-analysis of 13 trials, mostly in postmenopausal women losing weight, found exercise plus calorie restriction preserved hip and femoral neck bone density better than diet alone, but not lumbar spine density.
Mixed resultsMeta-analysis · 852 participants pooled · 2021Midlife womenCited 14 timesPubMed
In 101 postmenopausal women with obesity over 12 months, severe energy restriction caused greater weight and fat loss than moderate restriction but also greater hip bone density loss, with no difference in handgrip strength.
Reported a worseningRandomised trial · 101 women · 52 weeks · 2019PostmenopausalCited 103 timesPubMed
Overweight postmenopausal women on a 12 week calorie restricted diet with added aerobic and resistance exercise lost more fat and preserved lean mass compared to diet alone.
No difference foundRandomised trial · 118 women · 12 weeks · 1993PostmenopausalCited 155 timesPubMed
Overweight postmenopausal women underwent diet and exercise weight loss programs for up to a year, reporting that weight loss was linked to a modest decrease in total body bone mineral density.
Reported a worseningRandomised trial · 67 women · 52 weeks · 2000PostmenopausalCited 82 timesPubMed
Overweight postmenopausal women did a 12 month weight loss program with aerobic exercise plus vitamin D3 or placebo, and vitamin D did not improve lean mass or bone density but leg strength decreased more.
No difference foundRandomised trial · 218 women · 52 weeks · 2016PostmenopausalCited 38 timesPubMed
Postmenopausal women in a 6 month exercise-based weight loss program lost spine and hip bone density, which did not recover after regaining weight by 18 months.
Reported a worseningRandomised trial · 23 women · 78 weeks · 2011PostmenopausalCited 47 timesPubMed
373 premenopausal women aged 44 to 50 given a 5-year diet, weight-loss and physical activity program had greater hip bone loss than control women who gained weight.
Reported a worseningRandomised trial · 373 women · 260 weeks · 2007PerimenopausalCited 23 timesPubMed
Postmenopausal women did a 6-month supervised exercise weight-loss program with placebo, raloxifene or hormone therapy, and weight loss was linked to reduced bone density, especially without raloxifene or hormone therapy.
Mixed resultsRandomised trial · 94 women · 26 weeks · 2005PostmenopausalCited 29 timesPubMed
A systematic review of 34 studies in postmenopausal women found strength training improved body composition, muscle strength and bone density, while added protein gave no extra strength benefit.
Reported an improvementSystematic review · 1,541 participants pooled · 2026PostmenopausalPubMed
In 35 BRCA-positive breast cancer survivors after surgical menopause, a 12 month web-based lifestyle program maintained cardiovascular fitness and bone area and reduced body fat versus control.
Reported an improvementRandomised trial · 35 women · 52 weeks · 2017OtherCited 18 timesPubMed
Overweight postmenopausal women followed for six months after a 12 week diet with or without exercise showed those who kept exercising had greater fat loss, but bone density was not affected in either group.
No difference foundRandomised trial · 118 women · 78 weeks · 1994PostmenopausalCited 24 timesPubMed
Overweight or obese postmenopausal breast cancer survivors lost weight through diet plus physical activity over 12 months and showed no harmful changes in bone mineral density.
No difference foundRandomised trial · 81 women · 52 weeks · 2015PostmenopausalCited 13 timesPubMed
Overweight postmenopausal women who lost weight with or without aerobic exercise over 6 months and were followed for a year showed similar bone density loss in both groups.
No difference foundRandomised trial · 52 weeks · 2021PostmenopausalCited 13 timesPubMed
Postmenopausal women did a 12-month exercise and nutrition program then 6 months of voluntary home exercise; most physical benefits were maintained but bone and balance gains were not fully sustained with low exercise frequency.
Reported a worseningRandomised trial · 45 women · 78 weeks · 2009PostmenopausalCited 6 timesPubMed
Overweight postmenopausal women added walking to a weight loss program and showed a 2% increase in femoral neck bone density versus weight loss alone, linked to reduced inflammatory markers.
Reported an improvementControlled trial · 86 women · 2009PostmenopausalCited 59 timesPubMed
A 6-month pilot trial in 36 postmenopausal women combining weight-bearing aerobic exercise with calcium and vitamin D fortified meals found no significant difference in bone density between groups.
No difference foundRandomised trial · 36 women · 26 weeks · 2026Early postmenopausalPubMed
Diabetic postmenopausal women did treadmill walking before or after meals; exercising after meals raised bone formation markers and lowered insulin resistance more than exercising before meals.
Reported an improvementControlled trial · 15 women · 2019PostmenopausalCited 13 timesPubMed
In 40 postmenopausal women, 24 weeks of walking and strength training combined with dieting increased muscle strength, while bone density and VO2max did not change.
No difference foundControlled trial · 40 women · 24 weeks · 1997PostmenopausalCited 14 timesPubMed
Overweight postmenopausal women did combined aerobic and anaerobic exercise plus diet for 12 weeks and lost more fat with preserved lean mass versus diet alone.
No difference foundRandomised trial · 118 women · 12 weeks · 1994PostmenopausalPubMed
In a 4-month endurance exercise weight-loss program in obese postmenopausal women, bone strength estimate (section modulus) decreased significantly before bone density changes appeared.
Mixed resultsControlled trial · 24 women · 16 weeks · 2014PostmenopausalCited 5 timesPubMed
A review reported that calcium supplementation plus aerobic training increased femoral neck cortical bone density in postmenopausal women, while exercise also increased trabecular bone in the spine.
Reported an improvementOther · 1998Midlife womenCited 25 timesPubMed
A review of 11 studies found aerobic exercise gave a mild protective effect on bone density and reduced fat mass in postmenopausal women with obesity, especially combined with resistance training or caloric restriction.
Reported an improvementOther · 2024PostmenopausalCited 2 timesPubMed