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Lifting weights after menopause: how often, how many sets and how heavy for muscle and for bone

When women lift weights after menopause, muscle studies and bone studies ask different questions. Muscle trials ask how many days and sets it takes to add lean mass and strength. Bone trials ask how heavy, how fast and how many impacts it takes to move a bone density scan. This guide lines up the doses tested in women past menopause for each goal, shows where the major guidelines differ, and marks which numbers rest on a single small trial.

Researched and drafted by the Fit Over 40 editorial team. Last updated November 12, 2026. 10 minute read. How we research
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The short version

  • Muscle and bone studies test different doses. For muscle, 2 days or 3 days a week gave similar results when total work matched. For bone, the best-known trial used heavy lifts plus jumping, twice a week, under supervision.
  • LIFTMOR, a randomized trial of 101 women (average age 65) with low bone mass, compared 8 months of heavy lifting and impact work with a light home program. Lumbar spine bone density rose 2.9% versus a 1.2% fall, and femoral neck density rose 0.3% versus a 1.9% fall.
  • Whether heavy beats moderate is unsettled. Pooled analyses split, with one rating its certainty extremely low, and the reviews define high intensity at different cutoffs (70% versus 80% of one-repetition maximum).
  • Three 2025 and 2026 network meta-analyses do not fully agree on which exercise type ranks first at the lumbar spine: two put aerobic plus resistance training on top and one ranks mind-body training first, without a significant effect. Resistance training appears among the significant spine results in all three.
  • Guidelines differ: WHO and US guidance say 2 or more days a week; the UK osteoporosis consensus says 2 or 3 days with up to 3 sets of 8 to 12 repetitions and at least 50 moderate impacts per session; an Australian summary says 4 to 7 impact days a week.
  • Fracture evidence leans positive but is not settled: pooled rate ratios run from 0.67 to 0.84, one of them borderline, and none tested a specific lifting dose. HHS plans a US muscle-strengthening supplement in 2027.

The doses at a glance

This table lines up the doses that were tested in women after menopause. The rows come from different trials with different outcomes and time frames, so they are not directly comparable. Guideline recommendations come later in the guide.

GoalWhat was testedWhat happenedEvidence type
Muscle: weekly frequencyEqual total work done 2 days a week (3 sets) or 3 days a week (2 sets), 20 to 30 repetitions to fatigue, 8 weeks, untrained postmenopausal women1Muscle thickness, strength and endurance all rose, with no difference between schedules1Small randomized trial
Muscle: frequency over 24 weeks2 or 3 sessions a week, women aged 60 and over2Strength rose 19.5% with 2 days and 22.2% with 3 days. Lean soft tissue rose 3.0% and 1.6%2Small randomized trial
Muscle: sets3 or 6 sets per exercise, four leg exercises, 12 weeks, 58 postmenopausal women3Leg lean mass rose 2.3% with 3 sets and 6.1% with 6 sets. Leg press and leg extension strength gains were similar3Randomized trial
Muscle: a null resultTwice a week, about 6 to 8 sets per muscle per week, 10 weeks4In 19 postmenopausal women, strength rose but muscle mass and fat-free mass did not change significantly. Premenopausal women gained muscle mass4Small, partly non-randomized
Bone: heavy lifting plus impactTwice a week, 30 minutes, supervised. Deadlift, overhead press and back squat, 5 sets of 5 above 80 to 85% of one-repetition maximum, plus jumping chin-ups with drop landings, 8 months, 101 women averaging 655Lumbar spine bone density rose 2.9% versus a 1.2% fall in a low-intensity home program. Femoral neck density rose 0.3% versus a 1.9% fall5Randomized trial, supervised
Bone: pooled resistance training17 randomized trials, 690 postmenopausal women6Bone density improved at the lumbar spine, femoral neck and total hip. Subgroups favored loads of 70% of one-repetition maximum or more and 3 sessions a week, and the spine result was unstable when one study was removed6Meta-analysis, high heterogeneity

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Muscle: how many days and how many sets

Frequency matters less than total work. In untrained postmenopausal women, training 2 days a week or 3 days a week with the same total volume produced similar gains in muscle size, strength and endurance over 8 weeks, using light loads taken to fatigue.1 A 24-week trial in women 60 and over reached the same conclusion for 2 versus 3 sessions.2

Sets may matter for muscle size, not strength. In a 12-week trial, 6 sets per exercise added about 2.7 times as much leg lean mass as 3 sets (6.1% versus 2.3%), while strength gains were similar.3 Both groups beat a no-exercise control.3

The dose may need to be higher after menopause. In a 2023 study of 41 women (31 finished), premenopausal women gained muscle mass on a twice-weekly program of about 8 sets per muscle per week. Postmenopausal women on 6 to 8 sets did not show significant changes in muscle mass or fat-free mass, although their strength rose. The authors suggested that more than 6 to 8 sets per muscle per week, or more than two sessions, may be needed. The study was small, only partly randomized and used bioimpedance to estimate body composition.4

The older-adult pooled data are low quality. A meta-analysis of 25 trials in adults averaging 65 and older found the largest strength gains with 2 sessions a week, 2 to 3 sets per exercise and loads of 70 to 79% of one-repetition maximum. Muscle size came from only nine studies, and no volume variable predicted it. The authors flagged poor study quality (average PEDro score 4.6) and heavy heterogeneity.7

The beginner routine in our strength training guide is a muscle-and-function program. Bone-targeted trials, covered next, used heavier loads.

Bone: the heavy-lifting trial and what surrounds it

LIFTMOR (Lifting Intervention for Training Muscle and Osteoporosis Rehabilitation) randomized 101 postmenopausal women with low bone mass (T-score below -1.0 at the hip or spine) to supervised heavy lifting with impact or a home program. The women averaged 65 years.5

  • The heavy group: two 30-minute sessions a week for 8 months in groups of up to 8 per instructor. Lifts were the deadlift, overhead press and back squat at 5 sets of 5 above 80 to 85% of one-repetition maximum, plus jumping chin-ups with drop landings. The first month used body weight and low loads.5
  • The comparison group: the same frequency, but unsupervised at home, with 10 to 15 repetitions below 60% of one-repetition maximum and hand weights that reached 3 kg in the final month. This was not a no-exercise control.5
  • Bone results (intention-to-treat): lumbar spine density rose 2.9% versus a 1.2% fall, and femoral neck density rose 0.3% versus a 1.9% fall. Height changed by +0.2 cm versus -0.2 cm.5
  • Function: leg extensor strength rose 35.2% versus 8.1%, and back extensor strength 36.0% versus 11.0%.5
  • Safety record: one mild low-back muscle strain, in the last repetition of the last deadlift set at week 28, cost about a week of sessions. Seven women fell (5 heavy group, 2 comparison), none was injured and all falls happened outside sessions.5 A follow-up analysis found no vertebral fractures, and thoracic kyphosis improved.8
Change in bone density after 8 monthsSupervised heavy lifting plus impactLow-intensity home program+4%+2%0−2%Lumbar spine, Heavy lifting group: +2.9%+2.9%Lumbar spine, Low-intensity group: −1.2%−1.2%Lumbar spineFemoral neck, Heavy lifting group: +0.3%+0.3%Femoral neck, Low-intensity group: −1.9%−1.9%Femoral neck
Intention-to-treat results from the LIFTMOR randomized trial of 101 postmenopausal women with low bone mass (Watson et al., J Bone Miner Res 2018). Both groups trained twice a week; the comparison group exercised unsupervised at home.
Show the numbers
SiteHeavy lifting plus impactLow-intensity home program
Lumbar spine+2.9%−1.2%
Femoral neck+0.3%−1.9%

The trial's own limits matter. The sample was relatively healthy, with people who had other conditions excluded. The assessor was not blinded to group, the bone scanner changed partway through, and the trial was not powered to assess safety or falls. The authors do not recommend unsupervised high-intensity training for people with low bone mass.5

Conference data on what happens next. A retrospective, observational 3-year follow-up of 23 women from the heavy group, presented at a 2020 sports medicine meeting, compared 7 who kept up the training with 16 who did not. Lumbar spine density gains were 8.63% versus 2.18% (p = 0.042). Femoral neck gains were 3.67% versus 2.85%, which was not statistically significant. Women who stopped kept the gains they had made at 8 months.9 This is a small, unpublished-in-full comparison and should be read as a lead.

Heavy or moderate? The pooled evidence splits

LIFTMOR compared heavy lifting with a light program, not with moderate lifting. Pooled analyses try to fill the gap, and they do not agree.

  • A 2021 meta-analysis of 53 trials in postmenopausal women (19 low, 40 moderate and 4 high-intensity interventions) found larger lumbar spine gains with high intensity (0.031 g/cm2) than moderate (0.012) or low (0.010). High intensity showed no effect at the femoral neck, which the authors say may reflect low power.10 This review came from the Griffith University group that ran LIFTMOR.10,5
  • A 2022 meta-analysis of six randomized trials (391 women with osteoporosis) comparing moderate with high-intensity resistance and impact training found better lumbar spine density with high intensity (standardized mean difference 2.37, 95% CI 0.10 to 4.65). Heterogeneity was very high (I2 98% across three studies) and the authors rated certainty extremely low.11
  • A 2023 network meta-analysis of 19 trials (919 women) ranked moderate-intensity training 3 days a week first at four skeletal sites. It defined high intensity as 80% of one-repetition maximum or more and moderate as 65 to 80%, and it advised keeping programs within 48 weeks.12
  • A 2025 meta-analysis of 17 trials (690 women) found significant femoral neck and total hip effects for loads of 70% or more, and for programs of 48 weeks or longer. Its cutoff for high intensity (70%) was lower than the 2023 review's (80%), so the labels are not interchangeable.6

Read together, the data say that resistance training raises bone density in women after menopause, that the case for going heavier is clearest at the lumbar spine, and that no large head-to-head trial has settled how heavy is heavy enough.

Which exercise type ranks first? Three network meta-analyses, two answers

Network meta-analyses rank many exercise types at once, including pairs that no trial compared directly. Three recent ones, all pooling randomized trials, reach different top rankings at the lumbar spine.

ReviewSizeTop-ranked at lumbar spineSignificant versus control at lumbar spine
Feng, Bone, 2026162 trials, 10,475 adults aged 18 to 82, postmenopausal women the largest group13Aerobic plus resistance training (87% ranking probability)13Aerobic plus resistance 0.047 g/cm2, traditional Chinese exercise 0.044, resistance 0.02213
Xiaoya, Scientific Reports, 202549 trials, 3,360 postmenopausal women14Aerobic plus resistance training (p-score 0.87)14Aerobic plus resistance, aerobic alone and resistance alone. The abstract gives mean differences without units, so sizes are not compared here14
Ma, Frontiers in Physiology, 202555 trials, 3,453 women aged 60 and over15Mind-body training (76%), but not significant versus control15Whole-body vibration 0.03 g/cm2, multicomponent training 0.02, resistance training 0.01 (interval 0.00 to 0.02)15

Resistance training sits among the significant spine results in all three, but the top-ranked label changes. Feng and colleagues call their rankings exploratory because of sparse direct evidence, and in their analysis no intervention differed from control at the total hip.13 At the femoral neck, the 2025 Frontiers review found a significant gain only for multicomponent training.15

The 2026 analysis also modeled total weekly exercise at the lumbar spine. The best-fitting curve was an inverted U, with the largest predicted effect near 1,100 MET-minutes per week (a measure of total exercise energy), and no evidence that benefit keeps rising with more. The authors label this exploratory and note that MET-minutes do not capture how hard bone is loaded. Supervised programs, 3 or more sessions a week and interventions of 6 months or longer were linked to larger effects at the lumbar spine and femoral neck.13

What the guidelines recommend

SourceStrength trainingImpact and bone-specific advice
WHO, 2020Adults: muscle-strengthening at moderate or greater intensity, all major muscle groups, 2 or more days a week. Age 65 and over: varied multicomponent activity emphasizing balance and strength at moderate or greater intensity on 3 or more days a week16None specific to bone
US Physical Activity Guidelines, 2018Adults: muscle-strengthening at least 2 days a week17New steps and muscle-strengthening guidance planned for 202718
UK consensus on exercise and osteoporosis, 20222 or 3 days a week. Build to the maximum that can be lifted 8 to 12 times, up to 3 sets per exercise, including the back19Moderate impact (stamping, jogging, low-level jumping, hopping) on most days, at least 50 impacts per session. Not very high impact such as landing from height. With vertebral or multiple low-trauma fractures: impact up to brisk walking, 150 minutes a week19
RACGP clinical summary, AustraliaAt least two 30 to 45 minute sessions a week, 6 to 8 exercises, 2 to 3 sets of 8 to 10 repetitions at hard to very hard effort (Borg 14 to 16)20Impact 4 to 7 times a week, such as 50 to 100 jumps in 3 to 5 sets, added after 4 to 8 weeks of resistance training. Severe osteoporosis or a vertebral fracture: avoid dynamic, explosive, high-impact loads and excessive trunk flexion20

The Australian position statement behind the RACGP summary says bone responds to impact and high-intensity progressive resistance training, that loaded spinal flexion is not recommended, and that impact may need modifying with osteoarthritis or frailty.21

Where they disagree. LIFTMOR used drop landings from jumping chin-ups, while the UK statement advises against very high impact such as landing from height.5,19 The documents do not reconcile this. One difference is setting: LIFTMOR was fully supervised in small groups and enrolled relatively healthy volunteers.5 The UK panel also says professionals should avoid restricting exercise by bone density or fracture thresholds, which can put people off.19 On the spine, it links reported vertebral fractures in trials to end-range, repeated or loaded forward flexion, such as sit-ups and some yoga positions, and advises avoiding or modifying those.19 The RACGP summary adds that high-impact exercise may be a problem for women with continence issues, so pelvic floor training matters.20

Bone density is a stand-in: what about fractures?

Scan-measured bone density is a surrogate. Researchers describe the effect of exercise on it as frequently modest, and it may not capture the full benefit to bone.22 Fractures are the outcome that matters, and the pooled data lean positive without being settled.

  • The UK consensus pooled trials of exercise designed to raise bone density. Of 62 trials, 11 reported fractures, and overall 5.8% of exercisers and 9.6% of controls had one. The text reports no statistical test of that gap.19
  • A JAMA Internal Medicine meta-analysis of exercise lasting a year or more in adults 60 and over found a fracture rate ratio of 0.84 (95% CI 0.71 to 1.00, p = 0.05, 19 trials, 8,410 people). Falls fell by 12% (RR 0.88) and injurious falls by 26% (RR 0.74).23
  • A 2023 meta-analysis of 20 studies in adults 45 and over found fewer low-trauma fractures (incidence rate ratio 0.67, 95% CI 0.51 to 0.87) and fewer major osteoporotic fractures (0.69, 0.52 to 0.92).24

None of these tested a specific lifting dose. They pooled exercise programs of many kinds.

What we still do not know

  • Whether heavy lifting beats moderate lifting in a large head-to-head trial in women after menopause. One review rated its certainty extremely low.11
  • Whether LIFTMOR's results hold outside supervised settings and beyond relatively healthy volunteers. Its authors do not recommend unsupervised high-intensity training for people with low bone mass.5
  • Whether bone gains last and convert into fewer fractures. The 3-year data are an observational conference report of 23 women.9
  • The minimum effective dose for muscle after menopause. Trials run 8 to 24 weeks, and one suggests the threshold is higher than before menopause.1,2,4
  • What the US muscle-strengthening supplement will say. HHS plans to release it in 2027 and took public comment through November 12, 2026. Until then the 2018 guidance of at least 2 days a week stands.17,18,25

Questions to bring to a trainer or physical therapist

  • Is my goal muscle, bone or both, and which parts of the plan target each?
  • Who supervises my first heavy lifts, and how do we build up from body weight and light loads, as LIFTMOR did in its first month?
  • Which impact work suits my joints, pelvic floor and bone scan, and when do we add it after a strength base is in place?
  • Which movements should I avoid or modify for my back, given the risk tied to forward spinal flexion?

Related guides:

Common questions

How often should women over 50 lift weights?

WHO and US guidelines call for muscle-strengthening on 2 or more days a week for adults, and the WHO adds multicomponent balance-and-strength activity on 3 or more days for age 65 and over.16,17 In trials of postmenopausal women, 2 days and 3 days a week gave similar gains in muscle size and strength when total work was equal.1,2

How many sets and reps should women over 50 do?

Guidance differs. The UK osteoporosis consensus suggests building to 3 sets of the maximum that can be lifted 8 to 12 times,19 and an Australian clinical summary suggests 2 to 3 sets of 8 to 10 repetitions at hard to very hard effort.20 In a 12-week trial, 6 sets per exercise built more leg lean mass than 3 sets, but strength gains were similar.3

Do I need to lift heavy to protect my bones?

Heavy loading has the best-known trial: LIFTMOR used sets of 5 above 80 to 85% of one-repetition maximum under supervision.5 Pooled analyses disagree on whether heavy beats moderate, and one rated the certainty extremely low.11,12 The UK consensus recommends loads up to the maximum that can be lifted 8 to 12 times.19

Can lifting weights increase bone density after menopause?

In LIFTMOR, lumbar spine density rose 2.9% in the heavy-lifting group and fell 1.2% in the comparison group over 8 months.5 In a 2026 analysis of 162 trials in adults, resistance training raised lumbar spine density by 0.022 g/cm2 versus control.13 Researchers describe exercise effects on scan-measured density as frequently modest.22

Is jumping safe after menopause?

The UK consensus recommends moderate impact such as stamping, jogging, low-level jumping and hopping, with at least 50 impacts per session on most days, but not very high impact like landing from height. People with vertebral or multiple low-trauma fractures are advised to keep impact to the level of brisk walking.19 In LIFTMOR, which included supervised jumping chin-ups with drop landings, no vertebral fractures occurred.8 The RACGP summary notes that high-impact exercise may be a problem for women with continence issues.20

Is lifting light weights for more repetitions enough to build muscle?

In one 8-week trial of untrained postmenopausal women, sets of 20 to 30 repetitions taken to fatigue increased muscle thickness and strength.1 That trial did not compare against heavier loads and did not measure bone.

Does strength training reduce fractures?

Pooled results lean that way. Rate ratios were 0.84 for fractures in a JAMA Internal Medicine meta-analysis (borderline, p = 0.05) and 0.67 for low-trauma fractures in a 2023 meta-analysis.23,24 These pooled exercise programs of many kinds and did not test a specific lifting dose.

Are the US muscle-strengthening guidelines changing?

HHS is developing a supplement to the 2018 Physical Activity Guidelines on steps and muscle-strengthening, due in 2027, and took public comments through November 12, 2026. The current guidance for adults is muscle-strengthening on at least 2 days a week.17,18,25

References

  1. Grzyb K, Candow DG, Schoenfeld BJ, Bernat P, Butchart S, Neary JP. Effect of equal volume, high-repetition resistance training to volitional fatigue, with different workout frequencies, on muscle mass and neuromuscular performance in postmenopausal women. J Strength Cond Res. 2022;36(1):31-36. https://doi.org/10.1519/JSC.0000000000003422
  2. Pina FLC, Nunes JP, Nascimento MA, Ribeiro AS, Mayhew JL, Cyrino ES. Similar effects of 24 weeks of resistance training performed with different frequencies on muscle strength, muscle mass, and muscle quality in older women. Int J Exerc Sci. 2019;12(6):623-635. https://digitalcommons.wku.edu/ijes/vol12/iss6/8
  3. Nascimento de Oliveira Junior G, de Sousa JFR, Carneiro MAS, Martins FM, Santagnello SB, Souza MVC, Orsatti FL. Resistance training volume enhances muscle hypertrophy, but not strength in postmenopausal women: a randomized controlled trial. J Strength Cond Res. 2022;36(5):1216-1221. https://doi.org/10.1519/JSC.0000000000003601
  4. Isenmann E, Kaluza D, Havers T, et al. Resistance training alters body composition in middle-aged women depending on menopause: a 20-week control trial. BMC Womens Health. 2023;23:526. https://doi.org/10.1186/s12905-023-02671-y
  5. Watson SL, Weeks BK, Weis LJ, Harding AT, Horan SA, Beck BR. 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. J Bone Miner Res. 2018;33(2):211-220. https://doi.org/10.1002/jbmr.3284
  6. Zhao F, Su W, Sun Y, Wang J, Lu B, Yun H. Optimal resistance training parameters for improving bone mineral density in postmenopausal women: a systematic review and meta-analysis. J Orthop Surg Res. 2025;20(1):523. https://doi.org/10.1186/s13018-025-05890-1
  7. Borde R, Hortobagyi T, Granacher U. Dose-response relationships of resistance training in healthy old adults: a systematic review and meta-analysis. Sports Med. 2015;45(12):1693-1720. https://doi.org/10.1007/s40279-015-0385-9
  8. Watson SL, Weeks BK, Weis LJ, Harding AT, Horan SA, Beck BR. High-intensity exercise did not cause vertebral fractures and improves thoracic kyphosis in postmenopausal women with low to very low bone mass: the LIFTMOR trial. Osteoporos Int. 2019;30(5). https://www.springermedizin.de/high-intensity-exercise-did-not-cause-vertebral-fractures-and-im/16378684
  9. The Hospitalist (MDedge). High-impact training can build bone in older women. Coverage of the LIFTMOR 3-year follow-up, a retrospective observational study presented at the virtual American College of Sports Medicine 2020 Annual Meeting. https://blogs.the-hospitalist.org/content/high-impact-training-can-build-bone-older-women
  10. Kistler-Fischbacher M, Weeks BK, Beck BR. The effect of exercise intensity on bone in postmenopausal women (part 2): a meta-analysis. Bone. 2021;143:115697. https://doi.org/10.1016/j.bone.2020.115697
  11. Kitagawa T, Hiraya K, Denda T, Yamamoto S. A comparison of different exercise intensities for improving bone mineral density in postmenopausal women with osteoporosis: a systematic review and meta-analysis. Bone Rep. 2022;17:101631. https://doi.org/10.1016/j.bonr.2022.101631
  12. Wang Z, Zan X, Li Y, Lu Y, Xia Y, Pan X. Comparative efficacy of different resistance training protocols on bone mineral density in postmenopausal women: a systematic review and network meta-analysis. Front Physiol. 2023;14:1105303. https://www.frontiersin.org/articles/10.3389/fphys.2023.1105303/full
  13. Feng H, Xie Z, Wang Y, Zhang Y, Zuo H, Yang H. Effectiveness of different exercise types for improving bone mineral density in adults: a pairwise, network, and dose-response meta-analysis of 162 randomized controlled trials. Bone. 2026;213:118044. https://doi.org/10.1016/j.bone.2026.118044
  14. Xiaoya L, Junpeng Z, Li X, Haoyang Z, Xueying F, Yu W. Effect of different types of exercise on bone mineral density in postmenopausal women: a systematic review and network meta-analysis. Sci Rep. 2025;15(1):11740. https://doi.org/10.1038/s41598-025-94510-3
  15. Ma M, Su W, Liu D. Effects of different exercise interventions on bone mineral density in elderly postmenopausal women: a network meta-analysis. Front Physiol. 2025;16:1633913. https://www.frontiersin.org/journals/physiology/articles/10.3389/fphys.2025.1633913/full
  16. Bull FC, et al. World Health Organization 2020 guidelines on physical activity and sedentary behaviour. Br J Sports Med. 2020;54(24):1451-1462. https://doi.org/10.1136/bjsports-2020-102955
  17. US Department of Health and Human Services. Top 10 things to know about the second edition of the Physical Activity Guidelines for Americans (2018). https://odphp.health.gov/our-work/nutrition-physical-activity/physical-activity-guidelines/current-guidelines/top-10-things-know
  18. US Department of Health and Human Services, ODPHP. Physical Activity Guidelines for Americans, 2nd edition supplement: 2027 steps and muscle-strengthening guidance (page updated October 2026). https://odphp.health.gov/our-work/nutrition-physical-activity/physical-activity-guidelines/current-guidelines/2027-supplement
  19. Brooke-Wavell K, Skelton DA, Barker KL, et al. Strong, steady and straight: UK consensus statement on physical activity and exercise for osteoporosis. Br J Sports Med. 2022;56(15):837-846. https://pmc.ncbi.nlm.nih.gov/articles/PMC9304091
  20. Royal Australian College of General Practitioners. HANDI: exercise for preventing bone loss and reducing fracture risk. https://www.racgp.org.au/clinical-resources/clinical-guidelines/handi/a-z/e/exercise-for-preventing-bone-loss-and-reducing-fra
  21. Beck BR, Daly RM, Singh MAF, Taaffe DR. Exercise and Sports Science Australia (ESSA) position statement on exercise prescription for the prevention and management of osteoporosis. J Sci Med Sport. 2017;20(5):438-445. https://doi.org/10.1016/j.jsams.2016.10.001
  22. Harding AT, Beck BR. Exercise, osteoporosis, and bone geometry. Sports (Basel). 2017;5(2):29. https://pmc.ncbi.nlm.nih.gov/articles/PMC5968984
  23. de Souto Barreto P, Rolland Y, Vellas B, Maltais M. Association of long-term exercise training with risk of falls, fractures, hospitalizations, and mortality in older adults: a systematic review and meta-analysis. JAMA Intern Med. 2019;179(3):394-405. https://doi.org/10.1001/jamainternmed.2018.5389
  24. Shojaa M, Hoffmann I, Kohl M, et al. Exercise effects on the reduction of low-traumatic and major osteoporotic fractures in adults: systematic review and meta-analysis. Osteologie. 2023. https://doi.org/10.1055/a-2067-4323
  25. US Department of Health and Human Services. Announcing solicitation of written comments to inform the Physical Activity Guidelines for Americans, 2nd edition supplement: 2027 steps and muscle-strengthening guidance. Federal Register, October 13, 2026 (docket HHS-OASH-2026-0463). https://www.federalregister.gov/d/2026-20833
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