In this masterclass, I bring together six experts to untangle one of the most misunderstood areas of healthy ageing: bone health. Dr Lora Giangregorio, Prof Belinda Beck, Dr Deborah Kado, Dr Howard Luks, Dr Lauren Colenso-Semple, and Dr Alyssa Olenick each bring a different lens, from bone biology and fracture risk through to joint pain, surgery, and how to train for strength at any age.
Bone density has become the number everyone fixates on, yet it is only one piece of the picture. Structure, material properties, falls, and strength all shape whether a bone breaks, and the advice around heavy lifting and jumping often runs ahead of the evidence. This conversation is about replacing confusion and fear with a practical, evidence-based framework you can actually use.
What we cover:
- Why bone mineral density only tells part of the story when it comes to fracture risk, and what tools like FRAX add
- What a DEXA scan cannot see, and why the shape of a bone may matter as much as its density
- Whether blood markers of bone turnover can tell you anything useful about bone strength
- Whether you really need to lift heavy for your bones, or whether the evidence is less certain than the headlines suggest
- What a bare minimum strength program looks like for someone who has never trained before
- Why power matters so much as we age, and which activities our guests see in the people who age best
- When surgery helps, and why the words “bone on bone” can do more harm than good
- How to build movement into everyday life if you dislike structured exercise
Whatever your starting point, the message I took from this conversation is that the best program is the one you can sustain. I hope it leaves you feeling more confident, and less afraid, about looking after your bones.
To connect with our guests, you can find Dr Lora Giangregorio on TikTok, X, and LinkedIn, or learn more through her University of Waterloo profile. Prof Belinda Beck can be found through The Bone Clinic, ONERO, her Griffith University profile, and Facebook. Dr Deborah Kado has a Stanford profile and is on LinkedIn. Dr Howard Luks writes on Substack and is on X and Instagram. Dr Lauren Colenso-Semple is on Instagram and at drlaurencs.com, and Dr Alyssa Olenick is on Instagram and YouTube, with her programs at doclyssfitness.com.
- Osteoporosis Fracture Risk and FRAX Score (00:00)
- Bone Density vs Bone Strength (05:10)
- How Lifting Changes Bone Shape (09:41)
- Bone Health Blood Tests Explained (15:00)
- Heavy Lifting for Osteoporosis: LIFTMOR Study (17:31)
- Best Rep Range for Building Bone (22:49)
- Strength Training After 70 (29:25)
- How to Keep Muscle Power With Age (33:45)
- Meniscus Tears: Surgery vs Physical Therapy (38:04)
- Knee Osteoarthritis and Bone-on-Bone Myth (42:59)
- Jump and Balance Training for Bones (48:03)
- Daily Movement for Stronger Bones (53:30)
- Are Yoga and Pilates Enough? (57:48)
Resources and links:
- Osteoporosis Researcher: 3 Exercises That Actually Reduce Fracture Risk | Dr. Lora Giangregorio
- How to Increase Your Health Span and Longevity: According to a Geriatrician Who Treats 100-Year-Olds
- Orthopedic Surgeon Explains Joint Pain, Arthritis, MRI Tears & When Surgery Is Needed | Howard Luks
- Osteoporosis Exercise Scientist: The Lifting Protocol That Reduces Fractures by 78% Dr Belinda Beck
- Science-based exercise tips for women with Dr Lauren Colenso-Semple | The Proof EP#391
- How Are Women in Their 40s, 50s & 60s Supposed to Train and Eat? What the Science Says | EP#407
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More about Dr Lora Giangregorio
Lora Giangregorio, PhD is a Professor and Tier 1 Canada Research Chair in Bone Health and Exercise Science in the Department of Kinesiology and Health Sciences at the University of Waterloo. She leads the Bone Health and Exercise Science Lab, or BonES lab. The BonES lab team leads research on physical activity for fall and fracture prevention. Dr Giangregorio is a member of the Scientific Advisory Council for Osteoporosis Canada and was on the leadership team that developed the 2020 Canadian 24-hour Movement Guidelines. She also led the Exercise Working Group for the 2023 Clinical Practice Guidelines for Management of Osteoporosis and Fracture Prevention in Canada.
More about Prof Belinda Beck
Belinda Beck is a Professor of Exercise Physiology at Griffith University (Gold Coast, QLD) and Director of The Bone Clinic in Brisbane. Her work, primarily related to the effects of mechanical loading on bone, includes a series of clinical trials (the LIFTMOR and MEDEX-OP trials) that changed the way osteoporosis is managed with exercise. In 2015, she established The Bone Clinic, a translational research facility and clinical practice in Brisbane providing the ONERO® exercise program for osteoporosis which has been licenced for delivery around the world. She has been awarded almost $8M in research funding and has published over 150 papers and chapters in the field. She is a Fellow of numerous bone and exercise societies (including ACSM, ASBMR, ESSA and SMA), is on the Board of the Australian and New Zealand Bone and Mineral Society, Sports Medicine Australia, the SOS Fracture Alliance, the International Osteoporosis Foundation Capture the Fracture Governance Committee, and the Healthy Bones Australia Medicine and Science Advisory Committee.
More about Dr Deborah Kado
Deborah Kado, MD, MS professor of medicine at Stanford University, specialises in geriatrics and gerontology. She serves as the Director of the Geriatrics Research Education and Clinical Center (GRECC) for the Veterans Affairs Palo Alto Healthcare System, co-director of the Stanford Longevity Center, and Research Chief of the Geriatric Section of the Department of Medicine. She integrates biological, pharmacological, lifestyle, and psychological perspectives and research to optimise health and empower her patients. She has a special interest in bone health, conducting extensive research focused on osteoporosis and the related disorder hyperkyphosis, commonly known as the “dowager’s hump.” Her discoveries helped define the causes, consequences, and ways to improve it through spinal strengthening exercises. In the past decade, her research has focused on the interactions between aging and the gut microbiome with regards to vitamin D metabolism, sleep and mortality risk. She has over 140 peer-reviewed publications in highly cited journals such as the Annals of Internal Medicine, The Journal of Bone and Mineral Research, Nature Metabolism, and Nature Communications. She has been continuously funded by the National Institutes of Aging since 2000 and is a member of multiple professional organizations, including the American Geriatrics Society, the American Society of Bone and Mineral Research, the Gerontological Society of America, and the Endocrine Society. Dr Kado currently serves on the NIH Council of Councils Disability Health Research Working Group and is a frequent commentator for many newspapers including the San Francisco Chronicle, New York Times, Washington Post, Wall Street Journal and magazines such as Women’s Health, Vogue, Real Simple, Self, and Good Housekeeping.
More about Dr Howard Luks
Howard Luks, MD, is a board-certified orthopedic surgeon with nearly 30 years of clinical experience and a longtime focus on helping people remain active, strong, and capable as they age. He is an athlete, author of Longevity…Simplified, and writer of Built to Move, Born to Heal, where he translates the science of exercise, musculoskeletal health, and longevity into practical guidance for navigating midlife and beyond. Most importantly, he is the proud father of three awesome kids and believes that staying healthy and capable is ultimately about being able to keep doing the things, and being with the people, we care about most.
More about Dr Lauren Colenso-Semple
Dr Lauren Colenso-Semple, PhD is a science communicator with expertise in female physiology and exercise. She holds a PhD in Integrative Physiology from McMaster University and a Master’s in Exercise Science from the University of South Florida. Through her research, teaching, public speaking, and online platforms, Lauren is known for making complex topics accessible, and for calling out the myths that hold women back from reaching their full potential. She is also a seasoned fitness professional with extensive hands-on coaching experience and a co-owner of the MASS Research Review, where she helps bridge the gap between cutting-edge research and practical fitness strategies.
More about Dr Alyssa Olenick
Dr Alyssa Olenick holds a PhD in Exercise Physiology and is a certified sports nutritionist and Crossfit Level 2 Trainer. Alyssa completed her doctoral training in exercise and human metabolism, sex differences and menstrual cycle physiology. She is currently a postdoctoral research fellow researching the areas of menopause and metabolism. As a coach she specialises in the areas endurance, strength and hybrid training. She runs her online business ‘Doc Lyss Fitness’ and is a strength athlete, ultra-marathon runner, and all-around fitness lover who is passionate about educating people on science-based fitness to get them into the gyms and on the roads/trails, or often, doing both at the same time! You can learn more about Dr Alyssa Olenick and her programs at www.doclyssfitness.com.
