Beyond DEXA: other bone quality measures

In this episode, I speak with Dr Lora Giangregorio about how to train for stronger bones, better balance, and long-term independence. We break down what actually matters when it comes to preventing fractures and improving bone health.

We explore the role of resistance, balance, and impact training, and how to apply these in a practical, sustainable way.

What We Cover

• Why starting where you are matters more than following a perfect plan
• How balance, strength, and impact training work together
• What progressive overload looks like in real life
• Why effort matters more than the weight you lift
• How to safely introduce impact training
• The role of protein and energy intake in bone health

This episode is a practical guide to building strength and resilience for the long term.

To explore more of Dr Lora Giangregorio’s work, follow her on TikTok, connect with her on LinkedIn, and visit her University of Waterloo profile to learn more about her research in bone health, exercise, and fracture prevention.

• Intro (00:00)
• The Real Cost of Fractures (01:25)
• Is Osteoporosis a Lifelong Process? (06:39)
• Who Is Most at Risk for Fragility Fractures (09:32)
• What Actually Determines Fracture Risk (12:49)
• How a DEXA Scan Works and How to Read Your Results (26:30)
• How to Monitor Bone Loss and Choose the Right Treatment (32:06)
• How Menopause Accelerates Bone Loss (41:52)
• Bone Health Myths Debunked (46:08)
• Evidence-Based Exercise Guidelines for Bone Health (59:15)
• The Three Pillars of Bone Health Exercise (1:04:15)
• Why Specificity and Progressive Overload Matter (1:09:48)
• How to Structure Your Weekly Bone Health Training (1:13:39)
• Resistance Training for Bone Health (1:22:31)
• How to Choose the Right Load and Effort (1:27:10)
• Making Bone Health Exercise Accessible to Everyone (1:38:09)
• High-Risk Exercises to Avoid with Low Bone Density (1:42:22)
• Does Yoga, Swimming, or Cycling Help Your Bones? (1:47:18)
• What Is Bone Fit and Who Is It For? (1:52:47)
• How to Safely Build Up to Impact Training (1:55:57)
• Free Resources for Fracture Recovery (2:02:06)
• Nutrition for Bone Health (2:05:10)
• GLP-1 Drugs and Bone Loss (2:12:48)
• Future Research on Exercise, Creatine, and Bone Health (2:16:09)
• Why Effort Matters More Than the Weight You Lift (2:22:15)
• What Is Possible When You Commit to Bone Health (2:25:48)

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Simon Hill, MSc, BSc (Hons)

• Creator of theproof.com
• Host of The Proof with Simon Hill
• Author of The Proof is in the Plants

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