Fitness
Lower-calorie Mediterranean diet and exercise limit bone loss, even during weight loss, study finds
Older women who stayed on a reduced-calorie Mediterranean diet, walked and did resistance training for three years improved their bone density, especially in their lower backs, a new study found.
“A reduced-energy Mediterranean diet involves participants consuming a modified version of the traditional Mediterranean diet with approximately 30% fewer calories than their usual intake,” said coauthor Jesús Francisco García-Gavilán, a senior biostatistician at the University Rovira i Virgili in Tarragona, Spain.
Women in the study, who ranged in age from 55 to 75, were also able to prevent bone deterioration that typically occurs during weight loss, according to the research published Tuesday in the journal JAMA Network Open.
“Previous research has indicated that losing weight, particularly through diet alone, can lead to a reduction in bone density, which poses risks for older adults. Additionally, exercising alone does not always prevent this issue,” García-Gavilán said in an email.
“What is new in this study is the finding that combining a well-balanced, reduced-calorie Mediterranean diet with physical activity can prevent bone loss in older women, even while they are losing weight,” he said. “This emphasizes that the type of diet is important during weight loss, not just the calorie intake.”
The results of the study are not that surprising, said Dr. Andrew Freeman, director of cardiovascular prevention and wellness at National Jewish Health in Denver.
“When you practice the lifestyle that human beings were always meant to live, which is moving a lot and eating predominantly simple, plant-based foods, all sorts of systems get better, including bone density,” said Freeman, who was not involved in the new research.
The Mediterranean diet is full of good fats, vitamins, calcium and other minerals that support good bone health. – jeffbergen/E+/Getty Images
Why the Mediterranean diet?
The new study is part of the PREDIMED-Plus trial, a randomized clinical trial on lifestyle interventions conducted in 23 medical centers and hospitals in Spain. The trial included 924 older adults with metabolic syndrome who were overweight or had obesity. Half were randomized to eating a Mediterranean diet with no restrictions on calories and no requirement to exercise.
The other half were encouraged to walk for a minimum of 45 minutes per day six days per week and to do strength, flexibility and balance exercises three days per week. Their diet was cut to about 30% fewer calories than they typically consumed and only from a Mediterranean-style eating plan. Women in this group saw significantly stronger bones at one year and at three years into the study.
“While previous results from the PREDIMED-Plus trial highlighted benefits for maintaining lean mass and losing weight, this is the first publication to demonstrate that these lifestyle changes can also help preserve bone density, especially in older women,” García-Gavilán said.
The award-winning Mediterranean diet features simple, plant-based cooking, with much of each meal focused on fruits and vegetables, whole grains, beans and seeds, with a few nuts and a heavy emphasis on extra-virgin olive oil. Fats other than olive oil, such as butter, are consumed rarely, if at all, and sugar and refined foods are avoided.
Red meat is used sparingly, often only to flavor a dish. Eating healthy, oily fish, which are packed with omega-3 fatty acids, is encouraged, while eggs, dairy and poultry are eaten in much smaller portions than in the traditional Western diet.
Eating the Mediterranean way has been linked to reductions in the risk for breast cancer, dementia, depression, diabetes, high cholesterol and memory loss. Adherence to the diet can also lead to a healthier heart, weight loss and longer life.
But exactly why would the meal plan help preserve bone?
“The Mediterranean diet is rich in nutrients that promote bone health,” García-Gavilán said. “Nuts and dairy products provide essential calcium, magnesium, and vitamin D. Healthy fats, such as those found in olive oil, have been shown to reduce inflammation.”
Antioxidants such as vitamin C from fruits and vegetables may help protect and support bone cells, García-Gavilán added, while other important vitamins, like vitamin K found in vegetables such as spinach, play a role in bone formation.
“Together, these nutrients can lower the risk of bone loss and support bone maintenance, especially as we age,” García-Gavilán said. “Understanding this nutritional context is crucial for maintaining our long-term quality of life.”
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Format: Would you prefer wearing a ring or a wrist-based device? If you want something understated that you can wear all the time and don’t mind not having a screen to glance at, then a ring would be ideal. If having a watch on your wrist is comfortable, then a smartwatch or wrist-based tracker may be the right choice.
Compatibility: If you’re an Apple user, ensure your fitness tracker is compatible with iOS. The same goes if you’re an Android user.
Storage capacity: For those who don’t want their fitness tracker to be dependent on their phone, look at a device with its own storage capacity.
Special features: Before purchasing a fitness tracker, consider the health metrics that are important to you for your favorite workouts. If you’d like your tracker to do more than monitor your fitness, you’ll be better off with a smartwatch like the Pixel Watch 4 or Apple Watch SE 3.
Wi-Fi or Bluetooth: If you’re the type of person who likes to leave their phone behind when working out but still needs internet access, ensure your fitness tracker has Wi-Fi.
GPS? For those who run, hike or walk and want to keep track of metrics like distance and pace without their phone, choose a fitness tracker that has built-in GPS.
Screen size: Once you decide you want a fitness tracker with a screen, make sure it fits your personal preferences. A smaller screen may be better if you prefer for it to be less obvious that you’re wearing a fitness tracker on your wrist.
Battery life: How often do you want to be charging your fitness tracker? If frequently charging your devices is a pet peeve, ensure your fitness tracker of choice has a long battery life, especially for your preferred workouts.
Water resistance: Individuals who work out by swimming or those who enjoy taking a dip in the pool after exercising will want a fitness tracker that is water-resistant. Confirm your device is rated for the depth you plan to swim at.
Subscription cost: It’s common for fitness trackers to come with the added cost of a subscription, particularly if you want to access all available features or require extra features for your workout or fitness goals. To guarantee that a fitness tracker is in your budget, check not only the price of the device, but also how much your subscription of choice will run you over the course of a year.
“This study suggests that when you exercise may matter, not just how much you exercise,” says senior study author Prashant Rao, MBBS, a sports cardiologist and physician-scientist at Beth Israel Deaconess Medical Center and Harvard Medical School, both in Boston.
The research, which will be presented at the American College of Cardiology’s Annual Scientific Session later this month, relied on minute-level heart rate data from nearly 15,000 adults. Dr. Rao says this allowed his team to capture long-term, real-world exercise data with much more detail and accuracy.
Early Morning Workouts Are Linked to Better Cardiometabolic Health
The study analyzed health records and Fitbit heart rate data collected over a year. Researchers identified periods when participants had an elevated heart rate for 15 minutes or more to track physical activity. Then they grouped participants into categories based on the time of day exercise occurred.
Researchers compared these timing groups with health data including rates of high blood pressure, obesity, high cholesterol, atrial fibrillation, coronary artery disease, and other cardiovascular health problems. They adjusted the findings to account for differences in age, sex, income level, total activity level, sleep, alcohol use, and smoking status.
The results showed that compared with adults who exercised later in the day, those who worked out in the morning were:
These risk reductions were independent of how much exercise people actually got. Adults who exercised between 7 and 8 a.m. had the lowest odds of coronary artery disease.
Aubrey Grant, MD, a sports cardiologist at MedStar Health in Washington, D.C., who wasn’t involved with the research, says the results suggest that “timing may be a previously underappreciated lever in cardiometabolic risk reduction.”
He adds that wearable technology is giving scientists more granular exercise data, which “opens a more nuanced conversation about how physical activity interacts with the body’s daily rhythms.”
Exercise Timing Is a ‘New Frontier’
A main limitation of the research is that it’s an observational study, “so we can’t establish causality,” Rao says. Because participants weren’t randomized to exercise at different times, the results only show a link, not that earlier exercise directly leads to the observed health benefits.
“While we did our best to adjust for confounders [factors that could muddy the results], timing may still reflect differences in work schedules, socioeconomic factors, or lifestyle patterns that aren’t potentially fully captured in our analyses,” he says.
The link between exercise timing and health is a “new frontier in exercise science,” says Dr. Grant. For decades, research has focused on “how much and how hard” people worked out — variables that still matter, he says.
Why Exercise Timing May Lower Cardiometabolic Risk
“The honest answer is that we do not fully know yet” why this link is appearing, Grant says.
“Morning exercise may align better with circadian physiology,” or how bodily functions naturally correspond to the time of day, he says. “Cortisol peaks early in the day and can prime the body for physical exertion, potentially enhancing metabolic efficiency,” Grant adds.
Exercise is also a natural stimulant. When you work out early, it revs up your bodily systems and energizes you for the day, says Andrew Freeman, MD, director of cardiovascular prevention and wellness at National Jewish Health in Denver. Dr. Freeman was not involved with the new study.
People who work out earlier may also have healthier lifestyle habits, overall, says Alex Rothstein, EdD, an assistant professor of exercise science at the New York Institute of Technology in Old Westbury.
“If you work out earlier in the day, you tend to have fewer excuses to not work out,” and you may exercise more consistently, says Dr. Rothstein, who was not involved with the new research.
Should You Start Exercising in the Morning?
Freeman recommends getting 30 minutes a day of “breathless physical activity,” including a combination of cardio and strength training. But if you prefer to work out in the afternoons or have responsibilities preventing you from exercising in the morning, don’t worry.
“It does not mean people should feel guilty about evening workouts,” Grant says. “It means that when we counsel patients on optimizing their health, exercise timing is now a legitimate part of that conversation, alongside sleep, nutrition, and stress management.”
If you have flexibility, though, Rothstein suggests exercising in the morning, as it’s less likely that something will interfere with your workout later on, and it may offer extra heart health benefits.
“The most important message is still: Exercise consistently, regardless of timing,” Rao says. However, “Timing may represent a simple, low-cost way to potentially optimize health.”
Fitness
The HFA Show 2026 Demonstrates the Power of Community With Strong Turnout and Programming – Health & Fitness Association
From the HFA Hall of Fame to Innovation Alley to the launch of new products from more than 60 companies, The HFA Show 2026 delivers a standout week.
The 2026 HFA Hall of Fame inductees pose together (left to right): Cirulli, Eschbach, Landers, Mills, Runyon, and Elaine LaLanne. Missing are Dave Mortensen, who could not attend, and Jack LaLanne, who received the award posthumously. In the second photo, Keith Morrison, a correspondent for Dateline NBC, presents Elaine LaLanne as an inductee.
The HFA Show 2026 recorded 10,300 registrants, 380 exhibitors, 52 sponsors, and 150 speakers for the March 16-18 event in San Diego, according to the Health & Fitness Association (HFA). It was also the launching pad for new products and services from more than 60 companies.
“What an incredible week full of high energy, dynamic networking, insightful learning, and new product discoveries,” said HFA President and CEO Liz Clark. “It was gratifying to support such an extraordinary group of industry leaders and innovators from around the world with this year’s show. Our team has poured more than a year of work into this event, and we’re already energized to make next year’s gathering in Las Vegas on March 10–12, 2027, even more spectacular.”
Clark went on to thank additional groups beyond HFA team members.
“We’d like to thank all our sponsors, exhibitors, speakers, and board members for making this year’s event such a strong and inspiring showcase for the industry,” Clark said. “Your commitment and partnership helped create a world-class experience that truly moved our industry forward.”
The unofficial launch of the event occurred on the evening of March 15, with 240 people gathering for the HFA Hall of Fame Induction Ceremony, sponsored by The Bay Club Company, to honor the organization’s second class of inductees: Gainesville Health & Fitness CEO Joe Cirulli, Exhale and ResetOne Founder Annbeth Eschbach, Fitness Formula Founder Gale Landers, Les Mills Founder and Managing Director Phillip Mills, Purpose Brands Co-founders Dave Mortensen and Chuck Runyon, and fitness icons Jack and Elaine LaLanne. Ticket sales and sponsorships for the HFA Hall of Fame ceremony raised more than $200,000 for the HFA Foundation, a 501(c)3 public charity that works to support health through exercise.
The evening also included a celebration recognizing Elaine LaLanne’s 100th birthday, which was March 19. Keith Morrison, a Dateline NBC correspondent and friend of Elaine, presented Elaine and her husband Jack, who passed away in 2011, for induction. Celebrities such as Billy Crystal, Mark Wahlberg, and Tony Danza sent videos congratulating her on her 100th birthday.
HFA handed out three other awards at the event. The Jim Worthington Advocate of the Year Award went to Chris Craytor, CEO of ACAC Fitness & Wellness Centers, for his service to the fitness industry and HFA. The John Holsinger Global Leader Award was given to LifeFit Group CEO Martin Seibold. Bodytech Colombia Co-founder and Executive Vice President Gigliola Aycardi received the Woman Leader Award in Honor of Julie Main.
This year’s keynoters (left to right): Dhawan, Itzler, and Ohno.
The HFA Show included annual President’s Address by Clark as well as three keynote addresses:
- March 16 – Clark recapped the highlights of the past year for HFA and urged even further engagement by industry leaders as global influence and expectations grow for the industry.
- March 16 – Author and teamwork expert Erica Dhawan shared strategies for building trust, fostering agility, and strengthening collaboration in the age of AI. Her keynote was sponsored by Zenoti.
- March 17 – Author and entrepreneur Jesse Itzler shared lessons about creating opportunity, cultivating resilience, and building a life that achieves big goals without sacrificing what matters most. His keynote was sponsored by Matrix.
- March 18 – Olympic speed-skating champion Apolo Ohno shared lessons on reinvention, adaptability, and performance in a rapidly changing environment in his keynote, sponsored by ROR.
Other highlights of the conference program were:
- The 29th Annual Financial Panel, which was renamed the Rick Caro Financial Panel in honor of Rick Caro, president of Management Vision, who created the panel 28 years ago and had moderated it each year until his death in August 2025. This year’s panel was sponsored by AltaDX.
- The Women’s Leadership Summit and Reception, sponsored by Daxko.
- The Brazilian Forum and the Latin American Forum, both sponsored by ABC Fitness.
- The Canadian Forum, EMEA Forum, and APAC Forum
Highlights of the trade show floor were:
- Innovation Alley (sponsored by Sweatworks) featurinh the following companies: Alchemy Innovations LLC, AI Advertising by Mixo Ads, BELLIX, Bolt Recovery, Buzz Bomb Caffeine Company, DetecFit, Fit – M.O., Fit-X, HipDoc, InSquare, MatFresher, Milton AI, Nervō Labs, ObliQ Fitness, OmniFit, OnSight, Silient, Superset App, and xplate.
- Innovation Alley Pitchfest, which featured many of the Innovation Alley companies offering a three-minute pitch of their product. The winners of the Pitchfest will be announced soon. They will receive a complimentary booth at The HFA Show 2027 and will be recognized in a future issue of Health & Fitness Business.
- The New Product Zone featuring nine companies: Body Energy Technology, Buzz Bomb Caffeine, Core Champion, Echelon Fit, Escape Fitness, Linear Bar, Martoni Bikes, The Abs Company, and WeGym
- The Pickleball Experience
- The Demonstration Stage
- The Recovery Lounge (outside the trade show floor) with products from Am-Finn Sauna Company, CryoBuilt, Silent, WellFit, and WellnessSpace Brands.
“What stood out this year wasn’t just the scale of the event, but the strength of the conversations happening across every part of the show,” Clark said. “From the keynote stage and education sessions to the trade show floor, industry leaders came together to share ideas, explore innovation, and build the relationships that will help shape the future of health and fitness.”
HFA would like to acknowledge Alloy Personal Training Solutions, LLC for authorizing the use of its registered trademark “Stronger Together” as the theme for The HFA Show 2026. The HFA Show 2027 will take place March 10-12, 2027, at Mandalay Bay in Las Vegas.
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