Step Training for Agility, Balance, & Bone Strength with Joan Pagano and Margie Bissinger

You may be exercising, watching your nutrition, and taking steps to protect your bones, but are you paying attention to the things that can make your efforts more effective? On this World Osteoporosis Day episode, I'm joined by my husband, Dr. Craig Bissinger, to share the often-overlooked pieces of a comprehensive bone-health plan. We discuss bone turnover testing, why comparing DEXA results matters, and exercise components beyond lifting weights. We also explore nutrition, calcium, magnesium, vitamin K2, protein, and the connection between stress, happiness, and bones. The best part? You don't have to change everything at once. Small, consistent steps can help you build healthier habits and support your overall well-being. Tune in to discover what might be missing from your osteoporosis plan and choose one simple step to start with today!

Fear and confusion have surrounded hormone therapy for decades, especially since the Women's Health Initiative. But what really happened, what did the research show, and how did those findings shape the way women think about hormones today? In this episode, I'm joined by Dr. Felice Gersh, a double board-certified OB-GYN and integrative medicine physician, to discuss the history, the research, and the ongoing debate around hormone therapy and bone health. We talk about why estrogen matters for bones, Dr. Gersh's take on what was misunderstood in the Women's Health Initiative, and why she believes progesterone deserves more attention in the bone-health conversation. We also discuss what women in their 50s and 60s should know, why individualized decision-making matters, and why more research is still needed.

You want to exercise for stronger bones, but with so much conflicting advice, how do you know what really works? Lift heavy, wear a weighted vest, jump, use vibration platforms, try special bone-building devices...how do you know which advice is supported by research? In this episode, I'm joined by Dr. Lora Giangregorio, a bone health and exercise science researcher, to separate the science from the hype. She is a professor and a Tier 1 Canada Research Chair in Bone Health and Exercise Science at the University of Waterloo. She also leads the Bone Health and Exercise Science Lab and serves on the Scientific Advisory Council for Osteoporosis Canada. We talk about the exercises that have the strongest evidence for preventing falls and fractures. We also tackle balance training, progressive resistance, weighted vests, yoga, vibration platforms, and other popular exercise approaches, and why "lift heavy" isn't the right message for everyone. Most importantly, you'll learn how to start where you are, progress safely, and become a smarter consumer of bone-health information.

When we talk about osteoporosis, we often think about women, but men can develop osteoporosis too. And because it's frequently overlooked, many men don't discover they have a bone-health problem until after a fracture. In this episode, I'm joined by Dr. Tom Forfa, a medical doctor who was diagnosed with osteoporosis at just 37 after experiencing 13 fractures in 10 years. His experience led him to investigate the underlying factors affecting his bone health and ultimately turn things around. We talk about why osteoporosis can be missed in men, potential risk factors including low testosterone, certain medications, malabsorption, alcohol, and lifestyle factors. We also discuss exercise, nutrition, bone density testing, bone turnover markers, physical therapy, and how men can be more proactive about their bone health. I hope this conversation helps you and the men in your life see osteoporosis differently. Don't panic, but don't ignore it. Ask why it happened, get informed, and take action.

Did you know that Pilates could help you build strength, improve balance, and move with more confidence without compromising your bones? In this episode, I'm joined by physical therapist and Pilates expert Dr. Lisa Grimmer to explore how we can safely combine Pilates with strength training for osteoporosis. We talk about why traditional Pilates exercises may need modifications, why avoiding spinal flexion matters, and how strength training can provide the additional stimulus our bones need over time. Dr. Lisa also shares how to approach progression, balance, active warm-ups, and multidirectional movement. She demonstrates several Pilates-inspired exercises you can do at home, including standing options for those who don't comfortably get down on the floor. I hope that this conversation helps you feel more informed, confident, and empowered to keep moving and building strength safely.