Bone health for life: building strong bones, preventing age-related loss, and reversing osteoporosis with evidence-based exercise | Belinda Beck, Ph.D.

**Peter Attia, MD** (0:11)
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My guest this week is Professor Belinda Beck. Belinda is a Professor of Exercise Science in the School of Health Science and Social Work at Griffith University in Queensland, Australia. Her research is primarily related to the effects of mechanical loading on bone. In 2015, she established the Bone Clinic to roll out this groundbreaking program of research, which we discuss in a lot of detail in this podcast. She was the principal investigator of the Liftmor and Liftmor-M clinical trials, which demonstrated exercise as therapy for osteoporosis and low bone mass. Something I've discussed a lot on the podcast. In my conversation with Belinda, we dive into the physiology of bone. It's actually important that you understand how bone works as a tissue. It's easy to think of it as a static tissue, but in fact, it's quite a reactive tissue. We talk about how the foundation is set during childhood and how the remodeling over the course of one's life takes place based on, of course, activity, nutrition, and hormones. We then talk about what can be done to prevent bone loss as we age. Of course, this begins with what we as parents should be doing to help our kids achieve their genetic potential prior to the fusion of their growth plates. Talk about how to improve your bone health even once you're past the point of your genetic potential, i.e. once you've reached your maximum point in your late teens and early 20s, and what we can learn from the Liftmor studies in terms of how exercise can help and even reverse bone loss in people in the throes of osteopenia and osteoporosis. So without further delay, please enjoy my very fascinating discussion with Professor Belinda Beck.
Hey, Belinda, thank you so much for getting up so early in Australia to sit down with me. Would love to be doing this in person, but it's a bit of a hike for you, so this will more than suffice. I've referenced your work many times before in talking with patients and talking on social media, talking on other podcasts. And so I've wanted to speak with you for some time because it's one thing to hear me talk about something, but it's I think far better to hear the expert talk about it, as opposed to me just sort of paraphrasing. But maybe we'll just spend a second giving folks a little bit of your background. I'll have obviously introduced you already. But tell folks a little bit about how you came to find your interest in this. Your PhD and post-doc were both done here in the US, correct?

**Belinda Beck, Ph.D.** (3:38)
Yeah, that's right. And my masters as well, actually. I think we can safely say a lot of people end up in research because of some personal interests, and that's exactly the case for me. I was a runner and a field hockey player, and I constantly suffered from sore shins, and nobody could help me. They couldn't even tell me why I was getting them, much less how to prevent them or make them better. This was back in the day, mind you. And so even when I was in high school, I knew that I wanted to find out what was going on. And that's actually where my research started in my master's. I was looking at to deal with stress injuries. It became clear very, very early that this is a bone injury. This is not what everybody was saying. Two hours posterior, pulling on the border of that was all bunkum. That was somebody making a supposition. And that set me down the path of trying to figure out what are the mechanical signals that stimulate bone to adapt to mechanical loading. Pursuit of Wolf's Law, why does a change in mechanical loading cause the bone to change shape in this amazing way? And of course, as soon as I discovered bone did that, I was hooked because it is just an incredible tissue. I did an animal study for my PhD and quickly realized that that was not something I wanted to do for the rest of my life because it involved killing animals constantly. So I went to Stanford and did a post-doc, and that's where I learnt about clinical trials. Then realized, of course, that osteoporosis is the greatest burden when it comes to bone problems. And so being an exercise head, that's something that I wanted to figure out exactly what was the ideal exercise program to assist people living with osteoporosis.