Among middle-aged and older men with poor metabolic and immune health, a 13-week lifestyle change is linked to a larger improvement in bone density in the lower spine than in men who start with better metabolic health.

In healthy men aged middle-aged and older, improvements in a combined measure of immune and metabolic health are linked to increases in bone density in the lower spine after 13 weeks of lifestyle changes.

In middle-aged and older women, a 13-week program of diet and exercise that reduces body weight and fat mass does not change bone density in the spine or whole body, even though men experience similar weight and fat loss, suggesting that bone responses to these lifestyle changes differ between sexes.

In middle-aged and older men, losing body fat and weight during a 13-week lifestyle program is linked to small increases in bone density in the lower spine.

In healthy men aged middle-aged and older, a combination of moderate calorie reduction and increased physical activity over 13 weeks is linked to small increases in bone density in the spine and whole body, even though some muscle mass is lost and body fat decreases.