For women, risk for bone fractures increases significantly after menopause—even more so if they also have type 2 diabetes. One good way to protect against that risk is weight-bearing exercise, such as walking. Now a new study has found that walking a certain way may make walking even better at fracture-proofing bones.

Researchers at University of Michigan looked at the effect of weight-bearing exercise on bone in postmenopausal women with diabetes. For the exercise, the researchers chose two forms of walking—uphill, which involves working against gravity…and downhill, which involves adding downhill physical force to gravity. And because metabolism also affects bone formation relative to bone resorption (breakdown), they looked at whether eating a meal before or after walking made any difference in markers for bone growth.

Fifteen postmenopausal women with type 2 diabetes were randomly assigned to two of five different tests—walking uphill before eating a meal…walking downhill before eating a meal…walking uphill one hour after eating a meal…walking downhill one hour after eating a meal…no exercise (the control group).

The women who exercised walked twice a day for 40 minutes on treadmills that were set at a six-degree uphill or downhill slope. They wore shoe inserts that measured the amount of pressure being exerted on their feet and had their blood tested periodically to measure levels of two markers involved in bone growth—a marker for bone formation and one for bone resorption. Glucose and insulin levels were also measured. And either before or after exercising, the women ate a meal that contained sufficient calories to maintain weight. (Egg salad with a roll, salad, a piece of fruit, milk, orange juice and four graham cracker squares for the midmorning meal…or a bacon-ham-cheese sandwich, a cup of vegetables, salad, a piece of fruit, fruit juice and ice cream with a cookie for the late-afternoon meal.)


  • Walking before eating either meal, both uphill and downhill, had no effect on either marker involved in bone metabolism.
  • Walking after eating positively affected both markers for bone metabolism to varying degrees, depending on after which meal and whether walking uphill or downhill.
  • The greatest and most effective increase in bone growth changes was shown when walking downhill after the morning meal.

Bonus: Walking downhill after eating also lowered insulin resistance—47% lower during downhill exercise than during uphill exercise…and 62% lower than during the sedentary trial.

The women in this study had diabetes. However, the researchers have also done another study using healthy postmenopausal women and had similar results. They didn’t test walking or running outdoors down actual hills but believe that would be just as effective. No hills near you? Stairs work just as well. In fact, walking down stairs or outdoors may be your best way to get some downhill trekking, since most treadmills can only be set to incline. (Option: Put blocks under the back of a treadmill to tilt it downward. But make sure to do it in a way that is sturdy and secure—falling off your treadmill will not help your bones!) And don’t forget to have a balanced meal (or at least a snack) that includes carbs, fat and protein before you head out.

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