What is coronary artery disease? 

Coronary artery disease (CAD) results from the build-up of fatty deposits in the arteries of the heart, obstructing oxygen-rich blood flow to the heart muscle. This can result in symptoms including:

• shortness of breath
• chest pain
• heart attack (in severe cases)

(National Heart, Lung, and Blood Institute, 2024).

Prevalence in Australia

CAD is the leading cause of death and burden of disease in Australia. More than 2% of Australians report they are living with CAD, accounting for over 590,000 people. CAD claims more lives than any other long-term health condition and is responsible for around one in ten of all deaths (National Heart Foundation, 2026).

Risk factors

Both modifiable and non-modifiable risk factors can contribute to a person’s risk of developing CAD. Modifiable risk factors are generally lifestyle-related, and can include:

• high blood pressure
• high cholesterol
• diabetes
• obesity
• smoking
• poor diet
• sedentary lifestyle.

Non-modifiable risk factors include: 

• increasing age
• being of male gender
• ethnicity 
• family history 

(National Heart, Lung and Blood Institute, 2024).

Prevention and Management

Fortunately, CAD can be both prevented and managed through a range of lifestyle modifications. These include:

• quitting smoking
• limiting alcohol consumption
• eating heart-healthy foods (i.e. avoiding unhealthy fats, salt and added sugar)
• maintaining a healthy weight
• managing diabetes and blood pressure
• increasing physical activity levels.

How does Exercise Affect Coronary Artery Disease?

Exercise can be just as effective as many drug interventions in managing and/or preventing CAD, without the risk of side effects. Regular moderate intensity exercise helps to reduce plaque build-up in the arteries, decrease blood clotting risk, promote blood flow to the heart and aid in maintaining optimal function of the heart muscle. Additional benefits of regular exercise for those living with CAD include improved functionality and psychological wellbeing, along with favourable changes in blood pressure, cholesterol and insulin sensitivity, leading to reduced overall cardiac risk (Exercise is Medicine, n.d.).

Exercise Guidelines and how an Exercise Physiologist can help

A combination of both aerobic and resistance exercise is recommended for people living with CAD (Exercise is Medicine, n.d.).

Aerobic exercise improves the body’s ability to use oxygen as an energy source, thereby improving cardiorespiratory endurance. The guidelines recommend 30-60 minutes of moderate-intensity aerobic exercise per day (e.g. brisk walking), on 3-5 days per week. The intensity of this exercise is also important in achieving the most optimal outcomes, and an Exercise Physiologist can:

• prescribe a safe and appropriate intensity for you and your exercise capacity
• monitor your progress
• periodically update your program
• keep you accountable to goals you set

Full-body resistance exercise is important for those living with CAD, as it improves physical strength and functionality, which is essential for maintaining independence in daily tasks. Guidelines recommend performing resistance exercise on 2–3 days per week. An Exercise Physiologist can help you:

• engage in a variety of full-body strength exercises, individually tailored towards your needs and capabilities
• ensure correct technique, to minimise the chance of injury
• track your progress
• increase your load, as appropriate
• monitor your blood pressure, as required

Next steps

If you are living with CAD or wanting to reduce your cardiac risk, book an initial appointment with one of the Exercise Physiologists at The Body Refinery in New Farm, and start your exercise journey today. We look forward to welcoming you.

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References

Exercise is Medicine. (n.d.). Coronary Heart Disease and Exercise. Retrieved from https://exerciseismedicine.com.au/wp-content/uploads/2019/10/EIM-FactSheet_CoronaryHD_Professionals_FINAL-web.pdf

National Heart Foundation. (2026). Key Statistics: Coronary heart disease. Retrieved from Heart Foundation: https://www.heartfoundation.org.au/your-heart/evidence-and-statistics/coronary-heart-disease-key-stats

National Heart, Lung and Blood Institute . (2024, December 27). Coronary Heart Disease Risk Factors. Retrieved from National Heart, Lung and Blood Institute: https://www.nhlbi.nih.gov/health/coronary-heart-disease/risk-factors

National Heart, Lung, and Blood Institute . (2024). What Is Coronary Heart Disease? Retrieved from National Heart, Lung, and Blood Institute: https://www.nhlbi.nih.gov/health/coronary-heart-disease

Why Resistance Training Matters at Every Age – And Why Supervision Makes All the Difference

Resistance training is one of the most effective ways to support long-term health, strength, and physical resilience. Whether you’re a child building foundational movement skills, an adult managing work and lifestyle demands, or an older adult aiming to stay strong and independent, strength training plays a crucial role at every stage of life.

Building Strength Across the Lifespan

Regardless of age, resistance training provides benefits that reach far beyond muscle strength:

• Children and Teens: Strength training helps improve coordination, motor control, posture, and confidence. It also supports safe sports participation by reducing injury risk.
• Adults: In the prime working years, resistance training improves metabolism, supports joint health, enhances performance, and counteracts the effects of a sedentary lifestyle that often accompanies long hours sitting at a desk.
• Older Adults: Strength training is one of the most powerful tools for maintaining independence. It slows age-related muscle loss, supports bone density, improves balance, and reduces falls.

Simply put, strong muscles help to facilitate an active and healthy life, with a reduced chance of injury or joint/bone issues.

Why Working With an Exercise Physiologist Matters

While resistance training is incredibly beneficial, technique matters. Poor movement patterns can lead to unnecessary strain, pain, or injury. Supervision from an Accredited Exercise Physiologist (AEP) ensures that every repetition you perform is safe, effective, and tailored to your body’s needs.

An Exercise Physiologist provides:

• Technique correction to prevent injury and improve movement efficiency
• Evidence-based programming specific to your goals, history, and physical capabilities
• Progressive overload planning so you build strength safely over time
• Coaching and accountability to help you stay consistent and confident

This level of personalised guidance is particularly important for beginners, people with pain or health conditions, and those returning to exercise after injury.

How Much Strength Training Do We Need? (Australian Guidelines)

According to the Australian Physical Activity and Exercise Guidelines, people of all ages should complete muscle-strengthening activities at least two days per week. For older adults, the guidelines highlight the importance of strength, balance, and functional movement to maintain independence and reduce falls. Working with an Exercise Physiologist is one of the most effective ways to meet these recommendations safely and consistently.

Get Strong, Confident, and Supported

If you’re ready to improve your strength, boost your fitness, or build long-term resilience, our Strength & Conditioning programs offer a safe and structured path to success.

Book an initial appointment with one of the Exercise Physiologists at The Body Refinery in New Farm and start your strength journey with confidence.

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References

1. Australian Government Department of Health. Australian Physical Activity and Exercise Guidelines for All Ages>
2. Fragala, M. et al. (2019). Resistance Training for Health Across the Lifespan. Sports Medicine, 49(11), 1781–1800.

Bone health is something many people don’t think about until later in life, yet our bones are living structures that respond to how we move, fuel, and care for our bodies. After our mid-30s, bone density naturally begins to decline, and for women, the onset of menopause can accelerate these changes significantly. The good news is that bone loss is not inevitable – with the right exercise, nutrition, and lifestyle strategies, it is possible to maintain strong, healthy bones at any age.

At The Body Refinery, we are passionate about empowering people to take an active role in their musculoskeletal health. Whether you want to prevent bone loss, improve your strength, or manage osteoporosis safely, understanding the factors that influence bone health is the first step.

What Happens to Our Bones as We Age?

Bone is a dynamic tissue. Throughout life, old bone is continuously broken down and replaced with new bone – a process known as bone remodelling. We reach peak bone mass in our late 20s to early 30s, after which the balance gradually shifts toward more bone being lost than built.

For women, hormonal changes during menopause play a major role. Oestrogen is protective of bone tissue, and its decline can lead to a rapid drop in bone density over the first five to ten years following menopause. This increases the risk of conditions such as osteopenia and osteoporosis, as well as fractures.

However, ageing is not the only factor that influences bone strength. Nutrition, physical activity, genetics, medications, and overall health all contribute to the quality and resilience of your bones.

Key Factors That Influence Bone Health

1. Physical Activity

Weight-bearing exercise and resistance training create the mechanical stress that bones need to stay strong. Activities that challenge muscles – such as Pilates, gym-based strength training, and functional movement – stimulate bone formation and improve balance, posture, and coordination, reducing the risk of falls.

2. Nutrition

Calcium and vitamin D are essential for bone health. Protein intake also plays an important role in maintaining bone and muscle mass. A well-balanced diet that includes dairy or fortified alternatives, leafy greens, nuts, seeds, and adequate sun exposure (or supplementation when needed) supports bone strength.

3. Hormonal Changes

Menopause significantly impacts bone density due to declining oestrogen levels. Individuals who experience early menopause or prolonged amenorrhoea may be at greater risk and benefit from early assessment and intervention.

4. Lifestyle Factors

Smoking, excessive alcohol, chronic stress, and low physical activity levels can negatively affect bone health. Building positive lifestyle habits helps protect bone quality throughout life.

 

How Exercise Supports Strong, Healthy Bones

Research consistently shows that exercise is one of the most effective ways to maintain or improve bone density. The most beneficial types include:

Weight-Bearing Exercise

Activities that require your body to work against gravity — such as walking, stair climbing, low-level impact training, or dynamic functional movement — encourage healthy bone turnover.

Resistance Training

Progressive strength training helps stimulate bone formation by increasing muscle pull on the bone. Heavier, supervised resistance work has been shown to improve bone density in the spine and hips, two common fracture sites.

Balance and Strength for Fall Prevention

Improving strength, stability, and coordination is essential in reducing the risk of falls, which are the leading cause of fractures in older adults.

Pilates, especially when performed with specialised equipment such as the reformer or trapeze table, provides resistance-based loading and can be adapted to safely support those with low bone density.

How The Body Refinery Can Help

The Body Refinery offers a multidisciplinary approach to bone health. Our team of physiotherapists and exercise physiologists work together to develop personalised programs based on your bone density, medical history, strength, mobility, and goals.

For those with osteopenia or osteoporosis, our ONERO® classes provide a safe, structured environment to build strength, improve posture, increase load tolerance, and support long-term bone health.

Equipment-based Pilates can also be integrated into your program to improve core stability, alignment, and movement quality – all essential for protecting the spine and preventing falls.

Whether you are navigating menopause, recovering from injury, or simply wanting to future-proof your bones, we can help you move with confidence.

 

When Should You Seek Support?

You may benefit from an assessment if you:

• are approaching or experiencing menopause
• have a family history of osteoporosis
• have been diagnosed with osteopenia or osteoporosis
• have experienced a previous fracture
• feel unsteady or concerned about falling<
• want guidance on safe, effective exercise for bone strength

A physiotherapist or exercise physiologist can help interpret bone density results (DEXA scans), identify risk factors, and design a program tailored to your needs.

Key Message

Your bones are continually adapting to the way you live, move, and care for your body. While ageing and hormonal changes are unavoidable, the choices you make today can have a profound impact on your long-term bone health. With the right support, exercise, and lifestyle foundations, you can stay strong, mobile, and resilient throughout life.

If you would like to improve your bone health or find out whether ONERO® classes are right for you, our team at The Body Refinery is here to support you.

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References

1. Cosman, F., et al. (2014). Clinician’s Guide to Prevention and Treatment of Osteoporosis. Osteoporosis International.
2. Giangregorio, L. M., et al. (2014). Too Fit to Fracture: Exercise Recommendations for Individuals With Osteoporosis. Osteoporosis International.
3. Zhao, R., et al. (2017). Resistance Training and Bone Mineral Density in Postmenopausal Women. Sports Medicine.
4. Sherrington, C., et al. (2019). Exercise to Prevent Falls in Older Adults: Systematic Review and Meta-Analysis. British Journal of Sports Medicine.
5. Watts, N. B., et al. (2022). Osteoporosis in Postmenopausal Women: Diagnosis and Monitoring. Journal of Clinical Endocrinology & Metabolism.

Women can experience the menopausal transition differently, though common symptoms include hot flushes, mood changes, headaches, joint pains and irritability, all of which can understandably take a huge toll. It’s therefore important for women to understand what this transition means for their body, and more importantly, what methods and means can help with navigating these changes and minimising associated negative symptoms. You may be surprised to learn that exercise and physical activity may just be the best tool to help with this. So let’s look at the phases of the menopausal transition and the role exercise can play.

Phases of the Menopausal Transition

• Phase 1: Perimenopause

• • • Commences mid to late 40s to early 50s – lasting 5-10 years.
    • Characterised by erratic peaks in estrogen, with a wide variation in menstrual cycle length and flow

• Phase 2: Menopause

• • • The phase from the final menstrual period until 12 months later.
    • Symptoms of estrogen deficiency are more likely, including sleep disturbance, low libido, mood changes, and fatigue.

• Phase 3: Post-Menopause

• • Estrogen and progesterone remain very low.
  • Symptoms of low estrogen can persist, but often resolve within 2-5 years.

Let’s talk about Estrogen

Estrogen receptors are located pretty much everywhere in the human body, including the brain, reproductive tissues, bone, muscle, pancreas, liver, bladder, colon, immune system and adipose tissue. This explains why an overall decrease in this hormone leads to such a wide range of symptoms and changes to many systems within the body.

What does this mean for the body?

• Increased cardiovascular risk factors such as increased blood pressure, cholesterol and blood sugar levels (Elder et al., 2020).

• Body composition changes, including a loss of muscle mass and an increase in body fat accumulation (Juppi et al., 2020) (Greendale et al., 2019).

• Vasomotor symptoms, including hot flushes and night sweats (Woods et al., 2020.

• Cognitive decline, reduced attention, processing speed and working memory (Maiolie et al., 2021).

• Decline in bone mineral density, which increases risk of Osteoporosis and bone fractures (Beck et al., 2016).

Beneficial types of exercise

• High Intensity Interval Training (HIIT)

• Characterised by short, intense bursts of activity followed by brief recovery periods (e.g., 4 minutes of work, then 2 minutes of rest)
• Has been found to reduce blood pressure, blood sugar levels, lipid levels and inflammatory markers, whilst also improving cardiorespiratory fitness (Dupuit et al., 2020).
• Performing strength exercises in a circuit format is an effective way of implementing this!

• Sprint Interval Training (SIT)

• • • Characterised by supramaximal efforts followed by short rests (e.g., 12 sec sprint, 8 sec recovery).
    • Quite a challenging type of exercise, it may take some time to build up to this level of intensity.
    • Has been found to increase muscle mass, improve aerobic fitness and the efficiency of the heart, whilst reducing fat mass and blood vessel stiffness (Boutcher et al., 2019).
    • This type of interval training could be performed on an exercise bike.

• Continuous Aerobic Exercise

• • • This may include a 30-minute walk, five days a week.<
    • Has been found to decrease body fat and waist-hip ratio (Friedenreich et al., 2015).

• Resistance Training

• • • This may include bodyweight exercises such as a squat or plank, or can involve dumbbells or cable machines (e.g. shoulder press or seated row).
    • Has been shown to improve full-body strength, bone mineral density, muscle mass and overall quality of life (Nunes et al., 2023).
    • Load matters – consult your exercise physiologist to help you start at an appropriate weight for you.
    • Frequency also matters – aim for at least 3 sets, two days a week.

• Impact Exercise

• • May include hopping, step-ups, stomping, jumping, dancing or jogging.
  • Essential to increase and/or maintain bone strength (Beck et al., 2016).
  • Varying the direction of these movements is also recommended.

Our Exercise Physiologists (EPs) at The Body Refinery are here to support you during this transition and empower you to better navigate your menopause journey.

• You can access 1:1 sessions with one of our EPs to tailor an exercise program to suit you.
• Our EPs offer Better Bones classes which incorporate a combination of full-body strength, cardiovascular, impact and balance exercises. Join a group of like-minded individuals, improve your quality of life through exercise, and have fun whilst doing it!
• : ask your GP if you are eligible for a referral to see an EP on a GP Chronic Condition Menopause Plan (GPCCMP), which allows you to claim a Medicare rebate on up to 5 GPCCMP sessions. EP sessions can also be claimed through many private health insurance policies, depending on your level of cover.

Join our community at The Body Refinery, in New Farm. We look forward to welcoming you.

 

Written by Exercise Physiologist, Abbey Munro

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References

Boutcher YN, Boutcher SH, Yoo HY, Meerkin JD. The Effect of Sprint Interval Training on Body Composition of Postmenopausal Women. Med Sci Sports Exerc. 2019 Jul; 51(7): 1413-1419. doi:10.1249/MSS.0000000000001919. PMID: 31210647. 

Dupuit M, Maillard F, Pereira B, Maarquezi ML, Lancha AH Jr, Boisseau N. Effect of high intensity interval training on body composition in women before and after menopause: a meta-analysis. Exp Physiol. 2020 Sep; 105(9): 1470-1490. doi:10.1113/EP088654. Epub 2020 Jul 21. PMID: 32613697.

Elder P, Sharma G, Gulati M, Michos ED. Identification of female-specific risk enhancers throughout the lifespan of women to improve cardiovascular disease prevention. Am J Prev Cardiol. 2020;2:100028. doi:10.1016/j.ajpc.2020.100028

Greendale, G. A., Sternfeld, B., Huang, M. H., Han, W., Karvonen-Gutierrez, C., Rupper, K., Cauley, J. A., Finkelstein, J. S., Jian, S.-F., & Karlamangla, A. S. (2019). Changes in body composition and weight during the menopause transition. JCI insight, 4(5), e124865. https://doi.org/10.1172/jci.insight.124865 

Juppi, H.-K.; Sipila, S., Cronin, N.J., Karvinen, S., Karppinen, J.E., Tammelin, T.H., Auee, P., Kovanen, V., Kujala, U.M., Laakkonen, E.K. Role of Menopausal Transition and Physical Activity in Loss of Lean Muscle Mass: A Follow-Up Study in Middle-Aged Finnish Women. J. Clin. Med. 2020, 9, 1588. https://doi.org/10.3390/jcm9051588 

Woods R, Hess R, Biddington C, Federico M. Association of lean body mass to menopausal symptoms: The Study of Women’s Health Across the Nation. Women’s Midlife Health. 2020 Sep 15, 6:10. doi:10.1186/s40695-020-00058-9. PMID: 32944260; PMCID: PMC7490966. 

Maioli S, Leander K, Nilsson P, Nalvarte I. Estrogen receptors and the ageing brain. Essays Biochem. 2021 Dec 17; 65(6): 913-925. doi:10.1042/EBC20200162. PMID: 34623401; PMCID: PMC8628183.