Osteogenic dynamic loads delivered to the skeleton during exercise prevent aging-associated bone fragility. Moreover, because of its pleiotropic favourable effects on health, exercise improves quality of life, and specific types of exercise increase muscle strength, a known predictor of bone strength, and coordination and balance, and so reduce the risk of fallrelated fractures. Exercise should definitely be the mainstay of the prevention and treatment of osteoporosis; often however, physicians don't have enough know-how for evidencebased prescription of exercise. Moreover, the lack of facilities for safe implementation of the exercise programs compound the problem. Scientific societies and health authorities should invest in patient and physicians education about exercise and in promoting facilities (Gyms) devoted to training of persons with, or at risk of, metabolic diseases (osteoporosis, obesity, diabetes), like Metagym in Florence, Italy.