Mediterranean Diet and Progressive Resistance Training Effects on BMD and Bone Turnover in the Elderly

Inclusion Criteria: * Adults aged 65 years and older * Ability to provide written informed consent * Willingness to comply with study procedures and interventions * Capability to participate in a supervised exercise program Exclusion Criteria: * Presence of metabolic bone diseases (e.g., osteoporosis requiring pharmacological treatment, Paget's disease, osteomalacia) * Use of medications affecting bone metabolism, including systemic corticosteroids, bisphosphonates, hormone replacement therapy, selective estrogen receptor modulators, calcitonin, or parathyroid hormone analogs * Uncontrolled cardiometabolic or respiratory conditions (e.g., uncontrolled hypertension, unstable angina, recent cardiovascular events within 6 months, severe chronic obstructive pulmonary disease, or poorly controlled diabetes) * Severe musculoskeletal disorders or advanced osteoarthritis limiting safe exercise participation * Neurological or psychiatric conditions affecting mobility or adherence * Cognitive impairment (Mini-Mental State Examination score \<24) * Recent fractures or major orthopedic surgery within the past 12 months * Underweight (BMI \<18.5 kg/m²) or severe frailty * Severe renal or hepatic dysfunction (e.g., chronic kidney disease stage 4-5 or liver failure) * Active malignancy or ongoing chemotherapy/radiotherapy * Participation in another clinical trial within the previous 3 months