Osteoporosis: The Right Exercise Reverses Bone Mass Loss

It is a condition characterized by decreased density of the bones. They become fragile, and, eventually, can even become sponge-like. In most people, bone mass density decreases after age 35.  Among post-menopausal women, bone mass density decreases more rapidly, but osteoporosis is a condition of both men and women.¹

Fortunately, research shows that weight-bearing exercise can reverse the effects of osteoporosis to a certain degree. Bone mineral content has improved more than 5%, even among postmenopausal women. This correlates with more than a 30% decreased chance of bone fracture.^2-14 The problem is that exercises that are too easy-going will not have the full effect on bone mass density, and exercises that are too high impact can cause harm. This is why pretty much everyone with osteoporosis should have the benefit of a consultation with a qualified exercise physiologist. A qualified exercise physiologist will not only make sure a person is doing the right exercises, but that the intensity of the exercises progresses in a way that will not cause harm but will continue to create stronger bones.

Nutrition stands out as another important component of osteoporosis management. Specifically, correct levels of calcium and vitamin D can modulate the severity of the condition. The tricky part of this equation is that while diet modifications can help with vitamin D, 80% to 90% of our vitamin D comes from exposure to sunlight – not dietary intake! Without vitamin D, the calcium doesn’t work.  As we age, our ability to metabolize vitamin D from sunlight exposure lessens, and our vulnerability to the negatives of sunlight exposure increases.¹⁵ This is why an attentive and thorough consultation with a suitably trained professional plus some reasonable follow-up is important for ensuring the optimal management of osteoporosis. 

Preventing Osteoporosis

If you don’t already have osteoporosis, here’s what prevents it.¹⁶

• Do not drink alcohol to excess.
• Do not smoke, or smoke less.  One pack of cigarettes per day leads to a 5% to 10% loss of bone mass.
• Exercise regularly.
• Get the correct amount of sun for vitamin D.
• Consume the correct amount of calcium and vitamin D.

References

1. Torgerson D, Bell-Syer S. Hormone replacement therapy and prevention of nonvertebral fractures: a meta-analysis of randomized trials. JAMA. 2001;285(22):2891-7.
2. Pedersen B, Saltin B. Evidence for prescribing exercise as therapy in chronic disease. Scand J Med Sci Sports. 2006: 16 ( Suppl. 1): 3-63.
3. Melendez-Ortega A. Osteoporosis, falls, and exercise. Eur Rev Aging Phys Act. 2007: 4: 61-70.
4. Bonaituti D, Shea B, Lovine R, et al. Exercise for preventing and treating osteoporosis in postmenopausal women. Cochrane Database Syst Rev. 2002; CD000333.
5. Kelley GA, Kelley KS, Tran ZV. Resistance training and bone mineral density in women: a meta-analysis of controlled trials. Am J Phys Med Rehabil. 2001; 80: 65-77.
6. Wallace B, Cumming R. Systematic review of randomized trials of the effect of exercise on bone mass in pre- and postmenopausal women. Chacif Tissue Int. 2000; 67: 10-18.
7. Ernst E. Exercise for female osteoporosis. A systematic review of randomized clinical trials. Sports Med. 1998;25:359-68
8. Kelley G. Aerobic exercise and lumbar spine bone mineral density in postmenopausal women: a meta-analysis. J Am Geriatr Soc. 1998;46:143-52.
9. Mazzzeo R, Cavanagh P, Evans W, Fiatarone M, Hagberg J, Mcauley E, et al. Exercise and physical activity for older adults: ACSM position stand. Med Sci Sports Exerc. 1998;30(6):992-1008.
10. Villareal D, Binder E, Yarasheski K, et al. Effects of exercise training added to the ongoing hormone replacement therapy on bone mineral density in frail elderly women. J Am Geriatr Soc. 2003; 51 (7): 985-990.
11. Liu-Ambrose T, Khan K, Eng J, et al. Both resistance and agility training increase cortical bone density in 75-to-85-year-old women with low bone mass: A 6-month randomized controlled trial. Journal of Clinical Densitometry. 2004; 7 (4): 390-398.
12. Going S, Timothy L, Houtkooper L, et al. Effects of exercise on bone mineral density in calcium-replete postmenopausal women with and without hormone replacement therapy. Osteoporosis Int. 2003; 14: 637-643.