Abstract
Osteoporosis, a slowly evolving public health epidemic, often with an insidious presentation is largely preventable but the optimal dimensions of exercise that may be prescribed for enhancing bone-health among premenopausal adults are yet to be elucidated. Hence, the escalating incidence and burden of prevalence of osteoporosis is yet unabated. Considering that exogenous hormones in the form of hormonal contraception are known to modulate bone mass, investigations of their possible influence on the translation of exercise-induced osteogenic stimuli on the mature bone is pertinent. The aim of this study was to examine the effect of specified lifestyle exercise on bone-health of premenopausal women. Premenopausal women (n = 96, mean age: 22.25 ± 3.5 years; mean BMI: 23.43 ± 3.5 kg/m2) participated in a 6-month randomised controlled trial involving home-based rest-interspersed bouts of high-impact exercise for the intervention group and sham exercise for the control group. Approximately half (47) of the participants (24-exercise, 23-control) were on hormonal-based contraception while the other half (49: 24-exercise, 25-control) were not on hormonal contraception. The regime led to a significant 3.7 % increase in broadband ultrasound attenuation of exercisers compared to controls; hormonal contraceptive use did not appear to potentiate the osteogenic effects of the lifestyle exercise regime. The research highlights that short, discrete bouts of high-impact exercise may be a potential public health prescription for enhancing premenopausal bone-health regardless of hormonal contraceptive use.
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References
Anderson J, Rondano P (1996) Peak bone mass development of females: can young adult women improve their peak bone mass? J Am Coll Nutr 15:570–574
Theintz G, Buchs B, Rizzoli R, Slosman D, Clavien H, Sizonenko P, Bonjour JPH (1992) Longitudinal monitoring of bone mass accumulation in healthy adolescents: evidence for a marked reduction after 16 years of age at the levels of lumbar spine and femoral neck in female subjects. J Clin Endocrinol Metab 4:1060–1065
Matkovic V, Jelic T, Wardlaw G, Ilich J, Goel P, Wright J, Andon M, Smith K, Heaney R (1994) Timing of peak bone mass in Caucasian females and its implication for the prevention of osteoporosis. Inference from a cross-sectional model. J Clin Invest 93:799–808
Krolner B, Nielsen SP (1982) Bone mineral content of the lumbar spine in normal and osteoporotic women: cross-sectional and longitudinal studies. Clin Sci 62:329–336
Rodin A, Murby B, Smith M, Caleffi M, Fentiman I, Chapman M, Fogelman I (1990) Premenopausal bone loss in the lumbar spine and neck of femur: a study of 225 Caucasian women. Bone 11:1–5
Snow-Harter C, Bouxsein ML, Lewis BT, Carter DR, Marcus R (2009) Effects of resistance and endurance exercise on bone mineral status of young women: a randomized exercise intervention trial. J Bone Miner Res 7:761–769
Lohman T, Going S, Hall M, Ritenbaugh C, Bare L, Hill A, Houtkooper L, Aickin M, Boyden T, Pamenter R (1995) Effects of resistance training on regional and total bone mineral density in premenopausal women: a randomized prospective study. J Bone Miner Res 10:1015–1024
Friedlander AL, Genant HK, Sadowsky S, Byl NN, Glüer CC (1995) A two-year program of aerobics and weight training enhances bone mineral density of young women. J Bone Miner Res 10:574–585
Sinaki M, Wahner H, Bergstralh E, Hodgson S, Offord K, Squires R, Swee R, Kao P (1996) Three-year controlled, randomized trial of the effect of dose-specified loading and strengthening exercises on bone mineral density of spine and femur in nonathletic, physically active women. Bone 19:233–244
Rockwell J, Sorensen A, Baker S, Leahey D, Stock J, Michaels J, Baran D (1990) Weight training decreases vertebral bone density in premenopausal women: a prospective study. J Clin Endocrinol Metab 71:988–993
Dalsky GP (1990) Effect of exercise on bone: permissive influence of estrogen and calcium. Med Sci Sports Exerc 22:281–285
Lanyon L (1996) Using functional loading to influence bone mass and architecture: objectives, mechanisms, and relationship with estrogen of the mechanically adaptive process in bone. Bone 18:S37–S43
Borer KT (2005) Physical activity in the prevention and amelioration of osteoporosis in women: interaction of mechanical, hormonal and dietary factors. Sports Med 35:779–830
Babatunde O, Forsyth J, Gidlow C (2012) A meta-analysis of brief high-impact exercises for enhancing bone health in premenopausal women. Osteoporosis Int 23:109–119
Weaver CM, Teegarden D, Lyle RM, McCabe GP, McCabe LD, Proulx W, Kern M, Sedlock D, Anderson DD, Hillberry B (2001) Impact of exercise on bone health and contraindication of oral contraceptive use in young women. Med Sci Sports Exerc 33:873–880
Faul F, Erdfelder E, Buchner A, Lang A (2009) Statistical power analyses using G* Power 3.1: tests for correlation and regression analyses. Behav Res Methods 41:1149–1160
Glüer CC, Eastell R, Reid DM, Felsenberg D, Roux C, Barkmann R, Timm W, Blenk T, Armbrecht G, Stewart A (2004) Association of Five Quantitative Ultrasound Devices and Bone Densitometry With Osteoporotic Vertebral Fractures in a Population-Based Sample: the OPUS Study. J Bone Miner Res 19:782–793
Nguyen ND, Eisman JA, Center JR, Nguyen TV (2007) Risk factors for fracture in nonosteoporotic men and women. J Clin Endocrinol Metab 92:955–962
Bailey CA, Brooke-Wavell K (2010) Optimum frequency of exercise for bone health: randomised controlled trial of a high-impact unilateral intervention. Bone 46:1043–1049
Vainionpää A, Korpelainen R, Leppäluoto J, Jämsä T (2005) Effects of high-impact exercise on bone mineral density: a randomized controlled trial in premenopausal women. Osteoporosis Int 16:191–197
Baranowski T, Perry CL, Parcel GS (2002) How individuals, environments, and health behavior interact. In: Glanz K Rimer, BK Lewis, FM (Hg.): Health behavior and health education: theory, research, and practice (3rd edn.).San Francisco, Jossey-Bass, pp 165–184
Dishman RK, Motl RW, Saunders R, Felton G, Ward DS, Dowda M, Pate RR (2004) Self-efficacy partially mediates the effect of a school-based physical-activity intervention among adolescent girls. Prev Med 38:628–636
Hertzler AA, Frary RB (1994) A dietary calcium rapid assessment method (RAM). Top Clin Nutr 9:76–85
Sedlak CA, Doheny MO, Jones SL (1998) Osteoporosis prevention in young women. Orthop Nurs 21:53–60
Nicholson P, Alkalay R (2007) Quantitative ultrasound predicts bone mineral density and failure load in human lumbar vertebrae. Clin Biomech 22:623–629
Babatunde O, Forsyth J (2012) Quantitative Ultrasound and bone’s response to exercise: a meta-analysis. Bone 53:311–318
Cheng S, Njeh C, Fan B, Cheng X, Hans D, Wang L, Fuerst T, Genant H (2002) Influence of region of interest and bone size on calcaneal BMD: implications for the accuracy of quantitative ultrasound assessments at the calcaneus. Br J Radiol 889:59–68
Kohrt WM (2001) Aging and the osteogenic response to mechanical loading. Int J Sport Nutr Exerc Metab 11:S137–S142
Hartard M, Bottermann P, Bartenstein P, Jeschke D, Schwaiger M (1997) Effects on bone mineral density of low-dosed oral contraceptives compared to and combined with physical activity. Contraception 55:87–90
Zaman G, Cheng MZ, Jessop H, White R, Lanyon LE (2000) Mechanical strain activates estrogen response elements in bone cells. Bone 27:233–239
Ehrlich P, Noble B, Jessop H, Stevens H, Mosley J, Lanyon L (2002) The effect of in vivo mechanical loading on estrogen receptor α expression in rat ulnar osteocytes. J Bone Miner Res 17:1646–1655
Burr D, Yoshikawa T, Teegarden D, Lyle R, McCabe G, McCabe L, Weaver C (2000) Exercise and oral contraceptive use suppress the normal age-related increase in bone mass and strength of the femoral neck in women 18–31 years of age. Bone 27:855–863
Srinivasan S, Weimer DA, Agans SC, Bain SD, Gross TS (2002) Low-Magnitude mechanical loading becomes osteogenic when rest is inserted between each load cycle. J Bone Miner Res 17:1613–1620
Turner CH, Robling AG (2003) Designing exercise regimens to increase bone strength. Exerc Sport Sci Rev 31:45–50
Bassey E, Ramsdale S (1994) Increase in femoral bone density in young women following high-impact exercise. Osteoporosis Int 4:72–75
Bassey E, Rothwell M, Littlewood J, Pye D (1998) Pre- and postmenopausal women have different bone mineral density responses to the same high-impact exercise. J Bone Miner Res 13:1805–1813
Kato T, Terashima T, Yamashita T, Hatanaka Y, Honda A, Umemura Y (2006) Effect of low-repetition jump training on bone mineral density in young women. J Appl Physiol 100:839–843
Strong JE (2004) Effects of Different Jumping Programs on Hip and Spine Bone Mineral Density in Pre-menopausal Women. Doctoral Dissertation. Department of Physical Education Brigham Young University
Witzke KA (2009) Dose-dependent effects and feasibility of a home-based jumping program for bone health in women. Med Sci Sports Exerc 41:289
Niu K, Ahola R, Guo H, Korpelainen R, Uchimaru J, Vainionpää A, Sato K, Sakai A, Salo S, Kishimoto K (2010) Effect of office-based brief high-impact exercise on bone mineral density in healthy premenopausal women: the Sendai Bone Health Concept Study. J Bone Miner Metab 28:568–577
Heinonen A, Kannus P, Sievänen H, Oja P, Pasanen M, Rinne M, Uusi-Rasi K, Vuori I (1996) Randomised controlled trial of effect of high-impact exercise on selected risk factors for osteoporotic fractures. Lancet 348:1343–1347
Lanyon LE, Rubin C (1984) Static vs dynamic loads as an influence on bone remodeling. J Biomech 17:897–905
Rubin CT, Lanyon LE (1985) Regulation of bone mass by mechanical strain magnitude. Calcif Tissue Int 37:411–417
Umemura Y, Ishiko T, Yamauchi T, Kurono M, Mashiko S (1997) Five jumps per day increase bone mass and breaking force in rats. J Bone Miner Res 12:1480–1485
Sternfeld B, Ainsworth BE, Quesenberry CP (1999) Physical activity patterns in a diverse population of women. Prev Med 28:313–323
Murphy NM, Ni Dhuinn M, Browne PA, ÓRathaille MM (2006) Physical activity for bone health in inactive teenage girls: is a supervised, teacher-led program or self-led program best? J Adolesc Health 39:508–514
Khan K, McKay H, Kannus R, Bailey D, Wark J. Bennell K (2001) Physical activity and bone health. Champaign: Human Kinetics
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Babatunde, O., Forsyth, J. Effects of lifestyle exercise on premenopausal bone health: a randomised controlled trial. J Bone Miner Metab 32, 563–572 (2014). https://doi.org/10.1007/s00774-013-0527-9
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DOI: https://doi.org/10.1007/s00774-013-0527-9