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The Effects of Exercise on Bone Mineral Density in Men: A Systematic Review and Meta-Analysis of Randomised Controlled Trials

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Abstract

The aim of this systematic review and meta-analysis was to provide an updated analysis, including the use of more robust methods, on the effects of exercise on bone mineral density in men. Randomised Control Trials of > 24 weeks and published in English up to 01/05/20 were retrieved from 3 electronic databases, cross-referencing, and expert review. The primary outcome measures were changes in FN, LS, and lower limb BMD Standardised effect sizes were calculated from each study and pooled using the inverse heterogeneity model. A statistically significant benefit of exercise was observed on FN BMD [g = 0.21 (0.03, 0.40), Z = 2.23 p = 0.03], with no observed statistically significant benefit of exercise on LS BMD [g = 0.10 (− 0.07, 0.26), Z = 1.15 p = 0.25]. This analysis provided additional evidence to recommend ground- and/or joint-reaction force exercises for improving or maintaining FN, but not LS BMD. Additional well-designed RCTs are unlikely to alter this evidence, although interventions that include activities that directly load the lumbar spine are needed to ensure this is not a potential method of improving LS BMD.

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Data Availability

An Open Science Framework project entitled the effects of exercise on bone mineral density in men: a systematic review and meta-analysis of randomised controlled trials with all materials can be found here https://doi.org/10.17605/OSF.IO/E6W3V [42]

Abbreviations

BMD :

Bone mineral density

DPA:

Dual-energy photon absorptiometry

DXA:

Dual-energy X-ray absorptiometry

ES:

Effect size

FN:

Femoral neck

g:

Hedges standardised mean difference effect size

GRADE:

Grading of Recommendations assessment, development and evaluation

IVhet:

Inverse heterogeneity

LFK:

Luis furuya-kanamori

LS:

Lumbar spine

NNS:

Number-needed-to-screen

PRISMA:

Preferred reporting items for systematic reviews and meta-analyses

pQCT:

Peripheral quantified computer tomography

RCT:

Randomised controlled trial

SD:

Standard deviation

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Funding

This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.

Author information

Authors and Affiliations

  1. The Gender Identity Clinic, Tavistock and Portman NHS Foundation Trust, London, UK

    Blair R. Hamilton

  2. School of Sport and Health Sciences, University of Brighton, Brighton, UK

    Blair R. Hamilton & Yannis Pitsiladis

  3. Centre for Stress and Age-Related Disease, University of Brighton, Brighton, UK

    Blair R. Hamilton, Katherine A. Staines, Yannis Pitsiladis & Fergus M. Guppy

  4. School of Applied Sciences, University of Brighton, Huxley Building, Lewes Road, Brighton, BN2 4GJ, UK

    Katherine A. Staines & Fergus M. Guppy

  5. Department of Epidemiology and Biostatistics, School of Public Health, West Virginia University, Morgantown, WV, USA

    George A. Kelley & Kristi S. Kelley

  6. Department of Medicine, Education, and Clinical Center, University of Colorado Anschutz Medical Campus, and Eastern Colorado VA Geriatric, ResearchAurora, CO, USA

    Wendy M. Kohrt

  7. Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, Rome, Italy

    Yannis Pitsiladis

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  1. Blair R. Hamilton
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Contributions

Conceptualization, FMG and KS; methodology, BRH, FMG and GK; writing–original draft preparation, BRH and FMG; writing–review and editing, ALL.

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Correspondence to Fergus M. Guppy.

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Hamilton, B.R., Staines, K.A., Kelley, G.A. et al. The Effects of Exercise on Bone Mineral Density in Men: A Systematic Review and Meta-Analysis of Randomised Controlled Trials. Calcif Tissue Int 110, 41–56 (2022). https://doi.org/10.1007/s00223-021-00893-6

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