Osteoporosis International

, Volume 14, Issue 8, pp 637–643 | Cite as

Effects of exercise on bone mineral density in calcium-replete postmenopausal women with and without hormone replacement therapy

  • Scott Going
  • Timothy Lohman
  • Linda Houtkooper
  • Lauve Metcalfe
  • Hilary Flint-Wagner
  • Robert Blew
  • Vanessa Stanford
  • Ellen Cussler
  • Jane Martin
  • Pedro Teixeira
  • Margaret Harris
  • Laura Milliken
  • Arturo Figueroa-Galvez
  • Judith Weber
Original Article

Abstract

Osteoporosis is a major public health concern. The combination of exercise, hormone replacement therapy, and calcium supplementation may have added benefits for improving bone mineral density compared to a single intervention. To test this notion, 320 healthy, non-smoking postmenopausal women, who did or did not use hormone replacement therapy (HRT), were randomized within groups to exercise or no exercise and followed for 12 months. All women received 800 mg calcium citrate supplements daily. Women who exercised performed supervised aerobic, weight-bearing and weight-lifting exercise, three times per week in community-based exercise facilities. Regional bone mineral density (BMD) was assessed by dual energy X-ray absorptiometry. Women who used HRT, calcium, and exercised increased femoral neck, trochanteric and lumbar spine bone mineral density by approximately 1–2%. Trochanteric BMD was also significantly increased by ~1.0% in women who exercised and used calcium without HRT compared to a negligible change in women who used HRT and did not exercise. The results demonstrate that regional BMD can be improved with aerobic, weight-bearing activity combined with weight lifting at clinically relevant sites in postmenopausal women. The response was significant at more sites in women who used HRT, suggesting a greater benefit with hormone replacement and exercise compared to HRT alone.

Keywords

Bone mineral density Exercise Hormone replacement Osteoporosis Postmenopausal Women 

References

  1. 1.
    Consensus Development Statement (1997) Who are candidates for prevention and treatment for osteoporosis? Osteoporos Int 7:1–6Google Scholar
  2. 2.
    Obrant KJ, Bengner U, Johnell O, Nilsson BE, Sernbo I (1989) Increasing age-adjusted risk fragility fractures: a sign of increasing osteoporosis in successive generations? Calcif Tissue Int 44:157–167Google Scholar
  3. 3.
    Ray NF, Chan JK, Thamer M, Melton LJ (1997) Medical expenditures for the treatment of osteoporotic fractures in the United States in 1995: report from the National Osteoporosis Foundation. J Bone Miner Res 12:24–35PubMedGoogle Scholar
  4. 4.
    Adachi JD (1996) Current treatment options for osteoporosis. J Rheumatol 23:11–14Google Scholar
  5. 5.
    Drinkwater BL, Bruemmer B, Chestnut CH III (1990) Menstrual history as a determinant of current bone density in young athletes. JAMA 263:545–548CrossRefPubMedGoogle Scholar
  6. 6.
    Yeh JK, Aloia JF, Barilla M-L (1994) Effects of 17β-estradiol replacement and treadmill exercise on vertebral and femoral bones of the ovariectomized rat. Bone Miner 24:223–234PubMedGoogle Scholar
  7. 7.
    Heikkinen J, Kurttila-Matero E, Kyllonen E, Vuori J, Takala T, Vaananen H (1991) Moderate exercise does not enhance the positive effect of estrogen on bone mineral density in postmenopausal women. Calcif Tissue Int 49:S83–S84PubMedGoogle Scholar
  8. 8.
    Kohrt W, Snead D, Slatopolsky E, Birge S (1995) Additive effects of weight-bearing exercise and estrogen on bone mineral density in older women. J Bone Miner Res 10:1303–1311PubMedGoogle Scholar
  9. 9.
    Notelovitz M, Martin D, Tesar R et al. (1991) Estrogen therapy and variable-resistance weight training increase bone mineral in surgically menopausal women. J Bone Miner Res 6:583–590PubMedGoogle Scholar
  10. 10.
    Nilsson J, Thorstensson A (1989) Ground reaction forces at different speeds of human walking and running. Acta Physiol Scand 136:217–227PubMedGoogle Scholar
  11. 11.
    Bergmann G, Graichen F, Rohlmann A (1993) Hip joint loading during walking and running, measured in two patients. J Biomech 26:969–990PubMedGoogle Scholar
  12. 12.
    SPSS Incorporated (1999) SPSS, Version 10.0.5. SPSS Incorporated, ChicagoGoogle Scholar
  13. 13.
    Layne J, Nelson M (1999) The effects of progressive resistance training on bone density: a review. Med Sci Sports Exerc 31:25–30PubMedGoogle Scholar
  14. 14.
    Nelson M, Fiatarone M, Morganti C, Trice I, Greenberg R, Evans W (1994) Effects of high-intensity strength training on multiple risk factors for osteoporotic fractures, a randomized controlled trial. JAMA 272:1909–1914CrossRefPubMedGoogle Scholar
  15. 15.
    Kerr D, Morton A, Dick I, Prince R (1996) Exercise effects on bone mass in postmenopausal women are site-specific and load-dependent. J Bone Miner Res 1996;11:218–25Google Scholar
  16. 16.
    Kelley G (1998) Aerobic exercise and bone density at the hip in postmenopausal women: a meta-analysis. Prev Med 27:798–807CrossRefPubMedGoogle Scholar
  17. 17.
    Bassey E, Ramsdale S (1995) Weight-bearing exercise and ground reaction forces. A 12-month randomized controlled trial of effects on bone mineral density in healthy postmenopausal women. Bone 16:469–476PubMedGoogle Scholar
  18. 18.
    Kelley G (1998) Exercise and regional bone mineral density in postmenopausal women. Am J Phys Med Rehabil 77:76–87CrossRefPubMedGoogle Scholar
  19. 19.
    Wolff I, van Croonenborg J, Kemper H, Kostense P, Twisk J (1999) The effects of exercise training programs on bone mass: a meta-analysis of published controlled trials in pre- and postmenopausal women. Osteoporos Int 9:1–12CrossRefGoogle Scholar
  20. 20.
    Kohrt WM, Birge SJ Jr (1995) Differential effects of estrogen treatment on bone mineral density of the spine, hip, wrist and total body in late postmenopausal women. Osteoporos Int 5:150–155PubMedGoogle Scholar
  21. 21.
    Block JE (1997) Interpreting studies of exercise and osteoporosis: a call for rigor. Controlled Clin Trials 8:54–57CrossRefGoogle Scholar
  22. 22.
    Kohrt WM, Eshani AA, Birge SJ Jr (1997) Effects of exercise involving predominately either joint-reaction or ground-reaction forces on bone mineral density in older women. J Bone Miner Res 12:1253–1261PubMedGoogle Scholar
  23. 23.
    Snow C, Shaw M, Winters K, Witzke K (2000) Long-term exercise using weighted vests prevents hip bone loss in postmenopausal women. J Gerontol Med Sci 55A:M489–M491.Google Scholar

Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2003

Authors and Affiliations

  • Scott Going
    • 1
    • 2
    • 6
  • Timothy Lohman
    • 2
  • Linda Houtkooper
    • 1
  • Lauve Metcalfe
    • 2
  • Hilary Flint-Wagner
    • 1
  • Robert Blew
    • 1
  • Vanessa Stanford
    • 1
  • Ellen Cussler
    • 2
  • Jane Martin
    • 2
  • Pedro Teixeira
    • 1
  • Margaret Harris
    • 1
  • Laura Milliken
    • 3
  • Arturo Figueroa-Galvez
    • 4
  • Judith Weber
    • 5
  1. 1.Department of Nutritional SciencesThe University of ArizonaTucsonUSA
  2. 2.Department of PhysiologyThe University of ArizonaTucsonUSA
  3. 3.Department of Exercise Science and Physical EducationUniversity of Massachusetts at BostonBostonUSA
  4. 4.Department of Exercise ScienceSyracuse UniversitySyracuseUSA
  5. 5.Department of PediatricsArkansas Children's Hospital Research InstituteLittle RockUSA
  6. 6.Department of Nutritional Sciences, 238 Shantz BuildingThe University of ArizonaTucsonUSA

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