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Osteoporosis International

, Volume 23, Issue 10, pp 2517–2526 | Cite as

Self-reported recreational exercise combining regularity and impact is necessary to maximize bone mineral density in young adult women

A population-based study of 1,061 women 25 years of age
  • M. Callréus
  • F. McGuigan
  • K. Ringsberg
  • K. ÅkessonEmail author
Original Article

Abstract

Summary

Recreational physical activity in 25-year-old women in Sweden increases bone mineral density (BMD) in the trochanter by 5.5% when combining regularity and impact. Jogging and spinning were especially beneficial for hip BMD (6.4–8.5%). Women who enjoyed physical education in school maintained their higher activity level at age 25.

Introduction

The aims of this study were to evaluate the effects of recreational exercise on BMD and describe how exercise patterns change with time in a normal population of young adult women.

Methods

In a population-based study of 1,061 women, age 25 (±0.2), BMD was measured at total body (TB-BMD), femoral neck (FN-BMD), trochanter (TR-BMD), and spine (LS-BMD). Self-reported physical activity status was assessed by questionnaire. Regularity of exercise was expressed as recreational activity level (RAL) and impact load as peak strain score (PSS). A permutation (COMB-RP) was used to evaluate combined endurance and impacts on bone mass.

Results

More than half of the women reported exercising on a regular basis and the most common activities were running, strength training, aerobics, and spinning. Seventy percent participated in at least one activity during the year. Women with high RAL or PSS had higher BMD in the hip (2.6–3.5%) and spine (1.5–2.1%), with the greatest differences resulting from PSS (p < 0.001–0.02). Combined regularity and impact (high-COMB-RP) conferred the greatest gains in BMD (FN 4.7%, TR 5.5%, LS 3.1%; p < 0.001) despite concomitant lower body weight. Jogging and spinning were particularly beneficial for hip BMD (+6.4–8.5%). Women with high-COMB-RP scores enjoyed physical education in school more and maintained higher activity levels throughout compared to those with low scores.

Conclusion

Self-reported recreational levels of physical activity positively influence BMD in young adult women but to maximize BMD gains, regular, high-impact exercise is required. Enjoyment of exercise contributes to regularity of exercising which has short- and long-term implications for bone health.

Keywords

Bone mineral density Ground reaction force Impact load Physical activity Young females 

Notes

Acknowledgments

This work was supported by grants from the Swedish Research Council (K2009-53X-14691-07-3), FAS (Grant 2007-2125), Grant Greta and Johan Kock Foundation, A Påhlsson Foundation, A Osterlund Foundation, the H Järnhardt Foundation, King Gustav V and Queen Victoria Foundation, Malmö University Hospital Research Foundation, Swedish Centre for Sports Medicine Research, Research and Development Council of Region Skåne, Sweden, and the Swedish Medical Society.

Conflicts of interest

None.

References

  1. 1.
    Berger C et al (2010) Peak bone mass from longitudinal data: implications for the prevalence, pathophysiology, and diagnosis of osteoporosis. J Bone Miner Res 25(9):1948–1957PubMedCrossRefGoogle Scholar
  2. 2.
    Bonjour JP et al (2009) The importance and relevance of peak bone mass in the prevalence of osteoporosis. Salud Publica Mex 51(Suppl 1):S5–S17PubMedGoogle Scholar
  3. 3.
    Jouanny P et al (1995) Environmental and genetic factors affecting bone mass. Similarity of bone density among members of healthy families. Arthritis Rheum 38(1):61–67PubMedCrossRefGoogle Scholar
  4. 4.
    Slemenda CW et al (1991) Genetic determinants of bone mass in adult women: a reevaluation of the twin model and the potential importance of gene interaction on heritability estimates. J Bone Miner Res 6(6):561–567PubMedCrossRefGoogle Scholar
  5. 5.
    Eisman JA (1999) Genetics of osteoporosis. Endocr Rev 20(6):788–804PubMedCrossRefGoogle Scholar
  6. 6.
    Turner CH (1998) Three rules for bone adaptation to mechanical stimuli. Bone 23(5):399–407PubMedCrossRefGoogle Scholar
  7. 7.
    Lanyon LE (1992) Control of bone architecture by functional load bearing. J Bone Miner Res 7(Suppl 2):S369–S375PubMedCrossRefGoogle Scholar
  8. 8.
    O’Connor JA, Lanyon LE, MacFie H (1982) The influence of strain rate on adaptive bone remodelling. J Biomech 15(10):767–781PubMedCrossRefGoogle Scholar
  9. 9.
    Rubin CT, Lanyon LE (1985) Regulation of bone mass by mechanical strain magnitude. Calcif Tissue Int 37(4):411–417PubMedCrossRefGoogle Scholar
  10. 10.
    Nichols DL, Sanborn CF, Essery EV (2007) Bone density and young athletic women. An update. Sports Med 37(11):1001–1014PubMedCrossRefGoogle Scholar
  11. 11.
    Nikander R et al (2005) Femoral neck structure in adult female athletes subjected to different loading modalities. J Bone Miner Res 20(3):520–528PubMedCrossRefGoogle Scholar
  12. 12.
    Nikander R et al (2009) Targeted exercises against hip fragility. Osteoporos Int 20(8):1321–1328PubMedCrossRefGoogle Scholar
  13. 13.
    Kontulainen SA et al (2002) Does previous participation in high-impact training result in residual bone gain in growing girls? One year follow-up of a 9-month jumping intervention. Int J Sports Med 23(8):575–581PubMedCrossRefGoogle Scholar
  14. 14.
    Alfredson H, Nordstrom P, Lorentzon R (1996) Total and regional bone mass in female soccer players. Calcif Tissue Int 59(6):438–442PubMedGoogle Scholar
  15. 15.
    Alfredson H, Nordstrom P, Lorentzon R (1997) Bone mass in female volleyball players: a comparison of total and regional bone mass in female volleyball players and nonactive females. Calcif Tissue Int 60(4):338–342PubMedCrossRefGoogle Scholar
  16. 16.
    Nilsson M et al (2010) Association of physical activity with trabecular microstructure and cortical bone at distal tibia and radius in young adult men. J Clin Endocrinol Metab 95(6):2917–2926PubMedCrossRefGoogle Scholar
  17. 17.
    Lorentzon M, Mellstrom D, Ohlsson C (2005) Association of amount of physical activity with cortical bone size and trabecular volumetric BMD in young adult men: the GOOD study. J Bone Miner Res 20(11):1936–1943PubMedCrossRefGoogle Scholar
  18. 18.
    Daly RM, Bass SL (2006) Lifetime sport and leisure activity participation is associated with greater bone size, quality and strength in older men. Osteoporos Int 17(8):1258–1267PubMedCrossRefGoogle Scholar
  19. 19.
    Farr JN et al (2011) Associations of physical activity duration, frequency, and load with volumetric BMD, geometry, and bone strength in young girls. Osteoporos Int 22(5):1419–1430PubMedCrossRefGoogle Scholar
  20. 20.
    Trudeau F et al (1999) Daily primary school physical education: effects on physical activity during adult life. Med Sci Sports Exerc 31(1):111–117PubMedCrossRefGoogle Scholar
  21. 21.
    Bradney M et al (1998) Moderate exercise during growth in prepubertal boys: changes in bone mass, size, volumetric density, and bone strength: a controlled prospective study. J Bone Miner Res 13(12):1814–1821PubMedCrossRefGoogle Scholar
  22. 22.
    French SA, Fulkerson JA, Story M (2000) Increasing weight-bearing physical activity and calcium intake for bone mass growth in children and adolescents: a review of intervention trials. Prev Med 31(6):722–731PubMedCrossRefGoogle Scholar
  23. 23.
    Gustavsson A, Thorsen K, Nordstrom P (2003) A 3-year longitudinal study of the effect of physical activity on the accrual of bone mineral density in healthy adolescent males. Calcif Tissue Int 73(2):108–114PubMedCrossRefGoogle Scholar
  24. 24.
    Groothausen J et al (1997) Influence of peak strain on lumbar bone mineral density: an analysis of 15-year physical activity in young males and females. Pediatr Exerc Sci 9:159–173Google Scholar
  25. 25.
    Ainsworth BE, Shaw JM, Hueglin S (2002) Methodology of activity surveys to estimate mechanical loading on bones in humans. Bone 30(5):787–791PubMedCrossRefGoogle Scholar
  26. 26.
    Dolan S et al (2006) Development and reproducibility of the bone loading history questionnaire. Med Sci Sports Exerc 38(6):1121–1131PubMedCrossRefGoogle Scholar
  27. 27.
    Shedd K et al (2007) Quantifying leisure physical activity and its relation to bone density and strength. Med Sci Sports Exerc 39(12):2189–2198PubMedCrossRefGoogle Scholar
  28. 28.
    Weeks BK, Beck BR (2008) The BPAQ: a bone-specific physical activity assessment instrument. Osteoporos Int 19(11):1567–1577PubMedCrossRefGoogle Scholar
  29. 29.
    Morel J et al (2001) Bone mineral density of 704 amateur sportsmen involved in different physical activities. Osteoporos Int 12(2):152–157PubMedCrossRefGoogle Scholar
  30. 30.
    Bassey EJ et al (1998) Pre- and postmenopausal women have different bone mineral density responses to the same high-impact exercise. J Bone Miner Res 13(12):1805–1813PubMedCrossRefGoogle Scholar
  31. 31.
    Kato T et al (2006) Effect of low-repetition jump training on bone mineral density in young women. J Appl Physiol 100(3):839–843PubMedCrossRefGoogle Scholar
  32. 32.
    Chilibeck PD, Sale DG, Webber CE (1995) Exercise and bone mineral density. Sports Med 19(2):103–122PubMedCrossRefGoogle Scholar
  33. 33.
    Heinonen A et al (1995) Bone mineral density in female athletes representing sports with different loading characteristics of the skeleton. Bone 17(3):197–203PubMedCrossRefGoogle Scholar
  34. 34.
    Lee EJ et al (1995) Variations in bone status of contralateral and regional sites in young athletic women. Med Sci Sports Exerc 27(10):1354–1361PubMedGoogle Scholar
  35. 35.
    Emslander HC et al (1998) Bone mass and muscle strength in female college athletes (runners and swimmers). Mayo Clin Proc 73(12):1151–1160PubMedCrossRefGoogle Scholar
  36. 36.
    Fehling PC et al (1995) A comparison of bone mineral densities among female athletes in impact loading and active loading sports. Bone 17(3):205–210PubMedCrossRefGoogle Scholar
  37. 37.
    Heinonen A et al (1993) Bone mineral density of female athletes in different sports. Bone Miner 23(1):1–14PubMedCrossRefGoogle Scholar
  38. 38.
    Risser WL et al (1990) Bone density in eumenorrheic female college athletes. Med Sci Sports Exerc 22(5):570–574PubMedCrossRefGoogle Scholar
  39. 39.
    Neville CE et al (2002) Relationship between physical activity and bone mineral status in young adults: the Northern Ireland Young Hearts Project. Bone 30(5):792–798PubMedCrossRefGoogle Scholar
  40. 40.
    Trudeau F, Laurencelle L, Shephard RJ (2004) Tracking of physical activity from childhood to adulthood. Med Sci Sports Exerc 36(11):1937–1943PubMedCrossRefGoogle Scholar
  41. 41.
    Kjonniksen L, Anderssen N, Wold B (2009) Organized youth sport as a predictor of physical activity in adulthood. Scand J Med Sci Sports 19(5):646–654PubMedCrossRefGoogle Scholar
  42. 42.
    Jose KA et al (2011) Childhood and adolescent predictors of leisure time physical activity during the transition from adolescence to adulthood: a population based cohort study. Int J Behav Nutr Phys Act 8(1):54PubMedCrossRefGoogle Scholar
  43. 43.
    Nurmi-Lawton J et al (2004) Evidence of sustained skeletal benefits from impact-loading exercise in young females: a 3-year longitudinal study. J Bone Miner Res 19(2):314–322PubMedCrossRefGoogle Scholar
  44. 44.
    Pettersson U et al (2010) Physical activity is the strongest predictor of calcaneal peak bone mass in young Swedish men. Osteoporos Int 21(3):447–455PubMedCrossRefGoogle Scholar
  45. 45.
    Hagstromer M et al (2010) Comparison of a subjective and an objective measure of physical activity in a population sample. J Phys Act Health 7(4):541–550PubMedGoogle Scholar
  46. 46.
    Hagstromer M et al (2010) Levels and patterns of objectively assessed physical activity—a comparison between Sweden and the United States. Am J Epidemiol 171(10):1055–1064PubMedCrossRefGoogle Scholar

Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2012

Authors and Affiliations

  • M. Callréus
    • 1
  • F. McGuigan
    • 1
  • K. Ringsberg
    • 1
  • K. Åkesson
    • 1
    Email author
  1. 1.Department of OrthopaedicsLund University, Skåne University HospitalMalmöSweden

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