Abstract
Summary
The amount and intensity of walking to maintain a healthy skeleton is unknown. This study examined the relationship between habitual walking activity and femoral bone mineral density (BMD) in healthy individuals using a quantitative theory for bone maintenance. Our results suggest a gender, weight, and speed sensitivity of walking interventions.
Introduction
Walking has been extensively promoted for the prevention of osteoporosis. The amount and intensity of walking to maintain a healthy skeleton is unknown and evidence to support a specific target of steps per day is lacking. The goal of our study was to examine the relationship between habitual walking activity and femoral bone mineral density (BMD) in healthy individuals using a quantitative theory for bone maintenance.
Methods
Habitual walking activity and total femur BMD were measured in 105 individuals (49–64 years). An index of cumulative loading (bone density index, BDI) was examined as a predictor of BMD. The BDI–BMD relationship was used to predict the steps per day to maintain healthy BMD values for a range of body weights (BW) and walking speeds.
Results
For females but not for males, BDI was correlated with BMD (r 2 = 0.19, p < 0.001). The total required steps per day to maintain a T-score of −1.0 for a female with the average BW of the study cohort, walking at 1.00 m/s is 4,892 steps/day. Substantially more steps (18,568 steps/day) are required for a female with a BW 20% lighter than the average for our female cohort. For these lighter females, only at a walking speed greater than 1.32 m/s was 10,000 steps/day sufficient to maintain a T-score of −1.0.
Conclusions
Our results suggest a gender, weight, and speed sensitivity of walking interventions for osteoporosis. In persons of low BW, the necessary steps per day to maintain BMD can be substantially greater than the often-quoted 10,000 steps.
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Reference
Burge R, Dawson-Hughes B, Solomon DH, Wong JB, King A, Tosteson A (2007) Incidence and economic burden of osteoporosis-related fractures in the United States, 2005–2025. J Bone Miner Res 22:465–475
Lips P, van Schoor NM (2005) Quality of life in patients with osteoporosis. Osteoporos Int 16:447–455
Curry LC, Hogstel MO, Davis GC (2003) Functional status in older women following hip fracture. J Adv Nurs 42:347–354
Forsen L, Sogaard AJ, Meyer HE, Edna T, Kopjar B (1999) Survival after hip fracture: short- and long-term excess mortality according to age and gender. Osteoporos Int 10:73–78
Centers for Disease Control (CDC) and Prevention (2000) Compliance with physical activity recommendations by walking for exercise. MMWR Morb Mortal Wkly Rep 49(25):560–565
Feskanich D, Willett W, Colditz G (2002) Walking and leisure-time activity and risk of hip fracture in postmenopausal women. JAMA 288:2300–2306
Hatori M, Hasegawa A, Adachi H, Shinozaki A, Hayashi R, Okano H, Mizunuma H, Murata K (1993) The effects of walking at the anaerobic threshold level on vertebral bone loss in postmenopausal women. Calcif Tissue Int 52:411–414
Wu J, Oka J, Tabata I, Higuchi M, Toda T, Fuku N, Ezaki J, Sugiyama F, Uchiyama S, Yamada K, Ishimi Y (2006) Effects of isoflavone and exercise on BMD and fat mass in postmenopausal Japanese women: a 1-year randomized placebo-controlled trial. J Bone Miner Res 21:780–789
Martyn-St James M, Carroll S (2008) Meta-analysis of walking for preservation of bone mineral density in postmenopausal women. Bone 43:521–531
Bowley SM , Whalen RT. Physical activity and bone density in women. Orthop Res Soc 2001; 26-63
Worthen LC, Kim CM, Kautz SA, Lew HL, Kiratli BJ, Beaupre GS (2005) Key characteristics of walking correlate with bone density in individuals with chronic stroke. J Rehabil Res Dev 42:761–768
Tudor-Locke C, Burkett L, Reis JP, Ainsworth BE, Macera CA, Wilson DK (2005) How many days of pedometer monitoring predict weekly physical activity in adults? Prev Med 40:293–298
Lodder MC, Lems WF, Ader HJ, Marthinsen AE, van Coeverden SC, Lips P, Netelenbos JC, Dijkmans BA, Roos JC (2004) Reproducibility of bone mineral density measurement in daily practice. Ann Rheum Dis 63:285–289
Tudor-Locke C, Johnson WD, Katzmarzyk PT (2009) Accelerometer-determined steps per day in US adults. Med Sci Sports Exerc 41:1384–1391
Whalen RT , Breit GA. Method and apparatus for monitoring of daily activity in terms of ground reaction forces. 2001; 08/540,614:
Carter DR, Fyhrie DP, Whalen RT (1987) Trabecular bone density and loading history: regulation of connective tissue biology by mechanical energy. J Biomech 20:785–794
Whalen RT, Carter DR, Steele CR (1988) Influence of physical activity on the regulation of bone density. J Biomech 21:825–837
Pocock NA, Eisman JA, Hopper JL, Yeates MG, Sambrook PN, Eberl S (1987) Genetic determinants of bone mass in adults. A twin study. J Clin Invest 80:706–710
Block JE, Friedlander AL, Brooks GA, Steiger P, Stubbs HA, Genant HK (1989) Determinants of bone density among athletes engaged in weight-bearing and non-weight-bearing activity. J Appl Physiol 67:1100–1105
Tudor-Locke C, Bassett DR Jr (2004) How many steps/day are enough? Preliminary pedometer indices for public health. Sports Med 34:1–8
Tudor-Locke C, Hatano Y, Pangrazi RP, Kang M (2008) Revisiting “how many steps are enough?”. Med Sci Sports Exerc 40:S537–S543
Tudor-Locke C, Ainsworth BE, Whitt MC, Thompson RW, Addy CL, Jones DA (2001) The relationship between pedometer-determined ambulatory activity and body composition variables. Int J Obes Relat Metab Disord 25:1571–1578
Bennett GG, Wolin KY, Viswanath K, Askew S, Puleo E, Emmons KM (2006) Television viewing and pedometer-determined physical activity among multiethnic residents of low-income housing. Am J Public Health 96:1681–1685
Harvey JT, Eime RM, Payne WR (2009) Effectiveness of the 2006 Commonwealth Games 10, 000 Steps Walking Challenge. Med Sci Sports Exerc 41:1673–1680
Tse KY, Macias BR, Meyer RS, Hargens AR (2009) Heritability of bone density: regional and gender differences in monozygotic twins. J Orthop Res 27:150–154
May H, Murphy S, Khaw K (1994) Age-associated bone loss in men and women and its relationship to weight. Age Ageing 23:235–240
Bohannon RW (2007) Number of pedometer-assessed steps taken per day by adults: a descriptive meta-analysis. Phys Ther 87:1642–1650
Bohannon RW (1997) Comfortable and maximum walking speed of adults aged 20–79 years: reference values and determinants. Age Ageing 26:15–19
Visser M, Pluijm SM, Stel VS, Bosscher RJ, Deeg DJ (2002) Physical activity as a determinant of change in mobility performance: the Longitudinal Aging Study Amsterdam. J Am Geriatr Soc 50:1774–1781
Martin PE, Rothstein DE, Larish DD (1992) Effects of age and physical activity status on the speed-aerobic demand relationship of walking. J Appl Physiol 73:200–206
Bergmann G, Deuretzbacher G, Heller M, Graichen F, Rohlmann A, Strauss J, Duda GN (2001) Hip contact forces and gait patterns from routine activities. J Biomech 34:859–871
Englund U, Littbrand H, Sondell A, Bucht G, Pettersson U (2009) The beneficial effects of exercise on BMD are lost after cessation: a 5-year follow-up in older post-menopausal women. Scand J Med Sci Sports 19:381–388
Acknowledgments
This material was based on work supported by the Department of Veterans Affairs, Veterans Health Administration, Rehabilitation Research and Development Service, Merit Review project A2592R. Special thanks to Christy Dairaghi, Barb Elspas, Joe Guerricabeitia, Jonathan Rylander, and Sparkle Williams.
Conflicts of interest
None.
Funding sources
Department of Veterans Affairs, Veterans Health Administration, Rehabilitation Research and Development Service, Merit Review project A2592R.
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Boyer, K.A., Kiratli, B.J., Andriacchi, T.P. et al. Maintaining femoral bone density in adults: how many steps per day are enough?. Osteoporos Int 22, 2981–2988 (2011). https://doi.org/10.1007/s00198-011-1538-9
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DOI: https://doi.org/10.1007/s00198-011-1538-9