Calcified Tissue International

, Volume 59, Issue 2, pp 89–94

Exercise and reproductive factors as predictors of bone density among osteoporotic women in Mexico city

  • S. Parra-Cabrera
  • M. Hernandez-Avila
  • J. Tamayo-y-Orozco
  • L. Löpez-Carrillo
  • F. Meneses-Gonzalez
Clinical Investigations

Abstract

We examined the association between physical activity and reproductive factors with bone density among 313 Mexican women, aged 26–83 years. Bone mineral density (BMD) was measured with a HOLOGIC QRD 1000 w, DXA densitometer at the lumbar spine and femoral region. We explored the relation between BMD and parity, age, body mass index (BMI), type of menopause, and level of exercise. Multiple regression models examining determinants of bone density at the lumbar and femoral regions showed that increasing age and lack of exercise were statistically significant predictors of bone demineralization. The number of pregnancies also had a deletereous effect on bone density, especially for lumbar spine, as well as BMI < 20 kg/m2. Our results suggest that physical activity, parity, and BMI are important determinants of bone density in this population.

Key words

Bone mineral density Body mass index Menopause Exercise Parity Mexico 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Ravnikar VA (1993) Diet, exercise, and lifestyle in preparation for menopause. Obstet Gynecol Clin North Am 20:365–368PubMedGoogle Scholar
  2. 2.
    Jun Zhang MB, Feldblum PJ, Fortney JA (1992) Moderate physical activity and bone density among perimenopausal women. Am J Public Health 82:736–738Google Scholar
  3. 3.
    Michel BA, Lane NE, Bjorkengren A, Bloch DA, Fries JF (1992) Impact of running on lumbar bone density: a five-year longitudinal study. J Rheumatol 19:1759–1763PubMedGoogle Scholar
  4. 4.
    Recker RR, Lappe JM, Davies KM, Kimmel DB (1992) Change in bone mass immediately before menopause. J Bone Miner Res 7:857–862PubMedGoogle Scholar
  5. 5.
    Rosenthal DI, Mayo-Smith W, Hayes CW (1989) Age and bone mass in premenopausal women. J Bone Miner Res 4: 533–538PubMedCrossRefGoogle Scholar
  6. 6.
    Hannan MT, Felson DT, Anderson JJ (1992) Bone mineral density in elderly men and women: results from the Framingham Osteoporosis Study. J Bone Miner Res 7:547–553PubMedGoogle Scholar
  7. 7.
    Sowers MR, Clark MK, Hollies B (1992) Radial bone mineral density in pre- and perimenopausal women: a prospective study of rates and risk factors for loss. J Bone Miner Res 6:647–657Google Scholar
  8. 8.
    Richelson LS, Wahner HW, Melton LJ (1985) Relative contributors of aging and estrogen deficiency to postmenopausal bone loss. N Engl J Med 312:1097–1098CrossRefGoogle Scholar
  9. 9.
    Williams AR, Weis NS, Ure CL, Ballard J, Daling JR (1982) Effect of weight, smoking and estrogen use on risk of hip and forearm fracture in postmenopausal women. Obstet Gynecol 60:694–699Google Scholar
  10. 10.
    Nilas L, Christiansen C (1989) Bone mass and its relationship to age and the menopause. J Clin Endocrinol Metab 65:697–702CrossRefGoogle Scholar
  11. 11.
    Riggs L, Melton J (1992) The prevention and treatment of osteoporosis. N Engl J Med 27:620–627Google Scholar
  12. 12.
    Blanch J, Chines A, Pacifici R (1991) Pregnancy associated with osteoporosis: report of two cases with long-term bone density follow-up. Am J Bone Miner Res (suppl):sl65–168Google Scholar
  13. 13.
    Christensen MS, Christiansen C, Transbol I (1992) Doseresponse evaluation of cyclic estrogen/gestagen in postmenopausal women: placebo-controlled trial of its gynecologic and metabolic actions. Am J Obstet Gynecol 144:873–879Google Scholar
  14. 14.
    Bollet AJ, Engh G, Parson W (1965) Epidemiology of osteoporosis: sex and race indices of hip fractures. Arch Int Med 116:191–194Google Scholar
  15. 15.
    Smith DM, Nance WE, Kamg KW, Christian JC, Johnston CC Jr (1973) Genetic factors in determining body mass. J Clin Invest 52:2800–2808PubMedCrossRefGoogle Scholar
  16. 16.
    Nordin BE, Heaney RP (1990) Calcium supplementation of the diet: justified by present evidence. Calcif Tissue Int 47: 194–201CrossRefGoogle Scholar
  17. 17.
    Heaney RP (1991) Calcium intake in the osteoporotic fracture context: introduction. Am J Clin Nutr 54:242–244Google Scholar
  18. 18.
    Avioli LV (1984) Calcium and osteoporosis. Ann Rev Nutr 4:471–491CrossRefGoogle Scholar
  19. 19.
    Kreiger N, Gross A, Hunter G (1992) Dietary factors and fracture in postmenopausal women: a case-control study. Int J Epidemiol 21:953–957PubMedCrossRefGoogle Scholar
  20. 20.
    Spenser H, Kramer L, Osis D (1988) Do protein and phosphorus cause calcium loss? J Nutr 118:657–660Google Scholar
  21. 21.
    Hernández-Avila M, Stampfer MJ, Ravnikar VA, Willett WC, Schiff I, Francis M, Longcope C, McKinlay SM (1993) Caffeine and other predictors of bone density among pre- and perimenopausal women. Epidemiology 4:128–134PubMedCrossRefGoogle Scholar
  22. 22.
    Cooper C, Atkinson EJ, Wakner HW, O’Fallon WM, Riggs BL, Judd HL, Melton LJ III (1992) Is caffeine consumption a risk factor for osteoporosis? J Bone Miner Res 4:465–471Google Scholar
  23. 23.
    Hernández-Avila M, Colditz GA, Stampfer MJ, Rosner B, Speizer FE, Willett WC (1991) Caffeine, moderate alcohol intake, and risk of fractures of the hip and forearm in middleaged women. Am J Clin Nutr 54:157–163PubMedGoogle Scholar
  24. 24.
    Lalor B, Counihan TB (1982) Metabolic bone disease in heavy drinkers. Clin Sci 63:43–46Google Scholar
  25. 25.
    Yano K, Heilbrun LK, Wasnick RD, Hankin JH, Vogel JM (1985) The relationship between diet and bone mineral content of multiple skeletal sites in elderly Japanese-American men and women living in Hawaii. Am J Clin Nutr 42:877–888PubMedGoogle Scholar
  26. 26.
    Cummings SR, Kelsey JL, Nevitt MC, O’Dowd KJ (1985) Epidemiology of osteoporosis and osteoporotic fractures. Epidemiol Rev 7:178–208PubMedGoogle Scholar
  27. 27.
    Johnston CC, Melton LJ III (1990) Guidelines for osteoporosis prophylaxis. J Bone Min Res 5:423–424Google Scholar
  28. 28.
    Direction General de Estadistica, Evaluation e Informatica e Instituto Nacional de Estadistica, Geografia e Informática. Mortalidad 1990. Subsecretarfa de Coordinaciön y Desarrollo. Secretaría de Salud. México 1992Google Scholar
  29. 29.
    Johnston CC Jr, Slemenda CW (1990) Appropriate clinical use of bone mass measurement. In: Christiansen C, Overgaard K (eds) Osteoporosis 1990. 3rd Symp on Osteoporosis, Copenhagen, Denmark, pp 446–449Google Scholar
  30. 30.
    HOLOGIC Whole Body Bone Densitometer Operator’s Manual and Users Guide (1990) HOLOGIC, QRD/1000W. Oct 30. Document #8001-00184-00/48. Revision A. Hologic INC. Waltham, MA 02154. pp 1–406. Appendix A-14Google Scholar
  31. 31.
    SAS Institute (1990) Statistical Analysis System, Version 6. SAS Institute, Cary NCGoogle Scholar
  32. 32.
    Dalsky GP, Stocke KS, Ehsani AA, Slatoposky E, Lee WC, Birge SJ (1988) Weight-bearing exercise training and lumbar bone mineral content in postmenopausal women. Ann Intern Med 108:824–828PubMedGoogle Scholar
  33. 33.
    Washburn RA, Montoye HJ (1986) The assessment of physical activity by questionnaire. Am J Epidemiol 123:563–576PubMedGoogle Scholar
  34. 34.
    Grove KA, Londeree BR (1992) Bone density in postmenopausal women: high impact vs low impact exercise. Med Sci Sports Exer 24:1190–1194Google Scholar
  35. 35.
    Williams JA, Wagner J, Wasnich R, Helbrun L (1984) The effect of long distance running upon appendicular bone mineral content. Med Sci Sports Exer 16:223–227Google Scholar
  36. 36.
    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 52:411–414PubMedCrossRefGoogle Scholar
  37. 37.
    Smith EL, Gilligan C, McAdam M, Ensign CP, Smith P (1989) Deterring bone loss by exercise intervention in premenopausal and postmenopausal women. Calcif Tissue Int 44:312–321PubMedCrossRefGoogle Scholar
  38. 38.
    Zhang J, Feldblum PJ, Fortney JA (1992) Moderate physical activity and bone density among perimenopausal women. Am J Public Health 82:736–738PubMedGoogle Scholar
  39. 39.
    Pruitt LA, Jackson RD, Bartels RL, Lenhard HJ (1992) Weight training on bone mineral density of postmenopausal women. J Bone Miner Res 7:179–185PubMedGoogle Scholar
  40. 40.
    Martin D, Notelovitz M (1993) Effects of aerobic training on bone mineral density of postmenopausal women. J Bone Miner Res 8:931–936PubMedGoogle Scholar
  41. 41.
    Kreiger N, Kelsey JL, Holford TR, O’Connor T (1982) An epidemiological study of the hip fracture in postmenopausal women. Am J Epidemiol 116:141–148PubMedGoogle Scholar
  42. 42.
    Van Beresteijn EC, DeWaard H, Van’t-Hof MA, Roymakers JA, Doursma SA (1990) Relation of axial bone mass to habitual calcium intake and to corticol bone loss in healthy early postmenopausal women. Bone 11:7–13CrossRefGoogle Scholar
  43. 43.
    Sowers MF, Crutchfield M, Jannausch M, Updike S, Corton G (1991) A prospective evaluation of bone mineral change in pregnancy. Obstet Gynecol 77:841–845PubMedGoogle Scholar
  44. 44.
    Parra-Cabrera MS, Hernandez-Avila M, Tamayo y Orozco JA, Fernandez Ortega MC, Meneses F (1994) Factores de riesgo en la osteoporosis: evidencias clíncias y epidemiolögicas. Gaceta Medica de México 4:231–240Google Scholar
  45. 45.
    Kanis JA, Melton LJ, Christiansen C, Johnston CC, Khaltaev N (1994) The diagnosis of osteoporosis. JBMR 9:1137–1141Google Scholar

Copyright information

© Springer-Verlag New York Inc. 1996

Authors and Affiliations

  • S. Parra-Cabrera
    • 1
  • M. Hernandez-Avila
    • 1
  • J. Tamayo-y-Orozco
    • 2
  • L. Löpez-Carrillo
    • 1
  • F. Meneses-Gonzalez
    • 1
  1. 1.Center for Population Health ResearchNational Institute of Public HealthAhuacatitlán, Cuernavaca MorelosMexico
  2. 2.Osteoporosis ClinicHospital Medica SurTlalpan, Mexico CityMexico

Personalised recommendations