Journal of Bone and Mineral Metabolism

, Volume 32, Issue 5, pp 563–572 | Cite as

Effects of lifestyle exercise on premenopausal bone health: a randomised controlled trial

Original Article


Osteoporosis, a slowly evolving public health epidemic, often with an insidious presentation is largely preventable but the optimal dimensions of exercise that may be prescribed for enhancing bone-health among premenopausal adults are yet to be elucidated. Hence, the escalating incidence and burden of prevalence of osteoporosis is yet unabated. Considering that exogenous hormones in the form of hormonal contraception are known to modulate bone mass, investigations of their possible influence on the translation of exercise-induced osteogenic stimuli on the mature bone is pertinent. The aim of this study was to examine the effect of specified lifestyle exercise on bone-health of premenopausal women. Premenopausal women (n = 96, mean age: 22.25 ± 3.5 years; mean BMI: 23.43 ± 3.5 kg/m2) participated in a 6-month randomised controlled trial involving home-based rest-interspersed bouts of high-impact exercise for the intervention group and sham exercise for the control group. Approximately half (47) of the participants (24-exercise, 23-control) were on hormonal-based contraception while the other half (49: 24-exercise, 25-control) were not on hormonal contraception. The regime led to a significant 3.7 % increase in broadband ultrasound attenuation of exercisers compared to controls; hormonal contraceptive use did not appear to potentiate the osteogenic effects of the lifestyle exercise regime. The research highlights that short, discrete bouts of high-impact exercise may be a potential public health prescription for enhancing premenopausal bone-health regardless of hormonal contraceptive use.


Bone Brief high-impact exercise Contraception Women 


  1. 1.
    Anderson J, Rondano P (1996) Peak bone mass development of females: can young adult women improve their peak bone mass? J Am Coll Nutr 15:570–574PubMedCrossRefGoogle Scholar
  2. 2.
    Theintz G, Buchs B, Rizzoli R, Slosman D, Clavien H, Sizonenko P, Bonjour JPH (1992) Longitudinal monitoring of bone mass accumulation in healthy adolescents: evidence for a marked reduction after 16 years of age at the levels of lumbar spine and femoral neck in female subjects. J Clin Endocrinol Metab 4:1060–1065Google Scholar
  3. 3.
    Matkovic V, Jelic T, Wardlaw G, Ilich J, Goel P, Wright J, Andon M, Smith K, Heaney R (1994) Timing of peak bone mass in Caucasian females and its implication for the prevention of osteoporosis. Inference from a cross-sectional model. J Clin Invest 93:799–808PubMedCentralPubMedCrossRefGoogle Scholar
  4. 4.
    Krolner B, Nielsen SP (1982) Bone mineral content of the lumbar spine in normal and osteoporotic women: cross-sectional and longitudinal studies. Clin Sci 62:329–336PubMedGoogle Scholar
  5. 5.
    Rodin A, Murby B, Smith M, Caleffi M, Fentiman I, Chapman M, Fogelman I (1990) Premenopausal bone loss in the lumbar spine and neck of femur: a study of 225 Caucasian women. Bone 11:1–5PubMedCrossRefGoogle Scholar
  6. 6.
    Snow-Harter C, Bouxsein ML, Lewis BT, Carter DR, Marcus R (2009) Effects of resistance and endurance exercise on bone mineral status of young women: a randomized exercise intervention trial. J Bone Miner Res 7:761–769CrossRefGoogle Scholar
  7. 7.
    Lohman T, Going S, Hall M, Ritenbaugh C, Bare L, Hill A, Houtkooper L, Aickin M, Boyden T, Pamenter R (1995) Effects of resistance training on regional and total bone mineral density in premenopausal women: a randomized prospective study. J Bone Miner Res 10:1015–1024PubMedCrossRefGoogle Scholar
  8. 8.
    Friedlander AL, Genant HK, Sadowsky S, Byl NN, Glüer CC (1995) A two-year program of aerobics and weight training enhances bone mineral density of young women. J Bone Miner Res 10:574–585PubMedCrossRefGoogle Scholar
  9. 9.
    Sinaki M, Wahner H, Bergstralh E, Hodgson S, Offord K, Squires R, Swee R, Kao P (1996) Three-year controlled, randomized trial of the effect of dose-specified loading and strengthening exercises on bone mineral density of spine and femur in nonathletic, physically active women. Bone 19:233–244PubMedCrossRefGoogle Scholar
  10. 10.
    Rockwell J, Sorensen A, Baker S, Leahey D, Stock J, Michaels J, Baran D (1990) Weight training decreases vertebral bone density in premenopausal women: a prospective study. J Clin Endocrinol Metab 71:988–993PubMedCrossRefGoogle Scholar
  11. 11.
    Dalsky GP (1990) Effect of exercise on bone: permissive influence of estrogen and calcium. Med Sci Sports Exerc 22:281–285PubMedCrossRefGoogle Scholar
  12. 12.
    Lanyon L (1996) Using functional loading to influence bone mass and architecture: objectives, mechanisms, and relationship with estrogen of the mechanically adaptive process in bone. Bone 18:S37–S43CrossRefGoogle Scholar
  13. 13.
    Borer KT (2005) Physical activity in the prevention and amelioration of osteoporosis in women: interaction of mechanical, hormonal and dietary factors. Sports Med 35:779–830PubMedCrossRefGoogle Scholar
  14. 14.
    Babatunde O, Forsyth J, Gidlow C (2012) A meta-analysis of brief high-impact exercises for enhancing bone health in premenopausal women. Osteoporosis Int 23:109–119CrossRefGoogle Scholar
  15. 15.
    Weaver CM, Teegarden D, Lyle RM, McCabe GP, McCabe LD, Proulx W, Kern M, Sedlock D, Anderson DD, Hillberry B (2001) Impact of exercise on bone health and contraindication of oral contraceptive use in young women. Med Sci Sports Exerc 33:873–880PubMedCrossRefGoogle Scholar
  16. 16.
    Faul F, Erdfelder E, Buchner A, Lang A (2009) Statistical power analyses using G* Power 3.1: tests for correlation and regression analyses. Behav Res Methods 41:1149–1160PubMedCrossRefGoogle Scholar
  17. 17.
    Glüer CC, Eastell R, Reid DM, Felsenberg D, Roux C, Barkmann R, Timm W, Blenk T, Armbrecht G, Stewart A (2004) Association of Five Quantitative Ultrasound Devices and Bone Densitometry With Osteoporotic Vertebral Fractures in a Population-Based Sample: the OPUS Study. J Bone Miner Res 19:782–793PubMedCrossRefGoogle Scholar
  18. 18.
    Nguyen ND, Eisman JA, Center JR, Nguyen TV (2007) Risk factors for fracture in nonosteoporotic men and women. J Clin Endocrinol Metab 92:955–962PubMedCrossRefGoogle Scholar
  19. 19.
    Bailey CA, Brooke-Wavell K (2010) Optimum frequency of exercise for bone health: randomised controlled trial of a high-impact unilateral intervention. Bone 46:1043–1049PubMedCrossRefGoogle Scholar
  20. 20.
    Vainionpää A, Korpelainen R, Leppäluoto J, Jämsä T (2005) Effects of high-impact exercise on bone mineral density: a randomized controlled trial in premenopausal women. Osteoporosis Int 16:191–197CrossRefGoogle Scholar
  21. 21.
    Baranowski T, Perry CL, Parcel GS (2002) How individuals, environments, and health behavior interact. In: Glanz K Rimer, BK Lewis, FM (Hg.): Health behavior and health education: theory, research, and practice (3rd edn.).San Francisco, Jossey-Bass, pp 165–184Google Scholar
  22. 22.
    Dishman RK, Motl RW, Saunders R, Felton G, Ward DS, Dowda M, Pate RR (2004) Self-efficacy partially mediates the effect of a school-based physical-activity intervention among adolescent girls. Prev Med 38:628–636PubMedCrossRefGoogle Scholar
  23. 23.
    Hertzler AA, Frary RB (1994) A dietary calcium rapid assessment method (RAM). Top Clin Nutr 9:76–85CrossRefGoogle Scholar
  24. 24.
    Sedlak CA, Doheny MO, Jones SL (1998) Osteoporosis prevention in young women. Orthop Nurs 21:53–60Google Scholar
  25. 25.
    Nicholson P, Alkalay R (2007) Quantitative ultrasound predicts bone mineral density and failure load in human lumbar vertebrae. Clin Biomech 22:623–629CrossRefGoogle Scholar
  26. 26.
    Babatunde O, Forsyth J (2012) Quantitative Ultrasound and bone’s response to exercise: a meta-analysis. Bone 53:311–318PubMedCrossRefGoogle Scholar
  27. 27.
    Cheng S, Njeh C, Fan B, Cheng X, Hans D, Wang L, Fuerst T, Genant H (2002) Influence of region of interest and bone size on calcaneal BMD: implications for the accuracy of quantitative ultrasound assessments at the calcaneus. Br J Radiol 889:59–68CrossRefGoogle Scholar
  28. 28.
    Kohrt WM (2001) Aging and the osteogenic response to mechanical loading. Int J Sport Nutr Exerc Metab 11:S137–S142PubMedGoogle Scholar
  29. 29.
    Hartard M, Bottermann P, Bartenstein P, Jeschke D, Schwaiger M (1997) Effects on bone mineral density of low-dosed oral contraceptives compared to and combined with physical activity. Contraception 55:87–90PubMedCrossRefGoogle Scholar
  30. 30.
    Zaman G, Cheng MZ, Jessop H, White R, Lanyon LE (2000) Mechanical strain activates estrogen response elements in bone cells. Bone 27:233–239PubMedCrossRefGoogle Scholar
  31. 31.
    Ehrlich P, Noble B, Jessop H, Stevens H, Mosley J, Lanyon L (2002) The effect of in vivo mechanical loading on estrogen receptor α expression in rat ulnar osteocytes. J Bone Miner Res 17:1646–1655PubMedCrossRefGoogle Scholar
  32. 32.
    Burr D, Yoshikawa T, Teegarden D, Lyle R, McCabe G, McCabe L, Weaver C (2000) Exercise and oral contraceptive use suppress the normal age-related increase in bone mass and strength of the femoral neck in women 18–31 years of age. Bone 27:855–863PubMedCrossRefGoogle Scholar
  33. 33.
    Srinivasan S, Weimer DA, Agans SC, Bain SD, Gross TS (2002) Low-Magnitude mechanical loading becomes osteogenic when rest is inserted between each load cycle. J Bone Miner Res 17:1613–1620PubMedCentralPubMedCrossRefGoogle Scholar
  34. 34.
    Turner CH, Robling AG (2003) Designing exercise regimens to increase bone strength. Exerc Sport Sci Rev 31:45–50PubMedCrossRefGoogle Scholar
  35. 35.
    Bassey E, Ramsdale S (1994) Increase in femoral bone density in young women following high-impact exercise. Osteoporosis Int 4:72–75CrossRefGoogle Scholar
  36. 36.
    Bassey E, Rothwell M, Littlewood J, Pye D (1998) Pre- and postmenopausal women have different bone mineral density responses to the same high-impact exercise. J Bone Miner Res 13:1805–1813PubMedCrossRefGoogle Scholar
  37. 37.
    Kato T, Terashima T, Yamashita T, Hatanaka Y, Honda A, Umemura Y (2006) Effect of low-repetition jump training on bone mineral density in young women. J Appl Physiol 100:839–843PubMedCrossRefGoogle Scholar
  38. 38.
    Strong JE (2004) Effects of Different Jumping Programs on Hip and Spine Bone Mineral Density in Pre-menopausal Women. Doctoral Dissertation. Department of Physical Education Brigham Young UniversityGoogle Scholar
  39. 39.
    Witzke KA (2009) Dose-dependent effects and feasibility of a home-based jumping program for bone health in women. Med Sci Sports Exerc 41:289CrossRefGoogle Scholar
  40. 40.
    Niu K, Ahola R, Guo H, Korpelainen R, Uchimaru J, Vainionpää A, Sato K, Sakai A, Salo S, Kishimoto K (2010) Effect of office-based brief high-impact exercise on bone mineral density in healthy premenopausal women: the Sendai Bone Health Concept Study. J Bone Miner Metab 28:568–577PubMedCrossRefGoogle Scholar
  41. 41.
    Heinonen A, Kannus P, Sievänen H, Oja P, Pasanen M, Rinne M, Uusi-Rasi K, Vuori I (1996) Randomised controlled trial of effect of high-impact exercise on selected risk factors for osteoporotic fractures. Lancet 348:1343–1347PubMedCrossRefGoogle Scholar
  42. 42.
    Lanyon LE, Rubin C (1984) Static vs dynamic loads as an influence on bone remodeling. J Biomech 17:897–905PubMedCrossRefGoogle Scholar
  43. 43.
    Rubin CT, Lanyon LE (1985) Regulation of bone mass by mechanical strain magnitude. Calcif Tissue Int 37:411–417PubMedCrossRefGoogle Scholar
  44. 44.
    Umemura Y, Ishiko T, Yamauchi T, Kurono M, Mashiko S (1997) Five jumps per day increase bone mass and breaking force in rats. J Bone Miner Res 12:1480–1485PubMedCrossRefGoogle Scholar
  45. 45.
    Sternfeld B, Ainsworth BE, Quesenberry CP (1999) Physical activity patterns in a diverse population of women. Prev Med 28:313–323PubMedCrossRefGoogle Scholar
  46. 46.
    Murphy NM, Ni Dhuinn M, Browne PA, ÓRathaille MM (2006) Physical activity for bone health in inactive teenage girls: is a supervised, teacher-led program or self-led program best? J Adolesc Health 39:508–514PubMedCrossRefGoogle Scholar
  47. 47.
    Khan K, McKay H, Kannus R, Bailey D, Wark J. Bennell K (2001) Physical activity and bone health. Champaign: Human KineticsGoogle Scholar

Copyright information

© The Japanese Society for Bone and Mineral Research and Springer Japan 2013

Authors and Affiliations

  1. 1.School of Psychology, Sport and Exercise Faculty of Health SciencesStaffordshire UniversityStaffordshireUK

Personalised recommendations