Sustainability of exercise-induced increases in bone density and skeletal structure

BACKGROUND: The prevalence of osteoporosis with related fragility fractures has increased during the last decades. As physical activity influences the skeleton in a beneficial way, exercise may hypothetically be used as a prophylactic tool against osteoporosis. OBJECTIVE: This review evaluates if exercise-induced skeletal benefits achieved during growth remain in a long-term perspective. DESIGN: PUBLICATIONS WITHIN THE FIELD WERE SEARCHED THROUGH MEDLINE (PUBMED) USING THE SEARCH WORDS: exercise, physical activity, bone mass, bone mineral content (BMC), bone mineral density (BMD) and skeletal structure. We based our inferences on publications with the highest level of evidence, particularly randomised controlled trials (RCT). RESULTS: Benefits in BMD achieved by exercise during growth seem to be eroded at retirement, but benefits in skeletal structure may possibly be retained in a longer perspective. Recreational exercise seems to at least partially maintain exercise-induced skeletal benefits achieved during growth. CONCLUSIONS: Exercise during growth may be followed by long-term beneficial skeletal effects, which could possibly reduce the incidence of fractures. Exercise during adulthood seems to partly preserve these benefits and reduce the age-related bone loss

Physical activity increases bone mass during growth

BACKGROUND: The incidence of fragility fractures has increased during the last half of the 1990's. One important determinant of fractures is the bone mineral content (BMC) or bone mineral density (BMD), the amount of mineralised bone. If we could increase peak bone mass (the highest value of BMC reached during life) and/or decrease the age-related bone loss, we could possibly improve the skeletal resistance to fracture. OBJECTIVE: This review evaluates the importance of exercise as a strategy to improve peak bone mass, including some aspects of nutrition. DESIGN: PUBLICATIONS WITHIN THE FIELD WERE SEARCHED THROUGH MEDLINE (PUBMED) USING THE SEARCH WORDS: exercise, physical activity, bone mass, bone mineral content, bone mineral density, BMC, BMD, skeletal structure and nutrition. We included studies dealing with exercise during growth and young adolescence. We preferably based our inferences on randomised controlled trials (RCT), which provide the highest level of evidence. RESULTS: Exercise during growth increases peak bone mass. Moderate intensity exercise intervention programs are beneficial for the skeletal development during growth. Adequate nutrition must accompany the exercise to achieve the most beneficial skeletal effects by exercise. CONCLUSION: Exercise during growth seems to enhance the building of a stronger skeleton through a higher peak bone mass and a larger bone size