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Effects of physical activity on bone mineral density in older adults: Korea National Health and Nutrition Examination Survey, 2008–2011

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Abstract

Summary

We compared the relationship between physical activity (PA) and bone mineral density (BMD) in men and women aged over 50 years. Only moderate-to-vigorous PA was positively associated with hip BMD in men. There was no association between PA and BMD at any site in women.

Introduction

Physical activity (PA) is widely recommended for osteoporosis. However, epidemiological data regarding the intensity or volume of PA required for bone health are lacking. We aimed to investigate and compare the relationship between PA and bone mineral density (BMD) in men and women.

Methods

This population-based cross-sectional study used data from the 4th and 5th Korea National Health and Nutrition Examination Surveys and included 2767 men and 2753 women aged > 50 years. The intensity, frequency, and duration of PA were assessed using a questionnaire, and the participants were divided into the no activity, walking-only, moderate PA, and vigorous PA groups. BMD was measured at the lumbar spine (LS), femur neck (FN), and total hip (TH) using dual-energy X-ray absorptiometry.

Results

Adjusted-BMDs of the hip were higher in men and women in the moderate and vigorous PA groups than those in men and women in the walking-only and no activity groups, while frequency and duration of PA were not associated with BMD at any site. The odds ratios for osteoporosis were the lowest at the FN and TH in men in the vigorous PA group (0.354, 95% confidence interval (CI) 0.139–0.901, P < 0.002, and 0.072, 95% CI 0.007–0.766, P < 0.003, respectively), while it was not significant in women.

Conclusion

Only moderate-to-vigorous PA was positively associated with the hip BMD in men. There was no association between PA and BMD at any site in women. It is necessary to assess the PA intensity for bone health based on the site and sex.

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References

  1. Raisz LG (2005) Pathogenesis of osteoporosis: concepts, conflicts, and prospects. J Clin Invest 115:3318–3325

    Article  CAS  Google Scholar 

  2. Reginster JY, Burlet N (2006) Osteoporosis: a still increasing prevalence. Bone 38:S4–S9

    Article  Google Scholar 

  3. Park EJ, Joo IW, Jang MJ, Kim YT, Oh K, Oh HJ (2014) Prevalence of osteoporosis in the Korean population based on Korea National Health and Nutrition Examination Survey (KNHANES), 2008-2011. Yonsei Med J 55:1049–1057

    Article  Google Scholar 

  4. Amin S, Khosla S (2012) Sex- and age-related differences in bone microarchitecture in men relative to women assessed by high-resolution peripheral quantitative computed tomography. J Osteoporos 2012:129760

    Article  Google Scholar 

  5. Chastin SF, Mandrichenko O, Helbostadt JL, Skelton DA (2014) Associations between objectively-measured sedentary behaviour and physical activity with bone mineral density in adults and older adults, the NHANES study. Bone 64:254–262

    Article  CAS  Google Scholar 

  6. Rodriguez-Gomez I, Manas A, Losa-Reyna J, Rodriguez-Manas L, Chastin SFM, Alegre LM, Garcia-Garcia FJ, Ara I (2019) The impact of movement behaviors on bone health in elderly with adequate nutritional status: compositional data analysis depending on the frailty status. Nutrients 11:

  7. Onambele-Pearson G, Wullems J, Doody C, Ryan D, Morse C, Degens H (2019) Influence of habitual physical behavior - sleeping, sedentarism, physical activity - on bone health in community-dwelling older people. Front Physiol 10:408

    Article  Google Scholar 

  8. Frost HM (1987) Bone “mass” and the “mechanostat”: a proposal. Anat Rec 219:1–9

    Article  CAS  Google Scholar 

  9. Kemmler W, Shojaa M, Kohl M, von Stengel S (2018) Exercise effects on bone mineral density in older men: a systematic review with special emphasis on study interventions. Osteoporos Int 29:1493–1504

    Article  CAS  Google Scholar 

  10. Kemmler W, von Stengel S, Kohl M (2016) Exercise frequency and bone mineral density development in exercising postmenopausal osteopenic women. Is there a critical dose of exercise for affecting bone? Results of the Erlangen Fitness and Osteoporosis Prevention Study. Bone 89:1–6

    Article  Google Scholar 

  11. Kemmler W, Engelke K, von Stengel S (2016) Long-term exercise and bone mineral density changes in postmenopausal women--are there periods of reduced effectiveness? J Bone Miner Res 31:215–222

    Article  Google Scholar 

  12. Lau EM, Woo J, Leung PC, Swaminathan R, Leung D (1992) The effects of calcium supplementation and exercise on bone density in elderly Chinese women. Osteoporos Int 2:168–173

    Article  CAS  Google Scholar 

  13. Kelley GA, Kelley KS (2006) Exercise and bone mineral density at the femoral neck in postmenopausal women: a meta-analysis of controlled clinical trials with individual patient data. Am J Obstet Gynecol 194:760–767

    Article  Google Scholar 

  14. Kelley GA, Kelley KS, Tran ZV (2002) Exercise and lumbar spine bone mineral density in postmenopausal women: a meta-analysis of individual patient data. J Gerontol A Biol Sci Med Sci 57:M599–M604

    Article  Google Scholar 

  15. Lee SH, Lee Y, Seo JH, Kim YA (2018) Association between exercise and metabolic syndrome in Koreans. J Obes Metab Syndr 27:117–124

    Article  Google Scholar 

  16. Bolam KA, van Uffelen JG, Taaffe DR (2013) The effect of physical exercise on bone density in middle-aged and older men: a systematic review. Osteoporos Int 24:2749–2762

    Article  CAS  Google Scholar 

  17. Nikander R, Sievanen H, Heinonen A, Daly RM, Uusi-Rasi K, Kannus P (2010) Targeted exercise against osteoporosis: a systematic review and meta-analysis for optimising bone strength throughout life. BMC Med 8:47

    Article  Google Scholar 

  18. Benedetti MG, Furlini G, Zati A, Letizia Mauro G (2018) The effectiveness of physical exercise on bone density in osteoporotic patients. Biomed Res Int 2018:4840531

    Article  Google Scholar 

  19. Kukuljan S, Nowson CA, Bass SL, Sanders K, Nicholson GC, Seibel MJ, Salmon J, Daly RM (2009) Effects of a multi-component exercise program and calcium-vitamin-D3-fortified milk on bone mineral density in older men: a randomised controlled trial. Osteoporos Int 20:1241–1251

    Article  CAS  Google Scholar 

  20. Kukuljan S, Nowson CA, Sanders KM, Nicholson GC, Seibel MJ, Salmon J, Daly RM (2011) Independent and combined effects of calcium-vitamin D3 and exercise on bone structure and strength in older men: an 18-month factorial design randomized controlled trial. J Clin Endocrinol Metab 96:955–963

    Article  CAS  Google Scholar 

  21. Rodriguez-Gomez I, Manas A, Losa-Reyna J, Rodriguez-Manas L, Chastin SFM, Alegre LM, Garcia-Garcia FJ, Ara I (2018) Associations between sedentary time, physical activity and bone health among older people using compositional data analysis. PLoS One 13:e0206013

    Article  Google Scholar 

  22. Mohamad NV, Soelaiman IN, Chin KY (2016) A concise review of testosterone and bone health. Clin Interv Aging 11:1317–1324

    Article  CAS  Google Scholar 

  23. Kanis JA, Bianchi G, Bilezikian JP, Kaufman JM, Khosla S, Orwoll E, Seeman E (2011) Towards a diagnostic and therapeutic consensus in male osteoporosis. Osteoporos Int 22:2789–2798

    Article  CAS  Google Scholar 

  24. Khosla S (2010) Update in male osteoporosis. J Clin Endocrinol Metab 95:3–10

    Article  CAS  Google Scholar 

  25. Chaitou A, Boutroy S, Vilayphiou N, Munoz F, Delmas PD, Chapurlat R, Szulc P (2010) Association between bone turnover rate and bone microarchitecture in men: the STRAMBO study. J Bone Miner Res 25:2313–2323

    Article  Google Scholar 

  26. Frost HM (1994) Wolff's law and bone's structural adaptations to mechanical usage: an overview for clinicians. Angle Orthod 64:175–188

    CAS  PubMed  Google Scholar 

  27. Manolagas SC, Kousteni S, Jilka RL (2002) Sex steroids and bone. Recent Prog Horm Res 57:385–409

    Article  CAS  Google Scholar 

  28. Korpelainen R, Keinanen-Kiukaanniemi S, Nieminen P, Heikkinen J, Vaananen K, Korpelainen J (2010) Long-term outcomes of exercise: follow-up of a randomized trial in older women with osteopenia. Arch Intern Med 170:1548–1556

    Article  Google Scholar 

  29. Sinaki M, Itoi E, Wahner HW, Wollan P, Gelzcer R, Mullan BP, Collins DA, Hodgson SF (2002) Stronger back muscles reduce the incidence of vertebral fractures: a prospective 10 year follow-up of postmenopausal women. Bone 30:836–841

    Article  CAS  Google Scholar 

  30. Uusi-Rasi K, Sievanen H, Heinonen A, Vuori I, Beck TJ, Kannus P (2006) Long-term recreational gymnastics provides a clear benefit in age-related functional decline and bone loss. A prospective 6-year study. Osteoporos Int 17:1154–1164

    Article  CAS  Google Scholar 

  31. Kelley GA, Kelley KS, Kohrt WM (2012) Effects of ground and joint reaction force exercise on lumbar spine and femoral neck bone mineral density in postmenopausal women: a meta-analysis of randomized controlled trials. BMC Musculoskelet Disord 13:177

    Article  Google Scholar 

  32. Zhao R, Xu Z, Zhao M (2015) Effects of oestrogen treatment on skeletal response to exercise in the hips and spine in postmenopausal women: a meta-analysis. Sports Med 45:1163–1173

    Article  Google Scholar 

  33. Zhao R, Xu Z, Zhao M (2015) Antiresorptive agents increase the effects of exercise on preventing postmenopausal bone loss in women: a meta-analysis. PLoS One 10:e0116729

    Article  Google Scholar 

  34. Zhang J, Gao R, Cao P, Yuan W (2014) Additive effects of antiresorptive agents and exercise on lumbar spine bone mineral density in adults with low bone mass: a meta-analysis. Osteoporos Int 25:1585–1594

    Article  CAS  Google Scholar 

  35. Lang T, LeBlanc A, Evans H, Lu Y, Genant H, Yu A (2004) Cortical and trabecular bone mineral loss from the spine and hip in long-duration spaceflight. J Bone Miner Res 19:1006–1012

    Article  Google Scholar 

  36. Konda NN, Karri RS, Winnard A, Nasser M, Evetts S, Boudreau E, Caplan N, Gradwell D, Velho RM (2019) A comparison of exercise interventions from bed rest studies for the prevention of musculoskeletal loss. NPJ Microgravity 5:12

    Article  Google Scholar 

  37. Giangregorio LM, Papaioannou A, Macintyre NJ et al (2014) Too fit to fracture: exercise recommendations for individuals with osteoporosis or osteoporotic vertebral fracture. Osteoporos Int 25:821–835

    Article  CAS  Google Scholar 

  38. Kim YA (2018) Association between exercise and metabolic syndrome in Koreans (J Obes Metab Syndr 2018;27:117-24). J Obes Metab Syndr 27:264–266

    Article  Google Scholar 

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Author notes

  1. Ye An Kim and Young Lee contributed equally to this work.

Authors and Affiliations

  1. Division of Endocrinology, Department of Internal Medicine, Veterans Health Service Medical Center, Seoul, South Korea

    Ye An Kim & Ji Hyun Lee

  2. Veterans Medical Research Institute, Veterans Health Service Medical Center, Jinhwangdo-ro 61-gil 53, Gangdong-gu, Seoul, 05368, South Korea

    Young Lee & Je Hyun Seo

Authors
  1. Ye An Kim
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  2. Young Lee
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Corresponding author

Correspondence to Je Hyun Seo.

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Ethical approval

Korea National Health and Nutrition Examination Survey (KNHANES) adheres to the principles outlined in the Declaration of Helsinki for research involving humans; all participants provided written informed consents and the protocol for KNHANES was approved by the Institutional Review Board of Korea Center for Disease Control and Prevention (No. 2008-04EXP-01-C, 2009-01CON-03-2C, 2010-02CON-21-C, and 2011-02CON-06-C). The current study did not require additional approval because the KNHANES dataset is publicly available (http://knahnes.cdc.go.kr).

Informed consent

Informed consent was not required for this study because anonymized and de-identified data was used for the analyses.

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Kim, Y.A., Lee, Y., Lee, J.H. et al. Effects of physical activity on bone mineral density in older adults: Korea National Health and Nutrition Examination Survey, 2008–2011. Arch Osteoporos 14, 103 (2019). https://doi.org/10.1007/s11657-019-0655-5

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