Hostname: page-component-78c5997874-v9fdk Total loading time: 0 Render date: 2024-11-03T04:02:19.444Z Has data issue: false hasContentIssue false

The effect of physical activity and its interaction with nutrition on bone health

Published online by Cambridge University Press:  07 March 2007

Niamh M. Murphy*
Affiliation:
Centre for Health Behaviour Research, Waterford Institute of Technology, Waterford, Republic of Ireland
Paula Carroll
Affiliation:
Centre for Health Behaviour Research, Waterford Institute of Technology, Waterford, Republic of Ireland
*
*Corresponding author: Dr Niamh Murphy, fax +353 51 378292, [email protected]
Rights & Permissions [Opens in a new window]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

Physical activity (PA) is a popular therapy for the prevention and treatment of bone loss and osteoporosis because it has no adverse side effects, it is low cost, and it confers additional benefits such as postural stability and fall prevention. Bone mass is regulated by mechanical loading, and is limited but not controlled by diet. The mechanism by which strain thresholds turn bone remodelling ‘on’ and ‘off ’ is known as the mechanostat theory. Research in animals has shown that optimal strains are dynamic, with a high change rate, an unusual distribution and a high magnitude of strain, but the results of randomized controlled trials in human subjects have been somewhat equivocal. In the absence of weight-bearing activity nutritional or endocrine interventions cannot maintain bone mass. Biochemical markers of bone turnover predict bone mass changes, and findings from our research group and others have shown that both acute and chronic exercise can reduce bone resorption. Similarly, Ca intervention studies have shown that supplementation can reduce bone resorption. Several recent meta-analytical reviews concur that changes in bone mass with exercise are typically 2–3%. Some of these studies suggest that Ca intake may influence the impact of PA on bone, with greater effects in Ca-replete subjects. Comparative studies between Asian (high PA, low Ca intake) and US populations (low PA, high Ca intake) suggest that PA may permit an adaptation to low Ca intakes. Whether Ca and PA interact synergistically is one of the most important questions unanswered in the area of lifestyle-related bone health research.

Type
Meeting Report
Copyright
Copyright © The Nutrition Society 2003

References

Anderson, JJB (1999) Plant-based diets and bone health: nutritional implications. American Journal of Clinical Nutrition 70, Suppl. 3, 539S542S.CrossRefGoogle Scholar
Anderson, JJB & Sjoberg, HH (2001) Dietary calcium and bone health in the elderly: uncertainties about recommendations. Nutrition Research 21, 263268.CrossRefGoogle Scholar
Ashizawa, N, Fujimura, R, Tokuyama, K & Suzuki, M (1997) A bout of resistance exercise increases urinary calcium independently of osteoclastic activation in men. Journal of Applied Physiology 83, 11591163.CrossRefGoogle ScholarPubMed
Ashizawa, N, Ouchi, G, Fujimura, R, Yoshida, Y, Tokuyama, K & Suzuki, M (1998) Effects of a single bout of resistance exercise on calcium and bone metabolism in untrained young males. Calcified Tissue International 62, 104108.CrossRefGoogle ScholarPubMed
Bailey, DA, Martin, AD, McKay, HA, Whiting, S & Mirwall, R (2000) Calcium accretion in girls and boys during puberty: a longitudinal analysis. Journal of Bone and Mineral Research 15, 22452250.CrossRefGoogle ScholarPubMed
Bassey, EJ, Littlewood, JJ & Taylor, SJG (1997) Relations between ground reaction forces, compressive axial forces in an instrumental massive femoral implant and integrated electro-myographs from Vastus lateralis during various osteogenic exercises. Journal of Biomechanics 30, 213223.CrossRefGoogle Scholar
Bassey, EJ, Rothwell, MC, Littlewood, JJ & Pye, DW (1998) Pre- and post-menopausal women have different bone mineral density responses to the same high-impact exercise. Journal of Bone and Mineral Research 13, 18051813.CrossRefGoogle Scholar
Beck Jensen, JE, Kollerup, G, Sorensen, HA, Pors Nielsen, S & Sorensen, OH (1992) A single measurement of biochemical markers of bone turnover has limited utility in the individual person. Scandinavian Journal of Clinical and Laboratory Investigation 57, 351360.CrossRefGoogle Scholar
Bennell, KL, Malcom, SA, Khan, KM, Thomas, SA, Reid, SJ, Brukner, PD, Ebling, PR & Wark, JD (1997) Bone mass and bone turnover in power athletes, endurance athletes, and controls: A 12-month longitudinal study. Bone 20, 477484.CrossRefGoogle ScholarPubMed
Blumsohn, A, Hannon, RA, Al-Dehaimi, AW, Colwell, A & Eastell, R (1994) Short-term intraindividual variability of markers of bone turnover in healthy adults. Journal of Bone and Mineral Research 9, SI53.Google Scholar
Bonainti, D, Shea, B, Iovine, R, Negrini, S, Robinson, V, Kemper, HC, Wells, G, Tugwell, P & Cranney, A (2002) Exercise for preventing and treating osteoporosis in postmenopausal women (Cochrane Raiser). The Cochrane Library Issue 4. Oxford: Update Software.Google Scholar
Brahm, H, Piehl-Aulin, K & Ljunghall, S (1997) Bone metabolism during exercise and recovery; the influence of plasma volume and physical fitness. Calcified Tissue International 62, 192198.CrossRefGoogle Scholar
Burr, DB & Martin, RB (1992) Mechanism of bone mineral adaptation of the mechanical environment. Sandoz Journal of Medical Science 31, 5976.Google Scholar
Bushinsky, DA & Frick, KK (2000) The effects of acid on bone. Current Opinion in Nephrology and Hypertension 9, 369379.CrossRefGoogle ScholarPubMed
Bushinsky, DA, Krieger, NS, Geisser, DI, Grossman, EB & Coe, FL (1987) Mechanism of proton-induced bone calcium release: calcium carbonate dissolution. American Journal of Physiology 250, F1090F1097.Google Scholar
Bushinsky, DA & Sessler, NE (1992) Critical role of bicarbonate in calcium release from bone. American Journal of Physiology 263, F510F515.Google ScholarPubMed
Carter, DR (1987) Mechanical loading history and skeletal biology. Journal of Biomechanics 20, 10951109.CrossRefGoogle ScholarPubMed
Colwell, A, Russell, RG & Eastell, R (1993) Factors affecting the assay of urinary 3-hydroxy pyridinium crosslinks of collagen as markers of bone resorption. European Journal of Clinical Investigation 23, 341349.CrossRefGoogle ScholarPubMed
Cuneo, RC & Wallace, JD (1994) Growth hormone, insulin-like growth factors and sport: review. Endocrinology and Metabolism 1, 313.Google Scholar
Devine, A, Dick, IM, Heal, SJ, Criddle, RA & Prince, RL (1997) A 4-year follow-up study of the effect of calcium supplementation on bone density in early postmenopausal women. Osteoporosis International 7, 2324.CrossRefGoogle Scholar
Ernst, E (1998) Exercise for female osteoporosis. A systematic review of randomised clinical trials. Sports Medicine 25, 359368.CrossRefGoogle ScholarPubMed
Fesling, NE, Brasel, JA & Cooper, DM (1992) Effect of low and high intensity exercise on circulating growth hormone in men. Journal of Clinical Endocrinology and Metabolism 75, 157162.Google Scholar
Forwood, MR & Burr, DB (1993) Physical activity and bone mass: exercises in futility? Bone and Mineral 21, 89112.CrossRefGoogle ScholarPubMed
Frost, HM (1987) The Mechanostat: A proposed pathogenic mechanism of osteoporosis and the bone mass effects of mechanical and non-mechanical agents. Journal of Bone and Mineral Research 2, 7385.Google Scholar
Frost, HM (1991) A new direction for osteoporosis research: a revival and proposal. Bone 12, 429437.CrossRefGoogle Scholar
Fujimura, R, Ashizawa, N, Watanabe, M, Mukai, N, Amagai, H, Fukubayashi, T, Hayashi, K, Tokuyama, K & Suzuki, M (1997) Effect of resistance exercise on training on bone formation and resorption in young male subjects assessed by markers of bone metabolism. Journal of Bone and Mineral Research 12, 656662.CrossRefGoogle Scholar
Ginty, F, Flynn, A & Cashman, KD (1998 a) The effect of short-term calcium supplementation on biochemical markers of bone metabolism in healthy young adults. British Journal of Nutrition 80, 437443.CrossRefGoogle ScholarPubMed
Ginty, F, Flynn, A & Cashman, K (1998 b) Inter and intra-individual variations in urinary excretion of pyridinium crosslinks of collagen in healthy young adults. European Journal of Clinical Nutrition 52, 7173.CrossRefGoogle ScholarPubMed
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 post-menopausal women. Calcified Tissue International 52, 411414.CrossRefGoogle Scholar
Heaney, RP, Abrams, S, Dawson-Hughes, B, Looker, A, Marcus, R, Matkovic, V & Weaver, C (2000) Peak bone mass. Osteoporosis International 11, 9851009.CrossRefGoogle ScholarPubMed
Hedges, LV & Odkin, I (1985) Statistical Methods for Meta-analysis. San Diego, CA: Academic Press.Google Scholar
Honda, A, Sogo, N, Nagasawa, S, Shimuzu, T & Umemura, Y (2003) High-impact exercise strengthens bone in osteopenic ovariectomized rats with the same outcome as sham rats. Journal of Applied Physiology; abstract from the May issue available at: http://www.jap.physiology.orgCrossRefGoogle Scholar
Inman, CL, Warren, GL, Hogan, HA & Bloomfield, SA (1999) Mechanical loading attenuates bone loss due to immobilisation and calcium deficiency. Journal of Applied Physiology 87, 189195.CrossRefGoogle ScholarPubMed
luliano-Burns, S, Saxon, L, Naughton, G, Gibbons, K & Bass, SL (2003) Regional specificity of exercise and calcium during skeletal growth in girls: a randomised controlled trial. Journal of Bone and Mineral Research 18, 156162.CrossRefGoogle Scholar
Kanis, JA (1994) Osteoporosis. Oxford: Blackwell Science.Google ScholarPubMed
Kelley, GA (1998 a) Aerobic exercise and bone density at the hip in postmenopausal women: a meta-analysis. Preventive Medicine 27, 798807.CrossRefGoogle ScholarPubMed
Kelley, GA (1998 b) Exercise and regional bone mineral density in postmenopausal women: A meta-analytic review of randomised trials. American Journal of Physical Medicine and Rehabilitation 77, 7687.CrossRefGoogle Scholar
Kelley, GA, Kelley, KS & Tran, ZV (2000) Exercise and bone mineral density in men: a meta-analysis. Journal of Applied Physiology 88, 17301736.CrossRefGoogle ScholarPubMed
Kelley, GA, Kelley, KS & Tran, ZV (2001) Resistance training and bone mineral density in women: A meta-analysis of controlled trials. American Journal of Physical Medicine and Rehabilitation 80, 6577.CrossRefGoogle ScholarPubMed
Kelley, GA, Kelley, KS & Tran, ZV (2002) Exercise and lumbar spine bone mineral density in postmenopausal women: A meta-analysis of individual patient data. Journal of Gerontology 57A, M599M604.Google Scholar
Kelly, PJ, Eisman, JA & Sambrook, PN (1990) Interaction of genetic and environmental influences on peak bone density. Osteoporosis 1, 5660.CrossRefGoogle ScholarPubMed
Khan, K, McKay, H, Kannus, P, Bailey, D, Wark, J & Bennell, K (2001) Physical Activity and Bone Health. Champaign, IL: Human Kinetics.Google Scholar
Kohrt, WM, Ehsani, AA & Birge, SJ (1998) HRT preserves increases in bone mineral density and reductions in body fat after a supervised exercise program. Journal of Applied Physiology 84, 15061512.CrossRefGoogle ScholarPubMed
Lanyon, LE (1984) Functional strain as a determinant for bone remodelling. Calcified Tissue International 36, S56S61.CrossRefGoogle Scholar
Lanyon, LE (1992) Control of bone architecture by functional load-bearing. Journal of Bone and Mineral Research 7, Suppl. 2, 53695375.Google ScholarPubMed
Lanyon, LE (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, S37S43.CrossRefGoogle ScholarPubMed
Lanyon, LE, Goodship, AE, Pye, CJ & MacFie, JH (1982) Mechanically adaptive bone remodelling. Journal of Biomechanics 15, 141154.CrossRefGoogle ScholarPubMed
Lanyon, LE, Rubin, CT & Boust, G (1986) Modulation of bone loss during calcium insufficiency by controlled dynamic loading. Calcified Tissue International 38, 209216.CrossRefGoogle ScholarPubMed
McKane, WR, Khosla, S, Egan, KS, Robins, SP, Burritt, MF & Riggs, BL (1996) Role of calcium intake in modulating age-related increases in parathyroid function and bone resorption. Journal of Clinical Endocrinology and Metabolism 81, 16991703.Google ScholarPubMed
Menkes, C (1993) Strength training increases regional bone mineral density and bone remodelling in middle aged and older men. Journal of Applied Physiology 60, 20282034.Google Scholar
Morley, P, Whitfield, JF & Willick, GE (1997) Anabolic effects of parathyroid hormone on bone. Trends in Endocrinology and Metabolism 6, 225231.CrossRefGoogle Scholar
Nishiyama, S, Tomoeda, S, Ohta, T, Higuchi, A & Matsuda, I (1988) Differences in basal and post exercise osteocalcin levels in athletic and nonathletic humans. Calcified Tissue International 43, 150154.CrossRefGoogle Scholar
O'Connor, JA & Lanyon, LE (1982) The influence of strain rate on adaptive bone remodelling. Journal of Biomechanics 15, 767781.CrossRefGoogle ScholarPubMed
Orwoll, ES, Bell, NH, Nanes, MS, Flessland, KA, Pettinger, MB, Mallinal, NJ & Cain, DF (1998) Collagen N-telopeptide excretion in men: the affects of age and intrasubject variability. Journal of Clinical Endocrinology and Metabolism 83, 39303935.Google Scholar
Panteghini, M & Pagani, F (1995) Biological variation in bone-derived biochemical markers in serum. Scandinavian Journal of Clinical and Laboratory Investigation 55, 609616.CrossRefGoogle ScholarPubMed
Panteghini, M & Pagani, F (1996) Biological variation in urinary excretion of pyridinium crosslinks: recommendations of the optimum specimen. Annals of Clinical Biochemistry 33, 3642.CrossRefGoogle ScholarPubMed
Plebani, M, Bernardi, D, Meneghetti, MF, Ujka, F & Zaninotto, M (2000) Biological variability in assessing the clinical value of biochemical markers of bone turnover. Clinica Chimica Acta 299, 7786.CrossRefGoogle ScholarPubMed
Popp-Snijders, C, Lips, P & Netelenbos, JC (1996) Intra-individual variation in bone resorption markers in urine. Annals of Clinical Biochemistry 33, 347348.CrossRefGoogle ScholarPubMed
Prentice, A (1997) Is nutrition important in osteoporosis? Proceedings of the Nutrition Society 56, 357367.CrossRefGoogle ScholarPubMed
Riggs, L, O'Fallon, M, Mulis, J, O'Connor, MK, Kumer, R & Melton, L III (1998) Long-term effects of calcium supplementation on serum parathyroid hormone trial, bone turnover and bone loss in elderly women. Journal of Bone and Mineral Research 13, 168174.CrossRefGoogle ScholarPubMed
Robling, AG, Burr, DB & Turner, CH (2001) Recovery periods restore mechanosensitivity to dynamically loaded bone. Journal of Experimental Biology 204, 33893399.CrossRefGoogle ScholarPubMed
Rong, H, Berg, U, Torring, O, Sundberg, CJ, Granberg, B & Bucht, E (1997) Effect of acute endurance and strength exercise on circulating calcium regulating hormones and bone markers in young healthy males. Scandinavian Journal of Medicine and Science in Sports 7, 152159.CrossRefGoogle ScholarPubMed
Rosenfeld, RG & Roberts, CT Jr (1999) The IGF System; Molecular Biology Physiology and Clinical Applications. Town, NJ: Humana Press.CrossRefGoogle Scholar
Rubin, CT & Lanyon, LE (1984) Regulation of bone formation by applied dynamic loads. Journal of Bone and Joint Surgery 66A, 397402.CrossRefGoogle Scholar
Scariano, JK, Garry, PJ, Montoya, GD, Wilson, JM & Baumgartner, RN (2001) Critical differences in the serial measurements of three biochemical markers of bone turnover in the sera of pre-and postmenopausal women. Clinical Biochemistry 34, 639644.CrossRefGoogle ScholarPubMed
Scopacasa, F, Horowitz, M, Wishart, JM, Need, AG, Morris, HA, Wittert, G & Nordin, BE (1998) Calcium supplementation suppresses bone resorption in early postmenopausal women. Calcified Tissue International 62, 812.CrossRefGoogle ScholarPubMed
Specker, B & Binkley, T (2003) Randomized trial of physical activity and calcium supplementation on bone mineral content in 3 to 5 year-old children. Journal of Bone and Mineral Research 18, 885892.CrossRefGoogle Scholar
Specker, B & Wosje, K (2001) A critical appraisal of the insistence relating calcium and dairy intake to bone health early in life. In Nutritional Aspects of Osteoporosis, pp. 107123 [Burkhardt, P, Dawson-Hughes, B and Heaney, R, editors]. San Diego, CA: Academic Press.Google Scholar
Specker, BL (1996) Evidence for an interaction between calcium intake and physical activity on changes in bone mineral density. Journal of Bone and Mineral Research 11, 15391544.CrossRefGoogle ScholarPubMed
Sugiyama, T, Yamaguchi, A & Kawai, S (2002) Effects of skeletal loading on bone mass and compensation mechanism in bone: a new insight into the 'mechanostat' theory. Journal of Bone Mineral Metabolism 20, 196200.CrossRefGoogle Scholar
Takada, H, Washino, K, Nagashima, M & Iwata, H (1998) Response of parathyroid hormone to anaerobic exercise in adolescent female athletes. Acta Paediatrica Japonica 40, 7377.CrossRefGoogle ScholarPubMed
Turner, CH & Robling, AG (2003) Designing exercise regimens to increase bone strength. Exercise and Sport Science Reviews 31, 4550.CrossRefGoogle ScholarPubMed
Turner, CH, Takano, Y & Owan, I (1995) Aging changes mechanical loading thresholds for bone formation in rats. Journal of Bone and Mineral Research 10, 15441549.CrossRefGoogle ScholarPubMed
Uusi-Rasi, K, Sievanen, H, Pasanen, M, Oja, P & Vuoiri, I (2002) Association of calcium intake and physical activity with bone density and size in premenopausal and postmenopausal women: a peripheral quantitative computed tomography study. Journal of Bone and Mineral Research 17, 544552.CrossRefGoogle ScholarPubMed
Welsh, L, Rutherford, OM, James, I, Crowley, C, Comer, M & Wolman, R (1997) The acute effects of exercise on bone turnover. International Journal of Sports Medicine 18, 247251.CrossRefGoogle ScholarPubMed
Whitfield, JF, Morley, P & Willick, GE (1996) Stimulation of the growth of femoral trabecular bone in ovariectomised rats by the novel parathyroid fragment, hPTH (1–31)NH 2 (Ostabolin). Calcified Tissue International 58, 8187.CrossRefGoogle Scholar
Wolff, J (1892) The Law of Bone Transformation. Berlin: Hirshworld.Google Scholar