Leisure-time physical activity and rate of bone loss among peri- and postmenopausal women: a longitudinal study

Leisure time physical activity and bone mineral density preservation during the menopause transition and postmenopause: a longitudinal cohort analysis from the Study of Women's Health Across the Nation (SWAN)

Background

Whether greater leisure time physical activity (LTPA) is associated with less bone mineral density (BMD) loss during the menopause transition (MT) remains an open question. We hypothesized that: 1) larger increases in LTPA from pre-/early perimenopause (period 1) to late perimenopause/postmenopause (period 2) would be associated with a slower period 2 BMD loss rate; and 2) greater entire-study LTPA levels would be associated with better final absolute BMD (g/cm2).

Methods

Data were from of the Study of Women's Health Across the Nation (1996-2017). Exclusions were: bone beneficial medications, inability to identify start of the MT, and extreme BMD change rates. LTPA measures were a validated ordinal scale and number of metabolic equivalents per hour per week (MET hr wk-1) from sport/exercise. Multiply adjusted, linear regression models estimated: 1) BMD decline rate (annualized %) as a function of LTPA change; and 2) final BMD as a function of entire-study LTPA.

Findings

Median [p25, p75] MET hr wk-1 were 4.2 [0.9, 10.1] and 4.9 [1.4, 11.2] in periods 1 and 2, respectively; walking was the commonest activity. In adjusted models (N = 875), greater increases in LTPA ordinal score and MET hr wk-1 were statistically significantly associated with a slower decline in femoral neck (FN) BMD. Larger entire-study averages of each LTPA measure were statistically significantly related to better final FN and lumbar spine BMD levels.

Interpretation

Findings suggest that LTPA, at modest levels, mitigate MT-related BMD decline and even small increases in intensity, duration or frequency of common activities may lessen bone loss at the population level.

Funding

US-NIH.

Structural Strength Benefits Observed at the Hip of Premenarcheal Gymnasts Are Maintained Into Young Adulthood 10 Years After Retirement From the Sport

PURPOSE

Premenarcheal female gymnasts have been consistently found to have greater bone mass and structural advantages. However, little is known about whether these structural advantages are maintained after the loading stimulus is removed. Therefore, the purpose of this study was to investigate the structural properties at the hip after long-term retirement from gymnastics.

METHODS

Structural properties were derived from dual-energy X-ray absorptiometry scans using the hip structural analysis program for the same 24 gymnasts and 21 nongymnasts both in adolescence (8-15 y) and adulthood (22-30 y). Structural measures were obtained at the narrow neck, intertrochanter, and femoral shaft and included cross-sectional area, section modulus, and buckling ratio. Multivariate analysis of covariance was used to assess differences between groups in bone measures while controlling for size, age, maturity, and physical activity.

RESULTS

Gymnasts were found to have structural advantages at the narrow neck in adolescence (16% greater cross-sectional area, 17% greater section modulus, and 25% lower buckling ratio) and 14 years later (13% greater cross-sectional area and 26% lower buckling ratio). Benefits were also found at the intertrochanter and femoral shaft sites in adolescence and adulthood.

CONCLUSION

Ten years after retirement from gymnastics, former gymnasts' maintained significantly better hip bone structure than females who did not participate in gymnastics during growth.

The role of physical activity in early adulthood and middle-age on bone health after menopause in epidemiological population from Silesia Osteo Active Study

BACKGROUND

Osteoporosis is a growing problem in women after menopause. Among factors protecting from this disease is a physical activity (PA).

AIM

The objective of the study was to evaluate the influence of PA in early adulthood and at middle-age on bone health after menopause.

MATERIAL AND METHODS

The study group consisted of 362 randomly recruited postmenopausal women after menopause. Mean age was 65.2±6.9 years. Medical history was collected from all participants, and they completed questionnaires assessing PA in early adulthood and at middle-age. Physical capacity was estimated using the Duke scale. Bone status was measured with use of densitometry (DXA) for lumbar spine and hip and calcaneus quantitative ultrasound (QUS) measurements.

RESULTS

Physical activity and healthy lifestyle activity in early adulthood did not correlate with bone health, but current PA did (for QUS parameters r=.11; P<.05). Physical capacity correlated with all QUS parameters (r=.2 to .22; P<.05) and femoral neck (FN) BMD and T-score (for both r=.16; P<.05). Current PA frequency at the level of several times a week has the highest positive impact on FN DXA results (P=.01). Bone mass in DXA and QUS variables is related to the type of exercises (P<.05).

CONCLUSION

Physical activity, especially several times a week, at middle-age is a major factor influencing bone health in women after menopause. Further studies concerning the type of exercises are needed.

The effects of weight loss approaches on bone mineral density in adults: a systematic review and meta-analysis of randomized controlled trials

We assessed the impact of weight loss strategies including calorie restriction and exercise training on BMD in adults using a systematic review of randomized controlled trials. Weight reduction results in reduced BMD at the hip, but has less effect on the spine. Both calorie restriction and a combination of calorie restriction and exercise result in a decrease in hip bone density, whereas weight loss response to exercise training without dietary restriction leads to increased hip BMD.

INTRODUCTION

Findings are not consistent on the effect of weight loss on bone mineral density (BMD). We conducted a systematic review on the randomized controlled trials to assess the effect of weight loss strategies, including calorie restriction and exercise programs on BMD in adults.

METHODS

A structured and comprehensive search of MEDLINE and EMBASE databases was undertaken up to March 2016. Study-specific mean differences (MD) were pooled using a random-effects model. Subgroup analysis and meta-regression were used to find possible sources of between-study heterogeneity.

RESULTS

Thirty-two randomized controlled trials met predetermined inclusion criteria. The meta-analysis revealed no significant difference on total BMD (MD 0.007, 95 % CI -0.020-0.034, p = 0.608). In contrast, the pooled data of studies showed a significant effect of weight loss on hip BMD (MD -0.008, 95 % CI -0.09 to -0.006 g/cm(2), p < 0.001) and also lumbar spine BMD (MD -0.018 g/cm(2), 95 % CI -0.019 to -0.017, p < 0.001). BMD in the hip site decreased after more than 4 months, especially in those who were obese. Moreover, calorie restriction interventions longer than 13 months showed a significant decreased in lumbar spine BMD.

CONCLUSION

Weight loss led to significant decreases at the hip and lumbar spine BMD but not at the total. Weight loss response following calorie restriction resulted in a decrease in hip and lumbar spine bone density especially more than 1 year; whereas an exercise-induced weight loss did not.

Self-reported moderate-to-vigorous leisure time physical activity predicts less pain and disability over 12 months in chronic and persistent low back pain

BACKGROUND

Physical deconditioning in combination with societal and emotional factors has been hypothesized to compromise complete recovery from low back pain (LBP). However, there is a lack of longitudinal studies designed to specifically investigate physical activity as an independent prognostic factor. We conducted a prognostic study to investigate whether levels of leisure time physical activity are independently associated with clinical outcomes in people seeking care for chronic and persistent LBP.

METHODS

A total of 815 consecutive patients presenting with LBP to an outpatient spine centre in secondary care were recruited. Separate multivariate linear regression analyses were performed to investigate whether levels of leisure time physical activity (i.e., sedentary, light and moderate-to-vigorous leisure time physical activity levels) predict pain and disability at 12-month follow-up, after adjusting for age, pain, episode duration, disability, neurological symptoms, depression and fear of movement.

RESULTS

Final models showed evidence of an association between baseline physical activity and 12-month outcomes (p < 0.001). In both models, the moderate-to-vigorous physical activity group reported less pain and disability compared with the sedentary group.

CONCLUSIONS

Our findings suggest that physical activity levels may have a role in the prognosis of LBP. Specific domains of physical activity warrant further investigation to better understand this association.

Racial and ethnic differences in physical activity and bone density: National Health and Nutrition Examination Survey, 2007-2008

INTRODUCTION

Participation in regular physical activity (PA) may help maintain bone health as people age. However, most American adults do not engage in the recommended minimum levels of PA, and there are racial/ethnic differences in PA participation. This study aimed to determine whether current physical activity is related to bone density in a racially/ethnically diverse sample after controlling for age, sex, body mass index, poverty-income ratio, tobacco use, vitamin D and calcium intake, and use of osteoporosis medications.

METHODS

We obtained data on femoral bone mineral density for 2,819 adults aged 40 to 80 years who self-reported their race/ethnicity on the 2007-2008 National Health and Nutrition Examination Survey. Data on PA levels were obtained by self-report. We used linear regression models to examine the association between PA and bone density for each racial/ethnic group.

RESULTS

A greater percentage of non-Hispanic blacks (60.9%) and Hispanics (53.3%) reported low levels of PA than non-Hispanic whites (45.3%, P < .001). Non-Hispanic blacks (16.3%) and Hispanics (18.5%) had a lower prevalence of osteopenia than non-Hispanic whites (25.5%; P = .01) but were similar in the prevalence of normal and osteoporosis categories when compared with whites. There was a 0.031 g/cm(2) difference in bone density between those in the high PA versus the low PA category (P = .003). This association remained (β = 0.027, P < .001) after adjusting for race/ethnicity, sex, body mass index, poverty-income ratio, tobacco use, and use of osteoporosis medications.

CONCLUSION

Despite lower levels of activity, blacks and Hispanics were not more likely to have osteoporosis, and high levels of activity were significantly associated with higher bone density even when controlling for race/ethnicity and confounders. The lack of consistency in bone density differences suggests that the cause of the differences maybe multifactorial.

[Impact of physical activity and exercise on bone health in the life course : a review]

Physical activity and exercise are important determinants for metabolic and cardiovascular health. They also play an important role for bone health in childhood, adolescence, and adulthood. This review summarizes results from observational and intervention studies which evaluated the association between physical activity/exercise and bone health in different life course stages. In childhood and adolescence, physical activity and exercise induce improved bone accrual. In adulthood, mainly in postmenopausal women, long-term exercise programs reduce age-related bone loss. Especially weight-bearing activities seem to have an important osteogenic effect. Children and adolescent show a higher bone accrual until 5 years after cessation of an exercise program compared to their peers, who do not participate in an exercise program. In contrast, adults who quit exercising have a higher decrease in bone stiffness compared to adults who never exercised. This effect was particularly seen in postmenopausal women. Continuous physical activity and exercise over the life course and the implementation of exercise programs in schools and community-based intervention programs can help prevent or even reduce osteoporosis and osteoporosis-related fractures. Due to the lack of prospective longitudinal studies, the supposed long-term sustainable protective effect of physical activity and exercise in childhood and adolescent on bone health in later adulthood is not well established.

Physical activity and health during the menopausal transition

The benefits of regular physical activity are well established, but evidence for a protective effect against the adverse health consequences accompanying the menopausal transition is limited. This article reviews that evidence, concluding that more physical activity is generally associated with fewer somatic and mood symptoms. Physical activity seems to minimize weight gain and changes in body composition and fat distribution experienced at midlife and might attenuate the rapid bone density loss that occurs. Given these benefits, clinicians treating perimenopausal women should encourage their patients to follow guidelines for physical activity (≥150 minutes a week of moderate-intensity activity).

Physical activity, body mass index and bone mineral density-associations in a prospective population-based cohort of women and men: the Canadian Multicentre Osteoporosis Study (CaMos)

BACKGROUND

Physical activity (PA) is an important modifiable risk factor for both bone mineral density (BMD) and body mass index (BMI). However, BMI is itself strongly predictive of BMD. Our aim was to determine the association between PA and BMD, with consideration of BMI as a potential mediating factor.

METHODS

The Canadian Multicentre Osteoporosis Study (CaMos) is a population-based prospective cohort study of Canadian women and men. PA was determined from interviewer-administered questionnaires at baseline and Year 5 and summarized as daily energy expenditure in total metabolic equivalents of the task multiplied by minutes/day (MET*m/d). Height, weight, and total hip and lumbar spine BMD were measured at baseline and Year 5. General linear models assessed relationships between PA and BMD, both cross-sectionally (baseline PA with baseline BMD) and longitudinally (average PA and change in PA with change in BMD). BMI was considered as a mediating factor. Potential confounders included age, center, education, caffeine intake, alcohol exposure, smoking history, history of weight-cycling, age at menarche, past use of oral contraceptives, history of >3 months missed menstruation, menopausal status, and antiresorptive use, as relevant.

RESULTS

The study included 2855 men and 6442 women. PA was inversely associated with BMI at baseline, and an increase in PA between baseline and Year 5 was associated with a decrease in BMI, with 0.41 (95% CI: 0.22, 0.60) kg/m(2) loss per 1000 MET*m/d increase (in men) and 0.40 (95% CI: 0.23, 0.57) kg/m(2) loss per 1000 MET*m/d increase (in women). BMI was strongly associated with BMD, both cross-sectionally and longitudinally. However, increased PA was associated with a small increase in total hip BMD, 0.004 (95% CI: 0.000-0.008) g/cm(2) per 1000 MET*m/d (in men) and 0.003 (95% CI: 0.000-0.007) g/cm(2) per 1000 MET*m/d (in women). Average PA was associated with an increase in lumbar spine BMD in women, but not in men; it was not associated with change in total hip BMD in either sex.

CONCLUSION

Increased PA is associated with an increase in BMD and a concomitant decrease in BMI. These findings suggest that population-level interventions to increase PA would favorably impact bone and other health outcomes.

Pedometer determined ambulatory activity and bone mass: a population-based longitudinal study in older adults

In this large population-based study, walking was assessed twice yearly for a week, each time by pedometer, had consistent clinically important associations with hip areal bone mineral density (aBMD) in both sexes which appears most important in those over 65 years of age suggesting that walking becomes more important with increasing age.

INTRODUCTION

Walking is advocated as a preventative strategy for osteoporosis but the evidence is conflicting in females and lacking in males. The aim of this population-based longitudinal study in community dwelling older people (n=875) was to determine the association between pedometer determined ambulatory activity (PAA) and bone mass.

METHODS

Bone mass was assessed as aBMD at the hip and spine using dual X-ray absorptiometry. Steps per day were measured using pedometers for 1 week on four occasions at least 6 months apart. Data were analysed using linear mixed models.

RESULTS

At baseline, PAA was positively associated with hip aBMD. An age interaction was present with steps having a stronger association for those aged over 65 years. Longitudinally, the effect of steps on hip aBMD was constant, but not additive over time. For those over 65 years, the difference in hip aBMD between the lowest and highest steps quartiles ranged from 3.1% to 9.4%. With regard to the spine, the relationship between daily steps and spine aBMD was modified by sex. For males; there was no significant relationship between steps and spine aBMD. However, for females, higher steps were associated with higher spine aBMD with the effect being constant over time but not additive. There was no evidence of a threshold effect.

CONCLUSION

In conclusion, pedometer-determined ambulatory activity has consistent clinically important associations with hip aBMD in both sexes which appears most important in those over 65 years of age. The associations for spine aBMD were both weaker and inconsistent suggesting site specificity.

Efeitos da natação e do treinamento resistido na densidade mineral óssea de mulheres idosas

Exercícios com impacto como caminhada, saltos, corridas e exercícios resistidos são muito utilizados para prevenção da perda óssea em idosas. No entanto, poucos são os estudos que relatam os efeitos da natação na manutenção da massa óssea em mulheres idosas. Portanto, o objetivo deste estudo foi comparar os efeitos da natação com o treinamento resistido na densidade mineral óssea (DMO) de mulheres idosas. Vinte e três mulheres com idade média de 63,9 ± 6,49 anos foram divididas em dois grupos: 1) grupo natação (NAT, n = 13, que) treinou em intensidade entre 60 e 90% da freqüência cardíaca de reserva; 2) grupo treinamento resistido (TR, n = 10), que treinou os principais grupamentos musculares com três séries a 80% de 1RM. Os dois grupos praticaram três vezes por semana com uma hora de duração para cada sessão, durante seis meses. A DMO do colo do fêmur e da coluna lombar (L2-L3-L4) foi mensurada através de DXA antes (T0) e após seis meses de treino (T6). Os resultados mostraram que as médias para a DMO lombar em T0 (0,9250 ± 0,1506g/cm²) e T6 (0,9303 ± 0,1269g/cm²) para o NAT e em T0 (0,9739 ± 0,1249g/cm²) e T6 (0,9737 ± 0,1317g/cm²) para o TR não foram diferentes quando comparadas intra ou intergrupos. De modo similar, não houve diferenças entre a DMO do colo do fêmur em T0 (0,7784 ± 0,1523g/cm²) e T6 (0,7905 ± 0,1610g/cm²) para o NAT e T0 (0,7546 ± 0,1360g/cm²) e T6 (0,7522 ± 0,1421g/cm²) para o TR. Os resultados deste estudo não demonstraram diferenças na DMO entre NAT e TR após seis meses de treino; e que tanto TR quanto NAT não produzem aumentos significativos na DMO de mulheres idosas nesse período.

Vitamin-D-Receptor Genotypes and Bone-Mineral Density in Postmenopausal Women: Interaction with Physical Activity

The current study investigated the association between vitamin-D-receptor (VDR) genotypes with bone-mineral density (BMD) and its interaction with physical activity level (PAL). Individuals in a sample of 192 volunteers (67.84 ± 5.23 years) underwent BMD evaluation and were genotyped for VDR ApaI, BsmI, FokI, and TaqI polymorphisms. Haplotypes were reconstructed through expectation-maximization algorithm, and regression-based haplotype-specific association tests were performed with studied phenotypes. None of the polymorphisms were associated with BMD at any site; however, haplotype was associated with femoral-neck and Ward’s-triangle BMD. Interaction between PAL and VDR genotypes was significant for the FokI polymorphism at femoral-neck and Ward’s-triangle BMD. The FokI T/T genotype was associated with higher BMD in active women. It was concluded that VDR haplotypes, but not genotypes, are associated with femoral-neck and Ward’s-triangle BMD in post-menopausal women. Moreover, the results suggest that VDR FokI polymorphism might be a potential determinant of BMD response to physical activity.

Additional weight bearing during exercise and estrogen in the rat: the effect on bone mass, turnover, and structure

Mechanical loading and estrogen play important roles in bone homeostasis. The aim of this study was to evaluate the effects of mechanical loading on trabecular bone in the proximal femur of ovariectomized rats. We hypothesized that mechanical loading suppresses bone resorption and increases bone formation, which differs from the suppressive effects of estrogen on both resorption and formation. Furthermore, we expected to find changes in trabecular architecture elicited by the effects of mechanical loading and estrogen deficiency. Sixty female Wistar rats, 12 weeks old, were assigned to either the sedentary groups sham surgery (SED), ovariectomy (SED+OVX), and ovariectomy with estrogen replacement (SED+OVX+E2) or to the exercise groups EX, EX+OVX, EX+OVX+E2. Following ovariectomy, 5 microg 17beta-estradiol was given once weekly to the estrogen replacement groups. Exercise consisted of running with a backpack (load +/-20% of body weight) for 15 minutes/day, 5 days/week, for 19 weeks. Dual-energy X-ray absorptiometry (DXA) scans were performed before (T0), during (T6), and after (T19) the exercise period to obtain bone mineral content (BMC) and bone mineral density (BMD) data. After the exercise program, all rats were killed and right and left femora were dissected and prepared for micro-CT scanning and histomorphometric analysis of the proximal femoral metaphysis. After 19 weeks, increases in BMC (P = 0.010) and BMD (P = 0.031) were significant. At T19, mechanical loading had a significant effect on BMC (P = 0.025) and BMD (P = 0.010), and an interaction between mechanical loading and estrogen (P = 0.023) was observed. Bone volume and trabecular number decreased significantly after ovariectomy, while trabecular separation, mineralizing surface, bone formation rate, osteoclast surface, degree of anisotropy, and structure model index increased significantly after ovariectomy (P < 0.05). Trabecular bone turnover and structural parameters in the proximal femur were not affected by exercise. Estrogen deficiency resulted in a less dense and more oriented trabecular bone structure with increased marrow cavity and a decreased number of trabeculae. In conclusion, mechanical loading has beneficial effects on BMC and BMD of the ovariectomized rat. This indicates that the load in the backpack was high enough to elicit an osteogenic response sufficient to compensate for the ovariectomy-induced bone loss. The results confirm that estrogen suppresses both bone resorption and bone formation in the proximal metaphysis in the femoral head of our rat-with-backpack model. The effects of mechanical loading on the trabecular bone of the femoral head were not significant. This study suggests that the effect of mechanical loading in the rat-with-backpack model mainly occurs at cortical bone sites.

Effects of walking-only interventions on bone mineral density at various skeletal sites: a meta-analysis

BACKGROUND AND PURPOSE

Osteoporosis, a common disease in postmenopausal women and the elderly, is associated with decreases in bone mineral density (BMD) and fractures. As weight-bearing activity such as walking has the potential to maintain or increase BMD, I sought in this meta-analysis to mathematically consolidate research on the effects of walking interventions on BMD.

METHODS

A literature search for studies examining the effect of walking on BMD in postmenopausal women and men and women aged 50 years and older was conducted. Search strategies included online literature searches, hand-searches of journals, and examination of the reference lists of articles selected for inclusion. Effect sizes were calculated for each article selected for inclusion and a meta-analysis was conducted for these articles.

RESULTS

Ten articles met the inclusion criteria for the meta-analysis. Walking had a significant (P < or = .03) positive effect (.32) on lumbar BMD but not on the femur or the calcaneus.

DISCUSSION AND CONCLUSION

The results of this meta-analysis do not suggest that walking interventions alone will limit demineralization at all skeletal sites. Perhaps other forms of exercise in addition to walking should be incorporated into training regimens for patients at risk for osteoporosis.

Join the Movement to Have Healthy Bone Project (JHBP): changing behavior among older women in Thailand

Osteoporosis is a common silent disease in older adults presenting with fragility fractures. Lifestyle modifications may be an imperative strategy to minimize the increase of either osteoporosis or osteoporosis-related fractures. Targeted education is one way to promote osteoporosis preventive behaviors. Our aim of this study was to test the feasibility of the Join the Movement to Have Healthy Bone Project (JHBP) that was developed on osteoporosis preventive behaviors for Thai older women. By succeeding in making appropriate lifestyle changes, these women ultimately may reduce the risk of osteoporosis or fractures in later life.

Increased daily physical activity and fatigue symptoms in chronic fatigue syndrome

Individuals with chronic fatigue syndrome (CFS) have been shown to have reduced activity levels associated with heightened feelings of fatigue. Previous research has demonstrated that exercise training has beneficial effects on fatigue-related symptoms in individuals with CFS. PURPOSE: The aim of this study was to sustain an increase in daily physical activity in CFS patients for 4 weeks and assess the effects on fatigue, muscle pain and overall mood. METHODS: Six CFS and seven sedentary controls were studied. Daily activity was assessed by a CSA accelerometer. Following a two week baseline period, CFS subjects were asked to increase their daily physical activity by 30% over baseline by walking a prescribed amount each day for a period of four weeks. Fatigue, muscle pain and overall mood were reported daily using a 0 to 100 visual analog scale and weekly using the Profile of Mood States (Bipolar) questionnaire. RESULTS: CFS patients had significantly lower daily activity counts than controls (162.5 +/- 51.7 x 103 counts/day vs. 267.2 +/- 79.5 x 103 counts/day) during a 2-week baseline period. At baseline, the CFS patients reported significantly (P < 0.01) higher fatigue and muscle pain intensity compared to controls but the groups did not differ in overall mood. CFS subjects increased their daily activity by 28 +/- 19.7% over a 4 week period. Overall mood and muscle pain worsened in the CFS patients with increased activity. CONCLUSION: CFS patients were able to increase their daily physical activity for a period of four weeks. In contrast to previous studies fatigue, muscle pain, and overall mood did not improve with increased activity. Increased activity was not presented as a treatment which may account for the differential findings between this and previous studies. The results suggest that a daily "activity limit" may exist in this population. Future studies on the impact of physical activity on the symptoms of CFS patients are needed.

Healthy aging: health promotion and disease prevention

Successful aging includes the ability to perform functional tasks. This ability to perform functional tasks, or functional ability, is influenced by musculoskeletal and cardiovascular functioning and the presence and severity of symptoms of chronic disease. Empirical evidence indicates that musculoskleletal and cardiovascular functioning and symptoms of chronic disease in later life are strongly related to lifestyle choices involving physical activity and nutritional intake. Previous researchers have demonstrated that increases in physical activity and appropriate changes in nutritional intake can be effective interventions to prevent and treat symptoms of chronic disease and improve musculoskeletal and cardiovascular functioning. As a result of this evidence, several organizations have developed physical activity and nutritional intake recommendations aimed at maintaining or increasing the functional ability of older adults. These physical activity recommendations include engaging in cardiorespiratory, flexibility, strength, and balance training 3 to 5 days per week. Broad nutritional recommendations for older adults include a low-fat, plant-based diet including fruits, vegetables, whole grains, 8 glasses of water per day, and a vitamin and mineral supplement.

Effect of daily walking steps on ultrasound parameters of the calcaneus in elderly Japanese women

In this cross-sectional study, we investigated the effect of daily walking steps on ultrasound parameters of the calcaneus in elderly Japanese women. The subjects were 143 community-dwelling elderly women aged 61-87 years (mean age 71.4+/-5.5 years). The speed of sound (SOS), broadband ultrasound attenuation (BUA) and the stiffness index (Stiffness) of the calcaneus were measured. Walking steps were recorded using a pedometer for 7 consecutive days as an outcome measure of physical activity. In univariate analyses, steps/day significantly decreased with aging. SOS, BUA and Stiffness showed negative correlations with age and positive correlations with weight. Linear relationships were not seen between any of the ultrasound parameters and daily walking steps. Then, the ultrasound parameters were adjusted for age and/or weight using multiple regression models, and the relationships between the adjusted ultrasound measurements and walking steps were examined using quadratic regression models. Walking activity up to approximately 12,000 steps/day was positively associated with the adjusted ultrasound measurements, above which additional walking steps had no positive effect. We conclude that daily walking steps may be suitable for evaluating the relationship between ultrasound parameters and physical activity in elderly women, but further research is needed to confirm the effect of daily walking steps on the rate of bone loss.

Effect of previous and present physical activity on bone mass in elderly women

The importance of a physically active lifestyle as a preventive measure for maintaining bone mass is often stressed. The aim of this study was to evaluate the effect of everyday physical activity on bone mass from young adulthood to old age in 75-year-old women. Bone mineral density (BMD) was assessed by dual-energy X-ray absorptiometry technique in total body, hip (femoral neck and trochanter), and spine (LII-LIV) in a population-based cohort of 995 women, all 75 years old. Each woman responded to a questionnaire giving an estimate of the previous and present physical activity level at work and leisure time from youth and up to the present age of 75 years. No correlations were found between the different estimates of physical activity level and BMD. In a multiple regression analysis the different estimates of physical activity level did not have any combined effect on BMD in any of the skeletal regions measured; neither did the physical activity, previous or present, differ when the subgroup of women with a BMD in the highest quintile at all sites was compared with women with a BMD in the lowest quintile. The activity level in the various areas of life did not correlate to each other indicating that few women had chosen a generally active vs non-active lifestyle. A hypothetical positive effect on bone by one activity could therefore be diminished by another. The answer alternatives were mostly not normally distributed, which could also affect the results, making it difficult to identify women with extremely high or low physical activity level. In conclusion, the results from this study of randomly selected elderly women cannot confirm an effect of previous and present everyday physical activity on bone mass. Neither was it possible to find an effect of physical activity in those women with the highest BMD at all sites, suggesting that other factors are of greater importance for maintaining bone mass in elderly women.