What effect does exercise have on bone mass in older adults? A recent systematic review demonstrates that the effect is very beneficial, that older adults need to keep active in their advanced years to build bone mass, and that two main categories of exercise are essential (1). The two categories are weight bearing exercises and strength training.
A systematic review is a research study that involves a review of a large body of research articles and studies on a specific topic and draws appropriate conclusions.
A transcript of the video is available at the bottom of this article.
Weight Bearing and Cardiovascular Exercise
The review concluded that comfortable walking is not enough to stimulate bone mass. However, when we increase the pace (i.e., running, climbing or brisk movement) or make it multi-component (i.e, nordic walking), the benefit is noticeable. Depending on activity level, the increase in bone mass ranged from 1% to 6%.
What is even more significant was that when the review compared the active people with the control group (of inactive people) the differences were significant. The people in the control group (who were inactive) lost bone mass of up to 5%. Over time this difference between the groups demonstrates that cardiovascular weight bearing exercises are extremely beneficial – in fact, they are essential.
The review demonstrated that strength training allowed people to build bone mass not only at the hip but also at the spine. Further, like the experience with people who did weight bearing exercises, the benefits to people who did strength training compared to those who did none was significant. People who followed a strength training program improved bone mass. Those that did not, lost bone mass.
Benefit of Balance
The review also showed that weight bearing and strength training carried over to improved balance – a key part of fall prevention and fracture risk reduction.
Bone Loss Over Time – Use it Or Lose It
The review showed that both women and men lose bone mass (at different rates and at different times) if they are inactive. It also showed that both sexes can gain bone mass – even in their 60s and 70s.
The message is clear. Be active as early as you can. Stay active. Incorporate both strength training and weight bearing into your exercise program.
Effects of training on bone mass in older adults: a systematic review. Gomez-Cabello, et al. Sports Medicine. April, 2012.
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Video and Transcript
Transcript – Scroll Bar is on the Right Hand Side
Hi. Welcome back to MelioGuide. I’m Margaret Martin, and today I wanted to share with you a recent systematic review that looks at a whole bunch of studies, and this systematic review is specifically on the effects of training on bone mass with older adults, and older adults, which I guess I’m officially in that category, is 50 plus.
In this systematic review, they take all the research articles that talk about individuals with osteoporosis, osteopenia, people that are risk for low bone mass, and they go, What type of training best addresses the building of bone mass, and looking at all these studies what is the conclusion?
So I am always excited when I see large research reviews that supports what MelioGuide does and wanted to share that information with you. In case you do want to research it yourself, it is an article in Sports Medicine of April of 2012.
So, in the research study, there are two main categories of exercise. One is cardiovascular and the other is strength training. What the predominant conclusion of the studies with the cardiovascular was that things like comfortable walking, as we had indicated in a previous blog on walking, comfortable walking is not enough of a stimulus for our bones. But when we increase our walking pace and even make it multi-component where we can incorporate some step climbing and a little bit of jogging, definitely brisk walking, all of the studies show that women, and I say women because there are very few studies on bone mass done on men, so sorry guys, but that women do build bone even if it is incrementally 1% or 2%. Some studies where they did multiple types of cardiovascular, they had great numbers like 5% and 6% increase.
But the key here is even with a 1% increase, that’s what we were getting with the study group. With the control group, meaning the people that weren’t doing the cardiovascular exercise, they were losing bone at a rate of up to 5% in the same period of time. When you look at the difference and we know that that difference is building over time, that’s really significant. That’s the first thing on cardiovascular.
Let’s now talk about the strength studies, and in the strength studies, what was shown was that you were able to build bone not just at the hip, which is what predominantly was shown in the aerobic studies, but also at the spine. Most of the studies were then using a DEXA, which is the most standard way of measuring bone density.
But the key thing here is that the DEXAs, when they looked at studies using other forms of bone measurement, such as peripheral quantitative computer tomography, PQCT, they are going, Wow, we can actually see changes in the PQCT; which were positive in terms of bone building, but that weren’t actually seen on the DEXA. That’s an important component as well.
As I talked about earlier in terms of the aerobic exercise, the strength building exercises, the strength training then with enough intensity was able to build bone, again not at huge numbers, but it made the difference between not losing bone at huge numbers, and so people were actually able to not only maintain but continue to build bone well into their 60s and 70s, which is really exciting to see.
One other thing to bring up here is that they were looking specifically at men and women. Women, we know, they lose a lot of bone when they hit menopause, but they will continue losing bone well into their 60s, 70s, and 80s at a less of a quick rate than they did during menopause. Men, however, comparing the rate of bone loss in their 70s compared to their 60s, men generally will start losing bone even as early as their 40s if they’re not very active, and they will continue
losing bone. Men in this particular study, when they looked at men in their 70s versus their 60s, they were losing bone 2 to 4 times the rate.
When you’re looking at an active, pleasant retirement, that really is lost if you’re having to deal with multiple fractures. So we really encourage you to, if you’re older yourself, to embark upon a safe strength training program or encourage your loved ones to do so.
One last point to bring up in the studies that was looked at was that the benefits of the aerobic and the strength training did carry over into balance. The studies show that people that participated in the study also improved in their balance on significant measures.If you are wanting to follow a safe exercise program, the MelioGuide program has been designed, that follows the guidelines for aerobic strength training and I also incorporate balance exercises as well.
That’s it for today on MelioGuide. Thanks for tuning in.
Margaret Martin is a Physical Therapist, Certified Strength and Conditioning Specialist (CSCS) and Certified Yoga Teacher with over 27 years experience helping clients achieve their health and fitness goals.
She treats clients with low bone density at her clinic and teaches fellow Health Professionals how to treat osteoporosis.
Margaret is the recipient of the 2011 Award of Distinction from the College of Physiotherapists of Ontario for her significant contributions and achievements as a Physiotherapist.