Does exercise affect bone mineral density and content when added to a calorie-restricted diet? A systematic review and meta-analysis of controlled clinical trials

Yazdanpanah, Zeinab; Beigrezaei, Sara; Mohseni-Takalloo, Sahar; Soltani, Sepideh; Rajaie, Seyede Hamide; Zohrabi, Tayebeh; Kaviani, Mojtaba; Forbes, Scott C.; Baker, Julien S.; Salehi‐Abargouei, Amin

doi:10.1007/s00198-021-06187-9

Cited by 6 publications

(4 citation statements)

References 54 publications

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“…Moreover, the Cooperative Lifestyle Intervention Program (CLIP) II showed that adding resistance but not aerobic training to diet minimized long-term hip bone loss [41] and, in the Look AHEAD (Action in Health for Diabetes) trial, the BMD-preserving effect of exercise was observed in men, but not in women [42] . Meta-analyses confirmed the efficacy of exercise training in attenuating BMD loss after body weight loss induced by diet [43] and bariatric surgery [44] , and that resistance exercise is the training modality that partially preserves bone mass during calorie-restricted diets [45] .…”

Section: Effect Of Exercise On Bone Loss Associated With Body Weight ...mentioning

confidence: 82%

Effects of physical activity/exercise on bone metabolism, bone mineral density and fragility fractures

Haxhi¹,

Mattia²,

Vitale³

et al. 2022

Int J Bone Frag

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Bone adapts its mass to mechanical stress from muscle contraction and ground reaction forces, with osteocytes playing a central role in transducing mechanical stimuli into biochemical signals that orchestrate bone modeling and remodeling. This suggests that there is a potential benefit to be derived from physical activity (PA)/exercise for preservation of bone mass. This article briefly reviews the existing literature on the effects of PA/exercise on bone metabolism, bone mineral density (BMD), and fragility fractures. Epidemiological studies have demonstrated an inverse relationship between PA level and fracture risk and its determinants, such as low BMD and falls. Conversely, prolonged disuse or unloading are associated with bone loss. Intervention studies have shown that PA/exercise is effective in increasing BMD and reducing fracture risk, with resistance, weight-bearing and high-impact exercise and high-intensity and high-frequency and intermittent training protocols found to provide the most marked effect. These findings support a role for exercise as a non-pharmacological, safe, and low-cost tool against bone loss associated with age and other conditions. However, high-quality studies are needed to establish the optimal exercise prescription. Furthermore, PA/exercise is effective in mitigating weight loss-induced bone loss and has the potential for reducing the increased fracture risk associated with preserved BMD that characterizes individuals with type 2 diabetes.

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Section: Effect Of Exercise On Bone Loss Associated With Body Weight ...mentioning

confidence: 82%

Effects of physical activity/exercise on bone metabolism, bone mineral density and fragility fractures

Haxhi¹,

Mattia²,

Vitale³

et al. 2022

Int J Bone Frag

View full text Add to dashboard Cite

show abstract

“…When CR is paired with micronutrient enrichment, the reduction in bone mineral density is not accompanied by reduced bone quality and microstructure ( 51 ). Calcium intake and physical exercise during CR appear to be particularly effective to minimize detrimental effects on bone health ( 52 , 53 ).…”

Section: Discussionmentioning

confidence: 99%

Caloric restriction reduces trabecular bone loss during aging and improves bone marrow adipocyte endocrine function in male mice

Rinne,

Soultoukis,

Oveisi

et al. 2024

Front. Endocrinol.

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IntroductionCaloric restriction (CR) is a nutritional intervention that increases life expectancy while lowering the risk for cardio-metabolic disease. Its effects on bone health, however, remain controversial. For instance, CR has been linked to increased accumulation of bone marrow adipose tissue (BMAT) in long bones, a process thought to elicit detrimental effects on bone. Qualitative differences have been reported in BMAT in relation to its specific anatomical localization, subdividing it into physiological and potentially pathological BMAT. We here examine the local impact of CR on bone composition, microstructure and its endocrine profile in the context of aging.MethodsYoung and aged male C57Bl6J mice were subjected to CR for 8 weeks and were compared to age-matched littermates with free food access. We assessed bone microstructure and BMAT by micro-CT, bone fatty acid and transcriptomic profiles, and bone healing.ResultsCR increased tibial BMAT accumulation and adipogenic gene expression. CR also resulted in elevated fatty acid desaturation in the proximal and mid-shaft regions of the tibia, thus more closely resembling the biochemical lipid profile of the distally located, physiological BMAT. In aged mice, CR attenuated trabecular bone loss, suggesting that CR may revert some aspects of age-related bone dysfunction. Cortical bone, however, was decreased in young mice on CR and remained reduced in aged mice, irrespective of dietary intervention. No negative effects of CR on bone regeneration were evident in either young or aged mice.DiscussionOur findings indicate that the timing of CR is critical and may exert detrimental effects on bone biology if administered during a phase of active skeletal growth. Conversely, CR exerts positive effects on trabecular bone structure in the context of aging, which occurs despite substantial accumulation of BMAT. These data suggest that the endocrine profile of BMAT, rather than its fatty acid composition, contributes to healthy bone maintenance in aged mice.

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“…Both studies reported the group assigned to exercise combined with calorie restriction had less decrease in femoral neck BMD but no difference in lumbar spine BMD compared with the group assigned to calorie restriction alone. However, a larger and later metaanalysis found only resistance exercise beneficially affected total BMD during a calorie-restricted diet [78]. This was further supported by a recent clinical trial which was not included in the meta-analyses above and examined the bone effects of aerobic (e.g., walking on a treadmill, stationary cycling, and stair climbing) and resistance exercise (e.g., flexibility exercise, resistance training using weightlifting machines, and balance exercise) during weight loss.…”

Section: Physical Activitymentioning

confidence: 98%

Weight Loss Interventions and Skeletal Health in Persons with Diabetes

Zhao

Khedkar

Johnson

2022

Curr Osteoporos Rep

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Purpose of Review Weight loss is recommended for improving glycemic control and reducing cardiovascular risk factors in persons with diabetes. However, both diabetes and weight loss have been associated with detrimental skeletal health. This review aims to summarize recent study findings on the effects of lifestyle interventions for weight loss on skeletal health among persons with type 2 diabetes (T2D). Recent Findings A few large-scale observational studies have demonstrated an increased fragility fracture risk associated with weight loss among persons with T2D. Randomized control trials in persons with T2D also have shown that intentional lifestyle interventions for weight loss are associated with a greater decrease in bone mineral density (BMD) and an increase in the risk of fracture. The biological mechanisms underlying the compromised bone health during lifestyle interventions for weight loss are complex and not yet conclusive. However, there is evidence to suggest that bone loss and increased fracture risk during intentional weight loss may be mitigated by some intervention approaches, such as high protein intake, calcium supplementation, and resistance and balance training. Summary There is still a lack of studies investigating the effects of different interventions for weight loss on skeletal health among persons with T2D. However, certain types of diet and physical activity intervention combined with bone monitoring and fracture risk prediction may help achieve weight loss goals and maintain skeletal health among persons with T2D during intentional weight loss.

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Does exercise affect bone mineral density and content when added to a calorie-restricted diet? A systematic review and meta-analysis of controlled clinical trials

Cited by 6 publications

References 54 publications

Effects of physical activity/exercise on bone metabolism, bone mineral density and fragility fractures

Effects of physical activity/exercise on bone metabolism, bone mineral density and fragility fractures

Caloric restriction reduces trabecular bone loss during aging and improves bone marrow adipocyte endocrine function in male mice

Weight Loss Interventions and Skeletal Health in Persons with Diabetes

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