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Benefits of 2 Years of Intense Exercise on Bone Density, Physical Fitness, and Blood Lipids in Early Postmenopausal Osteopenic Women
Results of the Erlangen Fitness Osteoporosis Prevention Study (EFOPS)
Wolfgang Kemmler, PhD;
Dirk Lauber, PhD;
Jürgen Weineck, PhD, MD;
Johannes Hensen, MD;
Willi Kalender, PhD;
Klaus Engelke, PhD
Arch Intern Med. 2004;164:1084-1091.
Background Growing evidence indicates that physical exercise can prevent at least some of the negative effects on health associated with early menopause. Here we determine the effects of intense exercise on physical fitness, bone mineral density (BMD), back pain, and blood lipids in early postmenopausal women.
Methods The study population comprised 50 fully compliant women, with no medication or illness affecting bone metabolism, who exercised over 26 months (exercise group [EG]), and 33 women who served as a nontraining control group (CG). Two group training sessions per week and 2 home training sessions per week were performed in the EG. Both groups were individually supplemented with calcium and cholecalciferol. Physical fitness was determined by maximum strength and cardiovascular performance. Bone mineral density was measured at the lumbar spine (dual-energy x-ray absorptiometry [DXA] and quantitative computed tomography [QCT]), the proximal femur (DXA), and the forearm (DXA). In serum samples taken from a subset of the study participants, we determined bone formation (serum osteocalcin) and resorption (serum cross-links) markers as well as blood lipid levels. Vasomotor symptoms related to menopause and pain were also assessed.
Results After 26 months, significant exercise effects determined as percentage changes compared with baseline were observed for physical fitness (isometric strength: trunk extensors [EG +36.5% vs CG +1.7%], trunk flexors [EG +39.3% vs CG –0.4%], and maximum oxygen consumption [EG +12.4% vs CG –2.3%]); BMD (lumbar spine [DXA L1-L4, EG +0.7% vs CG –2.3%], QCT L1-L3 trabecular region of interest [EG +0.4% vs CG –6.6%], QCT L1-L3 cortical region of interest [EG +3.1% vs CG –1.7%], and total hip [DXA, EG –0.3% vs CG –1.7%]); serum levels (total cholesterol [EG –5.0% vs CG +4.1%] and triglycerides [EG –14.2% vs CG +23.2%]); and pain indexes at the spine.
Conclusion General purpose exercise programs with special emphasis on bone density can significantly improve strength and endurance and reduce bone loss, back pain, and lipid levels in osteopenic women in their critical early postmenopausal years.
From the Institute of Medical Physics (Drs Kemmler, Kalender, and Engelke), and Institute of Sport Sciences (Drs Lauber and Weineck), University of Erlangen, Erlangen, Germany; and Medizinische Klinik I, Klinikum Hannover Nordstadt, Hannover, Germany (Dr Hensen). The authors have no relevant financial interest in this article.
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