Hostname: page-component-7c8c6479df-xxrs7 Total loading time: 0 Render date: 2024-03-27T09:17:25.260Z Has data issue: false hasContentIssue false

Physical activity, diet and skeletal health

Published online by Cambridge University Press:  02 January 2007

Francesco Branca*
Affiliation:
National Institute of Nutrition, Via Ardeatina, 546, IT-00179 Rome, Italy
*
*Corresponding author: Email: f.branca@agora.stm.it
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.

Diet and physical exercise concur in the determination of skeletal mass at the end of adolescence and in the conservation of it during adult life. The functional demand imposed on bone is a major determinant of its structural characteristics. Stress applied to a skeletal segment affects the geometry of the bone, the microarchitecture and the composition of the matrix. The stimulatory effect occurs when the skeleton is subjected to strains exceeding habitual skeletal loads, and the intensity of load is more important than the duration of the stimulus.

Physical activity leads to greater bone density in children and adolescents and, to a minor extent, in adults. Weight bearing activities, such as walking, have a greater effect than non weight bearing activities, such as cycling and swimming. Reduction of loads as in bed resting or in space flights leads to bone loss. Intense training may cause damage, promptly repaired, as in stress fractures observed in army recruits. Female athletes may experience oligo-amenorrhea, though they still have a positive bone balance.

There is an important interaction between the mechanical demands and the availability of nutrients to manufacture bone tissue. The increase in bone density in post-menopausal women is positively related to calcium intake when calcium supplementation is accompanied by exercise. When mechanical demands are low, such as during immobilisation, the intestinal calcium absorption is reduced. Calcium intake should also be analysed in the light of other dietary factors affecting the balance between absorption and excretion, and in combination with a number of other minerals, trace elements and bioactive substances with an impact on bone metabolism.

Type
Research Article
Copyright
Copyright © CABI Publishing 1999

References

1 Consensus Development Conference. Diagnosis, prophylaxis and treatment of osteoporosis. Am. J. Med. 1993; 94: 646–50.CrossRefGoogle Scholar
2Cooper, C, Campion, G, Melton, LJ III. Hip fractures in the elderly: a world-wide projection. Osteoporosis Int. 1992; 2: 285–89.(Abstract).CrossRefGoogle ScholarPubMed
3Rutherford, OM. Bone density and physical activity. Proc.Nutr.Soc. 1997; 56: 967–75.CrossRefGoogle ScholarPubMed
4Grisso, JA, Capezuti, E, Schwartz, A. Falls as risk factors for fractures. In: Marcus, R, Feldman, D, Kelsey, J, eds., Osteoporosis. London: Academic Press, INC. 1996.Google Scholar
5Slemenda, CW, Johnston, CC, Hui, SL. Assessing fracture risk. In: Marcus, R, Feldman, D, Kelsey, J, eds., Osteoporosis. London: Academic Press, INC, 1996.Google Scholar
6Wickham, CAC, Walsh, K, Cooper, C, Barker, DJP, Margetts, BM, Morris, J, Bruce, SA. Dietary calcium, physical activity and risk of hip fracture: a prospective study. Br. Med. J. 1989; 299: 889–91.CrossRefGoogle ScholarPubMed
7Carter, DR, Van Der Meulen, MC, Beaupre, GS. Mechanical factors in bone growth and development. Bone 1996; 18(1 Suppl): 5S10S.CrossRefGoogle ScholarPubMed
8Tuukkanen, J, Wallmar, B, Jalovaara, P, Takala, T, Sjogren, S, Vaananen, K. Changes induced in growing rat bone by immobilization and remobilization. Bone 1991; 12: 113–8.CrossRefGoogle ScholarPubMed
9Yeh, JK, Liu, CC, Aloia, JF. Additive effect of treadmill exercise and 17 beta-estradiol replacement on prevention of tibial bone loss in adult ovariectomized rat. J. Bone Min. Res. 1993; 8(6): 677–83.CrossRefGoogle ScholarPubMed
10Frost, HM. The mechanostat: a proposed pathogenic mechanism of osteoporosis and bone mass effects on mechanical and non mechanical agents. Bone Miner. 1987; 2: 7385.Google Scholar
11Lanyon, LE. Control of bone architecture by functional load bearing. J. Bone Miner. Res. 1992; 7: S36975.CrossRefGoogle ScholarPubMed
12Forwood, MR, Burr, DB. Physical activity and bone mass: exercises in futility. Bone Miner. 1993; 21: 89112.CrossRefGoogle ScholarPubMed
13Welten, DC, Kemper, HCG, Post, GB, Van Mechelen, W, Twisk, J, Lips, P, Teule, GJ. Weight-bearing activity during youth is a more important factor for peak bone mass than calcium intake. J. Bone Miner. Res. 1994; 9: 1089–96.CrossRefGoogle ScholarPubMed
14Vogel, JM, White, MW. Bone mineral changes: the second manned Skylab mission. Aviation, Space and Environmental Medicine. 1976; 47: 396400.Google ScholarPubMed
15Wilmet, E, Ismail, AA, Heilporn, A, Weraeds, D, Bergmann, P. Longitudinal study of the bone mineral content and of soft tissue composition after spinal cord section. Paraplegia 1995; 33: 674–7.Google ScholarPubMed
16Uebelhart, D, Demiaux-Domenech, B, Roth, M, Chantraine, A. Bone metabolism in spinal cord injured individuals and in others who have prolonged immobilisation. A review. Paraplegia. 1995; 33: 669–73.Google ScholarPubMed
17Rodriguez, JI, Garcia-Alix, A, Palacios, J, Paniagua, R. Changes in long bones due to fetal immobility caused by neuromuscular disease. J. Bone Joint Surg. 1988; 70A: 1052–60.CrossRefGoogle Scholar
18Palle, S, Vico, L, Bourrin, S, Alexandre, C. Bone tissue response to four-month antiorthostatic bedrest: a bone histomorphometric study. Calcif. Tissue Int. 1992; 51(3): 189–94.CrossRefGoogle ScholarPubMed
19Goemaere, S, Van Laere, M, De Neve, P, Kaufman, JM. Bone mineral status in paraplegic patients who do or do not perform standind. Osteoporos. Int. 1994; 4: 138–43.CrossRefGoogle ScholarPubMed
20Karlsson, MK, Johnell, O, Obrant, KJ. Bone mineral density in weight lifters. 1993; 52: 212–15.Google ScholarPubMed
21Pruitt, LA, Jackson, RD, Bartels, RL, Lehnhard, HJ. Weight-training effects on bone mineral density in early postmenopausal women. J. Bone Miner. Res. 1992; 7: 179–85.CrossRefGoogle Scholar
22Slemenda, CW, Miller, JZ, Hui, SL, Reister, TK, Johnston, CC. Role of physical activity in the development of skeletal mass in children. J. Bone Min. Res. 1991; 6(1): 1227–33.CrossRefGoogle ScholarPubMed
23Rico, H, Revilla, M, Hernandez, ER, Gomez-Castresana, F, Villa, LF. Bone mineral content and body composition in postpubertal cyclist boys. Bone 1993 Mar–Apr; 14(2): 93–5.CrossRefGoogle ScholarPubMed
24Krall, EA, Dawson-Hughes, B. Walking is related to bone density and rates of bone loss. Am. J. Med. 1994; 96: 20–6.CrossRefGoogle ScholarPubMed
25Bassey, EJ, Ramsdale, SJ. Increase in femoral bone density in young women following high impact exercise. Osteop. Internat. 1994; 4: 275.CrossRefGoogle ScholarPubMed
26Welsh, L, Rutherford, OM. Hip bone mineral density is improved by high-impact exercise in post-enopausal women and men over 50 years. Eur. J. Appl. Physiol. 1996; 74: 511–17.CrossRefGoogle ScholarPubMed
27van der Wiel, HE, Lips, P, Graafmans, WC, Danielsen, CC, Nauta, J, van Lingen, A, Mosekilde, L. Additional weight-bearing during exercise is more important than duration of exercise for anabolic stimulus of bone: a study of running exercise in female rats. Bone 1995; 16: 7380.CrossRefGoogle Scholar
28Dalsky, GP, Stocke, KS, Ehsani, AA, Slatpolsky, E, Lee, CW, Birge, SJ. Weight-bearing exercise training and lumbar bone mineral content in postmenopausal women. Ann. Int. Med. 1988; 108: 824–28.CrossRefGoogle ScholarPubMed
29Järvinen, TLN, Järvinen, TAH, Sievanen, H, Heinonen, A, Tanner, M, Huang, X-H, Nenonen, A, Isola, JJ, Jarvinen, M, Kanus, P. Vitamin D receptor alleles and bone's response to physical activity. Calcif. Tissue Int. 1998; 62: 413–17.CrossRefGoogle ScholarPubMed
30Borer, KT. The effects of exercise on growth. Sports Med. 1995 12; 20(6): 375–97.CrossRefGoogle ScholarPubMed
31Drinkwater, BL, Nilson, K, Chesnut, CH, Bremner, WJ, Shainholtz, S, Southworth, MB. N. Eng. J. Med. 1984; 311: 277–81.CrossRefGoogle Scholar
32Myburgh, KH, Hutchins, J, Fataar, AB, Hough, SF, Noakes, TD. Low bone density is an etiologic factor for stress fractures in athletes. Ann. Int. Med. 1990; 113: 754–59.CrossRefGoogle ScholarPubMed
33Wilson, JH, Wolman, RL. Osteoporosis and fracture complications in an amenorrhoeic athlete. Br J Rheumatol 1994; 33: 480–1.CrossRefGoogle Scholar
34Pester, S, Smith, PC. Stress fractures in the lower extremities of soldiers in basic training. Orthop. Rev. 1992; 21(3): 297303.Google ScholarPubMed
35Coleman, EA, Buchner, DM, Cress, ME, Chan, BK, de Lateur, BJ. The relationship of joint symptoms with exercise performance in older adults. J. Am. Geriatr. Soc. 1996; 01; 44(1): 1421.CrossRefGoogle ScholarPubMed
36Sinaki, M, Mikkelsen, BA. Postmenopausal spinal osteoporosis: flexion versus extension exercises. Arch. Phys. Med. Rehabil. 1984 10; 65(10): 593–6.Google ScholarPubMed
37Reid, DM, New, SA. Nutritional influences on bone mass. Proc. Nutr. Soc. 1997; 56: 977–87.CrossRefGoogle ScholarPubMed
38Robins, SP, New, SA. Markers of bone turnover in relation to bone health. Proc. Nutr. Soc. 1997; 56: 903–14.CrossRefGoogle ScholarPubMed
39Matkovic, V. Calcium metabolism and calcium requirements during skeletal modelling and consolidation. Am. J. Clin. Nutr. 1991; 54: 245S–60S.CrossRefGoogle ScholarPubMed
40Walker, ARP. The human requirement of calcium: should low intakes be supplemented? Am J Clin Nutr 1972; 25: 518–30.CrossRefGoogle ScholarPubMed
41Lloyd, T, Andon, MB, Rollings, N, et al. Calcium supplementation and bone mineral density in adolescent girls. JAMA 1993; 270: 841–44.CrossRefGoogle ScholarPubMed
42Johnston, CC, Miller, JZ, Slemenda, CW, et al. Calcium supplementation and increases in bone mineral density in children. N. Engl. J. Med. 1992; 327: 82–7.CrossRefGoogle ScholarPubMed
43Lee, WTK, Leung, SSF, Leung, DMY, Tsang, HSY, Lau, J, Cheng, JCY. A randomized double-blind controlled calcium supplementation trial, and bone and height acquisition in children. Br. J. Nutr. 1995; 74: 125–39.CrossRefGoogle ScholarPubMed
44Specker, BL. Evidence for an interaction between calcium intake and physical activity on changes in bone mineral density. J. Bone Min. Res. 1996; 11: 1539–44.CrossRefGoogle ScholarPubMed
45Yeh, JK, Aloia, JF. Effect of physical activity on calciotropic hormones and calcium balance in rats. Am. J. Physiol. 1990; 258: E2638.Google ScholarPubMed
46Wallwork, JC, Sandstead, HH. Zinc. In: Simmons, D.J., ed., Nutrition and bone development. New York: Oxford University Press, 1990.Google Scholar
47Seco, C, Revilla, M, Hernandez, ER, Gervas, J, Gonzalez-Riola, J, Villa, LF, Rico, H. Effects of zinc supplementation on vertebral and femoral bone mass in rats on strenuous treadmill training exercise. J. Bone Miner. Res. 1998 03; 13(3): 508–12.CrossRefGoogle ScholarPubMed
48 American College of Sports Medicine. ACSM position stand on osteoporosis and exercise. Medicine and Science in Sports and Exercise 1995; 27: I–VII.CrossRefGoogle Scholar
49 ISTAT. Indagine Multiscopo sulle famiglie, Anni 1987–1991.No.4.L'uso del tempo in Italia. Roma: Istituto di Statistica, 1993.Google Scholar
50Riggs, BL, Melton, LJ. The prevention and treatment of osteoporosis. N. Engl. J. Med. 1992; 27;327(9): 620–7.Google Scholar
51Duppe, H, Gardsell, P, Johnell, O, Nilsson, BE, Ringsberg, K. Bone mineral density, muscle strength and physical activity. Acta Orthop. Scand. 1997; 68: 97103.CrossRefGoogle ScholarPubMed
52Brahm, H, Malmin, H, Michaelsson, K, Strom, H, Ljunghall, S. Relationships between bone mass measurements and lifetime physical actvity in a Swedish population. Calcif. Tissue Int. 1998; 62: 400–12.CrossRefGoogle Scholar