Osteoporosis continues to plague the West. 10 million Americans have Osteoporosis and 34 million have Osteopenia, the precursor to Osteoporosis. This costs $19 billion/year to treat medically. No reason exists for this cost. Some people are at higher risk for osteoporosis; genetics, build and nutrition play roles but the number factor in its development has been and continues to be weight-bearing activity. This is a behaviour and behaviors can be modified.
In 2007, Kemmler et al published a 4 year study on the effects of exercise on osteoporosis development. 86 subjects with osteopenia were assigned to the exercise group and 56 to the control group. 61 of the exercise group completed the study and 34 of the control (4 years is a long-time). All the women were post-menopausal.
The fundamental thing to note is that while calcium, vitamin D and magnesium intake were monitored, they found that as long as minimums were met, it was exercise and not nutrition that determined bone density. This is important and I find most in the health care industry missing the boat on this. You can eat all the calcium you want- if you are not exercising, you will not upregulate it to bone matrix. It simply will not occur.
Thus we come to the important part- what was there exercise program? The first 7 months consisted of group exercise classes. 20 min of weight bearing aerobics, 5 min of jumping exercise, 40 min of weight training. The aerobics were moderate intensity- 70-85% of max HR and designed primarily for cardiovascular benefits and to warm up the body. The jumping program consisted of close legged jumps, jumping jacks, diagonal jumps and lateral jumps- 15 reps each. This alone is a great shock to the bones and would help increase bone mass formation. They then went on to the weight training session: leg press, leg curl, bench press machine, seated row, abdominal flexion, back extension, lat pull down, hyperextension, leg extension and shoulder raise. 2 sets of 20 reps at 50% of max were performed. During the second period of the study, the weight bearing exercises were modified to include the squat, deadlift, dumbbell row, and dumbbell bench press. 2 sets of 15 reps at 60% were used. At this time, home stretching and working with resistance elastics were recommended. The protocol involved 6 min of stretching and 3 min of strength work. The final portion of the protocol involved the same exercises but the protocol was adapted to 2 sets of 12 at 65% of max and rope jumping 3 sets of 15 jumps was integrated to both the jumping program and the home program.
Three 1 hour sessions/week and 10 min of exercise at home was the time the participants had to put into this program to complete it. No cooking, no group meetings (beyond twice yearly meet ups for the study). Supervised, regular exercise was the bulk of the intervention.
The result? First it should be noted that there was a 15% drop out rate. Some were excluded due to changes in health status (asthma, cancer, etc.) It is important to note that not a single person who completed the 4 year program on the experimental group developed osteoporosis. In fact, 75% reversed their osteopenia as measured by DXA at the lumbar spine. In the control group, 12% went on to develop osteoporosis and no one improved their bone mineral density status.
It is really that simple. Eat an adequate amount of calcium, vitamin D and magnesium so your bones can function. The rest is aerobics, plyometrics and some solid strength work- squats, deadlifts, rows and bench press. Doesn’t this sound like a basic training program? Given that everyone who was physically capable of following the program and who did for 4 years did not get worse and 75% got better- is it not safe to assume that the overwhelming majority of men and women suffering from low bone mineral density can (with medical supervision) go to a gym and get themselves exercising and eventually get a handle on this? Remember, the participants spent 7 months on a basic program before progressing to more intense training- don’t go out a try to squat double bodyweight today. The point remains; this is a manageable and preventable condition. Eat well and go train hard. We can take those $19 billion dollars and put them in other areas of medical research that we can’t control.