Abstract
The optimal type of exercise that simultaneously decreases body weight and preserves bone health in people with obesity is unknown. This parallel randomized trial aimed to compare the effect of endurance and endurance-strength training on bone mineral density (BMD) and content (BMC) in abdominally obese postmenopausal women. A total of 101 women were recruited and randomly assigned to endurance or endurance-strength training groups. Participants trained for 60 min per day, three times per week for 12 weeks. The endurance exercises were performed at an intensity of 50–75% of the maximum heart rate, whereas the strength exercises were at 50–60% of the one-repetition maximum. Pre- and post-intervention BMD and BMC of the total body, lumbar spine, and femoral neck and physical capacity were measured. There were no differences among the densitometric parameters in the endurance group, but a significant increase in whole-body BMD in the endurance-strength group was found. Moreover, there was a significant difference between the groups in the changes in the lumbar spine BMC. Furthermore, both training programs significantly improved physical capacity with no differences between groups. Endurance training was more effective in maintaining BMC at the lumbar spine. However, both groups did not differ in effect on BMD. Further studies with a long-term follow-up should be considered to confirm these findings. The study was registered with the German Clinical Trials Register within the number DRKS00019832, and the date of registration was 26 February 2020 (retrospective registration).
Highlights
Several studies have shown that obesity is related to a high bone mass [1] while decreases in body weight might cause bone loss [2]
BMC, bone mineral content; BMD, bone mineral density; BMI, body mass index; Q1–Q3, interquartile range; and 95% CI, 95% confidence interval of means
The major finding of the present study was that endurance training was more effective in maintaining BMC at the lumbar spine
Summary
Several studies have shown that obesity is related to a high bone mass [1] while decreases in body weight might cause bone loss [2]. It should be highlighted that, in women, estrogen levels are an important determinant of bone health and that the relationship between estrogen depletion and bone loss is well established [4]. Insulin resistance can increase circulating quantities of sex hormones, thereby increasing bone mass [5]. It has been suggested that a high body weight might negatively affect bone health [6]. The risk of osteoporosis, osteopenia, or non-spine fractures increases in subjects with a higher percentage of body fat, probably due to the replacement of osteoblasts in bone by adipocytes [7]. Adipokines levels might play important roles in bone formation and resorption [8]
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