2
04
NELSON AND BOUXSEIN
mined) muscle than is needed for normal activities affecting
8. Parfitt AM 1994 The two faces of growth: Benefits and risks to
(33)
bone integrity. Osteoporos Int 4:382–398.
the skeleton.
Thus, as Turner points out in an accompa-
9
. Bassey EJ, Ramsdale SJ 1994 Increase in femoral bone density
in young women following high-impact exercise. Osteoporos
Int 4:72–75.
nying editorial, the “genetics have superceded the biome-
(33)
chanical balance between muscle and bone.”
These fas-
cinating data should stimulate further research in this area,
and a better understanding of the interactions of genes and
the environment in relation to skeletal health can only
improve our ability to devise appropriate public health
measures for the prevention of osteoporosis.
1
0. Taaffe D, Robinson T, Snow C, Marcus R 1997 High impact
exercise promotes bone gain in well-trained female athletes.
J Bone Miner Res 12:255–260.
1. Welsh L, Rutherford O 1996 Hip bone mineral density is
improved by high-impact aerobic exercise in postmenopausal
women and men over 50 years. Eur J Appl Physiol 74:511–
1
In view of the previous cursory discussion of the many
factors that can affect the skeletal benefits of exercise and
despite the hopefulness of the study by Kontulainen et al. in
5
17.
1
1
2. Turner C 1998 Exercise as a therapy for osteoporosis: The
drunk and the streetlamp revisited. Bone 23:83–86.
3. Dalsky GP, Stocke KS, Ehsani AA, Slatopolsky E, Lee WC,
Birge SJ Jr 1988 Weight-bearing exercise training and lumbar
bone mineral content in postmenopausal women. Ann Intern
Med 108:824–828.
(6)
this issue of the Journal, the relative utility of exercise
intervention in maintaining or increasing bone mass in the
general population is still problematic. For those individuals
who are willing and able to be active and stay active, at least
moderately, there appear to be multiple benefits of exercise
in overall fitness, balance, and strength. The importance of
these benefits for preventing falls that might result in frac-
ture cannot be emphasized enough. The greatest effects of
physical activity on bone mass appear to occur during
growth and development. Therefore, it seems reasonable to
1
4. Karlsson MK, Linden C, Karlsson C, Johnell O, Obrant K,
Seeman E 2000 Exercise during growth and bone mineral
density and fractures in old age. Lancet 355:469–470 (letter).
5. Bass S, Pearce G, Bradney M, Hendrich E, Delmas PD,
Harding A, Seeman E 1998 Exercise before puberty may
confer residual benefits in bone density in adulthood: Studies
in active prepubertal and retired female gymnasts. J Bone
Miner Res 13:500–507.
1
turn our attention to intervening in the younger population 16. Sinaki M, Wahner HW, Bergstralh EJ, Hodgson SF, Offord
in hopes of establishing lifelong exercise habits that maxi-
mize peak bone mass within the limits of one’s genetic
potential. In addition, this lifelong exercise may ultimately
reduce fracture risk by attenuating age-related bone loss and
lowering the incidence and severity of falls. Motivating
people, at any age, to get involved and to stay involved in
physical activities for their skeletal health is the ultimate
challenge.
KP, Squires RW, Swee RG, Kao PC 1996 Three-year con-
trolled, randomized trial of the effect of dose-specified loading
and strengthening exercises on bone mineral density of spine
and femur in nonathletic, physically active women. Bone 19:
2
33–244.
1
1
1
7. Ebrahim S, Thompson PW, Baskaran V, Evans K 1997 Random-
ized placebo-controlled trial of brisk walking in the prevention of
postmenopausal osteoporosis. Age Ageing 26:253–260.
8. Rikli RE, McManis BG 1990 Effects of exercise on bone
mineral content in postmenopausal women. Res Q Exerc Sport
6
1:243–249.
9. Kerschan K, Alacamlioglu Y, Kollmitzer J, Wober C, Kaider
A, Hartard M, Ghanem AH, Preisinger E 1998 Functional
impact of unvarying exercise program in women after meno-
pause. Am J Phys Med Rehabil 77:326–332.
0. Shephard RJ 1985 Factors influencing the exercise behaviour
of patients. Sports Med 2:348–366.
1. Birge SJ, Dalsky G 1989 The role of exercise in preventing
osteoporosis. Public Health Rep 104(Suppl):54–58.
2. Henderson N, White C, Eisman J 1998 The roles of exercise
and fall risk reduction in the prevention of osteoporosis. En-
docrinol Metab Clin North Am 27:369–387.
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