Association of physical exercise and calcium intake with bone mass measured by quantitative ultrasound

Abstract

Background: Interventions other than medications in the management of osteoporosis are often overlooked. The purpose of this study was to investigate the association of physical activity and calcium intake with bone parameters.

Methods: We measured the heel T-score and stiffness index (SI) in 1890 pre- and postmenopausal women by quantitative ultrasound (QUS) and assessed physical activity and dietary calcium intake by questionnaire. Participants were divided according to their weekly physical activity (sedentary, moderately active, systematically active) and daily calcium consumption (greater than or less than 800 mg/day).

Results: SI values were significantly different among premenopausal groups (p = 0.016) and between sedentary and systematically active postmenopausal women (p = 0.039). QUS T-scores in systematically active premenopausal women with daily calcium intake > 800 mg/day were significantly higher than those in all other activity groups (p < 0.05) independent of calcium consumption.

Conclusions: Systematic physical activity and adequate dietary calcium intake are indicated for women as a means to maximize bone status benefits.

Figure 1

Weekly physical activity according to age decade. This figure depicts a categorization of weekly physical activity frequency according to age-decade only. The cut-off decade for reduction of physical activity in women was found 60-69 decade.

Figure 2

Stiffness Index (SI) values in study's population. This figure depicts a categorization of stiffness index values and number of participants in our study population according to age-decade only. No significant decline in stiffness index was seen in women (premenopausal and postmenopausal) below 50 years. This parameter exhibits a fall pattern especially after the 6^th decade as seen in the figure (p = 0.001).

Figure 3

Mean QUS T-score in various age decades. This figure depicts a categorization of QUS T-score values and number of participants in our study population according to age-decade only. No significant decline in T-score was seen in women (premenopausal and postmenopausal) below 50 years. This parameter exhibits a fall pattern especially after the 5^th decade as seen in the figure (p = 0.01).

Figure 4

Daily amount of dietary calcium intake in total population. This figure depicts the daily amounts of dietary calcium intake (and percent) in total population.

Figure 5

Daily calcium intake in premenopausal and postmenopausal women. This figure depicts the daily amounts of dietary calcium intake (and percent) according to menopausal status using 800 mg daily as cut off point.

Figure 6

Synergy between physical activity and dietary calcium intake in women consuming calcium amounts greater than 800 mg/day. This graphic depicts mean QUS T-score values calculated according to daily calcium intake in all premenopausal and postmenopausal activity groups using 800 mg daily as cut off point (for statistical significant values see text).