Part of the reduction in bone density observed in older people is due to disuse rather than the aging process itself. While some mechanical stress is needed to maintain optimal bone density, it is not clear just which types of exercise are most valuable or whether appropriate exercise might reduce the need for estrogen therapy in postmenopausal women. Cross-sectional studies. Physical activity, aerobic fitness, and strength have all been correlated with bone density. Young people who use a specific part of the body in vigorous exercise exhibit enhanced bone density in that part of the body, but not necessarily in other regions. Older people who have been active for many years seem to exhibit generally enhanced bone density. Prospective studies. Most regimens which used vigorous aerobic and strength training enhanced bone density, but walking is relatively ineffective for prevention of postmenopausal bone loss. Most studies using specific bone-loading exercise have shown substantial increases in bone density at the specific sites loaded. Elderly people seem capable of responding favorably to vigorous exercise. No direct comparisons of exercise and estrogen therapy have been reported. Excessive exercise. Extremely high volumes of exercise may overwhelm a person's adaptive capacity, leading to stress fractures. For example, young women athletes who suffer from menstrual dysfunction exhibit reduced bone density and musculoskeletal disorders. Clinical implication. Although the evidence is far from conclusive, an exercise regimen should probably include vigorous total body exercise, including strength and aerobic training.
Although a dose-response relationship between resistance training frequency and strength has been identified, there is limited research regarding the association between frequency and body composition. This study evaluated the effects of 3 vs. 4 d·wk(-1) of resistance training on body composition and strength in middle-aged women. Twenty-one untrained women (age 47.6 ± 1.2 years) completed 8 weeks of resistance training either 3 nonconsecutive days of the week using a traditional total-body protocol (RT3) or 4 consecutive days of the week using an alternating split-training protocol (RT4). The RT3 completed 3 sets of 8 exercises, whereas RT4 completed 3 sets of 6 upper body exercises or 6 sets of 3 lower body exercises. Both groups completed 72 sets per week of 8-12 repetitions at 50-80% 1 repetition maximum. Weekly training volume load was calculated as the total number of repetitions × load (kg) completed per week. Body composition was measured using air displacement plethysmography. At baseline and after 8 weeks of resistance training, there were no significant between-group differences. Both protocols resulted in significant increases in absolute lean mass (1.1 ± 0.3 kg; p = 0.001), body weight (1.02 ± 0.3 kg; p = 0.005), body mass index (0.3 ± 0.1 kg·m(-2); p = 0.006), strength (p < 0.001), and weekly training volume load (p < 0.001). Correlation analysis revealed that weekly training volume load was strongly and positively related to gains in lean mass (r = 0.56, p = 0.05) and strength (r = 0.60, p = 0.006). In these untrained, middle-aged women, initial short-term gains in lean mass and strength were not influenced by training frequency when the number of training sets per week was equated.
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