Effects of Exercise Training on Bone Health Parameters in Individuals With Obesity: A Systematic Review and Meta-Analysis

Abstract

BackgroundOsteoporosis causes bone fragility, increasing the risk of fractures. Evidence suggests a strong correlation between obesity and fracture risk. Physical training is known to enhance bone resistance and protect from fracture; however, its osteogenic effect in the presence of obesity remains unknown.ObjectiveWe sought to evaluate the influence of exercise training on bone health indices in individuals with obesity.MethodsThis systematic literature search was conducted using common electronic databases from inception - December 2019. The following key terms (and synonyms searched for by the MeSH database) were included and combined using the operators “AND,” “OR,” “NOT”: [(“body mass index” OR obesity OR obese OR overweight OR fat mass) AND (“bone mineral density” OR “bone mineral content” OR “peak bone mass” OR “mechanical loading” OR “Osteoporosis” OR “bone geometry” OR “bone resistance”) AND (“exercise training” OR “physical training” OR “strength training,” OR “resistance training” OR “aerobic training” OR “combined training”)].ResultsAfter screening, 10 studies (889 initial records) were included in the final analysis (8 different countries, 263 participants). Two studies investigated males, six females, and two, both sexes. The training duration was at least eight weeks with 2–3 sessions/week. Physical training displayed a significant trivial impact on the whole body (WB) BMD (0.13 SMD; 95% CI [0.00, 0.26], p = 0.046). Subgroup analyses indicated a significant small increase in the WB BMD (0.27 SMD; 95% CI [0.00, 0.53], p = 0.048) in the endurance training group, a non-significant trivial increase in the WB BMD (0.11 SMD; 95% CI [−0.06, 0.29], p = 0.203) in the resistance group, and a non-significant trivial increase in the WB BMD (0.03 SMD; 95% CI [−0.26, 0.32], p = 0.86) in the combined training group. In addition, a significant small decrease was found in the weight of trained subjects (−0.24 SMD; 95% CI [−0.42, −0.05], p = 0.011).ConclusionPhysical training has little to no effect on the WB BMD in subjects with overweight/obesity. Currently, insufficient evidence to advocate for any specific type of exercise for enhancing bone health exists for overweight/obese individuals. Investigations examining the impact of varying types of physical exercise on WB BMD of obese individuals are needed.

Bone marrow metabolism is affected by body weight and response to exercise training varies according to anatomical location

“…We found no training effect in BMD in either group. In accordance to our study, Zouhal et al suggest that in people with overweight or obesity, BMD is not expected to increase, as they already have high BMD values 39 . Six months may also be too short a time to detect significant changes in BMD 41 .…”

“…In accordance to our study, Zouhal et al suggest that in people with overweight or obesity, BMD is not expected to increase, as they already have high BMD values. 39 Six months may also be too short a time to detect significant changes in BMD. 41 Interestingly, when we analysed BMD individually, not taking into account the study participants' twin pair status, there was a statistically significant increase of 4.1% ( p = .005, 95% CI 1.5; 6.8) in BMD (data not shown).…”

“…However, how the effect of exercise on bone is influenced by obesity has not been widely studied. 39 While the benefits of weight-bearing exercise on bone are well established, 5,40 the effects of exercise are mostly explained by baseline BMD level. We found no training effect in BMD in either group.…”

Exploring the mechanism of Alisma orientale for the treatment of pregnancy induced hypertension and potential hepato-nephrotoxicity by using network pharmacology, network toxicology, molecular docking and molecular dynamics simulation

“…The uniport ID of the target was converted to the standardized gene name by Uniport ( Holzhüter and Geertsma, 2022 ) ( https://www.uniprot.org/ ) database. MeSH database ( https://www.ncbi.nlm.nih.gov/mesh ) was utilized to verify the standard name of the disease as “Pregnancy-induced Hypertension” “drug-induced liver injury” (DILI) and “drug-induced kidney injury” (DIKI) ( Zouhal et al, 2021 ). Then, GeneCards database ( Barshir et al, 2021 ) ( https://www.genecards.org/ ), DisGeNET database ( Piñero et al, 2020 ) ( https://www.disgenet.org ) and Online Mendelian Inheritance in Man ( Li et al, 2012 ) (OMIM, https://omim.org ) database were retrieved to obtain potential targets using the keywords “Pregnancy-induced Hypertension” “drug-induced liver injury” and “drug-induced kidney injury”.…”

Reversal of Soleus Muscle Atrophy in Older Adults: A Non-Volitional Exercise Intervention for a Changing Climate

“…Similar to muscle mass, bone mineral density peaks in the fourth decade of life, and then declines slowly, although women often experience a more rapid decline in the peri-menopausal years. Exercise interventions have not been shown to be particularly helpful in slowing or reversing age-related bone loss, 42 , 43 so osteopenia and osteoporosis remain a major concern for healthcare providers caring for older adults.…”