Physical Activity and Bone Health in Men: A Systematic Review and Meta-Analysis

Abstract

Background Research on osteoporosis and physical activity often focuses on women. We aimed to conduct a systematic review to assess the benefits and harms of physical activity interventions for men’s bone health. Methods We used standard methods and searched for randomized controlled trials (RCTs) (duration, ≥6 months) published in all languages across multiple databases and trial registries. The last search was conducted on July 22, 2020. Results We included 11 studies (14 publications), resulting in a sample of N=723 men (range, 17–132 participants). We found low-certainty evidence that physical activity has little influence on the areal bone mineral density (aBMD) at the total hip (5 RCTs, N=324; mean difference [MD], 0.03 [95 confidence interval (CI), 0.01 to 0.05]) and little or no influence on the aBMD at the femoral neck (3 RCTs, N=186; MD, 0.00 [95% CI, −0.04 to 0.04]), lumbar spine (3 RCTs; N=213; MD, 0.05 [95% CI, −0.01 to 0.11]), and whole body (4 RCTs, N=203; MD, −0.00 [95% CI, −0.03 to 0.02]). Conclusions We found low-certainty evidence that physical activity (≥6 months) has some effect on the total hip in men, but new evidence may change this finding. This review highlights the gap in the evidence on specific intervention prescriptions that can benefit the bone geometry, structure, microarchitecture, and, ultimately, bone strength in men. Future research should engage in comprehensive reporting of harms, quality of life outcomes, advanced imaging findings, and long-term interventions.

The Effects of Exercise on Bone Mineral Density in Men: A Systematic Review and Meta-Analysis of Randomised Controlled Trials

“…Based on GRADE, it was concluded that further research is unlikely to change the direction of the effect (Supplementary Table 2). These findings are different to the recently published metaanalysis [51], however Ashe et. al.…”

Exercise Effects on Bone Mineral Density in Men

“…(5) Review articles, case reports, editorials, conference abstracts, and letters were not considered. (6) We also excluded studies with participants with pre-training exercise habits close to the volume and intensity applied by the intervention protocol.…”

“…Many guidelines on osteoporosis and fracture prevention consider physical exercise as the most effective non-pharmacologic agent for increasing bone strength and reducing falls (e.g., [1][2][3]). However, in contrast to female cohorts [4,5], evidence for a favorable effect of exercise on Bone Mineral Density (BMD) in men is still limited (review in [6][7][8][9]). Recently, two systematic reviews and meta-analyses of randomized controlled trials reported data on physical activity/exercise effects on BMD in men 18 years and older [6,8].…”

“…However, in contrast to female cohorts [4,5], evidence for a favorable effect of exercise on Bone Mineral Density (BMD) in men is still limited (review in [6][7][8][9]). Recently, two systematic reviews and meta-analyses of randomized controlled trials reported data on physical activity/exercise effects on BMD in men 18 years and older [6,8]. Ashe et al [6] reported significant exercise effects on BMD at the total hip but little or no effect of exercise on the adjacent femoral neck (FN)-BMD.…”

“…Recently, two systematic reviews and meta-analyses of randomized controlled trials reported data on physical activity/exercise effects on BMD in men 18 years and older [6,8]. Ashe et al [6] reported significant exercise effects on BMD at the total hip but little or no effect of exercise on the adjacent femoral neck (FN)-BMD. In contrast, the meta-analysis of Hamilton et al [8] indicates significant evidence for an exercise effect on FN-BMD.…”