Position Statement: Exercise Guidelines to Increase Peak Bone Mass in Adolescents

Abstract

Background: An increase in bone mineral density during adolescence increases resistance to fractures in older age. The Korean Society for Bone and Mineral Research and the Korean Society of Exercise Physiology developed exercise guidelines to increase the peak bone mass (PBM) in adolescents based on evidence through a systematic review of previous research. Methods: Articles were selected using the systematic method, and the exercise guidelines were established by selecting key questions (KQs) and defining the effects of exercises based on evidence through a literature review for selecting the final exercise method. There were 9 KQs. An online search was conducted on articles published since 2000, and 93 articles were identified. Results: An increase in PBM in adolescence was effective for preventing osteoporosis and fractures in older age. Exercise programs as part of vigorous physical activity (VPA) including resistance and impact exercise at least 5 to 6 months were effective for improving PBM in adolescents. It is recommended that resistance exercise is performed 10 to 12 rep•set-1 1-2 set•region-1 and 3 days•week-1 using the large muscles. For impact exercises such as jumping, it is recommended that the exercise is performed at least 50 jumps•min-1 , 10 min•day-1 and 2 days•week-1. Conclusions: Exercise guidelines were successfully developed, and they recommend at least 5 to 6 months of VPA, which includes both resistance and impact exercises. With the development of exercise guidelines, the incidence of osteoporosis and fractures in the aging society can be reduced in the future, thus contributing to improved public health.

Influence of Mediterranean Diet Adherence and Physical Activity on Bone Health in Celiac Children on a Gluten-Free Diet

“…Nevertheless, several small randomized controlled trials suggest that impact activities, moderate-intensity resistance training, and participation in sports involving running and jumping are all osteogenic stimuli in children. Vigorous PA, including both resistance and impact exercises (e.g., through jumping [ 25 ] or weight-bearing activities [ 67 ]), during childhood and adolescence, improves bone mineral content, BMD, and structural properties without side effects [ 28 , 67 ]. Therefore, this type of intervention should be implemented when possible to increase bone mass in the early stages of life, which may directly prevent bone diseases such as osteoporosis later in life, especially among children with CD [ 67 ].…”

“…Previous studies suggest that potentially modifiable factors might positively impact BMD; however, these results have not been fully verified. In this context, adequate physical activity (PA) levels during childhood are essential for bone formation and for achieving an optimal bone peak mass [ 25 ]. Usually, PA levels are not assessed despite their importance for BMD and general health status.…”

The Efficacy of Brief School-Based Exercise Programs in Improving Pubertal Bone Mass and Physical Fitness: A Randomized Controlled Trial

“…Our findings are consistent with the results of previous studies. The osteogenic effect depends on the internal muscle activity and the impact of external force [ 47 ], which regulate the proliferation and maturation of osteoblasts and osteoclasts through the signal transduction system of bone cells and improve the positive balance of bone metabolism. High-impact load programs can produce the two types of osteogenic forces and generate beneficial effects on bone mass and structure [ 48 ].…”

Association between serum creatinine level within the normal range and bone mineral density in adolescents

“…It is widely accepted that the increase in peak bone mass achieved during adolescence is effective in preventing osteoporosis and osteoporosis-associated fractures [19]. Creatine has been a popular dietary supplement choice of adolescents, and no study has observed any gastro-intestinal discomforts or changes in markers of clinical health and safety following creatine supplement use periods [20].…”