Benefits of 2 years of intense exercise on bone density, physical fitness, and blood lipids in early postmenopausal osteopenic women: results of the Erlangen Fitness Osteoporosis Prevention Study (EFOPS)

BACKGROUND: Growing evidence indicates that physical exercise can prevent at least some of the negative effects on health associated with early menopause. Here we determine the effects of intense exercise on physical fitness, bone mineral density (BMD), back pain, and blood lipids in early postmenopausal women. METHODS: The study population comprised 50 fully compliant women, with no medication or illness affecting bone metabolism, who exercised over 26 months (exercise group EG]), and 33 women who served as a nontraining control group (CG). Two group training sessions per week and 2 home training sessions per week were performed in the EG. Both groups were individually supplemented with calcium and cholecalciferol. Physical fitness was determined by maximum strength and cardiovascular performance. Bone mineral density was measured at the lumbar spine (dual-energy x-ray absorptiometry DXA] and quantitative computed tomography QCT]), the proximal femur (DXA), and the forearm (DXA). In serum samples taken from a subset of the study participants, we determined bone formation (serum osteocalcin) and resorption (serum cross-links) markers as well as blood lipid levels. Vasomotor symptoms related to menopause and pain were also assessed. RESULTS: After 26 months, significant exercise effects determined as percentage changes compared with baseline were observed for physical fitness (isometric strength: trunk extensors EG +36.5% vs CG +1.7%], trunk flexors EG +39.3% vs CG -0.4%], and maximum oxygen consumption EG +12.4% vs CG -2.3%]); BMD (lumbar spine DXA L1-L4, EG +0.7% vs CG -2.3%], QCT L1-L3 trabecular region of interest EG +0.4% vs CG -6.6%], QCT L1-L3 cortical region of interest EG +3.1% vs CG -1.7%], and total hip DXA, EG -0.3% vs CG -1.7%]); serum levels (total cholesterol EG -5.0% vs CG +4.1%] and triglycerides EG -14.2% vs CG +23.2%]); and pain indexes at the spine. CONCLUSION: General purpose exercise programs with special emphasis on bone density can significantly improve strength and endurance and reduce bone loss, back pain, and lipid levels in osteopenic women in their critical early postmenopausal years.