Physical Activity and Bone Health in Men: A Systematic Review and Meta-Analysis
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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.
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.
참고문헌 (41)
- J. A. Kanis, "Long-Term Risk of Osteoporotic Fracture in Malmö", Osteoporosis International, 11(8), pp.669~674 (2000), Springer Science and Business Media LLC[DOI]
- M. Naves, "Prevalence of osteoporosis in men and determinants of changes in bone mass in a non-selected Spanish population", Osteoporosis International, 16(6), pp.603~609 (2005), Springer Science and Business Media LLC[DOI]
- P. N. Kannegaard, "Excess mortality in men compared with women following a hip fracture. National analysis of comedications, comorbidity and survival", Age and Ageing, 39(2), pp.203~209 (2010), Oxford University Press (OUP)[DOI]
- Neil Binkley, "A perspective on male osteoporosis", Best Practice & Research Clinical Rheumatology, 23(6), pp.755~768 (2009), Elsevier BV[DOI]
- Adrianne C. Feldstein, "The near absence of osteoporosis treatment in older men with fractures", Osteoporosis International, 16(8), pp.953~962 (2005), Springer Science and Business Media LLC[DOI]
- Jean-Eric Tarride, "The burden of illness of osteoporosis in Canadian men", Journal of Bone and Mineral Research, 27(8), pp.1830~1838 (2012), Wiley[DOI]
- Howe TE, "Exercise for preventing and treating osteoporosis in postmenopausal women", Cochrane Database Syst Rev, pp.CD000333~ (2011)[DOI]
- Cathie Sherrington, "Exercise for preventing falls in older people living in the community: an abridged Cochrane systematic review", British Journal of Sports Medicine, 54(15), pp.885~891 (2020), BMJ[DOI]
- K. A. Bolam, "The effect of physical exercise on bone density in middle-aged and older men: A systematic review", Osteoporosis International, 24(11), pp.2749~2762 (2013), Springer Science and Business Media LLC[DOI]
- A. Gómez-Cabello, "Effects of Training on Bone Mass in Older Adults", Sports Medicine, 42(4), pp.301~325 (2012), Springer Science and Business Media LLC[DOI]
- G.A. Kelley, "Exercise and bone mineral density in men: A meta-analysis of randomized controlled trials", Bone, 53(1), pp.103~111 (2013), Elsevier BV[DOI]
- Kelley GA, "Exercise and bone mineral density in men: a meta-analysis", J Appl Physiol, 88, pp.1730~1736 (2000)[DOI]
- W. Kemmler, "Exercise effects on bone mineral density in older men: a systematic review with special emphasis on study interventions", Osteoporosis International, 29(7), pp.1493~1504 (2018), Springer Science and Business Media LLC[DOI]
- A. Liberati, "The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: explanation and elaboration", BMJ, 339, pp.b2700~b2700 (2009), BMJ[DOI]
- Gordon H Guyatt, "GRADE: an emerging consensus on rating quality of evidence and strength of recommendations", BMJ, 336(7650), pp.924~926 (2008), BMJ[DOI]
- Lefebvre C, "Cochrane handbook for systematic reviews of interventions: Version 5.1.0" (2011), The Cochrane Collaboration
- Fiona Stewart, "Are men difficult to find? Identifying male-specific studies in MEDLINE and Embase", Systematic Reviews, 3(1), pp.78~ (2014), Springer Science and Business Media LLC[DOI]
- J. P. T. Higgins, "The Cochrane Collaboration's tool for assessing risk of bias in randomised trials", BMJ, 343, pp.d5928~d5928 (2011), BMJ[DOI]
- GRADEpro GDT, (2015), McMaster University
- Higgins JPT, "Cochrane handbook for systematic reviews of interventions: Version 5.1.0" (2011), The Cochrane Collaboration;
- John E. Cornell, "Random-Effects Meta-analysis of Inconsistent Effects: A Time for Change", Annals of Internal Medicine, 160(4), pp.267~270 (2014), American College of Physicians[DOI]
- The R Development Core Team, "R: A language and environment for statistical computing. Version 4.0.3", R Foundation for Statistical Computing, ~ (2020)
- Sara Balduzzi, "How to perform a meta-analysis with R: a practical tutorial", Evidence Based Mental Health, 22(4), pp.153~160 (2019), BMJ[DOI]
- Sarah J. Allison, "High impact exercise increased femoral neck bone mineral density in older men: A randomised unilateral intervention", Bone, 53(2), pp.321~328 (2013), Elsevier BV[DOI]
- Allison SJ, "The influence of highimpact exercise on cortical and trabecular bone mineral content and 3D distribution across the proximal femur in older men: A randomized controlled unilateral intervention", J Bone Miner Res, 30, pp.1709~1716 (2015)[DOI]
- S. Kukuljan, "Effects of a multi-component exercise program and calcium–vitamin-D3-fortified milk on bone mineral density in older men: a randomised controlled trial", Osteoporosis International, 20(7), pp.1241~1251 (2009), Springer Science and Business Media LLC[DOI]
- Sonja Kukuljan, "Independent and combined effects of calcium-vitamin D3 and exercise on bone structure and strength in older men: an 18-month factorial design randomized controlled trial", The Journal of Clinical Endocrinology & Metabolism, 96(4), pp.955~963 (2011), The Endocrine Society[DOI]
- Joshua Matthews, "Effects of a multicomponent exercise program combined with calcium–vitamin D3-enriched milk on health-related quality of life and depressive symptoms in older men: secondary analysis of a randomized controlled trial", European Journal of Nutrition, 59(3), pp.1081~1091 (2020), Springer Science and Business Media LLC[DOI]
- J. Woo, "A randomised controlled trial of Tai Chi and resistance exercise on bone health, muscle strength and balance in community-living elderly people", Age and Ageing, 36(3), pp.262~268 (2007), Oxford University Press (OUP)[DOI]
- K. Bolam, "The effect of high-impact exercise on hip and spine bone density in community-dwelling middle-aged and older men: A 9-month dose-response randomised controlled trial", Journal of Science and Medicine in Sport, 16, pp.e14~e15 (2013), Elsevier BV[DOI]
- J. Whiteford, "Effects of a 1-year randomized controlled trial of resistance training on lower limb bone and muscle structure and function in older men", Osteoporosis International, 21(9), pp.1529~1536 (2010), Springer Science and Business Media LLC[DOI]
- E. W. Helge, "Recreational football improves bone mineral density and bone turnover marker profile in elderly men", Scandinavian Journal of Medicine & Science in Sports, 24, pp.98~104 (2014), Wiley[DOI]
- Huuskonen J, "Regular physical exercise and bone mineral density: a four-year controlled randomized trial in middle-aged men. The DNASCO study", Osteoporos Int, 12, pp.349~355 (2001)[DOI]
- M. B. Randers, "Positive performance and health effects of a football training program over 12 weeks can be maintained over a 1-year period with reduced training frequency", Scandinavian Journal of Medicine & Science in Sports, 20(Suppl 1), pp.80~89 (2010), Wiley[DOI]
- Mohamed Salaheldien Mohamed Alayat, "Long-Term Effect of Pulsed Nd-YAG Laser Combined with Exercise on Bone Mineral Density in Men with Osteopenia or Osteoporosis: 1 Year of Follow-Up", Photomedicine and Laser Surgery, 36(2), pp.105~111 (2018), Mary Ann Liebert Inc[DOI]
- G. F. Maddalozzo, "High Intensity Resistance Training: Effects on Bone in Older Men and Women", Calcified Tissue International, 66(6), pp.399~404 (2000), Springer Science and Business Media LLC[DOI]
- N. McCartney, "Long-term Resistance Training in the Elderly: Effects on Dynamic Strength, Exercise Capacity, Muscle, and Bone", The Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 50A(2), pp.B97~B104 (1995), Oxford University Press (OUP)[DOI]
- Anitha D, "Assessing Bone Quality in Terms of Bone Mineral Density, Buckling Ratio and Critical Fracture Load", 대한골대사학회지, 21(4), pp.243~247 (2014), 대한골대사학회[DOI]
- Amy T. Harding, "Effects of supervised high-intensity resistance and impact training or machine-based isometric training on regional bone geometry and strength in middle-aged and older men with low bone mass: The LIFTMOR-M semi-randomised controlled trial", Bone, 136, pp.115362~ (2020), Elsevier BV[DOI]
- Amy T Harding, "A Comparison of Bone‐Targeted Exercise Strategies to Reduce Fracture Risk in Middle‐Aged and Older Men with Osteopenia and Osteoporosis: LIFTMOR‐M Semi‐Randomized Controlled Trial", Journal of Bone and Mineral Research, 35(8), pp.1404~1414 (2020), Wiley[DOI]
- 홍아람, "Effects of Resistance Exercise on Bone Health", Endocrinology and Metabolism, 33(4), pp.435~444 (2018), 대한내분비학회