The importance of sport and physical exercise in the prevention and therapy of osteoporosis

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Abstract
Osteoporosis is a systemic skeletal disorder involving low bone mass and micro-architectural deterioration of the bone tissue. Effective prevention of osteoporosis can primarily be expected from optimized nutrition and from increasing general physical exercise: “Food and exercise—equal attention to both is wise.” This article reviews the effects of sport and physical activity in the prevention and therapy of osteoporosis. The main aspects and conclusion are the following: (a) not duration, but rather frequency of exercise, combined with its intensity, seems to determine the level of the bone-anabolic effect; (b) training stimuli should become effective at those skeletal sites where an increase in bone mass is desired; (c) considerable evidence supports the importance of activity, especially activity initiated before puberty, for the development of peak bone mass; (d) even raised physical activity in daily life without any specific training of a certain body region may have a positive effect on total skeletal mass; (e) both general and specific strength are of great importance to bone mass to individual skeletal sections and to the entire skeleton; (f) non-specific variable strain with accordingly high peak strengths and various forces acting on the skeletal system are of enormous bone-stimulating importance; (g) in older adults, high-intensity resistance training, in contrast to traditional pharmacological and nutritional approaches for improving bone health, has the added benefit of influencing multiple risk factors for osteoporosis including improved strength and balance and increased muscle mass; (h) training adjustments of the bone in the sense of overcompensation can only be achieved if the “endocrine environment” and/or food-dependent parameters are not changed pathologically, and training is carried out according to individual load tolerance under scientific training aspects; (i) in the periand postmenopausal period, an actual increase in bone mass might be achieved by the combination of exercise and hormone replacement therapy; (j) physical activity may be a particularly promising preventive measure for hip fractures.