Does exercise affect bone mineral density and content when added to a calorie-restricted diet? A systematic review and meta-analysis of controlled clinical trials

Zeinab Yazdanpanah, Sara Beigrezaei, Sahar Mohseni-Takalloo, Sepideh Soltani, Seyede Hamide Rajaie, Tayebeh Zohrabi, Mojtaba Kaviani, Scott C. Forbes, Julien S. Baker, Amin Salehi-Abargouei*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

Abstract

The effects of exercise in conjunction with weight-loss diets on bone health are mixed. Our objective was to systematically review and meta-analyze controlled clinical trials in adults investigating the addition of exercise to a weight-loss diet compared with a calorie-matched weight-loss diet without exercise on bone measures. Online databases including PubMed/MEDLINE, EMBASE, ISI (Web of Science), Scopus, and Google Scholar were searched up to April 2021 with no restriction. A random effects model was used to calculate the overall estimates. Quality of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology. Fourteen eligible controlled clinical trials were included in the systematic review. The meta-analysis revealed that, compared to weight-loss diets alone, the addition of exercise did not improve total body bone mineral density (BMD) [weighted mean difference (WMD) = 0.002 g/cm2, P = 0.62, n = 8], lumbar BMD (WMD = 0.007 g/cm2, P = 0.44, n = 9), total hip BMD (WMD = 0.015 g/cm2, P = 0.14, n = 4) and total bone mineral content (BMC) (WMD = − 11.97 g, P = 0.29, n = 7). Subgroup analysis revealed that resistance exercise in conjunction with hypocaloric diets positively affects total BMD compared to an energy restrictive diet alone (WMD = 0.01 g/cm2, P = 0.003, n = 3). Overall, it appears that only resistance exercise beneficially affects total BMD during a calorie-restricted diet in adults. Further well-controlled and long-term clinical trials are still needed to confirm these results.

Original languageEnglish
Pages (from-to)339–354
Number of pages16
JournalOsteoporosis International
Volume33
Issue number2
Early online date13 Oct 2021
DOIs
Publication statusPublished - Feb 2022

Scopus Subject Areas

  • Endocrinology, Diabetes and Metabolism

User-Defined Keywords

  • Bone mineral content
  • Bone mineral density
  • Diet
  • Exercise
  • Meta-analysis
  • Weight loss

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