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Independent and Combined Effects of Exercise and Calcium on Bone Structural and Material Properties in Older Adults

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Nutritional Influences on Bone Health

Abstract

Whole bone strength is determined by the combination of the mass, macro- and micro- structure, and intrinsic material properties of bone. Bone strength decreases with aging because of an imbalance in bone remodeling, so that the balance between the volume of bone resorbed and the volume formed in the basic multicellular unit is negative. This leads to a reduction in bone density and cortical thickness, with accompanying increases in periosteal and endosteal areas. Any factor that influences bone remodeling (disease, drugs, or lifestyle factors) will therefore impact upon whole bone strength. Regular weight-bearing exercise and adequate nutrition, particularly calcium and vitamin D, are two widely recommended strategies that have been shown to independently have positive effects on bone in older adults. However, the mechanism by which exercise and calcium–vitamin D influence bone is different; exercise has a site-specific modifying effect, whereas nutrition has a permissive, generalized effect that act systematically to influence bone remodeling. There is no evidence that excess intakes will result in greater skeletal gains. However, it has been suggested that the beneficial effects of exercise on bone may be dependent on adequate calcium (or nutrient) intake. Early research suggested that there may be a threshold of calcium (∼1,000 mg/day) needed to optimize the skeletal response to loading. However, current data from a limited number of studies using state-of-the-art imaging techniques [(p)QCT] indicate that additional calcium or calcium and vitamin D does not enhance the effects of exercise on bone structural or material properties in older adults with adequate calcium intakes or sufficient circulating vitamin D levels. It is more likely that additional calcium may only promote exercise-induced osteogenesis in older adults in a state of nutritional calcium insufficiency. However, further studies are still needed using three-dimensional bone imaging technology to increase our understanding of the structural based by which exercise and/or nutrition influence whole bone strength.

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Authors and Affiliations

  1. Department of Medicine (RMH/WH), Western Hospital, The University of Melbourne, Corner of Eleanor and Marion Street, Melbourne, VIC, 3011, Australia

    Robin M. Daly

Authors
  1. Robin M. Daly
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  2. Sonja Kukuljan
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Correspondence to Robin M. Daly .

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Editors and Affiliations

  1. University Hospital CHUV, Lausanne, 1006, Switzerland

    Peter Burckhardt

  2. Tufts University Boston, USDA Human Nutrition Research Centre on, 711 Washington Street, Boston, 02111, USA

    Bess Dawson-Hughes

  3. , Foods and Nutrition, Purdue University, 700 W. State Street, West Lafayette, 47907, USA

    Connie Weaver

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Daly, R.M., Kukuljan, S. (2011). Independent and Combined Effects of Exercise and Calcium on Bone Structural and Material Properties in Older Adults. In: Burckhardt, P., Dawson-Hughes, B., Weaver, C. (eds) Nutritional Influences on Bone Health. Springer, London. https://doi.org/10.1007/978-1-84882-978-7_7

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  • DOI: https://doi.org/10.1007/978-1-84882-978-7_7

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  • Online ISBN: 978-1-84882-978-7

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