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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)
Wolfgang Kemmler, PhD; Dirk Lauber, PhD; Ju¨ rgen Weineck, PhD, MD;
Johannes Hensen, MD; Willi Kalender, PhD; Klaus Engelke, PhD
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% vsCG-2.3%]);BMD(lumbar spine [DXA
L1-L4, EG +0.7% vsCG-2.3%],QCTL1-L3 trabecular region
of interest [EG +0.4% vsCG-6.6%],QCTL1-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% vsCG+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.
Arch Intern Med. 2004;164:1084-1091