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Peak bone mass is largely determined by genetic control, however, 30% is determined by environmental fac- tors, most important exercise, nutrition and chronic illness. It is recognized that the maximizing peak bone density is es- sential in the reduction of fracture risk at all stages of life. For children and adolescents regular exercise particularly ones that include high impact features and a well balanced diet including milk based calcium and vitamin D is critical to main- taining and building strong bones. During the postmenopausal years, a regular schedule of physical activity emphasizing weight bearing exercises can help maintain bone mineral density and may reduce fracture risk. EXERCISE AND ITS EFFECT ON BONE HEALTH Bone Growth and Development The mature adult skeleton contains about 1200 grams of calcium with the total bone mass increasing about 50 times between birth and maturity. Bone mass is largely driven by bone growth with men reaching a greater bone mass than women because their bones are, at skeletal maturity, larger not denser. The maximum amount of bone an individual accrues is called peak bone mass. While largely under genetic control, it is estimated that about 30% of peak bone mass is determined by environmental factors, most importantly nutrition, exercise and chronic illness. The age at which peak bone mass is achieved varies between areas of skeleton and among different populations. During adolescence and early childhood, bone mass increases until peak bone mass is fully attained during the third decade of life. There are gender differences in bone growth and development with females reaching peak bone mass earlier than males. Data from healthy girls indicate that bone mass gains are most pronounced between the ages 11 and 14 with the rates decreasing after the age 16 and/or two years after menarche (1). In general, by the age of twenty, 90-96% of peak bone mass has been attained. Exercise has been shown to help build bone mass in premenarchal girls during the main bone acquisition period of adolescence (2) and in older premenopausal women in their 40's and early 50's. In a study involving young women 10-20 years of age that analyzed the contributions of exercise and calcium intake to bone mineral density values, Lloyd and colleagues found that achievable levels of exercise had a favorable effect on bone mineral density (BMD) and section modulus (bending strength) at the femoral neck and femoral shaft (3). In contrast, calcium intake greater than 500mg daily had little effect on bone density values.

Exercise and Its Effect on Bone Health