An optimal exercise regimen includes a combination of strength and resistance training; weight-bearing aerobic training; and exercises that build flexibility, stability, and balance. MedTwitter
. Her bone density was low for her age, and she had had three low-impact fractures of her long bones in the preceding 4 years.Loss of weight after the onset of Crohn's disease, subsequent loss of periods, inflammation associated with her underlying diagnosis, and early treatment with glucocorticoids were believed to have caused osteoporosis in this young woman.
A few months previously, she was switched to a medication that doesn't impair bone health and glucocorticoids were discontinued; her weight began to improve, and her Crohn's disease was now in remission. Her menses had resumed about 3 months before her visit to my clinic after a prolonged period without periods. She was on calcium andAfter reading that exercise was good for bones, she asked me about it.
Many factors determine bone health including genetics, nutritional status, exercise activity , macro- and micronutrient intake, hormonal status, chronic inflammation and other disease states, and medication use. Exercise certainly has beneficial effects on bone. Bone-loading activities increase bone formation through the activation of certain cells in bone called osteocytes, which serve as mechanosensors and sense bone loading. Osteocytes make a hormone called sclerostin, which typically inhibits bone formation. When osteocytes sense bone-loading activities, sclerostin secretion reduces, allowing for increased bone formation.
Consistent with this, investigators in Canada have demonstrated greater increases in bone density and strength in schoolchildren who engage in moderate to vigorous physical activity, particularly bone-loading exercise, during the school day compared with those who don't (
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