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Physical Activity and Bone Health in Men: A Systematic Review and Meta-Analysis


J Bone Metab. 2021 Feb;28(1):27-39. doi: 10.11005/jbm.2021.28.1.27. Epub 2021 Feb 28.

Maureen C Ashe 1 2Isis Kelly Dos Santos 3Nicola Y Edward 1Laura A Burnett 1Rosanne Barnes 1Lena Fleig 4Joseph H Puyat 5Joanna E M Sale 6Heather A McKay 1 2Lora M Giangregorio 7 8

Author Information

1 Centre for Hip Health and Mobility, The University of British Columbia, Vancouver, Canada.

2 Department of Family Practice, The University of British Columbia, Vancouver, Canada.

3 Department of Health Sciences, Federal University of Rio Grande do Norte, Natal, Brazil.

4 Department of Psychology, MSB Medical School Berlin, Berlin, Germany.

5 School of Population and Public Health, The University of British Columbia, Vancouver, Canada.

6 Musculoskeletal Health and Outcomes Research, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health, Toronto, Canada.

7 Department of Kinesiology and Schlegel Research Institute for Aging, University of Waterloo, Waterloo, Canada.

8 Schlegel-University of Waterloo Research Institute for Aging, Waterloo, Canada.


Background: Research on osteoporosis and physical activity often focuses on women. We aimed to conduct a systematic review to assess the benefits and harms of physical activity interventions for men's bone health.

Methods: We used standard methods and searched for randomized controlled trials (RCTs) (duration, ≥6 months) published in all languages across multiple databases and trial registries. The last search was conducted on July 22, 2020.

Results: We included 11 studies (14 publications), resulting in a sample of N=723 men (range, 17-132 participants). We found low-certainty evidence that physical activity has little influence on the areal bone mineral density (aBMD) at the total hip (5 RCTs, N=324; mean difference [MD], 0.03 [95 confidence interval (CI), 0.01 to 0.05]) and little or no influence on the aBMD at the femoral neck (3 RCTs, N=186; MD, 0.00 [95% CI, -0.04 to 0.04]), lumbar spine (3 RCTs; N=213; MD, 0.05 [95% CI, -0.01 to 0.11]), and whole body (4 RCTs, N=203; MD, -0.00 [95% CI, -0.03 to 0.02]).

Conclusions: We found low-certainty evidence that physical activity (≥6 months) has some effect on the total hip in men, but new evidence may change this finding. This review highlights the gap in the evidence on specific intervention prescriptions that can benefit the bone geometry, structure, microarchitecture, and, ultimately, bone strength in men. Future research should engage in comprehensive reporting of harms, quality of life outcomes, advanced imaging findings, and long-term interventions.