Additive Effects of Exercise and Vitamin D Supplementation (with and without Calcium) on Bone Mineral Density in Older Adults: A Systematic Review and Meta-Analysis
Exercise is a recognized component in the prevention and therapy of osteoporosis. The present systematic review and meta-analysis aimed to determine the effect of Vitamin D (Vit-D) added to exercise versus exercise alone on bone mineral density (BMD) at the lumbar spine (LS) or hip in older adults....
Saved in:
| Main Authors: | , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2023-01-01
|
| Series: | Journal of Osteoporosis |
| Online Access: | http://dx.doi.org/10.1155/2023/5570030 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832546514113658880 |
|---|---|
| author | Cecilie Fischer Franz Jakob Matthias Kohl Stephanie Kast Simon Von Stengel Katharina Kerschan-Schindl Uwe Lange Friederike Thomasius Stefan Peters Michael Uder Wolfgang Kemmler |
| author_facet | Cecilie Fischer Franz Jakob Matthias Kohl Stephanie Kast Simon Von Stengel Katharina Kerschan-Schindl Uwe Lange Friederike Thomasius Stefan Peters Michael Uder Wolfgang Kemmler |
| author_sort | Cecilie Fischer |
| collection | DOAJ |
| description | Exercise is a recognized component in the prevention and therapy of osteoporosis. The present systematic review and meta-analysis aimed to determine the effect of Vitamin D (Vit-D) added to exercise versus exercise alone on bone mineral density (BMD) at the lumbar spine (LS) or hip in older adults. A systematic review based on six literature databases according to PRISMA included (a) exercise trials, with an exercise (EX) and a combined exercise + Vit-D group (EX + Vit-D), (b) intervention ≥ 6 months, and (c) BMD assessments at LS or hip. Effects sizes (MD) and 95%-confidence intervals (95%-CI) were calculated using a random-effect model that includes the inverse heterogeneity model (IVhet). Five studies with 281 participants in the EX and 279 participants in the EX + Vit-D were included. No significant differences between EX versus EX + Vit-D were observed for BMD-LS (MD: 0.002, 95%-CI: −0.033 to 0.036) or BMD-hip (MD: 0.003, 95%-CI: −0.035 to 0.042). Heterogeneity between the trial results was moderate-substantial for LS (I2 = 0%) and moderate for hip-BMD (I2 = 35%). The funnel plot analysis suggests evidence for a publication/small study bias for BMD-LS and hip results. In summary, this present systematic review and meta-analysis were unable to determine significant positive interaction of exercise and Vit-D on LS- or hip-BMD. We predominately attribute this finding to (1) the less bone-specific exercise protocols of at least two of the five studies and (2) the inclusion criteria of the studies that did not consequently focus on Vit-D deficiency. This issue should be addressed in more detail by adequately powered exercise trials with promising exercise protocols and participants with Vit-D deficiency. This trial is registered with the International Prospective Register of Systematic Reviews (PROSPERO) ID: CRD42022309813. |
| format | Article |
| id | doaj-art-26b3c8b4bde94428ae610ee25c085eb3 |
| institution | Kabale University |
| issn | 2042-0064 |
| language | English |
| publishDate | 2023-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Osteoporosis |
| spelling | doaj-art-26b3c8b4bde94428ae610ee25c085eb32025-02-03T06:48:29ZengWileyJournal of Osteoporosis2042-00642023-01-01202310.1155/2023/5570030Additive Effects of Exercise and Vitamin D Supplementation (with and without Calcium) on Bone Mineral Density in Older Adults: A Systematic Review and Meta-AnalysisCecilie Fischer0Franz Jakob1Matthias Kohl2Stephanie Kast3Simon Von Stengel4Katharina Kerschan-Schindl5Uwe Lange6Friederike Thomasius7Stefan Peters8Michael Uder9Wolfgang Kemmler10Institute of RadiologyBernhard-Heine-Centrum für BewegungsforschungDepartment of Medical and Life SciencesInstitute of RadiologyInstitute of RadiologyAustrian Society for Bone and Mineral ResearchGerman Society for Physical and Rehabilitative MedicineOsteology Umbrella Association GermanyGerman Association for Health-Related Fitness and Exercise Therapy (DVGS) e.V.Institute of RadiologyInstitute of RadiologyExercise is a recognized component in the prevention and therapy of osteoporosis. The present systematic review and meta-analysis aimed to determine the effect of Vitamin D (Vit-D) added to exercise versus exercise alone on bone mineral density (BMD) at the lumbar spine (LS) or hip in older adults. A systematic review based on six literature databases according to PRISMA included (a) exercise trials, with an exercise (EX) and a combined exercise + Vit-D group (EX + Vit-D), (b) intervention ≥ 6 months, and (c) BMD assessments at LS or hip. Effects sizes (MD) and 95%-confidence intervals (95%-CI) were calculated using a random-effect model that includes the inverse heterogeneity model (IVhet). Five studies with 281 participants in the EX and 279 participants in the EX + Vit-D were included. No significant differences between EX versus EX + Vit-D were observed for BMD-LS (MD: 0.002, 95%-CI: −0.033 to 0.036) or BMD-hip (MD: 0.003, 95%-CI: −0.035 to 0.042). Heterogeneity between the trial results was moderate-substantial for LS (I2 = 0%) and moderate for hip-BMD (I2 = 35%). The funnel plot analysis suggests evidence for a publication/small study bias for BMD-LS and hip results. In summary, this present systematic review and meta-analysis were unable to determine significant positive interaction of exercise and Vit-D on LS- or hip-BMD. We predominately attribute this finding to (1) the less bone-specific exercise protocols of at least two of the five studies and (2) the inclusion criteria of the studies that did not consequently focus on Vit-D deficiency. This issue should be addressed in more detail by adequately powered exercise trials with promising exercise protocols and participants with Vit-D deficiency. This trial is registered with the International Prospective Register of Systematic Reviews (PROSPERO) ID: CRD42022309813.http://dx.doi.org/10.1155/2023/5570030 |
| spellingShingle | Cecilie Fischer Franz Jakob Matthias Kohl Stephanie Kast Simon Von Stengel Katharina Kerschan-Schindl Uwe Lange Friederike Thomasius Stefan Peters Michael Uder Wolfgang Kemmler Additive Effects of Exercise and Vitamin D Supplementation (with and without Calcium) on Bone Mineral Density in Older Adults: A Systematic Review and Meta-Analysis Journal of Osteoporosis |
| title | Additive Effects of Exercise and Vitamin D Supplementation (with and without Calcium) on Bone Mineral Density in Older Adults: A Systematic Review and Meta-Analysis |
| title_full | Additive Effects of Exercise and Vitamin D Supplementation (with and without Calcium) on Bone Mineral Density in Older Adults: A Systematic Review and Meta-Analysis |
| title_fullStr | Additive Effects of Exercise and Vitamin D Supplementation (with and without Calcium) on Bone Mineral Density in Older Adults: A Systematic Review and Meta-Analysis |
| title_full_unstemmed | Additive Effects of Exercise and Vitamin D Supplementation (with and without Calcium) on Bone Mineral Density in Older Adults: A Systematic Review and Meta-Analysis |
| title_short | Additive Effects of Exercise and Vitamin D Supplementation (with and without Calcium) on Bone Mineral Density in Older Adults: A Systematic Review and Meta-Analysis |
| title_sort | additive effects of exercise and vitamin d supplementation with and without calcium on bone mineral density in older adults a systematic review and meta analysis |
| url | http://dx.doi.org/10.1155/2023/5570030 |
| work_keys_str_mv | AT ceciliefischer additiveeffectsofexerciseandvitamindsupplementationwithandwithoutcalciumonbonemineraldensityinolderadultsasystematicreviewandmetaanalysis AT franzjakob additiveeffectsofexerciseandvitamindsupplementationwithandwithoutcalciumonbonemineraldensityinolderadultsasystematicreviewandmetaanalysis AT matthiaskohl additiveeffectsofexerciseandvitamindsupplementationwithandwithoutcalciumonbonemineraldensityinolderadultsasystematicreviewandmetaanalysis AT stephaniekast additiveeffectsofexerciseandvitamindsupplementationwithandwithoutcalciumonbonemineraldensityinolderadultsasystematicreviewandmetaanalysis AT simonvonstengel additiveeffectsofexerciseandvitamindsupplementationwithandwithoutcalciumonbonemineraldensityinolderadultsasystematicreviewandmetaanalysis AT katharinakerschanschindl additiveeffectsofexerciseandvitamindsupplementationwithandwithoutcalciumonbonemineraldensityinolderadultsasystematicreviewandmetaanalysis AT uwelange additiveeffectsofexerciseandvitamindsupplementationwithandwithoutcalciumonbonemineraldensityinolderadultsasystematicreviewandmetaanalysis AT friederikethomasius additiveeffectsofexerciseandvitamindsupplementationwithandwithoutcalciumonbonemineraldensityinolderadultsasystematicreviewandmetaanalysis AT stefanpeters additiveeffectsofexerciseandvitamindsupplementationwithandwithoutcalciumonbonemineraldensityinolderadultsasystematicreviewandmetaanalysis AT michaeluder additiveeffectsofexerciseandvitamindsupplementationwithandwithoutcalciumonbonemineraldensityinolderadultsasystematicreviewandmetaanalysis AT wolfgangkemmler additiveeffectsofexerciseandvitamindsupplementationwithandwithoutcalciumonbonemineraldensityinolderadultsasystematicreviewandmetaanalysis |