Disclosures: The authors report no relevant financial disclosures.
January 12, 2021
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Physical exercise may minimize bariatric surgery-induced bone loss

Disclosures: The authors report no relevant financial disclosures.
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A supervised, multicomponent physical training program was associated with bone mass benefits for adults who had bariatric surgery, according to findings published in the Journal of Bone and Mineral Research.

Florencio Diniz-Sousa

“Bariatric surgery is the best available treatment for severe obesity, but it also presents drawbacks, such as an accelerated bone deterioration,” Florencio Diniz-Sousa, MSc, of the Research Centre in Physical Activity, Health and Leisure at the University of Porto, Portugal, told Healio. “Our findings showed that a structured exercise program may be a valid treatment option to minimize the bariatric surgery-induced bone loss.”

Exercise cycle 2019
Source: Adobe Stock

Diniz-Sousa and colleagues analyzed data from 84 adults who underwent gastric bypass or sleeve gastrectomy and randomly assigned to an exercise intervention or a control group. One month after bariatric surgery, participants in the exercise group began an 11-month supervised multicomponent exercise program. The control group received standard medical care.

Researchers assessed participants before bariatric surgery and at 1, 6 and 12 months after surgery for body composition, areal bone mineral density, bone turnover markers, calciotropic hormones, sclerostin, bone material strength index, muscle strength and daily physical activity. Primary outcome was the between-group difference on lumbar spine BMD at 12 months after surgery. A secondary analysis assessed whether the exercise effect depended on training attendance.

At 12 months after surgery, researchers found that participants in the exercise group had a higher BMD at the lumbar spine (mean, 0.024 g/cm2; 95% CI, 0.004-0.044) compared with controls.

In assessing secondary outcomes, researchers found that only BMD at the radius improved among participants in the exercise group vs. controls (mean, 0.013 g/cm2; 95% CI, 0.003-0.023). There were no exercise effects observed on bone biochemical markers or bone material strength index.

Participants in the exercise group also had a mean 1.5 kg higher lean mass (95% CI, 0.1-2.9) and mean 51.4 higher number of high impacts (95% CI, 6.6-96.1) compared with controls.

Secondary analyses demonstrated that exercise-induced benefits may be obtained on femoral neck BMD, but only among participants with at least 50% exercise attendance compared with controls (mean, 5.3%; 95% CI, 2-8.6).

“Although current guidelines state that regular physical activity should be encouraged after bariatric surgery, there are no solid evidence about its effects on bone health and how exercise should be prescribed,” Diniz-Sousa said. “Our study describes in detail an effective structured exercise program that may be applied by health care professionals that follows these patients.”

Diniz-Sousa said future studies should focus on determining the issues that most influence the bariatric patients’ adherence to exercise to ensure that exercise prescription is effective in clinical practice.

For more information:

Florencio Diniz-Sousa, MSc, can be reached at joseflorenciosousa@gmail.com.