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BEST Study
Demonstration Today How Older Women Reduced
Osteoporosis Risk With Exercise, Calcium
Surgeon General's bone health report spurs action
 Nov.
17, 2004 A study completed in 2001 is getting new attention since the
U.S. Surgeon General issued his warning that half the population is at
risk of osteoporosis unless action is taken. Leaders in fitness and
nutrition are demonstrating today in Manhattan exactly how older women
in the BEST Study, a four-year investigation conducted at the University
of Arizona, improved their bone mineral density using calcium and
weight-bearing exercise.
Data from the UA Bone Estrogen Strength Training
(BEST) Study showed that a regimen of twice-a-day calcium citrate
supplementation (Citracal) and three-times weekly resistance training
improved bone density in postmenopausal women whether or not they took
estrogen. Findings presented at the October meeting of the American
Society for Bone and Mineral Research (ASBMR) also demonstrated that the
amount of weight lifted by calcium-supplemented women can be predictive
of bone health.
Today, Miriam Nelson, PhD, author of the Strong
Women book series, will join study investigators from the UA Center for
Physical Activity and Nutrition, Timothy Lohman, PhD, Center director
and Lauve Metcalfe, intervention coordinator who, along with Bally
fitness trainer Nikki Kimbrough and her expert team, will coach guests
in the BEST way to improve bone health and help prevent osteoporosis. In
remarking on the results of the BEST Study, Dr. Nelson said, "Bone
health improved. No one had to eat differently--they just took calcium
citrate supplements to ensure adequate intake--and did the weight
bearing workouts. They all increased their fracture resistance."
The findings of the BEST Study provide evidence on
how nutrition and exercise can help make bone health a reality. Judith
Cranford, Executive Director of the National Osteoporosis Foundation,
urges women and men to take action. "There are 44 million Americans with
osteoporosis or low bone mass and this number will only increase if we
do not take action. By taking simple steps including eating a balanced
diet with plenty of calcium and Vitamin D, and engaging in
weight-bearing exercise, we can each reduce our personal risk of
osteoporosis and fractures."
The BEST Study Regimen
The BEST bone health regimen is focused on building BMD in typically
vulnerable areas of the spine and hip. The program includes daily
calcium citrate supplementation (800 mg) to ensure adequate intake and
three-times-a-week sessions of 20 to 25 minutes of resistance
training--two sets of six to eight repetitions--using six core
exercises:
1. Back Extension
2. Lat Pull Down
3. Leg Press
4. One-Arm Military Press
5. Seated Row
6. Wall or Smith Squat
Seven to ten minutes of cardiovascular
weight-bearing activity, such as weighted walking, stair climbing and
jogging, and small muscle group exercises involving therabands and
physio-balls round out the study regimen. The key to achieving the goal
of improved bone health is in the intensity of the weight-bearing
workout and the level of the resistance training. Progressively
increasing the weight lifted and consistently exercising two to three
times a week are essential for success.
The findings of the BEST study come at a time when
bone health is in the forefront of many American's minds. The Surgeon
General's report indicated the need for osteoporosis prevention. Richard
H. Carmona, MD, MPH, the Surgeon General, has been encouraging Americans
to improve diet and exercise.
Mission Pharmacal, makers of Citracal, the calcium
citrate used in the BEST Study, sponsors the BEST osteoporosis education
initiative, joined by Bally Fitness Center, whose personal trainers are
specially trained in the BEST techniques.
About Citracal Calcium Citrate
Citracal is the trademark name of a highly soluble calcium citrate
supplement that is readily absorbed by the body. Many physicians
recommend Citracal calcium citrate as one of the best absorbed, most
easily digestible forms of supplemental calcium. It is a logical choice
for older individuals because acid production decreases with age,
reducing the body's ability to utilize dietary calcium. Citracal caplets
also are available formulated with Vitamin D. Vitamin D helps calcium
absorption and is a recommended supplement when daily exposure to
sunshine is restricted. Mission Pharmacal, the makers of the Citracal
brand of calcium citrate supplement, is a family-owned pharmaceutical
company based in San Antonio, TX.
The Bone Estrogen
Strength Training Study
1995 - 2004
The Bone Estrogen Strength Training (BEST) Study
was conducted between 1995 and 2001 with funding from the National
Institute of Arthritis and Musculoskeletal Diseases (National Institutes
of Health) and Mission Pharmacal Pharmaceutical Company. BEST set out to
determine to investigate how strength training affects changes in bone
density in two groups of women: women currently on hormone replacement
therapy by the advice of their physicians and those who are not, through
the involvement of an interdisciplinary team of researchers in the
Departments of Physiology and Nutritional Sciences at the University of
Arizona.
The BEST study was completed on 266 healthy,
non-smoking, postmenopausal, women, with an average age of 56 years.
Approximately half took hormone replacement therapy (HRT) while the
other half did not. All the women received calcium citrate supplements
that when taken in two doses twice daily, provided 800 mg a day. These
women were followed for one year. Bone density was measured at the hip,
spine, arm and total body by dual energy x-ray absorptiometry (DXA) and
calcium supplementation compliance was monitored regularly through pill
counts.
Women were randomized to either a control group or
to an exercise group. The women in the exercise group performed
supervised aerobic, weightbearing and weightlifting exercises, three
times per week in community-based exercise facilities. To encourage and
maintain interest in exercise for one year, the women participated in
social support programs resulting in a high level of adherence.
Results from the study showed that weight bearing
and resistance exercises over a one-year period, combined with Citracalฎ
calcium supplementation, significantly improved bone mineral density at
skeletal sites at risk for osteoporotic fractures in postmenopausal
women.
The participants in the exercise group had not
lifted weight before the study and as a result of the study improved not
only their bone density but their strength as well.
The BEST study demonstrated that a combination of
adequate calcium intake with increased physical activity through
strength training prevents bone loss in women taking or not taking HRT.
Ultimately, BEST showed that the key to achieving a goal of improved
bone health is in the intensity of the workout and the level of
resistance training preformed on a regular weekly schedule.
The BEST study findings led to the development of,
The BEST Exercise Program for Osteoporosis Prevention, to provide
guidelines for exercise that will make a difference in bone health.
- Center
for Physical Activity & Nutrition, University of Arizona
The BEST Exercise Program for Osteoporosis
Prevention book is available from the University of Arizona for $42 at
the link above.
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