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Exercise may protect bone health after bariatric surgery

Wed, 12/09/2020 - 09:44
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An exercise intervention programme after bariatric surgery is an effective strategy to improve bone health, according to researchers from Portugal. Although weight loss surgery is a highly effective treatment for obesity, some studies have shown that it can be detrimental to bone health. The study, ‘The Effect of an Exercise Intervention Program on Bone Health After Bariatric Surgery: A Randomized Controlled Trial’, published in the Journal of Bone and Mineral Research suggests that exercise may help address this shortcoming.

Lead author of the study, Florêncio Diniz-Sousa from the University of Porto, and colleagues assessed whether an exercise‐training programme could induce benefits on bone mass after surgery. Eighty‐four patients, who had a gastric bypass or sleeve gastrectomy, were randomised to either the exercise group (EG), undergoing a supervised multicomponent exercise programme, or control group (CG) one month after surgery and followed for 11 months.

Patients were assessed before surgery and one, six and 12 months for body composition, areal bone mineral density (BMD), bone turnover markers, calciotropic hormones, sclerostin, bone material strength index, muscle strength and daily physical activity. The researchers also conducted a primary analysis according to intention‐to‐treat principles and the primary outcome was the between‐group difference on lumbar spine BMD at 12 months post‐surgery. In addition, they carried out a secondary analysis to assess whether the exercise effect depended on training attendance.

At 12 months post‐surgery, primary analysis results revealed that EG had a higher BMD at lumbar spine (p=0.015), compared with CG. Among total hip, femoral neck and 1/3 radius secondary outcomes, only 1/3 radius BMD improved in EG, compared with CG (p=0.020). No significant exercise effects were observed on bone biochemical markers or bone material strength index. The EG also had a higher lean mass (p=).037) and higher number of high impacts (p=0.026) compared with CG.

The researchers also revealed that the secondary analysis results suggested that exercise‐induced benefits may be obtained on femoral neck BMD but only on those participants with ≥50% exercise attendance, compared with CG (p=.006).

"These findings showed that a structured exercise programme may be a valid treatment option to minimise weight loss surgery-induced bone loss, which may be particularly important since many patients undergo surgery in early adulthood or even at paediatric ages," said Diniz-Sousa. "As stated in recently released World Health Organization physical activity guidelines, regular exercise should be a priority for everyone, including patients who have undergone weight loss surgery."