Exercise and Peak Bone Mass

PURPOSE OF REVIEW: The main goal of this narrative review is to assess whether physical activity (PA) influences peak bone mass and fracture risk. RECENT FINDINGS: Several randomized controlled trials (RCT) show that short-term PA intervention programs in childhood improve the accrual of bone mineral. There are now also long-term controlled PA intervention studies demonstrating that both boys and girls with daily school PA through puberty gain higher bone mineral content (BMC) and bone mineral density (BMD) and greater bone size than boys and girls with school PA 1–2 times/week. These benefits seem to be followed by a gradual reduction in expected fracture rates, so that in children with daily school PA, the incidence rate ratio (IRR) after 8 years is less than half that expected by age. SUMMARY: Daily school PA from before to after puberty is associated with beneficial gains in bone traits and gradually lower relative fracture risk.