Effect of aerobic exercise on bone health in postmenopausal women with obesity: Balancing benefits with caloric restriction and resistance exercise

The decline in bone mineral density (BMD) poses a significant concern for postmenopausal women with obesity. Research indicates that aerobic exercises show potential for enhancing bone health. However, there remains no consensus regarding their effects on BMD. This study aimed to evaluate the effect of various exercise interventions on BMD and overall health among postmenopausal women with obesity, with particular attention to caloric restriction (CR). Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines, we performed a comprehensive literature search on PubMed, targeting studies published up to August 2023. Our search focused on aerobic exercise, resistance training, and combined exercise modalities, examining their impact on BMD, body composition, and physical fitness in postmenopausal women with obesity. We reviewed 11 studies, predominantly on aerobic exercise, involving women who are overweight and sedentary, nine of which were randomized trials. Our findings suggest that aerobic exercise has a mild protective effect on BMD and can significantly reduce fat mass. Notably, when combined with CR, aerobic exercise not only enhances the reduction of fat tissue mass but also potentially offers a certain level of protection for BMD. Additionally, the intervention combining aerobic exercise with resistance training emerges as a key promoter of bone health, underscoring the importance of tailored exercise programs for this population. Consequently, balanced dietary patterns (like the Mediterranean diet), combined with exercise, are recommended for optimal health outcomes. Tailored exercise programs integrating both aerobic and resistance training are crucial for sustaining overall health and bone density in this population.