The effects of exercise interventions on bone mineral density in middle-aged and older men: a systematic review and...

Exercise interventions are increasingly used as a non-pharmacological strategy to promote skeletal health. Nevertheless, their site-specific effects on bone mineral density (BMD) in middle-aged and older men remain unclear and inconsistent. This study aimed to systematically assess the impacts of exercise interventions on BMD across multiple skeletal sites in this population.

We performed a comprehensive systematic search in major electronic databases (PubMed, Web of Science, Embase) to identify randomized controlled trials investigating exercise and BMD in men. Eligible studies were selected according to prespecified inclusion criteria, and a random-effects model was applied in the meta-analysis to compute pooled effect sizes.

Pooled analyses revealed that exercise interventions significantly increased BMD at the lumbar spine and femoral neck in middle-aged and older men. However, no significant beneficial effects were detected at the total hip or other cortical-dominant skeletal regions. Subgroup analyses further confirmed that a training frequency of ≥f sessions per week, an intervention duration of >6 months, and multicomponent exercise regimens maximized skeletal benefits.

Exercise represents an effective approach to improve site-specific BMD in aging men, especially at high-fracture-risk sites including the lumbar spine and femoral neck. These results offer evidence-based implications for designing sex-specific exercise prescriptions, and underscore the key roles of training frequency and exercise modality in eliciting optimal skeletal adaptive responses.

https://www.crd.york.ac.uk/prospero/, identifier CRD420251126500.