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Changes in spinal bone density, back muscle size, and visceral adipose tissue and their interaction following a multi-component exercise program in older men: secondary analysis of an 18-month randomized controlled trial

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Abstract

Summary

In middle-aged and older men, an 18-month multi-component exercise program improved spinal trabecular BMD, paraspinal, and psoas muscle cross-sectional area (CSA) but not visceral adipose tissue (VAT). However, changes in both muscle and VAT CSA were associated with changes in spinal BMD, independent of the exercise intervention.

Introduction

In older men, we previously reported that a multi-component exercise program improved lumbar spine (LS) trabecular volumetric BMD (Tb.vBMD) compared with no exercise. This study aimed to investigate the following: (1) the effect of the exercise program on paraspinal and psoas (back) muscle CSA and VAT, and 2) if any exercise-related changes in muscle CSA and/or VAT were associated with changes in spinal BMD.

Methods

Men (n = 180) aged 50–79 years were randomized to an exercise or no-exercise group. Exercise involved high-intensity progressive resistance training (60–85% max) with weight-bearing impact exercise (3 days/week) for 18 months. Quantitative computed tomography was used to assess L1–L3 Tb.vBMD, paraspinal, and psoas muscle CSA and VAT.

Results

Exercise resulted in a 2.6% ((95% CI, 1.1, 4.1), P < 0.01) net gain in back muscle CSA, but no effect on VAT (−1.6% (95% CI, −7.3, 4.2)) relative to no exercise. Robust regression indicated that percentage changes in Tb.vBMD were positively associated with changes (expressed as z-scores) in back muscle CSA in both the exercise (beta (β)-coefficient = 1.9, 95% CI 0.5, 3.2, P = 0.007) and no-exercise (β = 2.6, 95% CI, 1.1, 4.1, P = 0.001) group, and negatively with the changes in VAT (β = −2.0, 95% CI −3.3, −0.7, P = 0.003) in the exercise only group. There were no group differences in the slopes for the muscle-bone or VAT-bone relationships. Regression analysis (pooled data) revealed that back muscle CSA and VAT were independent predictors of the change in Tb.vBMD, explaining 14% of the variance.

Conclusion

A multi-component exercise program in middle-aged and older men improved spinal BMD and back muscle size but not visceral fat. However, changes in back muscle size and VAT were associated with the changes in spinal BMD, independent of exercise.

Trial registration

ACTRN 12617001224314, 22/08/2017 retrospectively registered

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Data availability

Data described in the manuscript, code book, and analytic code will not be made available because approval was not sought or granted from the Deakin University Human Research Ethics Committee to freely make available the data.

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Funding

This work was financially supported by a grant from the Australian Research Council Linkage Scheme in collaboration with Murray Goulburn Cooperative Company Limited. R. M. Daly was supported by National Health and Medical Research Council Career Development Award ID 425849.

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Authors and Affiliations

  1. Endocrinology and Nephrology Unit, CHU de Québec-Université Laval Research Centre, Québec City, Canada

    A.-F. Turcotte & C. Gagnon

  2. Department of Medicine, Laval University, Québec City, Canada

    A.-F. Turcotte & C. Gagnon

  3. Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, 3128, VIC, Australia

    S. Kukuljan, J. Dalla Via, G. Abbott & R.M. Daly

  4. Québec Heart and Lung Institute Research Centre, Québec City, Canada

    C. Gagnon

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  1. A.-F. Turcotte
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Correspondence to R.M. Daly.

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Conflicts of interest

Robin Daly received an Australian Research Council Linkage Scheme research grant (LP0347469) for this study that included Murray Goulburn Cooperative Company Limited as an industry partner. The sponsor was not involved in the conduct of the study, collection, management or analysis of the data, or the decision to publish the results. Robin Daly reports funding from a Primary Growth Partnerships grant via the Ministry of Primary Industries in New Zealand with Fonterra Co-operative Group Ltd that is unrelated to this study. Anne Frederique, Sonja Kukuljan, Jack Dalla Via, Claudia Gagnon, and Gavin Abbott declare that they have no conflict of interest.

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Informed consent was obtained from all individual participants included in the study.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The Deakin University Human Ethics Committee and Barwon Health Research and Ethics Advisory Committee approved this study.

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Examples of some of the resistance training, weight-bearing impact and core exercises that were prescribed during the program. (PPTX 2505 kb)

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Turcotte, AF., Kukuljan, S., Dalla Via, J. et al. Changes in spinal bone density, back muscle size, and visceral adipose tissue and their interaction following a multi-component exercise program in older men: secondary analysis of an 18-month randomized controlled trial. Osteoporos Int 31, 2025–2035 (2020). https://doi.org/10.1007/s00198-020-05484-z

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