The Bone Estrogen Strength Training (BEST) Study was conducted between 1995 and 2001 with funding from the National Institute of Arthritis and Musculoskeletal diseases (National Institutes of Health) and Mission Pharmacal Company. The study, led by an interdisciplinary research team, from the University of Arizona Departments of Physiology and Nutritional Sciences, showed that weight bearing and resistance exercises over a one-year period, combined with Citracal® calcium supplementation, significantly improved bone mineral density at clinically important skeletal sites in postmenopausal women. This project translated the research findings into a practical exercise program for osteoporosis prevention.
The study enrolled 266 healthy, sedentary, non-smoking, postmenopausal, women, with an average age of 55.6±4.7 years, half of whom were currently taking hormone replacement therapy (HRT). All participants received calcium citrate supplements that provided 800 milligrams a day of calcium. Compliance was tracked with tablet counts with 91.3±14.4% of women taking 80% or more of their calcium supplement. Bone mineral density was measured at baseline and after one year of intervention at the hip, spine, arm and total body using dual energy x-ray absorptiometry.
The women randomized to the exercise program performed supervised weight bearing and weightlifting exercise (The BEST Exercise Program), three times per week in community-based exercise facilities. To encourage and maintain interest in exercise for one year, the women participated in social support programs resulting in a high level of adherence (71.8±19.9% attendance at exercise classes). Women who used HRT, calcium and exercised increased bone mineral density (femoral neck, trochonteric and lumbar spine) by approximately 1-2% and women who did not use HRT, took calcium, and exercised had smaller gains of ~1.0% (trochonteric). The participants also significantly increased muscle strength (11-21% increase). The study demonstrated that a combination of adequate calcium intake and increased physical activity (strength training) prevents bone loss in both populations of women. The key to achieving the goal of improved bone health was in the intensity of the workout performed on a regular weekly schedule. The BEST Exercise Program for Osteoporosis Prevention (BEST Book) was developed to provide research based guidelines and training for an exercise program that increases bone mineral density.
The BEST exercise program was presented by three instructors in a workshop to health care providers (N=19) at a local YMCA site in Phoenix, Arizona. The presentation covered the basics of osteoporosis, osteoporosis screening, and nutrition and osteoporosis in a power point presentation. The participants were divided up into three groups and participated in the demonstration of the BEST exercise program. The majority of the 4 hour workshop was devoted to the demonstration of the proper form and function of the 6 core exercises for osteoporosis prevention. Selected balance and small muscle group exercises were also demonstrated. The goal was to use the train-the-trainer model and expose the health care providers to the BEST Book so they could incorporate this training into their community education programming. Additionally, professional continuing education units could be received through Desert Southwest Fitness, Inc.
Nineteen health care providers attended the workshop. Seventeen evaluations were completed.
Table 1. Results from the workshop evaluations. (1-5 scale; 1 being the highest) Format of workshop 1.1; Usefulness of the workshop 1.3; Length of workshop 3.4- not enough time; Overall rating of workshop 1.3; Appropriateness of the content 1.3.
All 17 surveys returned stated they would recommend the workshop and the BEST Book to their colleagues. In the future, the workshop will be modified based on the feedback and tailored to meet the needs of the audience.
This workshop was the first step translating results from a clinical trial into an effective education program for health professional.
Disclosure Information:
Faculty Member's Name: Vanessa A. Stanford, MS, RD, CSCS
Other Financial or Material Support: Publisher of Book
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