Bone, Estrogen, Strength Training Study Translation to Osteoporosis Prevention Research and Education

Introduction/Purpose: Osteoporosis is a bone disease that a combination of exercise, hormone replacement therapy (HT), and calcium intake may help prevent by preserving or increasing bone mineral density (BMD) in postmenopausal women. The Bone, Estrogen, Strength Training (BEST) Study clinical trial was designed to determine the effects of exercise training on BMD in postmenopausal women either with or without HT. Methods: The BEST Study was unique because it included progressive resistance and weight-bearing exercises, addressed HT use, supplemented and documented calcium intake, provided robust intervention support, and extended the intervention protocol for multiple years. Results: The study findings demonstrated that postmenopausal women who had adequate calcium intake and followed the BEST exercise program maintained or increased their BMD. This article describes key lessons learned from the longitudinal BEST Study for translating the findings to the research community to improve future intervention research studies and to health professionals to inform osteoporosis prevention and bone health education. The BEST Study produced five lessons that can inform and improve osteoporosis prevention research and educational practice: 1) long-term bone health effects are important to study and require proactive strategies to obtain longitudinal funding support, 2) long-term retention of participants and compliance with study protocols require a participant focused study design and protocols, 3) extensive documentation of intervention protocols and sophisticated analytical strategies are essential to determine study intervention effects, 4) heterogeneity in responses to research study interventions should be expected and explored, and 5) osteoporosis prevention can be facilitated by translating the positive results from the BEST Study into practical educational tools. Conclusion: The BEST Study results can be translated into effective exercise and dietary practices to help prevent osteoporosis. Future research studies that use participant motivation and support protocols and meticulous documentation will further advance research in the prevention of osteoporosis.