Benefits for bone from resistance exercise and nutrition in long-duration spaceflight: Evidence from biochemistry and densitometry
Open accessAbstract
Exercise has shown little success in mitigating bone loss from long-duration spaceflight. The first crews of the International Space Station (ISS) used the “interim resistive exercise device” (iRED), which allowed loads of up to 297 lbf (or 1337 N) but provided little protection of bone or no greater protection than aerobic exercise. In 2008, the Advanced Resistive Exercise Device (ARED), which allowed absolute loads of up to 600 lbf (1675 N), was launched to the ISS. We report dietary intake, bone densitometry, and biochemical markers in 13 crewmembers on ISS missions from 2006 to 2009. Of these 13, 8 had access to the iRED and 5 had access to the ARED. In both groups, bone-specific alkaline phosphatase tended to increase during flight toward the end of the mission (p = 0.06) and increased 30 days after landing (p < 0.001). Most markers of bone resorption were also increased in both groups during flight and 30 days after landing (p < 0.05). Bone densitometry revealed significant interactions (time and exercise device) for pelvis bone mineral density (BMD) and bone mineral content (p < 0.01), hip femoral neck BMD (p < 0.05), trochanter BMD (p < 0.05), and total hip BMD (p < 0.05). These variables were unchanged from preflight only for ARED crewmembers, who also returned from flight with higher percent lean mass and lower percent fat mass. Body mass was unchanged after flight in both groups. All crewmembers had nominal vitamin D status (75 ± 17 nmol/L) before and during flight. These data document that resistance exercise, coupled with adequate energy intake (shown by maintenance of body mass determined by dual-energy X-ray absorptiometry [DXA]) and vitamin D, can maintain bone in most regions during 4- to 6-month missions in microgravity. This is the first evidence that improving nutrition and resistance exercise during spaceflight can attenuate the expected BMD deficits previously observed after prolonged missions. © 2012 American Society for Bone and Mineral Research.
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Those who did not lose body mass managed to maintain bone mineral density.
“Importantly, those that did not lose body mass managed to maintain bone mineral density (discussed below)76.”
From Red risks for a journey to the red planet: The highest priority human health risks for a mission to Mars (2020) · cites this paper as [76]
The Abstract reports that body mass was unchanged after flight in both exercise groups, but the measured bone mineral density outcomes were unchanged from preflight only in the ARED group. The Results likewise distinguish ARED from iRED crewmembers, so maintaining body mass did not, by itself, mean maintaining bone mineral density. (LLM, conf=0.90)
Checked by a reasoning model — may be wrong.
Experimental — accuracy not yet measuredARED crews had better dietary intakes and better vitamin D status as a result of increased supplementation dose and awareness starting in 2006.
“ARED crews had better dietary intakes (as evidenced by maintenance of body mass) and better vitamin D status as a result of increased dose of supplementation and awareness of the importance of these supplements starting in 200676.”
From Red risks for a journey to the red planet: The highest priority human health risks for a mission to Mars (2020) · cites this paper as [76]
The Results (page unavailable) report a tendency toward higher energy intake in ARED crews, but no significant dietary-intake differences; body mass was maintained in both groups. The Discussion (page unavailable) says the ISS vitamin D supplement recommendation doubled in late 2006 and that the new dose was adequate to maintain vitamin D status. It does not establish that ARED crews had better vitamin D status than iRED crews or that increased awareness caused their status. (LLM, conf=0.86)
Experimental — accuracy not yet measuredBone mineral density was protected in these astronauts, proving diet and exercise are a powerful countermeasure combination.
“Bone mineral density was protected in these astronauts76, proving that diet and exercise are a powerful countermeasure combination.”
From Red risks for a journey to the red planet: The highest priority human health risks for a mission to Mars (2020) · cites this paper as [76]
The Abstract reports that BMD measures were unchanged from preflight in the five ARED crewmembers, and the Discussion says exercise with adequate energy intake and vitamin D may mitigate bone loss in most skeletal regions. The claim overstates this as proof of a powerful combination: the paper calls it initial evidence, notes that protection was not universal, and says it could not separate the effects of exercise and nutrition. (LLM, conf=0.88)
Experimental — accuracy not yet measuredAdvances in exercise devices and nutrition have significantly attenuated the bone mineral density losses observed during prolonged missions on vehicles like the International Space Station.
“Although advances in exercise devices and nutrition have significantly attenuated the bone mineral density losses observed during prolonged missions on vehicles like the International Space Station (ISS) (23, 24), future exploration missions to destinations like Mars will be significantly longer (∼3 y) and impose mass constraints that will not allow for the same, highly effective exercise”
From Targeting myostatin/activin A protects against skeletal muscle and bone loss during spaceflight (2020) · cites this paper as [23]
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Self-citationNutrition and Bone Health in Space
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Self-citation
- Authors
- Smith, S. M., Heer, M. A., Shackelford, L. C., Sibonga, J. D., Ploutz-Snyder, L., & Zwart, S. R.
- Affiliations
- National Aeronautics and Space Administration (US)
- University of Bonn (DE)
- Division of Space Life Sciences, Universities Space Research Association, Houston, TX, USA
- Universities Space Research Association (US)
- Corresponding author
- Smith, Scott M
- Venue
- Journal of Bone and Mineral Research
- Publisher
- Oxford University Press (OUP)
- Published
- 2012-05-01
- Volume
- 27
- Issue
- 9
- Pages
- 1896-1906
- ISSN
- 0884-0431 (ISSN-L)
- 1523-4681
- OpenAlex
- W1982931874
- Cited by
- 351
- References
- 44
- Citations by year
- 2026: 21 · 2025: 19 · 2024: 18 · 2023: 21 · 2022: 30 · 2021: 29 · 2020: 36 · 2019: 28 · 2018: 28 · 2017: 29 · 2016: 24 · 2015: 20 · 2014: 27 · 2013: 16 · 2012: 5
- FWCI
- 14.55
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model (vor)
- Locations
- Journal of Bone and Mineral Research (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Aeronautics and Space Administration
- Deutsches Zentrum für Luft- und Raumfahrt (WB 0931)
- Topics
- Health Sciences › Medicine › Physiology › Spaceflight effects on biology
- Health Sciences › Medicine › Orthopedics and Sports Medicine › Bone health and osteoporosis research
- Physical Sciences › Engineering › Aerospace Engineering › Space Exploration and Technology
- Keywords
- spaceflight, bone loss, resistance training, International Space Station, bone mineral density, bone resorption markers, bone-specific alkaline phosphatase, dietary intake, energy intake, vitamin D, microgravity, bone metabolism
- MeSH terms
- Biochemical Phenomena, Body Composition, Bone and Bones, Calcium, Densitometry, Diet, Female, Humans, Male, Middle Aged, Nutritional Physiological Phenomena, Parathyroid Hormone, Pelvis, Space Flight, Time Factors, Vitamin D, Biomarkers, Exercise, Bone Density, Resistance Training
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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