Muscle and Bone Health in Postmenopausal Women: Role of Protein and Vitamin D Supplementation Combined with Exercise Training
Open accessAbstract
Menopause is an age-dependent physiological condition associated with a natural decline in oestrogen levels, which causes a progressive decrease of muscle mass and strength and bone density. Sarcopenia and osteoporosis often coexist in elderly people, with a prevalence of the latter in elderly women. The profound interaction between muscle and bone induces a negative resonance between the two tissues affected by these disorders worsening the quality of life in the postmenopausal period. It has been estimated that at least 1 in 3 women over age 50 will experience osteoporotic fractures, often requiring hospitalisation and long-term care, causing a large financial burden to health insurance systems. Hormonal replacement therapy is effective in osteoporosis prevention, but concerns have been raised with regard to its safety. On the whole, the increase in life expectancy for postmenopausal women along with the need to improve their quality of life makes it necessary to develop specific and safe therapeutic strategies, alternative to hormonal replacement therapy, targeting both sarcopenia and osteoporosis progression. This review will examine the rationale and the effects of dietary protein, vitamin D and calcium supplementation combined with a specifically-designed exercise training prescription as a strategy to counteract these postmenopausal-associated disorders.
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Peri-menopausal and post-menopausal athletes experience a decline of estradiol and ensuing insulin and anabolic resistance coupled with the demands of physical activity.
“due to the decline of estradiol and the ensuing insulin and anabolic resistance coupled with the demands of physical activity [242–244]”
From International society of sports nutrition position stand: nutritional concerns of the female athlete (2023) · cites this paper as [242]
Section 2 (page not provided) says oestrogen and IGF-1 decline at menopause and discusses effects on muscle. Section 4 (page not provided) describes anabolic resistance in aged muscle, reduced responsiveness to insulin, and higher protein needs with exercise. The paper does not establish that estradiol decline causes insulin and anabolic resistance in peri- or postmenopausal athletes specifically. (LLM, conf=0.86)
Experimental — accuracy not yet measuredParticipants aged >50 were not included as age- or menopause-induced endocrine adaptations secondary to bed rest could have negatively affected the sample's homogeneity.
“Participants aged >50 were not included as age- or menopause-induced endocrine adaptations secondary to bed rest could have negatively affected the sample’s homogeneity (31, 32).”
From Nonuniform loss of muscle strength and atrophy during bed rest: a systematic review (2021) · cites this paper as [32]
The Introduction (page not provided) says muscle loss becomes substantial around age 50 and describes age-related declines in sex hormones. Section 2 (page not provided) also links menopause-related hormonal changes to muscle health. The paper does not say these changes are secondary to bed rest or justify excluding participants over 50 to preserve sample homogeneity. (LLM, conf=0.83)
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References 149 · Cited by 151
Research works printed but not linked: 1
- [73]American College of Sports Medicine Riebe D. Ehrman J.K. Liguori G. Magal M. ACSM’s Guidelines for Exercise Testing and Prescription 10th ed. Wolters Kluwer Health Philadelphia, PA, USA 2018 472
- Authors
- Agostini, D., Donati Zeppa, S., Lucertini, F., Annibalini, G., Gervasi, M., Ferri Marini, C., Piccoli, G., Stocchi, V., Barbieri, E., & Sestili, P.
- Affiliations
- University of Urbino (IT)
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, 61029 (PU) Urbino, Italy
- Corresponding author
- Barbieri, Elena
- ORCID
- Venue
- Nutrients
- Publisher
- MDPI AG
- Published
- 2018-08-16
- Volume
- 10
- Issue
- 8
- Pages
- 1103
- ISSN
- 2072-6643 (ISSN-L)
- PMC
- PMC6116194
- OpenAlex
- W2887534823
- Cited by
- 151
- References
- 149
- Citations by year
- 2026: 9 · 2025: 13 · 2024: 16 · 2023: 25 · 2022: 22 · 2021: 16 · 2020: 37 · 2019: 11 · 2018: 2
- FWCI
- 3.38
- Type
- journal article
- Language
- en
- Open access
- gold
- dx.doi.org
- Licence
- Locations
- Nutrients (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- CINECA IRIS Institutional Research information system (University of Urbino) (submittedVersion, cc-by-nc-nd)
- CINECA IRIS Institutional Research information system (University of Urbino) (submittedVersion)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion)
- Funders
- Università degli Studi di Urbino Carlo Bo
- Topics
- Health Sciences › Medicine › Orthopedics and Sports Medicine › Bone health and osteoporosis research
- Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Menopause: Health Impacts and Treatments
- Keywords
- postmenopausal women, sarcopenia, osteoporosis, muscle mass and strength, bone mineral density, protein supplementation, vitamin D supplementation, calcium supplementation, exercise training, menopause, osteoporotic fractures
- MeSH terms
- Dietary Proteins, Female, Humans, Osteoporosis, Vitamin D, Exercise, Postmenopause, Muscle, Skeletal
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