Adolescence is a critical period for bone development, and physical exercise has been recognized as a key factor in promoting bone health. Whole-body bone mineral density (BMD) serves as a vital indicator of bone strength and future fracture risk.
Objective:
To systematically review and perform a meta-analysis of the effects of physical exercise on whole-body BMD in adolescents, identifying types of exercise beneficial for bone health.
Data Sources:
A comprehensive search was conducted across databases including Web of Science, PubMed, Embase, EBSCOhost, Cochrane, and Scopus to identify relevant studies published between 1991 and 2025.
Study Selection:
Studies were selected based on predefined inclusion criteria that focused on adolescents, physical exercise, and whole-body BMD outcomes. A total of 12 studies involving 1845 participants met the criteria for inclusion.
Study Design:
Systematic review and meta-analysis.
Level of Evidence:
Level 1.
Data Extraction:
Data were extracted using the Cochrane Handbook guidelines, and meta-analysis was conducted using Review Manager software. Publication bias was assessed using a funnel plot.
Results:
Physical exercise increased whole-body BMD significantly in adolescents (pooled effect size of mean difference, 0.06; 95% CI, 0.04, 0.09; P < 0.001). Physical exercise significantly improved whole-body BMD in both male and female adolescents, but the effect was more pronounced in boys (P < 0.001) compared with girls (P = 0.002). High-impact and weightbearing exercises, such as basketball, soccer, ice hockey, and boxing, significantly enhanced whole-body BMD in adolescents, whereas nonweightbearing exercises, such as swimming, had a weaker effect on BMD improvement. Judo showed no significant effect.
Conclusion:
Physical exercise, particularly high-impact sports, significantly enhances whole-body BMD in adolescents, especially in boys. These findings highlight the importance of incorporating effective physical activities into adolescent physical education to promote optimal bone health.
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