Effects of Combined Exercise and Calcium/Vitamin D Supplementation on Bone Mineral Density in Postmenopausal Women: A Systematic Review and Meta-Analysis

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Effects of Combined Exercise and Calcium/Vitamin D Supplementation on Bone Mineral Density in Postmenopausal Women: A Systematic Review and Meta-Analysis

Bai et al., 2025 | Nutrients | Meta Analysis

Citation

Bai Jie, Huang Wenrui, ... Du Xuelian. Effects of Combined Exercise and Calcium/Vitamin D Supplementation on Bone Mineral Density in Postmenopausal Women: A Systematic Review and Meta-Analysis. Nutrients. 2025-Dec-11;17(24). doi:10.3390/nu17243866

Abstract

BACKGROUND: Postmenopausal osteoporosis (PMO) is a major cause of fragility fractures worldwide. While exercise and calcium/vitamin D are standard preventive measures, the synergistic effects of their combined use on bone mineral density (BMD) remain unclear. METHODS: We systematically searched eight databases through October 2025 and synthesized data using Review Manager version 5.4. Subgroup, sensitivity, and meta-regression analyses were conducted to examine heterogeneity and test the robustness of results. Risk of bias was assessed using the Cochrane RoB 2.0 tool, and the certainty of evidence was graded with the GRADE framework. RESULTS: 13 RCTs involving postmenopausal women were included. Compared with calcium and vitamin D supplementation alone, combined interventions significantly increased lumbar spine (SMD = 0.31, 95% CI [0.06, 0.55]) and femoral neck BMD (SMD = 0.47, 95% CI [0.09, 0.84]), with consistent but nonsignificant trends at other skeletal sites. Subgroup analyses showed that whole-body vibration produced the greatest and most consistent benefits at both sites, while mind-body or traditional Chinese exercises (e.g., Baduanjin) significantly improved lumbar spine BMD. Shorter interventions (≤6 months) yielded greater gains in BMD, whereas longer durations provided no additional advantage. CONCLUSIONS: Exercise combined with calcium and vitamin D supplementation effectively improves bone mineral density in postmenopausal women, especially at the lumbar spine and femoral neck. Whole-body vibration and mind-body exercises show the greatest benefits, with short-term interventions proving most effective. This combined approach offers a practical, evidence-based strategy to preserve skeletal health in aging women.

Key Findings

13 RCTs involving postmenopausal women were included. Compared with calcium and vitamin D supplementation alone, combined interventions significantly increased lumbar spine (SMD = 0.31, 95% CI [0.06, 0.55]) and femoral neck BMD (SMD = 0.47, 95% CI [0.09, 0.84]), with consistent but nonsignificant trends at other skeletal sites. Subgroup analyses showed that whole-body vibration produced the greatest and most consistent benefits at both sites, while mind-body or traditional Chinese exercises (e.g

Outcomes Measured

  • Requires manual extraction

Population

Field Value
Population postmenopausal women
Sample Size 13
Age Range See abstract
Condition See abstract

MeSH Terms

  • Humans
  • Bone Density
  • Female
  • Vitamin D
  • Dietary Supplements
  • Osteoporosis, Postmenopausal
  • Postmenopause
  • Middle Aged
  • Exercise
  • Lumbar Vertebrae
  • Femur Neck
  • Aged
  • Calcium
  • Randomized Controlled Trials as Topic

Evidence Classification

  • Level: Meta Analysis
  • Publication Types: Journal Article, Systematic Review, Meta-Analysis
  • Vertical: calcium

Provenance

Source extracted via PubMed E-utilities API on 2026-04-09