***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Physical exercise has a favorable impact on bones , but optimum training strategies are still under discussion . In this study , we compared the effect of slow and fast resistance exercises on various osteodensitometric parameters .  Fifty-three postmenopausal women were r and omly assigned to a strength training ( ST ) or a power training group ( PT ) . Both groups carried out a progressive resistance training , a gymnastics session , and a home training over a period of 12 mo . During the resistance training , the ST group used slow and the PT group fast movements ; otherwise there were no training differences . All subjects were supplemented with Ca and vitamin D. At baseline and after 12 mo , bone mineral density ( BMD ) was measured at the lumbar spine , proximal femur , and distal forearm by dual-energy X-ray absorptiometry . We also measured anthropometric data and maximum static strength . Frequency and grade of pain were assessed by question naire . After 12 mo , significant between-group differences were observed for BMD at the lumbar spine ( P < 0.05 ) and the total hip ( P < 0.05 ) . Whereas the PT group maintained BMD at the spine ( + 0.7 + /- 2.1 % , not significant ) and the total hip ( 0.0 + /- 1.7 % , not significant ) , the ST group lost significantly at both sites ( spine : -0.9 + /- 1.9 % ; P < 0.05 ; total hip : -1.2 + /- 1.5 % ; P < 0.01 ) . No significant between-group differences were observed for anthropometric data , maximum strength , BMD of the forearm , or frequency and grade of pain . These findings suggest that power training is more effective than strength training in reducing bone loss in postmenopausal women Summary The EFOPS trial clearly established the positive effect of long-term exercise on clinical low-trauma fractures in postmenopausal women at risk . Bearing in mind that the complex anti-fracture exercise protocol s also affect a large variety of diseases of increased age , we strongly encourage older adults to perform multi purpose exercise programs . Introduction Physical exercise may be an efficient option for autonomous fracture prevention during increasing age . The aim of the study was to evaluate the effect of exercise on clinical overall fracture incidence and bone mineral density ( BMD ) in elderly subjects at risk . Methods In 1998 initially , 137 early-postmenopausal , osteopenic women living in Erlangen-Nuremberg , Germany , were included in the EFOPS trial . Subjects of the exercise group ( EG ; n = 86 ) conducted two supervised group and two home exercise sessions/week while the control group ( CG ; n = 51 ) was requested to maintain their physical activity . Primary study endpoints were clinical overall low-trauma fractures determined by question naires , structured interviews , and BMD at the lumbar spine and femoral neck assessed by dual-energy X-ray absorptiometry . Results In 2014 , 105 subjects ( EG : n = 59 vs. CG : n = 46 ) representing 1680 participant-years were included in the 16-year follow-up analysis .  Risk ratio in the EG for overall low-trauma fractures was 0.51 ( 95 % confidence interval ( 95 % CI ) 0.23 to 0.97 , p = .046 ) , rate ratio was 0.42 ( 95 % CI 0.20 to 0.86 , p = .018 ) . Based on comparable baseline values , lumbar spine ( MV −1.5 % , 95 % CI −0.1 to −2.8 vs. −5.8 % , −3.3 to −7.2 % ) and femoral neck ( −6.5 % , −5.2 to −7.7 vs. −9.6 % , −8.2 to 11.1 % ) BMD decreased in both groups ; however , the reduction was more pronounced in the CG ( p ≤ .001 ) . Conclusion This study clearly evidence d the high anti-fracture efficiency of multi purpose exercise programs . Considering furthermore the favorable effect of exercise on most other risk factors of increasing age , we strongly encourage older adults to perform multi purpose exercise programs Background : Regular exercise has been recommended as a potential strategy to counteract the age-related bone loss experienced by men ; however , the optimal exercise prescription is not known . Objective : To perform a pilot study to examine the osteogenic effect , safety and feasibility of a combined program of upper body resistance exercise and two doses of impact-loading exercise on bone mineral density ( BMD ) of middle-aged and older men . Methods : Forty-two community-dwelling men aged 50 - 74 years were r and omly assigned to either an exercise program of combined upper body resistance exercise and either high-dose impact-loading ( HI ; 80 jumps per session ) or moderate-dose impact-loading ( MOD ; 40 jumps per session ) or a control ( CON ) group . The 9-month intervention involved 4 sessions each week : 2 supervised clinic-based and 2 home-based . BMD of the lumbar spine , femoral neck , total hip , trochanter and whole body as well as lean and fat mass were assessed at baseline and 9 months by dual-energy X-ray absorptiometry . Bone turnover markers , hormone levels , physical function and muscle strength were also assessed . Results : Following 9 months of training , significant differences in BMD among groups were found at the total hip ( p = 0.010 ) and trochanter ( p = 0.047 ) with BMD in the MOD group decreasing relative to the HI group . Although not significant , the HI group consistently preserved BMD , whereas BMD of the MOD and CON groups declined at the hip sites . Mean change for all groups at all skeletal sites was approximately within ±1 % . There was no change in bone turnover markers . There were no adverse events as a result of the intervention ; however , overall attendance for the HI and MOD groups was 53 % ( clinic : 68 % , home : 38 % ) and 65 % ( clinic : 74 % , home : 55 % ) , respectively . Conclusions : This study indicates that while impact-loading exercise can be safely undertaken in middle-aged and older men , the current combined program did not elicit significant improvements in BMD Limited data have suggested that the consumption of fluid milk after resistance training ( RT ) may promote skeletal muscle hypertrophy . The aim of this study was to assess whether a milk-based nutritional supplement could enhance the effects of RT on muscle mass , size , strength , and function in middle-aged and older men . This was an 18-mo factorial design ( r and omized control trial ) in which 180 healthy men aged 50 - 79 yr were allocated to the following groups : 1 ) exercise + fortified milk , 2 ) exercise , 3 ) fortified milk , or 4 ) control . Exercise consisted of progressive RT with weight-bearing impact exercise . Men assigned to the fortified milk consumed 400 ml/day of low-fat milk , providing an additional 836 kJ , 1000 mg calcium , 800 IU vitamin D(3 ) , and 13.2 g protein per day . Total body lean mass ( LM ) and fat mass ( FM ) ( dual-energy X-ray absorptiometry ) , midfemur muscle cross-sectional area ( CSA ) ( quantitative computed tomography ) , muscle strength , and physical function were assessed . After 18 mo , there was no significant exercise by fortified milk interaction for total body LM , muscle CSA , or any functional measure . However , main effect analyses revealed that exercise significantly improved muscle strength ( approximately 20 - 52 % , P < 0.001 ) , LM ( 0.6 kg , P < 0.05 ) , FM ( -1.1 kg , P < 0.001 ) , muscle CSA ( 1.8 % , P < 0.001 ) , and gait speed ( 11 % , P < 0.05 ) relative to no exercise . There were no effects of the fortified milk on muscle size , strength , or function . In conclusion , the daily consumption of low-fat fortified milk does not enhance the effects of RT on skeletal muscle size , strength , or function in healthy middle-aged and older men with adequate energy and nutrient intakes BACKGROUND The beneficial role of exercise in improving bone mineral density , muscle strength and balance , has been documented predominantly in younger population s. These findings may not apply to elderly population s with limited ability to perform exercises of high intensity . OBJECTIVE To examine the effects of Tai Chi ( TC ) and resistance exercise ( RTE ) on bone mineral density ( BMD ) , muscle strength , balance and flexibility in community living elderly people . DESIGN R and omised controlled trial , using blocked r and omization with stratification by sex . SETTING A community in the New Territories Region of Hong Kong , China . SUBJECTS One hundred eighty subjects ( 90 men , 90 women ) aged 65 - 74 , were recruited through advertisements in community centres . METHODS Subjects were assigned to participate in TC , RTE three times a week , or no intervention ( C ) for 12 months . Measurements were carried out at baseline , 6 and 12 months . Analyses of covariance ( ANCOVA ) adjusted for age , and baseline values of variables that were significantly different between groups : i.e. smoking and flexibility for men ; quadriceps strength for women . RESULTS Compliance was high  ( TC 81 % , RTE 76 % ) . In women , both TC and RTE groups had less BMD loss at total hip compared with controls . No effect was observed in men . No difference in either balance , flexibility or the number of falls was observed between either intervention or controls after 12 months . CONCLUSION The beneficial effects of TC or RTE on musculoskeletal health are modest and may not translate into better clinical outcomes Summary A 1-year r and omized controlled trial of resistance training compared with a control group was undertaken in 143 men aged 55–80 years . Although hip bone mineral density , lean body mass , and function increased in both groups , lean body mass and function but not bone density increased more in the resistance group . Introduction Previous studies have demonstrated a positive effect of resistance training on bone mineral density ( BMD ) in postmenopausal women , but the effect in men is unclear . The aim was to examine the effect of a 1-year resistance training program on bone and lean body mass in 143 men aged 55–80 years , r and omized to either resistance training or active control . Methods Resistance exercises were selected to provide loading at the hips . Measurements were taken at 0 , 6 , and 12 months for BMD ( whole body , hip , and spine ) , lean body mass , strength , and functional fitness . Results The intervention showed a significant increase in total hip BMD for both groups at 12 months ( active control , 1,014–1,050 mg/cm2 ; resistance , 1,045–1,054 mg/cm2 , p < 0.05 ) with no increased effect of resistance training compared to active control . However , compared to the active control group , the resistance group increased their lean body mass ( active control , 0.1 ± 2.1 % ; resistance , 1.5 ± 2.7 % , p < 0.05 ) , fitness ( active control , 4.6 ± 11.1 % ; resistance , 13.0 ± 13.4 % , p < 0.05 ) , and lower limb muscle strength ( active control , 14.3 ± 16.8 % ; resistance , 39.4 ± 30.87 % , p < 0.05 ) . Conclusions In contrast to previous findings in older women , in older men , a resistance training program does not increase hip bone mass more than walking 30 min three times a week UNLABELLED In a prospect i ve study of 5384 older men , hip BMD was a very strong predictor of hip fracture , much stronger than spine BMD . The relationship between hip BMD and hip fracture risk seemed to be stronger than observed in a large prospect i ve study of women .  Hip BMD is an excellent test for predicting fracture risk in men . INTRODUCTION There have been few studies of the relationship between BMD and risk of fractures in men and none for the association between lumbar spine BMD and risk of hip and nonvertebral fractures . There is also controversy about whether the associations between BMD and risk of fracture are the same in men and women . MATERIAL S AND METHODS We measured proximal femur and lumbar spine BMD in 5384 men , 5384 men , > or= 65 years of age . We compared the results to the very similar cohort of 7871 women > or=65 of age . During 4.4 years of 99 % complete follow-up , we vali date d 317 nonvertebral ( 59 hip ) fractures in men and 1169 nonvertebral ( 208 hip ) fractures in women . RESULTS Total hip BMD was very strongly associated with risk hip fracture in men ( 3.2-fold increased risk per sex-specific SD decrease in BMD ; 95 % CI , 2.4 - 4.1 ) . The association was stronger than observed in SOF ( 2.1 ; 95 % CI , 1.8 , 2.4 ; p < 0.001 for interaction ) . Among the men , lumbar spine BMD was weakly associated with risk of hip fracture ( relative risk [ RR ] per sex-specific SD decrease in BMD : 1.5 ; 95 % CI , 1.2 , 2.0 ) . The association between total hip BMD and risk of nonvertebral fractures was somewhat stronger for men ( RR = 1.6 ; 95 % CI , 1.5 , 1.8 ) than found for women 
    Output:
    
This systematic review detected only limited positive effects of exercise on  bone mineral density in older men .
Further , based on the present literature , we were unable to suggest dedicated exercise prescriptions for this male cohort that might differ from recommendations based on studies with postmenopausal women .
Based on the present studies , there is only limited evidence for a favorable effect  of exercise on BMD in men .