***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: BACKGROUND Studies of weight loss and changes in bone mineral density ( BMD ) have primarily been short-term trials in obese subjects . OBJECTIVE We examined the effects of a 5-yr intervention design ed to prevent menopausal weight gain or promote modest weight loss on BMD in premenopausal women participating in the Women 's Healthy Lifestyle Project . DESIGN We enrolled 373 premenopausal women ( age 44 - 50 yr ) and r and omly assigned them to either lifestyle intervention ( 175 women , low-fat dietary modification , weight loss , and physical activity intervention ) or control group ( 198 women ) .  BMD and body weight were measured at baseline , annual follow-up visits ( 18 , 30 , 42 , and 54 months ) , and two postintervention follow-ups ( 66 and 78 months ) . BMD was measured by dual x-ray absorptiometry . RESULTS Over the 54 months of intervention , women in the intervention group lost 0.4 kg , whereas control women gained 2.6 kg ( P = 0.011 ) . The intervention group experienced significantly greater hip bone loss ( -0.20%/yr ) than the control group ( -0.03%/yr ) . During the postintervention , differences in rates of bone loss disappeared . When considering both menopausal status and use of hormone therapy ( HT ) , the annualized BMD changes were lower in women reporting HT use ; nevertheless , among women on HT , those who lost more than 3 % body weight experienced greater total hip BMD loss ( -0.25%/yr ) compared with those who gained weight ( -0.02%/yr ) ( P = 0.025 ) . CONCLUSIONS Women r and omized to a lifestyle intervention aim ed at preventing menopausal weight gain or promoting modest weight loss experienced greater rates of hip bone loss than control women 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 BACKGROUND Race and sex differences in the effect of diet on bone mineral density ( BMD ) at the hip in the elderly are unknown . OBJECTIVES This study related cross-sectional nutrient and dairy product consumption to hip BMD in white and black men and women aged > 60 y and evaluated the influence of nutrient and dairy product consumption on changes in BMD in a white cohort participating in a calcium , vitamin D , or placebo trial . DESIGN The Health Habits and History Question naire was used in 289 white women and 116 white men who participated in the trial and in 265 black women and 75 black men to predict total hip and femoral neck BMD or  changes in BMD . RESULTS Blacks had higher calcium intakes than did whites ( 700 and 654 mg/d , respectively ; P = 0.0094 ) , and men had higher calcium intakes than did women ( 735 and 655 mg/d , respectively ; P = 0.0007 ) . For men , the correlation between total hip BMD and dairy calcium intake after adjustment for age , race , and weight was 0.23 ( P < 0.005 ) ; this relation was not significant in women ( r = 0.02 , P = 0.12 ) . Similar results were found for femoral neck BMD . In the longitudinal study , calcium supplementation reduced bone loss from the total hip and femoral neck in those who consumed < 1.5 servings of dairy products/d and were < 72 y old . CONCLUSIONS Cross-sectional results indicated that higher dairy product consumption is associated with greater hip BMD in men , but not in women . Calcium supplementation protected both men and women from bone loss in the longitudinal study of whites BACKGROUND No published studies have directly examined the effect of soy protein with isoflavones on bone or bone turnover  in perimenopausal women . OBJECTIVE Our objective was to determine the effects of 24 wk of consumption of soy protein isolate with isoflavones ( 80.4 mg/d ) in attenuating bone loss during the menopausal transition . DESIGN Perimenopausal subjects were r and omly assigned , double blind , to treatment : isoflavone-rich soy ( SPI+ ; n = 24 ) , isoflavone-poor soy ( SPI- ; n = 24 ) , or whey ( control ; n = 21 ) protein . At baseline and posttreatment , lumbar spine bone mineral density ( BMD ) and bone mineral content ( BMC ) were measured by using dual-energy X-ray absorptiometry . At baseline , midtreatment , and posttreatment , urinary N:-telopeptides and serum bone-specific alkaline phosphatase ( BAP ) were measured . RESULTS The percentage change in lumbar spine BMD and BMC , respectively , did not differ from zero in the SPI+ or SPI- groups , but loss occurred in the control group ( -1.28 % , P : = 0.0041 ; -1.73 % , P : = 0.0037 ) . By regression analysis , SPI+ treatment had a positive effect on change in BMD ( 5.6 % ; P : = 0.023 ) and BMC ( 10.1 % ; P : = 0.0032 ) . Baseline BMD and BMC ( P : < or = 0.0001 ) negatively affected the percentage change in their respective models ; baseline body weight ( P : = 0.0036 ) and bone-free lean weight ( P : = 0.016 ) contributed positively to percentage change in BMD and BMC , respectively . Serum BAP posttreatment was negatively related to percentage change in BMD ( P : = 0.0016 ) and BMC ( P : = 0.019 ) . Contrast coding using analyses of covariance with BMD or BMC as the outcome showed that isoflavones , not soy protein , exerted the effect . CONCLUSION Soy isoflavones attenuated bone loss from the lumbar spine in perimenopausal women BACKGROUND The positive association between body weight and bone mineral density ( BMD ) is well documented ; in contrast , the effect of changes in body weight on BMD is not well understood , particularly , in normal-weight population s. OBJECTIVE We examined the effect of a lifestyle intervention aim ed at lowering dietary fat intake and increasing physical activity to produce modest weight loss or prevent weight gain on BMD in a population of 236 healthy , premenopausal women aged 44 - 50 y. DESIGN All women were participating in a clinical trial known as The Women 's Healthy Lifestyle Project and were r and omly assigned to intervention or control groups . Dual-energy X-ray absorptiometry of BMD at the lumbar spine and proximal femur were made before and after 18 mo of participation in the trial . RESULTS The intervention group ( n = 115 ) experienced a mean ( + /-SD ) weight loss of 3.2 + /- 4.7 kg over the 18 mo compared with a weight gain of 0.42 + /- 3.6 kg in the control group ( n = 121 ) ( P < 0.001 ) . The annualized rate of hip BMD loss was 2-fold higher ( P < 0.015 ) in the intervention group ( 0.81 + /- 1.3 % ) than in the control group ( 0.42 + /- 1.1 % ) ; a similar , although nonsignificant pattern was observed for the loss in spine BMD : 0.70 + /- 1.4 % and 0.37 + /- 1.5 % ( P = 0.093 ) in the intervention and control groups , respectively . Large increases in physical activity attenuated spine BMD loss , but had no significant effect on BMD loss at the hip . CONCLUSIONS The intervention group , who modified their lifestyle to lose weight , had a higher rate of BMD loss at the hip and lumbar spine than did the weight-stable control group . Recommendations for weight loss must be made with consideration that such an endorsement may result in BMD loss BACKGROUND Impaired hip structure assessed by dual-energy X-ray absorptiometry ( DXA ) areal bone mineral density ( aBMD ) is an independent predictor for osteoporotic hip fracture . Some studies suggest that tea intake may protect against bone loss . OBJECTIVE Using both cross-sectional and longitudinal study design s , we examined the relation of tea consumption with hip structure . DESIGN R and omly selected women ( n = 1500 ) aged 70 - 85 y participated in a 5-y prospect i ve trial to evaluate whether oral calcium supplements prevent osteoporotic fractures . aBMD at the hip was measured at years 1 and 5 with DXA . A cross-sectional analysis of 1027 of these women at 5 y assessed the relation of usual tea intake , measured by using a question naire , with aBMD . A prospect i ve analysis of 164 women assessed the relation of  tea intake  at baseline , measured by using a 24-h dietary recall , with change in aBMD from years 1 to 5 . RESULTS In the cross-sectional analysis , total hip aBMD was 2.8 % greater in tea drinkers ( x : 806 ; 95 % CI : 797 , 815 mg/cm(2 ) ) than in non-tea drinkers ( 784 ; 764 , 803 mg/cm(2 ) ) ( P < 0.05 ) . In the prospect i ve analysis over 4 y , tea drinkers lost an average of 1.6 % of their total hip aBMD ( -32 ; -45 , -19 mg/cm(2 ) ) , but non-tea drinkers lost 4.0 % ( -13 ; -20 , -5 mg/cm(2 ) ) ( P < 0.05 ) . Adjustment for covariates did not influence the interpretation of results . CONCLUSION Tea drinking is associated with preservation of hip structure in elderly women . This finding provides further evidence of the beneficial effects of tea consumption on the skeleton BACKGROUND The effects of dietary changes on  osteoporosis , low bone density , and frequent falls  are unestablished . OBJECTIVE We assessed the effect of the Women 's Health Initiative Dietary Modification low-fat and increased fruit , vegetable , and grain intervention on incident hip , total , and site-specific fractures and self-reported falls , and , in a subset , on bone mineral density ( BMD ) . DESIGN Postmenopausal women ( n = 48,835 ) aged 50 - 79 y ( 18.6 % of minority race-ethnicity ) were r and omly assigned to receive the Dietary Modification intervention ( 40 % , n = 19,541 ) ( daily goal : < or = 20 % of energy as fat , > or = 5 servings of vegetables and fruit , and > or = 6 servings of grains ) or to a comparison group that received no dietary changes ( 60 % ; n = 29,294 ) . RESULTS After a mean 8.1 y of follow-up , 215 women in the intervention group and 285 women in the comparison group ( annualized rate : 0.14 % and 0.12 % , respectively ) experienced a hip fracture ( hazard ratio : 1.12 ; 95 % CI : 0.94 , 1.34 ; P = 0.21 ) . The intervention group ( n = 5423 ; annualized rate : 3.44 % ) had a lower rate of reporting > or = 2 falls than did the comparison group ( n = 8695 ; annualized rate : 3.67 % ) ( HR : 0.92 ; 95 % CI : 0.89 , 0.96 ; P < 0.01 ) . There was a significant interaction according to hormone therapy use ; those in the comparison group receiving hormone therapy had the lowest incidence of hip fracture . In a subset of 3951 women , hip BMD at 
    Output:
    
Strength exercises had a positive effect on fracture .
Aerobic exercises had a positive impact on lumbar bone mineral density , fall , and balance .
Soy protein supplementation was effective for improving lumbar bone mineral density while vitamin K supplementation had a positive effect on of femur bone mineral density .
Calcium supplementation had a positive impact on femur and lumbar bone mineral density .
The combination of exercise , calcium , and vitamin D supplementation was effective for improving lumbar bone mineral density , risk of fall , and balance .
Self-management programs for better bone health had a positive effect on balance and quality of life .
CONCLUSION The results indicate that lifestyle interventions including exercise and taking daily calcium and vitamin D supplementation are beneficial for improving bone health in women at high risk of osteoporosis .