Association of the various physical activity patterns with low bone mineral density in Americans aged 20-60.

Through analyzing the data of the NHANES 2007-2020 cycle, this study concluded that high-intensity exercise 1-2 sessions a week can help maintain bone mass, and there is no significant difference from regular exercise more than 3 times a week.
Purpose: This study aims to explore the relationship between the various physical activity(PA) patterns and the risk of low bone mineral density(BMD) in Americans of working age.
Method: A total of 6482 participants aged 20-60 were selected from the National Health and Nutrition Survey (NHANES) conducted from 2007 to 2020. The PA data of the participants were obtained through individual interviews, and the participants were divided into four groups (inactive, insufficiently active, less frequent but sufficiently active(1-2 sessions a week and PA ≥ 150 min), and regularly active). Weighted logistic regression was used to analyze the correlation between PA patterns and the risk of low BMD. Subgroup analyses were applied to display the correlation between PA patterns and low BMD in different subgroups.
Result: After adjusting for confounding factors, the multiple logistic regression model showed that compared with inactive individuals, sufficiently active and regularly active individuals had a 35% (OR, 0.65; 95% CI, 0.46-0.92) and 24% (OR, 0.76; 95% CI, 0.62-0.93) lower risk of low BMD, respectively. Compared with regularly active adults, inactive adults had a 32% (OR, 1.32; 95% CI, 1.07-1.62) increased risk of low BMD, while sufficiently active individuals (OR, 0.85; 95% CI, 0.59-1.23) showed no significant difference compared with regularly active adults.
Conclusion: Compared with inactive adults, less frequent but sufficiently active adults have a lower risk of low BMD and showed benefits similar to those in regularly active groups. The sufficiently active pattern may become a new trend in modern working-age adults' PA patterns.
Competing Interests: Declarations. Ethics approval and consent to participate: The National Center has approved the survey plan and study procedure for Health Statistics’ Ethics Review Board, and the participants/patients have given their written informed consent. We conducted a study exempt from institutional review since it involves secondary data analysis from the National Health and Nutrition Examination Survey. Consent for publication: All authors consent for the publication of the manuscript and figures. Conflicts of interest: None.
(© 2025. International Osteoporosis Foundation and Bone Health and Osteoporosis Foundation.)