Physical activity and postmenopausal health.

Physical activity leads to a 30-50 % reduction in cardiovascular disease in women. Moderate activities such as walking, gardening or light sports appear to have beneficial effects. Additional exercise training may enhance these effects. Moderate-intensity activities constitute a key recommendation for primary prevention. Vigorous intensity activity may render additional benefits. Recent recommendations suggest an increase to at least 60 minutes of cumulative daily physical activity. Practical recommendations for the prevention of osteoporosis are less clear. There is a relative abundance of randomised controlled trials assessing bone mineral density at various sites. Meta-analyses of these studies indicate a beneficial health effect of physical activity on prevention of bone loss. However, the effects seen appear to be relatively small. Two recent end-point studies examining hip and fragility fractures show stronger evidence for the protective potential of physical activity in bone health. Exercise throughout life, particularly weight-bearing, is assumed to be beneficial for bone health. Older people at risk of falling are advised to participate in tailored exercise programmes to improve strength and balance, since physical training might contribute to fracture prophylaxis by increasing mobility and general activity of ageing people. Beyond the promotion of regular physical activity, primary disease prevention requires the adoption of healthy life habits including dietary patterns, weight control, and avoiding smoking. In the light of the failure of postmenopausal hormone use to protect against heart disease, rethinking the role of exercise in maintaining postmenopausal health is of increasing importance.