OBJECTIVES: This study determined the effect of enriched foods and all-around physical exercise on bone and body composition in frail elderly persons. METHODS: A 17-week randomized, controlled intervention trial, following a 2x2 factorial design -- (1) enriched foods, (2) exercise, (3) both, or (4) neither -- was performed in 143 frail elderly persons (aged 78.6 +/- 5.6 years). Foods were enriched with multiple micronutrients; exercises focused on skill training, including strength, endurance, coordination, and flexibility. Main outcome parameters were bone and body composition. RESULTS: Exercise preserved lean mass (mean difference between exercisers and non-exercisers: 0.5 kg +/- 1.2 kg; p < 0.02). Groups receiving enriched food had slightly increased bone mineral density (+0.4%), bone mass (+0.6%), and bone calcium (+0.6%) compared with groups receiving non-enriched foods, in whom small decreases of 0.1%, 0.2%, and 0.4%, respectively, were found. These groups differed in bone mineral density (0.006 +/- 0.020 g/cm2; p = 0.08), total bone mass (19 +/- g; p = 0.04), and bone calcium (8 +/- 21 g; p = 0.03). CONCLUSIONS: Foods containing a physiologic dose of micronutrients slightly increased bone density, mass, and calcium, whereas moderately intense exercise preserved lean body mass in frail elderly persons.
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