A hypothesis about the role of exercise training intensities on bone turn over and muscle-bone cross talk in post-menopausal women: pH influences

Document Type : Hypothesis


1 Exercise Physiology, Department of Sport Injuries & Corrective Exercises, Faculty of Physical Education & Sport Sciences, Allameh Tabataba'i University, Tehran, Iran

2 Department of Exercise Physiology, Faculty of Sport Science, University of Mazandaran, Babolsar, Iran

3 Exercise Physiology Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran

4 Maternal, Fetal & Neonatal Research Center, Tehran University of Medical Sciences (TUMS), Tehran, Iran.


PH stress can be caused by menopause, poor nutrition, high protein intake, old age, prolonged strenuous and anaerobic exercise, anemia, diabetes, AIDS, and respiratory diseases. High calcium enters the bloodstream from the bones during the proton buffering due to metabolic acidosis, which the renal system excretes a significant amount of this calcium to eliminate the acidosis condition and regulate body pH. At the bone surface, this increase in hydrogen ions due to metabolic acidosis can destroy osteoblastic and strengthen osteoclast activity, which negative bone turnover and increases the amount of excreted calcium, thus accelerating the progress of osteoporosis. Due to the widespread prevalence of osteoporosis in postmenopausal women and the provision of various therapies such as medication, estrogen therapy, and proper diet, in recent studies, special attention has been paid to the role of endurance and resistance exercise to decrease osteoporosis or prevent the development of this disease. Also exercise training increases irisin secretion from muscle tissue, which this myokine has beneficial effects on other tissues especially on bone. Irisin increases osteocytic survival and production of sclerostin in bone tissue, which is associated with bone remodeling. However, exercise training in some intensity through metabolic mechanisms can increase pH stress and acidosis and may contribute to the development of osteoporosis in postmenopausal women.  As a result, the hypothesis of different intensities of exercise and their induced acidosis stimuli in postmenopausal women should be considered.

What is already known on this subject?

Numerous studies have evaluated the role of pH stress on the destruction of bone turn over. Exercise by stimulating the secretion of Myokines and Osteokines can improve the homeostasis of these cells, but different intensities of exercise, especially anaerobic exercise can destroy cell homeostasis by destroying the pH.


What this study adds?

It seems that although various exercises can destroy the bone turn over by expanding the pH, but Osteokines and Myokines such as irisin can neutralize this stress and have beneficial effects on bone metabolism in different exercise intensities in postmenopausal women.


Main Subjects

Alexander, R. T., Cordat, E., Chambrey, R., Dimke, H., & Eladari, D. (2016). Acidosis and urinary calcium excretion: insights from genetic disorders. Journal of the American Society of Nephrology, 27(12), 3511-3520. doi: https://doi.org/10.1681/ASN.2016030305
Armamento‐Villareal, R., Aguirre, L., Waters, D. L., Napoli, N., Qualls, C., & Villareal, D. T. (2020). Effect of aerobic or resistance exercise, or both, on bone mineral density and bone metabolism in obese older adults while dieting: a randomized controlled trial. Journal of bone and mineral research, 35(3), 430-439. doi: https://doi.org/10.1002/jbmr.3905
Arnett, T. (2003). Regulation of bone cell function by acid–base balance. Proceedings of the Nutrition Society, 62(2), 511-520. doi: https://doi.org/10.1079/PNS2003268
Batlle, D., Chin-Theodorou, J., & Tucker, B. M. (2017). Metabolic acidosis or respiratory alkalosis? Evaluation of a low plasma bicarbonate using the urine anion gap. American Journal of Kidney Diseases, 70(3), 440-444. doi: https://doi.org/10.1053/j.ajkd.2017.04.017
Beavers, K. M., Beavers, D. P., Martin, S. B., Marsh, A. P., Lyles, M. F., Lenchik, L., . . . Nicklas, B. J. (2017). Change in bone mineral density during weight loss with resistance versus aerobic exercise training in older adults. Journals of Gerontology Series A: Biomedical Sciences and Medical Sciences, 72(11), 1582-1585. doi: https://doi.org/10.1093/gerona/glx048
Benedetti, M. G., Furlini, G., Zati, A., & Letizia Mauro, G. (2018). The effectiveness of physical exercise on bone density in osteoporotic patients. BioMed research international, 2018. doi: https://doi.org/10.1155/2018/4840531
Bonewald, L. F. (2011). The amazing osteocyte. Journal of bone and mineral research, 26(2), 229-238. doi: https://doi.org/10.1002/jbmr.320
BostrÖm, P., Wu, J., Jedrychowski, M., & Korde, A. (2012). Irisin induces brown fat of white adipose tissue in vivo and protects against diet-induced obesity and diabetes. Nature, 481, 463-468. doi: https://doi.org/10.1038/nature10777
Burger, M., & Schaller, D. J. (2019). Physiology, Acidosis, Metabolic StatPearls [Internet]: StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK482146/
Bushinsky, D. A. (1995). Stimulated osteoclastic and suppressed osteoblastic activity in metabolic but not respiratory acidosis. American Journal of Physiology-Cell Physiology, 268(1), C80-C88. doi: https://doi.org/10.1152/ajpcell.1995.268.1.C80
Bushinsky, D. A., & Ori, Y. (1993). Effects of metabolic and respiratory acidosis on bone. Current Opinion in Nephrology and Hypertension, 2(4), 588-596. PMID: 7859021
Chatel, B., Messonnier, L. A., Hourdé, C., Vilmen, C., Bernard, M., & Bendahan, D. (2017). Moderate and intense muscular exercises induce marked intramyocellular metabolic acidosis in sickle cell disease mice. Journal of applied physiology, 122(5), 1362-1369. doi: https://doi.org/10.1152/japplphysiol.01099.2016
Colaianni, G., Cuscito, C., Mongelli, T., Oranger, A., Mori, G., Brunetti, G., . . . Grano, M. (2014). Irisin enhances osteoblast differentiation in vitro. International journal of endocrinology, 2014. doi: https://doi.org/10.1155/2014/902186
Frick, K. K., & Bushinsky, D. A. (2003). Metabolic acidosis stimulates RANKL RNA expression in bone through a cyclo‐oxygenase‐dependent mechanism. Journal of bone and mineral research, 18(7), 1317-1325. doi: https://doi.org/10.1359/jbmr.2003.18.7.1317
Gambacciani, M. (2020). The relative contributions of menopause and aging to postmenopausal osteoporosis. Climacteric: the journal of the International Menopause Society, 23(1), 105. doi:  10.1080/13697137.2019.1679114
Henderson, S., Graham, H., Mollan, R., Riddoch, C., Sheridan, B., & Johnston, H. (1989). Calcium homeostasis and exercise. International orthopaedics, 13(1), 69-73. doi: https://doi.org/10.1007/BF00266727
Herrmann, M., Müller, M., Scharhag, J., Sand-Hill, M., Kindermann, W., & Herrmann, W. (2007). The effect of endurance exercise-induced lactacidosis on biochemical markers of bone turnover. Clinical Chemistry and Laboratory Medicine (CCLM), 45(10), 1381-1389. doi: https://d