title: Long-term effects of exercise in postmenopausal women: 16-year results of the Erlangen Fitness and Osteoporosis Prevention Study (EFOPS).
abstract: Multimorbidity related to menopause and/or increased age will put healthcare systems in western nations under ever-greater strain. Effective strategies to prevent diseases are thus of high priority and should be started earlier in life. The purpose of the study was to evaluate the long-term effect of exercise on different important health parameters in initially early postmenopausal women over a 16-year period.
  
  
  
  In 1998, 137 early postmenopausal women with osteopenia living in Erlangen-Nürnberg were included in the study. Eighty-six women joined the exercise group (EG) and conducted two supervised group and two home training sessions per week, whereas the control group (CG: n = 51) maintained their physical activity level. Primary outcome parameters were clinical overall fractures incidence; secondary study endpoint was Framingham study-based 10-year risk of coronary death/myocardial infarction and low back pain.
  
  
  
  In 2014, 59 women of the EG and 46 women of the CG were included in the 16-year follow-up analysis. Framingham study-based 10-year risk of myocardial infarction/coronary death increased significantly (P < 0.001) in both groups; however, changes were significantly more favorable in the EG (5.00% ± 2.94% vs CG: 6.90% ± 3.98%; P = 0.02). The ratio for clinical "overall" fractures was 0.47 (95% CI: 0.24-0.92; P = 0.03), and thus significantly lower in the EG. Although we focused on a high-intensity exercise strategy, low back pain was favorably affected in the EG.
  
  
  
  Multipurpose exercise programs demonstrated beneficial effects on various relevant risk factors and diseases of menopause or/and increased age, and should thus be preferentially applied for primary or secondary prevention in postmenopausal women.
authors.affiliation: 1Institute of Medical Physics, University of Erlangen-Nürnberg, Erlangen, Germany 2Department of Medical and Life Sciences, University of Furtwangen, Schwenningen, Germany.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Kemmler
authors.forename: Matthias
authors.initials: M
authors.lastname: Kohl
authors.forename: Simon
authors.initials: S
authors.lastname: von Stengel
mesh_terms: D002318:Cardiovascular Diseases / Q000517:prevention & control; D016022:Case-Control Studies; D015444:Exercise / Q000502:physiology*; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D050723:Fractures, Bone / Q000453:epidemiology; D006801:Humans; D008137:Longitudinal Studies; D017116:Low Back Pain / Q000628:therapy; D008875:Middle Aged; D015663:Osteoporosis, Postmenopausal / Q000517:prevention & control*; D010809:Physical Fitness / Q000502:physiology; D017698:Postmenopause / Q000502:physiology*; D012307:Risk Factors; D013997:Time Factors