Bone formation is suppressed in the diabetic state, being the osteoporotic fractures a serious co-morbidity and complication of diabetes. A better lifestyle with proper diet and exercise have been linked to delay the progression of diabetes and may improve bone metabolism. With diabetes negatively affecting bone health we evaluated the impact of diet and exercise on serum bone markers, hormones and densitometry. This study assessed effects of twelve weeks of recreational soccer training combined with a caloric restricted diet (SO+D) vs. diet alone (D) in markers of bone health of type 2 diabetes (T2D) patients. Training sessions were performed for 40 min, 3 times per week for 12 weeks. We examined the following baseline and postprandial serum bone markers of formation: procollagen type 1 N-terminal propeptide (P1NP), and osteocalcin (OC); and C-terminal telopeptides of type I collagen (CTX) as bone resorption marker. Bone metabolic hormones such as parathyroid hormone (PTH) and 25-hydroxyvitamin D (25[OH]D) were also measured.

Results: Compared to baseline levels, the first soccer session for SO+D induced acute increases of osteocalcin (35.0 ± 14.3 to 48.0 ± 26.3 ng/mL, P<0.05) and CTX remained unchanged. Osteocalcin, P1NP and CTX were lower in the D group (P<0.05). Compared to the D group, SO+D group resulted in increased osteocalcin (P<0.05), while P1NP and CTX levels did not alter. After 12 weeks, bone mineral density increased in both SO+D and D groups (P<0.05) and baseline levels of PTH remained unchanged, whereas 25[OH]D increased only in SO+D group (19.1±1.2 to 22.1 ± 1.4 ng/mL, P<0.05). Diet alone or combined with soccer training improved bone health status among T2D patients elicited by suppression on bone resorption marker and increased bone mineral density. However, recreational soccer training enhanced bone formation marker and vitamin D levels decreasing risk factors associated with osteoporosis and osteoporotic fractures in T2D patients better than diet alone.


M. Vieira de Sousa: None. M.R. da Silva: None.


Fundação de Amparo a Pesquisa do Estado de São Paulo (2012/01400-0)

Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. More information is available at