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Abstract

Osteoporosis affects one in three women over 50, often resulting in fractures that impair mobility and quality of life. Although bone mass and density decline with age, achieving higher peak values before menopause may reduce this risk. Physical activity (PA) is a modifiable factor in skeletal integrity, yet its impact across life stages remains underexplored. Since 80–90% of peak bone mass is accrued by age 16, PA during adolescence and early adulthood is critical. Few studies have examined how specific PA patterns during these periods relate to adult bone health in pre‑menopausal women. PURPOSE: To investigate the relationship between early‑life and lifelong PA and adult bone mineral density (BMD) and mass in women. METHODS: This correlational study recruited 50 women aged 30–40 years. Participants completed a pre‑screening survey, followed by an in‑person visit with informed consent, structured interviews, and a DEXA scan. The Lifetime Total Physical Activity Questionnaire (LTPAQ) assessed PA type, frequency, and timing across life stages. Additional data on health behaviors, reproductive history, and medical background were collected. RESULTS: Pearson correlations examined the relationship between lifetime exercise (METs) and BMD (age-matched Z‑scores) at multiple skeletal sites. Physical activity showed a significant positive correlation with overall BMD Z‑score (r = .298, p = .036). A borderline positive correlation was observed between PA and lumbar spine (L2–L4) Z‑score (r = .280, p = .052). The relationship between PA and dual femur Z‑score was positive but not statistically significant (r = .209, p = .145). Distributional analysis indicated that overall Z‑scores were symmetric and moderately dispersed (Mean = 0.482, SD = 0.887, Skewness = 0.210). CONCLUSION: The positive correlation between lifetime PA and adult BMD, particularly the significant relationship with overall BMD, reinforces the importance of sustained movement across life stages. The emerging trend toward higher lumbar spine BMD with greater PA further highlights adolescence and early adulthood as critical windows for establishing lifelong skeletal strength. These findings underscore the need for physical literacy education and accessible public health messaging that encourages women to engage in bone‑loading activities throughout life. This research supports a movement‑as‑medicine framework and positions physical activity as foundational to women’s health policy, education, and long‑term osteoporosis prevention.

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