REF-896 · Olmedillas et al., 2012 · BMC Medicine, Vol. 10, article · Paper · PubMed

Cycling and bone health: a systematic review

A-fairly strong evidenceMeasured on a mixed groupWritten before October 2026, being re-checked

Cycling improves cardiovascular fitness, but studies show little or no corresponding gain in bone mass. This systematic review gathered all published studies on bone mass and bone metabolism in cyclists up to April 2012: 31 descriptive, cross-sectional, longitudinal and interventional studies met the criteria.

Despite heterogeneous and partly conflicting results, adult road cyclists in regular training had low bone mineral density at key sites such as the lumbar spine, while mountain biking or combining cycling with other sports could reduce this. Diet and endocrine factors did not yet explain the finding.

The authors conclude that road cycling does not appear to confer a significant osteogenic benefit, possibly because of long hours in a weight-supported position plus recovery time spent sitting or lying.

Participants

31 studies included (literature to April 2012). Participant numbers are not given in the abstract.

Protocol

Literature search for studies on bone mass and bone metabolism in cyclists, up to April 2012.
Descriptive, cross-sectional, longitudinal and interventional studies all reviewed; 31 met the inclusion criteria.
Narrative synthesis; no meta-analysis is described in the abstract.

Key Results

Studies were heterogeneous (sex, age, data source, comparison group, cycling level, modality), with "minor but important" differences in results.
Adult road cyclists in regular training have low bone mineral density in key regions, for example the lumbar spine.
Other types of cycling (such as mountain biking), or cycling combined with other sports, could reduce this effect.
The results cannot yet be explained by dietary patterns or endocrine factors.
Conclusion: road cycling does not appear to confer any significant osteogenic benefit.

Practical Application

A systematic review of 31 studies found that adult road cyclists in regular training have low bone mineral density at key sites such as the lumbar spine, that road cycling does not appear to build bone, and that mountain biking or combining cycling with other sports may reduce the problem. To "does all my riding keep my bones healthy?": not on its own; road cycling is fitness without a bone stimulus.
The authors' explanation, not tested here: long hours in a weight-supported position, plus recovery time spent sitting or lying, especially at the competitive level.
Inference, not tested here: because other sports and mountain biking reduced the effect, some impact or loaded activity alongside road riding is the logical countermeasure; this review does not test a specific programme.
Not from this paper; the base's own practice: add impact or heavy strength work for bone (REF-522, narrative); fuel the training, since low energy availability is a separate route to bone injury (REF-343) and the UCI nutrition statement treats bone as a nutrition problem too (REF-748).

Limitations

No meta-analysis; heterogeneous studies with some conflicting results.
Mostly observational; causation cannot be shown.
Literature only to April 2012.
The abstract gives no bone-density values or effect sizes.
Written from the abstract and record metadata only (full text not read).
How this entry was checked and changed
Why this level

systematic review of heterogeneous, mostly observational studies, without pooling

Full text (checked 2026-10-12)
The authors cite that two-thirds of the professional and master adult road cyclists could be classified as osteopenic (full text).
Rector et al. found male cyclists (n = 27) had lower whole-body and lumbar-spine BMD and were 7 times more likely to have osteopenia than runners (n = 16) (full text, Table 1).
Warner et al. found cross-country (mountain) cyclists had higher BMD at all sites than road cyclists and controls, both cycling groups training ≥10 h/week (full text, Table 1).
Stewart et al. found cyclists had lower lumbar-spine BMD than controls, while runners who also cycled (RUN+CYC) had higher whole-body BMD than controls (full text, Table 1).
In Barry et al. (14 male cyclists, >450 h/year), both the HIGH and LOW calcium supplementation groups decreased hip BMD over a 1-year season, and no association between calcium intake and BMD was found in adult cyclists (full text, Table 1).
Nichols et al. followed master cyclists (11.1 h/week) and controls for 7 years and found a higher and increasing percentage of osteopenic/osteoporotic cyclists (full text, Table 1).
Under the age of 18 the BMD differences between cyclists and controls were not observable, and the authors hypothesise they grow from 17 years of age onwards (full text).
The authors conclude cycling as a sole form of exercise is not recommended for people at risk of osteoporosis unless complemented with osteogenic training, cite proposals to add impact activities such as plyometric jumps, and recommend DXA scans for adult female cyclists training at a high level (full text).