Bone mineral density (BMD) is a measure of skeletal health that may foretell disorders like osteoporosis. To reduce bone losses on Earth, treatments include exercise, diet, and drugs. Each impact osteoblast and osteoclast activity dictates skeletal remodeling and subsequent BMD changes. BMD loss is a concern during spaceflight. For astronauts, low BMD undermines in-flight tasks and compromises their postflight health. While bisphosphonates exhibited promise as an in-flight bone loss treatment, study results are mixed, and this class of drugs has numerous side-effects. While the role antiresorptive agents play in reducing BMD loss is discussed, this review focuses on exercise-induced strains and nutrition, two in-flight treatments without bisphosphonates' side-effects. Evidence supports in-flight exercise and a healthy diet with vitamin D and Ca supplementation to limit BMD loss. This review suggests how exercise and nutrition may limit BMD loss during spaceflight. Also discussed is an in-flight version of the inertial exercise trainer (IET; Impulse Technologies, Knoxville TN). By imparting high bone-strain magnitudes, rates, and frequencies with less mass, footprint, and power needs than other forms of in-flight resistance exercise hardware, the IET warrants inquiry for use aboard future long-term spaceflights.

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http://dx.doi.org/10.3357/AMHP.6255.2023DOI Listing

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