{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,13]],"date-time":"2026-09-13T15:10:02Z","timestamp":1789312202815,"version":"build-2803163510"},"reference-count":56,"publisher":"MDPI AG","issue":"24","license":[{"start":{"date-parts":[[2025,12,11]],"date-time":"2025-12-11T00:00:00Z","timestamp":1765411200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Background: Postmenopausal osteoporosis (PMO) is a major cause of fragility fractures worldwide. While exercise and calcium\/vitamin D are standard preventive measures, the synergistic effects of their combined use on bone mineral density (BMD) remain unclear. Methods: We systematically searched eight databases through October 2025 and synthesized data using Review Manager version 5.4. Subgroup, sensitivity, and meta-regression analyses were conducted to examine heterogeneity and test the robustness of results. Risk of bias was assessed using the Cochrane RoB 2.0 tool, and the certainty of evidence was graded with the GRADE framework. Results: 13 RCTs involving postmenopausal women were included. Compared with calcium and vitamin D supplementation alone, combined interventions significantly increased lumbar spine (SMD = 0.31, 95% CI [0.06, 0.55]) and femoral neck BMD (SMD = 0.47, 95% CI [0.09, 0.84]), with consistent but nonsignificant trends at other skeletal sites. Subgroup analyses showed that whole-body vibration produced the greatest and most consistent benefits at both sites, while mind\u2013body or traditional Chinese exercises (e.g., Baduanjin) significantly improved lumbar spine BMD. Shorter interventions (\u22646 months) yielded greater gains in BMD, whereas longer durations provided no additional advantage. Conclusions: Exercise combined with calcium and vitamin D supplementation effectively improves bone mineral density in postmenopausal women, especially at the lumbar spine and femoral neck. Whole-body vibration and mind\u2013body exercises show the greatest benefits, with short-term interventions proving most effective. This combined approach offers a practical, evidence-based strategy to preserve skeletal health in aging women.<\/jats:p>","DOI":"10.3390\/nu17243866","type":"journal-article","created":{"date-parts":[[2025,12,11]],"date-time":"2025-12-11T11:17:27Z","timestamp":1765451847000},"page":"3866","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Effects of Combined Exercise and Calcium\/Vitamin D Supplementation on Bone Mineral Density in Postmenopausal Women: A Systematic Review and Meta-Analysis"],"prefix":"10.3390","volume":"17","author":[{"given":"Jie","family":"Bai","sequence":"first","affiliation":[{"name":"School of Nursing and Health, Shenzhen Polytechnic University, Shenzhen 518000, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenrui","family":"Huang","sequence":"additional","affiliation":[{"name":"The Fourth Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou 510405, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-7413-7949","authenticated-orcid":false,"given":"Ruixiang","family":"Yan","sequence":"additional","affiliation":[{"name":"School of Athletic Training, Guangzhou Sport University, Guangzhou 510500, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1358-5477","authenticated-orcid":false,"given":"Xuelian","family":"Du","sequence":"additional","affiliation":[{"name":"The Fourth Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou 510405, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,12,11]]},"reference":[{"key":"ref_1","first-page":"154","article-title":"Economic burden of osteoporosis in the world: A systematic review","volume":"34","author":"Rezapour","year":"2020","journal-title":"Med. 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