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The women were categorized as either currently undergoing HRT by their own choice and those not taking the hormones. No women were asked to start taking hormones.

"In hindsight, it was a good thing," Going says, "In light of problems that later surfaced with cerebral and cardiovascular problems associated with HRT uncovered by the Women's Health Initiative (WHI)." The UA is now one of three WHI-designated bone centers in the nation.

Between 1995 and 2001, 256 women participated in the BEST study. All of the women were given calcium citrate supplements throughout the study and a baseline DEXA scan with additional scans at six months and one year. Eight times during the first year, study participants completed diet records that were developed and evaluated at the college's nutritional assessment lab. With the exception of calcium supplements, participants were asked not to alter their diet. Personal check-in, newsletters, group interactions such as picnics combined with awards ceremonies were just a few of the strategies designed to keep the women connected to and active in the study.

All of the women were separated to either participate in a strength-exercise program three times a week or not. The exercise program included weight-bearing or resistance training, seven to 10 minutes of cardiovascular weight-bearing activity, and small group exercises. They were followed for a year as they worked out for free with a certified trainer at local community fitness centers.

After the first year, study participants' bone health continually improved. Findings indicated that there was an increase in bone mineral density in the hip area but no increase in spine bone mineral density. By the second year, Going noted, the exercise program participants had also increased their spine bone mineral density. The research also indicated that those who showed symptoms of depression — not clinically depressed but with higher indicators of depression — gained less bone mass.

Besides verification that taking adequate amounts of calcium in the diet led to increased bone mass, researchers got a surprise. "Iron intakes from the diet at the high end of the recommended range of iron needs for post-menopausal women were also related to higher bone mineral density," Houtkooper says.

In June 2003, the UA colleges of Agriculture and Life Sciences, and Medicine formed The Center for Physical Activity and Nutrition (CPAN). One of its charges is to translate new discoveries into culturally appropriate and effective individual and community programs. Not until 2004 did the U.S. Surgeon General formally recognize that a public health approach to improve bone health is critical to overall health.

The team of UA researchers collaborating on the Bone Estrogen Strength Training (BEST) project includes Scott Going, Linda Houtkooper, Melanie Hingle and Vanessa Stanford of the College of Agriculture and Life Sciences' department of nutritional sciences, and Timothy Lohman and Lauve Metcalfe, College of Medicine department of physiology.