在傳統的觀念中，骨頭對身體所提供的功能包括：保護腦／臟器、儲存礦物質、支撐身體、作為執行各種運動時的槓桿系統以及造血。近年來，骨生物學最新的發現指出，骨頭不再只是激素調節過程中的接受者，實際上，骨頭可被視為一器官看待，並具有主動調節能量代謝反應(包括：血糖調控)的能力。胰島素已被證實會進一步作用在造骨細胞上的胰島素受器，而其下游反應除了直接促成造骨細胞分泌骨鈣素之外，同時也會間接促進蝕骨細胞進行骨吸收作用而釋出存放於骨基質中的骨鈣素。經研究證實，羧化不完全的骨鈣素會刺激胰臟的β細胞分泌更多的胰島素，因而使得血糖調降的過程更有效率。耐力運動及飲食控制(例如：熱量限制)為具有減重以及促進能量代謝敏感性的行為改變方式，然而，這兩種介入方式經常伴隨有較低骨頭質量及較小骨頭尺寸的現象，因此，常被認為對骨骼健康沒有正面助益。本文旨在整合骨頭可被視為內分泌器官的新知與傳統已知的骨代謝調節機制，針對耐力運動及飲食控制所導致的低骨量及較小骨尺寸提供一嶄新的觀點，文中論述亦包含骨代謝與能量代謝兩者之間的交互作用。耐力運動和飲食控制除了和較低的骨量或骨尺寸有關之外，實際上，這兩種介入方式所改善的代謝特徵(例如：較低的發炎反應或向下調節的氧化壓力)反而對長期的骨代謝而言是有助益的。同時，本文亦針對骨密度學測量方法以及骨品質指標的有效性進行論述，藉以闡明耐力運動及飲食控制對骨健康的影響。

Traditionally, well-known functions of bones include protecting brain/internal organs, serving as a reservoir of mineral, supporting body, providing leverage system for various movements and producing blood cells. Recently novel findings suggest that bone is not only a tissue served as a recipient of hormonal inputs but also an organ actively mediating energy metabolism, which includes blood sugar regulation. Insulin has been verified to act through insulin receptor (IR) located on osteoblast, and the downstream reactions of osteoblast IR which would directly stimulate the secretion of osteocalcin from osteoblast as well as indirectly up-regulate the bone resorption released osteocalcin from bone matrix. And, it is the undercarboxylated osteocalcin further stimulating insulin secretion from β-cell of pancreas and enhancing the efficiency of blood glucose down-regulation. Endurance exercise and dietary manipulations (e.g caloric restriction) are behavioral modifications, which have well-proven efficiencies in body weight reduction and also in promoting energy metabolic sensitivity. However, the effects of those two interventions frequently accompany with lower bone mass as well as smaller bone sizes. Hence, endurance exercise and caloric restriction have been considered not beneficial for bone health. The first purpose of the current review was to integrate the new knowledge of bone serving as an endocrine organ with traditional bone regulating mechanisms. Then, we provided a brand-new opinion with regard to endurance exercise and dietary manipulations caused low bone mass as well as smaller bone size. Discussions of interactions between bone metabolism and energy metabolism were included. In spite of correlating with lower bone mass/size, endurance exercise and dietary manipulation actually ameliorate the metabolism profile (e.g. lower inflammatory response, down-regulated oxidative stress) which would further benefit to bone metabolism. In addition, arguments regarding the validity of densitometric measurements and bone quality were also included to elucidate the effects of endurance exercise and dietary manipulations on bone health.