Amir Tirosh1, Russell J de Souza1, Frank Sacks1, George A Bray1, Steven R Smith1, Meryl S LeBoff1. 1. Division of Endocrinology, Diabetes, and Hypertension (A.T., M.S.L.), Brigham and Women's Hospital, Boston, Massachusetts 02115; Harvard Medical School (A.T., M.S.L., F.S.), Boston, Massachusetts 02115; Department of Clinical Epidemiology and Biostatistics (R.J.d.S.), McMaster University, Hamilton, Ontario, L8S 4L8 Canada; Channing Laboratory (F.S.), Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts 02115; Department of Nutrition (F.S.), Harvard School of Public Health, Boston, Massachusetts 02115; and Pennington Biomedical Research Center of the Louisiana State University System (G.A.B., S.R.S.), Baton Rouge, Louisiana 70808.
Abstract
CONTEXT: Weight loss is associated with reduction in bone mineral density (BMD). OBJECTIVE: The objective was to address the role of changes in fat mass (FM) and lean mass (LM) in BMD decline in both sexes. DESIGN: A 2-year randomized controlled trial, the Preventing Overweight Using Novel Dietary Strategies (POUNDS-LOST). SETTING: The setting was the general community. PATIENTS OR OTHER PARTICIPANTS: Enrolled were 424 overweight and obese participants (mean age, 52 ± 9 y; 57% females). INTERVENTION: Intervention included weight loss diets differing in fat, protein, and carbohydrates. MAIN OUTCOME MEASURES: Main outcome measures were change in spine, total hip (TH), and femoral neck (FN) BMD and sex differences after dietary intervention. RESULTS: At baseline, a stronger correlation between BMD and body composition measurements was observed in women, primarily with LM (r = 0.419, 0.507, and 0.523 for spine, FN, and TH, respectively; all P < .001). In men, only LM correlated with hip BMD (r = 0.298; P < .001). Mean weight loss at 2 years was -6.9%, without differences among diets. Two-year changes in BMD were 0.005 (P = .04), -0.014 (P < .001), and -0.014 g/cm(2) (P < .001), at the spine, TH, and FN, respectively. These changes directly correlated with changes in LM in women (r = 0.200, 0.324, and 0.260 for spine, FN, and TH, respectively), whereas FM loss correlated only with changes in TH BMD (0.274; P < .001). In men, changes in LM (-0.323; P < .001) and FM (-0.213; P = .027) negatively correlated with changes in spine BMD. CONCLUSIONS:Weight loss diets result in sex-specific effects on BMD. Although men exhibited a paradoxical increase in spine BMD, women tended to decrease in BMD at all sites.
RCT Entities:
CONTEXT: Weight loss is associated with reduction in bone mineral density (BMD). OBJECTIVE: The objective was to address the role of changes in fat mass (FM) and lean mass (LM) in BMD decline in both sexes. DESIGN: A 2-year randomized controlled trial, the Preventing Overweight Using Novel Dietary Strategies (POUNDS-LOST). SETTING: The setting was the general community. PATIENTS OR OTHER PARTICIPANTS: Enrolled were 424 overweight and obeseparticipants (mean age, 52 ± 9 y; 57% females). INTERVENTION: Intervention included weight loss diets differing in fat, protein, and carbohydrates. MAIN OUTCOME MEASURES: Main outcome measures were change in spine, total hip (TH), and femoral neck (FN) BMD and sex differences after dietary intervention. RESULTS: At baseline, a stronger correlation between BMD and body composition measurements was observed in women, primarily with LM (r = 0.419, 0.507, and 0.523 for spine, FN, and TH, respectively; all P < .001). In men, only LM correlated with hip BMD (r = 0.298; P < .001). Mean weight loss at 2 years was -6.9%, without differences among diets. Two-year changes in BMD were 0.005 (P = .04), -0.014 (P < .001), and -0.014 g/cm(2) (P < .001), at the spine, TH, and FN, respectively. These changes directly correlated with changes in LM in women (r = 0.200, 0.324, and 0.260 for spine, FN, and TH, respectively), whereas FM loss correlated only with changes in TH BMD (0.274; P < .001). In men, changes in LM (-0.323; P < .001) and FM (-0.213; P = .027) negatively correlated with changes in spine BMD. CONCLUSIONS:Weight loss diets result in sex-specific effects on BMD. Although men exhibited a paradoxical increase in spine BMD, women tended to decrease in BMD at all sites.
Authors: Russell J de Souza; George A Bray; Vincent J Carey; Kevin D Hall; Meryl S LeBoff; Catherine M Loria; Nancy M Laranjo; Frank M Sacks; Steven R Smith Journal: Am J Clin Nutr Date: 2012-01-18 Impact factor: 7.045
Authors: Jeannette M Beasley; Andrea Z LaCroix; Joseph C Larson; Ying Huang; Marian L Neuhouser; Lesley F Tinker; Rebecca Jackson; Linda Snetselaar; Karen C Johnson; Charles B Eaton; Ross L Prentice Journal: Am J Clin Nutr Date: 2014-02-19 Impact factor: 7.045
Authors: Sue A Shapses; Deeptha Sukumar; Stephen H Schneider; Yvette Schlussel; Robert M Sherrell; M Paul Field; Hasina Ambia-Sobhan Journal: Am J Clin Nutr Date: 2013-01-30 Impact factor: 7.045
Authors: P S Hinton; R S Rector; M A Linden; S O Warner; K C Dellsperger; A Chockalingam; A T Whaley-Connell; Y Liu; T R Thomas Journal: Eur J Clin Nutr Date: 2011-12-21 Impact factor: 4.016
Authors: Kara C Hamilton; Gordon Fisher; Jane L Roy; Barbara A Gower; Gary R Hunter Journal: Obesity (Silver Spring) Date: 2013-03 Impact factor: 5.002
Authors: Ashley A Weaver; Denise K Houston; Sue A Shapses; Mary F Lyles; Rebecca M Henderson; Daniel P Beavers; Arlynn C Baker; Kristen M Beavers Journal: Am J Clin Nutr Date: 2019-02-01 Impact factor: 7.045
Authors: Anne L Schafer; Galateia J Kazakia; Eric Vittinghoff; Lygia Stewart; Stanley J Rogers; Tiffany Y Kim; Jonathan T Carter; Andrew M Posselt; Courtney Pasco; Dolores M Shoback; Dennis M Black Journal: J Bone Miner Res Date: 2018-02-05 Impact factor: 6.741
Authors: Rocky Strollo; Andreea Soare; Yeganeh Manon Khazrai; Antonio Di Mauro; Andrea Palermo; Rossella Del Toro; Sara Fallucca; Maria Giovanna Belluomo; Laura Dugo; Mario Pianesi; Paolo Pozzilli; Nicola Napoli Journal: Endocrine Date: 2016-11-25 Impact factor: 3.633
Authors: Tao Zhou; Dianjianyi Sun; Yoriko Heianza; Xiang Li; Catherine M Champagne; Meryl S LeBoff; Xiaoyun Shang; Xiaofang Pei; George A Bray; Frank M Sacks; Lu Qi Journal: Am J Clin Nutr Date: 2018-11-01 Impact factor: 7.045
Authors: L Langsetmo; J M Shikany; A J Burghardt; P M Cawthon; E S Orwoll; J A Cauley; B C Taylor; J T Schousboe; D C Bauer; T N Vo; K E Ensrud Journal: Osteoporos Int Date: 2017-10-23 Impact factor: 4.507