Match!

A Losing Battle: Weight Regain Does Not Restore Weight Loss-Induced Bone Loss in Postmenopausal Women.

Published on Dec 1, 2011in Obesity3.969
· DOI :10.1038/oby.2011.263
Karen L. Villalon3
Estimated H-index: 3
(University of Colorado Denver),
Wendolyn S. Gozansky18
Estimated H-index: 18
(University of Colorado Denver)
+ 4 AuthorsWendy M. Kohrt61
Estimated H-index: 61
(University of Colorado Denver)
Abstract
Previously, we reported significant bone mineral density (BMD) loss in postmenopausal women after modest weight loss. It remains unclear whether the magnitude of BMD change in response to weight loss is appropriate (i.e., proportional to weight loss) and whether BMD is recovered with weight regain. We now report changes in BMD after a 1-year follow-up. Subjects (n = 23) in this secondary analysis were postmenopausal women randomized to placebo as part of a larger trial. They completed a 6-month exercise-based weight loss program and returned for follow-up at 18 months. Dual-energy X-ray absorptiometry (DXA) was performed at baseline, 6, and 18 months. At baseline, subjects were aged 56.8 ± 5.4 years (mean ± s.d.), 10.0 ± 9.2 years postmenopausal, and BMI was 29.6 ± 4.0 kg/m2. They lost 3.9 ± 3.5 kg during the weight loss intervention. During follow-up, they regained 2.9 ± 3.9 kg. Six months of weight loss resulted in a significant decrease in lumbar spine (LS) (−1.7 ± 3.5%; P = 0.002) and hip (−0.04 ± 3.5%; P = 0.03) BMD that was accompanied by an increase in a biomarker of bone resorption (serum C-terminal telopeptide of type I collagen, CTX: 34 ± 54%; P = 0.08). However, weight regain was not associated with LS (0.05 ± 3.8%; P = 0.15) or hip (−0.6 ± 3.0%; P = 0.81) bone regain or decreased bone resorption (CTX: −3 ± 37%; P = 0.73). The findings suggest that BMD lost during weight reduction may not be fully recovered with weight regain in hormone-deficient, postmenopausal women. Future studies are needed to identify effective strategies to prevent bone loss during periods of weight loss.
  • References (39)
  • Citations (37)
📖 Papers frequently viewed together
133 Citations
103 Citations
96 Citations
78% of Scinapse members use related papers. After signing in, all features are FREE.
References39
Newest
#1Hye Jin Yoo (KU: Korea University)H-Index: 33
#2Man Sik Park (UPR-RP: UPRRP College of Natural Sciences)H-Index: 14
Last. Kyung Mook Choi (KU: Korea University)H-Index: 47
view all 10 authors...
Osteoporosis and obesity are important public health problems in an aging society. We investigated the differential impacts of fat on bone mineral density (BMD) according to gender and menopausal status. We analyzed the baseline data of an ongoing observational cohort study, including a total of 502 healthy subjects 20–88 years of age (144 men, 159 premenopausal women, 199 postmenopausal women). Body composition and fat mass were measured using computed tomography and dual energy X-ray absorptio...
43 CitationsSource
#1Rawad El Hage (University of Balamand)H-Index: 11
#2Christophe Jacob (University of Balamand)H-Index: 16
Last. Rafic Baddoura (""St. Joe's"": Saint Joseph's University)H-Index: 12
view all 4 authors...
Abstract The aim of this study was to determine the relative importance of lean mass and fat mass on bone mineral density (BMD) in a group of Lebanese postmenopausal women. One hundred ten Lebanese postmenopausal women (aged 65–84yr) participated in this study. Age and years since menopause were recorded. Body weight and height were measured and body mass index (BMI) was calculated. Body composition (lean mass, fat mass, and fat mass percentage) was assessed by dual-energy X-ray absorptiometry (...
20 CitationsSource
#1Deeptha Sukumar (RU: Rutgers University)H-Index: 11
#2Hasina Ambia-Sobhan (RU: Rutgers University)H-Index: 7
Last. Sue A. Shapses (RU: Rutgers University)H-Index: 39
view all 7 authors...
75 CitationsSource
#1J. Saarelainen (University of Eastern Finland)H-Index: 6
#2Risto Honkanen (University of Eastern Finland)H-Index: 41
Last. Leo NiskanenH-Index: 71
view all 6 authors...
Abstract Objective To assess the association between the body fat distribution and axial bone mineral density (BMD) in postmenopausal women with or without hormone replacement therapy (HRT). Design Cross-sectional population-based study. Setting University of Eastern Finland, Bone and Cartilage Research Unit, Kuopio, Finland. Population 198 postmenopausal women, mean age 67.5 (1.9 SD), mean BMI 27.1 (3.9 SD). Methods Regional body composition and BMD assessed by dual X-ray absorptiometry (DXA, P...
18 CitationsSource
#1Emanuela A. Greco (Policlinico Umberto I)H-Index: 18
#2R. Fornari (Policlinico Umberto I)H-Index: 1
Last. Silvia Migliaccio (Policlinico Umberto I)H-Index: 33
view all 14 authors...
SUMMARY Background: Obese individuals often present comorbidities while they appear protected against the development of osteoporosis. However, few and contradictory data are now available on skeletal modifications in obese patients. The aim of this study was to characterise bone mineral density (BMD) in overweight (BMI > 25 30) patients. Methods: We selected 398 patients (291 women, 107 men, age 44.1 + 14.2 years, BMI 35.8 + 5.9 kg ⁄m 2 ) who underwent clinical examination, blood tests and exam...
107 CitationsSource
#1L. B. Jensen (Copenhagen Municipal Hospital)H-Index: 7
#2Flemming QuaadeH-Index: 2
Last. Ole Helmer Sørensen (Copenhagen Municipal Hospital)H-Index: 36
view all 3 authors...
Dual-energy x-ray absorptiometry was performed in 51 obese patients before and after 15 weeks on a low-calorie diet. Of these patients 39 were scanned 6 months later. Total and regional body bone mineral, fat mass, and fat free mass were measured. In the control group, 9 normal volunteers were scanned with up to 23 kg lard distributed anteriorly, and 9 volunteers were scanned with 15 kg lard posteriorly. The lard was then gradually removed to simulate the fat loss found in the patient group. In ...
138 CitationsSource
#1Sundeep Khosla (Mayo Clinic)H-Index: 2
#2Elizabeth J. Atkinson (Mayo Clinic)H-Index: 77
Last. L. Joseph Melton (Mayo Clinic)H-Index: 164
view all 4 authors...
Increasing body weight is associated both with higher bone mass and with lower rates of bone loss. Whether the effects of body weight are mediated by lean body mass (LBM) or fat body mass (FBM) is, however, uncertain because different studies have used different measures of bone mass and arrived at contradictory conclusions. The parameter actually measured is bone mineral content (BMC). Bone mineral density (BMD), bone mineral apparent density (BMAD), and the BMD/height attempt to "correct" BMC ...
269 CitationsSource
#1Siri ForsmoH-Index: 22
#2Arnulf LanghammerH-Index: 33
Last. Berit ScheiH-Index: 38
view all 3 authors...
Objective: The aim of this study was to investigate the association between bone loss and weight change before and concurrently to the assessment of forearm bone loss over 4.6 years in a population-based cohort of middle-aged women followed for more than 15 years. Methods: Among 8,856 women aged 45 to 60 years attending the first Nord-Trondelag Health Study study, Norway (1984-1986), a 35% random sample was invited for forearm densitometry at Nord-Trondelag Health Study 2 (1995-1997), and 2,188 ...
4 CitationsSource
#1Leanne M. RedmanH-Index: 39
#2Jennifer RoodH-Index: 37
Last. Eric RavussinH-Index: 101
view all 6 authors...
Background Calorie restriction (CR) is promoted to increase longevity, yet this regimen could lead to bone loss and fracture and therefore affect quality of life. Methods Forty-six individuals were randomized to 4 groups for 6 months: (1) healthy diet (control group); (2) 25% CR from baseline energy requirements (CR group); (3) 25% energy deficit by a combination of CR and increased aerobic exercise (CR + EX group); and (4) low-calorie diet (890 kcal/d; goal, 15% weight loss) followed by weight ...
64 CitationsSource
#1Ian R. Reid (University of Auckland)H-Index: 93
Body weight impacts both bone turnover and bone density, making it, therefore, an important risk factor for vertebral and hip fractures and ranking it alongside age in importance. The effect of body weight is probably contributed to by both fat mass and lean mass, though in postmenopausal women, fat mass has been more consistently demonstrated to be important. A number of mechanisms for the fat-bone relationship exist and include the effect of soft tissue mass on skeletal loading, the associatio...
368 CitationsSource
Cited By37
Newest
#1Chaise A Murphy (TUM: Technische Universität München)
#2Karsten Koehler (TUM: Technische Universität München)H-Index: 14
PURPOSE: Weight loss can result in the loss of muscle mass and bone mineral density. Resistance exercise is commonly prescribed to attenuate these effects. However, the anabolic endocrine response to resistance exercise during caloric restriction has not been characterized. METHODS: Participants underwent 3-day conditions of caloric restriction (15 kcal kg FFM(-1)) with post-exercise carbohydrate (CRC) and with post-exercise protein (CRP), and an energy balance control (40 kcal kg FFM(-1)) with ...
Source
#1Reina Armamento-Villareal (BCM: Baylor College of Medicine)H-Index: 24
#2Lina E. Aguirre (UNM: University of New Mexico)H-Index: 7
Last. Dennis T. Villareal (BCM: Baylor College of Medicine)H-Index: 46
view all 6 authors...
Weight loss therapy of older adults with obesity is limited by weight loss-induced decrease in bone mineral density (BMD), which could exacerbate ongoing age-related bone loss and increase the risk for fractures. Therefore, it is recommended that weight loss therapy of older adults with obesity should include an intervention such as regular exercise to reduce the concomitant bone loss. However, the most appropriate exercise types to combine with weight loss therapy in this older population is un...
2 CitationsSource
#1Daniel E. Kammire (Wake Forest University)
#2Michael P. Walkup (Wake Forest University)H-Index: 21
Last. Kristen M. Beavers (Wake Forest University)H-Index: 16
view all 10 authors...
OBJECTIVE: This study aimed to examine change in bone mineral density (BMD) and trabecular bone score among older adult weight regainers (WR) and weight maintainers (WM). METHODS: Observational data come from 77 older adults (mean age: 67 [SD 5] years; 69% women; 70% white) with obesity (mean BMI: 33.6 [SD 3.7] kg/m2 ) who lost weight during an 18-month weight loss intervention. Total body mass and body composition, along with regional (total hip, femoral neck, lumbar spine) BMD and trabecular b...
Source
#1K BeaversH-Index: 10
#2Rebecca H. NeibergH-Index: 22
Last. Stephen B. KritchevskyH-Index: 99
view all 10 authors...
: The purpose of this study is to explore the impact of body weight change following intentional weight loss on incident fracture and bone mineral density (BMD) in overweight and obese adults with diabetes. A total of 1885 individuals with type 2 diabetes (baseline age: 58.5 ± 6.7 years, 58% women, body mass index: 35.7 ± 6.0 kg/m2) who participated in the Look AHEAD study and lost any weight 1 year after being randomized to an intensive lifestyle intervention were assessed. Body weight was meas...
Source
#1Nathan P. De Jong (University of Colorado Denver)H-Index: 2
#2Corey A. Rynders (University of Colorado Denver)H-Index: 8
Last. Audrey Bergouignan (University of Colorado Denver)H-Index: 16
view all 9 authors...
Insulin sensitivity as assessed by HOMA-IR was improved after 4 days of physical activity independent of frequency and duration of activity bouts. Temporal patterns of activity across the day diffe...
2 CitationsSource
#1Andrea E. Bombak (UNB: University of New Brunswick)H-Index: 1
#2Lee F. Monaghan (UL: University of Limerick)H-Index: 21
Last. Emma Rich (University of Bath)H-Index: 24
view all 3 authors...
Despite considerable contestation, ‘excess’ weight/fatness is commonly framed as fatal and in need of behavioural interventions. This article reviews literature which places a question mark over or challenges dietary approaches to weight-loss before critically discussing an alternative weight-inclusive intervention, Health At Every Size®, which is filtering into mainstream discourse while also becoming increasingly fractious. After discussing principles, tensions, resonance and controversies, we...
3 CitationsSource
AbstractObesity in older adults is a growing public health problem, yet the appropriate treatment remains controversial partly due to evidence that weight loss reduces bone mass and may increase fracture risk. The purpose of this review is to summarize the research to date on the effects of diet-induced weight loss on bone health in obese (body mass index 30 kg/m2 and above) older (aged 65 years or older) adults. Observational studies have shown that weight loss in this population decreases tota...
1 CitationsSource
#1K BeaversH-Index: 10
#2Michael P. WalkupH-Index: 21
Last. W. Jack RejeskiH-Index: 58
view all 12 authors...
The objective of this study was to determine the ability of either aerobic or resistance training to counter weight loss associated bone loss in older adults. 187 older adults (67 years, 70% women, 64% Caucasian) with obesity (body mass index: 34.5±3.7 kg/m2) and cardiovascular disease and/or metabolic syndrome were randomized to participate in an 18 month, community-based trial, with a follow-up assessment occurring at 30 months. Intervention arms included: weight loss alone (WL; 7–10% baseline...
3 CitationsSource
#1Jason Fanning (Wake Forest University)H-Index: 15
#2Maria Theresa D. Opina (Wake Forest University)H-Index: 2
Last. W.J. Rejeski (Wake Forest University)
view all 6 authors...
Abstract Promoting lasting weight loss among older adults is an important public health challenge. Participation in physical activity aids in weight loss and is important for the maintenance of physical function and quality of life. However, traditional intensive lifestyle interventions place a focus on discrete bouts of structured activity, leaving much of the remainder of the day for sedentary behavior. Structured exercise and weight loss programs often produce short-term weight loss that is t...
Source
#1Lily O’Hara (Abu Dhabi University)H-Index: 2
#2Jane Taylor (University of the Sunshine Coast)H-Index: 16
Discourse about health that focuses predominantly on body weight is referred to as the weight-centered health paradigm (WCHP). In recent years, there has been a significant increase in critical analysis of the WCHP. This has resulted in arguments for a paradigm shift away from focusing on weight and focusing instead on health and well-being. The aim of this study was to identify, critique, and synthesize the values, claims, and assumptions of the WCHP and to develop a framework to be used as a h...
4 CitationsSource