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Weight loss associated with sex-specific effects on BMD
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The effects of weight loss on bone mineral density differ among men and premenopausal and postmenopausal women, according to research in The Journal of Clinical Endocrinology & Metabolism.
After completing a variety of diets with different compositions of fat, protein and carbohydrates, women tended to lose BMD in the spine, hip and femoral neck areas, whereas men who followed the same diets exhibited an increase in BMD in the spine area, according to researchers.
“Since women are at a higher risk of osteoporosis than men, weight loss may adversely affect the skeletal health in females compared with men,” the researchers wrote.
Amir Tirosh, MD, of the division of endocrinology, diabetes and hypertension at Brigham and Women’s Hospital in Boston, and colleagues at other institutions studied 424 adults with overweight and obesity (mean age, 52 years; 57% women) who participated in the 2-year, randomized controlled Preventing Overweight Using Novel Dietary Strategies (POUNDS-LOST) trial and who had available body composition and BMD measurements. POUNDS-LOST examined the effects of four energy-restricted diets varying in fat, protein and carbohydrate content. This study assessed BMD changes in the spine, total hip and femoral neck.
Researchers measured BMD and fat and lean tissue masses at baseline, 6 months and 2 years after dietary interventions. At 6 and 24 months, the participants had lost an average of 7.9% and 6.4% of initial body weight, respectively, with no significant changes among the different diet groups. At 2 years, postmenopausal women showed bone loss in both the spine (–0.01 ± 0.004 g/cm²; P = .005) and femoral neck (–0.033 ± 0.004 g/cm²; P < .0001). Premenopausal women exhibited significant decrease in BMD only at the femoral neck area (–0.024 ± 0.008 g/cm²; P = .002). No change was observed in BMD in the femoral neck area for men. However, at the end of the study, men exhibited an increase in spine BMD (0.022 ± 0.003 g/cm²; P < .0001).
The study data show that long-term weight loss, regardless of the type of diet, results in complex effects on BMD, according to researchers.
“Sex was an important factor in determining bone loss — diet composition didn’t prevent or accelerate it,” George Bray, MD, of the division of clinical obesity and metabolism at Harvard Medical School, told Endocrine Today. “The reason that men showed a small increase at the end of 2 years is unknown and unexpected.” Sex-related factors, hormonal changes, differences in physical activity, as well as relative changes in fat and muscle mass, may all contribute to the differential effects of weight loss on BMD in men and women at different ages, according to researchers.
“Additional studies are required to identify the ideal weight-loss regimen combining efficient weight loss with positive effects on [BMD] and fracture risk,” the researchers wrote” – by Regina Schaffer
Disclosure: The researchers report no relevant financial disclosures.
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