Bone Turnover and Density in Obese Premenopausal Women During Moderate Weight Loss and Calcium Supplementation

Abstract

Bone turnover is increased during weight loss in postmenopausal women and can be suppressed with calcium supplementation. In this study, we assessed the influence of energy restriction with and without calcium supplementation (1 g/day) in premenopausal women. Thirty-eight obese premenopausal women (body mass index [BMI] of 35.0 ؎ 3.9 kg/m 2 ) completed a 6-month study of either moderate weight loss or weight maintenance. During weight loss, women were randomly assigned to either a calcium supplementation (n ‫؍‬ 14) or placebo group (n ‫؍‬ 14) and lost 7.5 ؎ 2.5% of their body weight. The control group of women (n ‫؍‬ 10) maintained their body weight. Total body and lumbar bone mineral density (LBMD) and content were measured by dual-energy X-ray absorptiometry (DXA) at baseline and after weight loss. Throughout the study, blood and urine samples were collected to measure bone turnover markers and hormones. During moderate energy restriction, dietary calcium intake decreased (p < 0.05) and the bone resorption marker deoxypyridinoline (

Blood lead levels and bone turnover with weight reduction in women

“…It may be that Ca intake cannot suppress the high rate of bone turnover associated with severe caloric restriction. Other high bone turnover conditions, such as pregnancy and lactation, show either a beneficial effect of Ca supplementation to reduce mobilization of skeletal mineral stores (Reid et al, 1993;Prince et al, 1995;Cepollaro et al, 1996;Ricci et al, 1998;Shapses et al, 2001) and BPb levels (Hernandez-Avila et al, 2003;Ettinger et al, 2006) or no effect on BPb levels (Hertz-Picciotto et al, 2000;Gulson et al, 2004Gulson et al, , 2006. We found a weak association amongst all women between higher Ca intakes and lower bone resorption (PYD cross-links) and BPb levels during caloric restriction.…”

“…Hence, it is possible that increased Ca intake had a marginal effect on attenuating BPb during severe weight loss, especially if intake was deficient prior to surgery (i.e., single patient example in Figure 3). This is of particular importance because caloric restriction results in Ca intake that is often in the deficient range (Ricci et al, 1998;Shapses et al, 2001).…”

Total body bone mineral content and density during weight loss and maintenance on a low- or recommended-dairy weight-maintenance diet in obese men and women

“…The effect of weight loss on bone mineral remains controversial. Although weight loss in postmenopausal women apparently results in loss of bone mass (Avenell et al, 1994;Ricci et al, 1998Ricci et al, , 2001Riedt et al, 2005;, findings in premenopausal women (Salamone et al, 1999;Fogelholm et al, 2001;Shapses et al, 2001;Park et al, 2007;Riedt et al, 2007) and in middle-aged men (Pritchard et al, 1996; are inconsistent. The discrepant results may be explained, in part, by differences in skeletal site examined, baseline body weight, rate or magnitude of weight loss, calcium or protein intake, physical activity and duration of post-weight loss follow-up.…”

“…Studies in overweight pre-and post-menopausal women have demonstrated that high calcium intakes (1.5-1.8 g/day) both prevent the reduction in bone mass associated with moderate weight loss, and suppress bone turnover and parathyroid hormone (PTH) secretion (Ricci et al, 1998;Jensen et al, 2001;Shapses et al, 2001). Weight-loss diets that are high in dairy and, therefore, in calcium, vitamin D and protein content also have been shown to preserve BMD and suppress bone turnover after weight reduction (Bowen et al, 2004;Thorpe et al, 2008).…”

Efeitos da perda de peso na massa óssea e alterações metabólicas em adolescentes obesos pós-púberes

“…9,31 Some studies suggest that supplementation of this mineral in women perimenopause reduces negative alterations in BMD during weight modifications. 32,33 Although the studies are inconclusive. and women, respectively.…”