Effect of Weight Loss and Exercise Therapy on Bone Metabolism and Mass in Obese Older Adults: A One-Year Randomized Controlled Trial

Villareal, Dennis T.; Shah, Krupa; Banks, Marian; Sinacore, David R.; Klein, Samuel

doi:10.1210/jc.2007-1473

Cited by 131 publications

(133 citation statements)

References 42 publications

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“…Although these relatively short-term weight loss intervention studies, which are typically 3-6-month long, have demonstrated significant reductions in total body or regional BMD, long-term consequences of weight loss on bone mass, bone turnover and subsequent fracture remain relatively unknown. However, results from the few studies that included a post-weight loss follow-up suggest that alterations in BMD and bone turnover may persist during weight maintenance (Avenell et al, 1994;Fogelholm et al, 2001;Jensen et al, 2001;Hinton et al, 2010;Villareal et al, 2008). Consistent with these findings, observational data indicate that both weight loss and repeated cycles of weight loss and regain increase fracture risk in both men and women (Langlois et al, 1998(Langlois et al, , 2001Meyer et al, 1998;Bacon et al, 2004).…”

Section: Introductionmentioning

confidence: 94%

“…However, even moderate weight reduction (B10%) in overweight or obese individuals both decreases bone mineral density (BMD) (Avenell et al, 1994;Pritchard et al, 1996;Ricci et al, 1998Ricci et al, , 2001Van Loan et al, 1998;Fogelholm et al, 2001;Jensen et al, 2001;Riedt et al, 2005;Villareal et al, , 2008 and accelerates bone turnover, as assessed by serum biomarkers of bone formation and resorption (Ricci et al, 1998Salamone et al, 1999;Holecki et al, 2007). Although these relatively short-term weight loss intervention studies, which are typically 3-6-month long, have demonstrated significant reductions in total body or regional BMD, long-term consequences of weight loss on bone mass, bone turnover and subsequent fracture remain relatively unknown.…”

Section: Introductionmentioning

confidence: 99%

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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

et al. 2010

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Background: Diets high in either dairy or calcium during moderate weight reduction both prevent loss of bone mineral density (BMD) and suppress bone turnover. The purpose of this study was to determine whether recommended dairy and calcium intakes during weight maintenance favorably affect total body BMD (TBBMD) and bone mineral content (TBBMC) in obese adults. Methods: Obese men (n ¼ 49) and women (n ¼ 64), aged 40.8 ± 0.6 years, underwent 12 weeks of moderate energy restriction (B1200 kcal/day) followed by 24 weeks on either a low or recommended dairy weight maintenance diet. The TBBMC and TBBMD values were measured using dual energy X-ray absorptiometry at baseline, 12, 24 and 36 weeks. Concentrations of calcium, intact parathyroid hormone (iPTH), 25OH and 1,25 (OH) 2 vitamin D in plasma were also measured. Data were analyzed using a two-factor repeated measures analysis of variance. Results: After weight loss, women exhibited a small, but statistically significant, increase in TBBMC (1.17±0.57%), whereas TBBMD increased in the men (1.34 ± 0.28%). The iPTH concentration decreased significantly in all subjects. Despite significantly greater intakes of calcium, vitamin D and protein compared with the recommended dairy diet, there were no treatment-related differences in outcome variables after 24 weeks of weight maintenance. The TBBMC remained unchanged in women during weight stabilization; both TBBMC and TBBMD decreased in men (À1.59±0.51% and À0.70±0.25%, respectively). Conclusions: In summary, results of this study do not provide convincing evidence that moderate weight loss through energy restriction and mild exercise reduces TBBMC in obese men and women. Similarly, a weight-maintenance diet providing the recommended daily servings of dairy does not seem to affect changes in BMC after weight loss.

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Section: Introductionmentioning

confidence: 94%

Section: Introductionmentioning

confidence: 99%

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

et al. 2010

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“…However, results are inconsistent. After diet-and exercise-induced weight loss, both increased [9][10][11] and unaltered 12,13 circulating levels of 25OHD have been reported. Likewise, after major weight loss by bariatric surgery, both temporary [14][15][16] and long-term increases [16][17][18] in circulating levels of 25OHD have been reported, along with reports of no changes one year after surgery.…”

Section: Introductionmentioning

confidence: 99%

Expression of vitamin D-metabolizing enzymes in human adipose tissue—the effect of obesity and diet-induced weight loss

et al. 2012

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OBJECTIVE: Low vitamin D (VD) levels are common in obesity. We hypothesized that this may be due to metabolism of VD in adipose tissue (AT). Thus, we studied (1) whether the VD-metabolizing enzymes were expressed differently in AT of lean and obese individuals and in visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT), and (2) whether their expression was influenced by weight loss. METHODS: Samples of SAT and VAT were analyzed for expression of the vitamin-D-25-hydroxylases CYP2R1, CYP2J2, CYP27A1 and CYP3A4, the 25-vitamin-D-1a-hydroxylase CYP27B1, the catabolic vitamin-D-24-hydroxylase CYP24A1, and the vitamin D receptor, using reverse transcriptase-PCR. Moreover, plasma 25-hydroxy-vitamin D (25OHD) level was measured and related to the expression of these enzymes. Samples of SAT and VAT from 20 lean women and 20 obese women, and samples of SAT from 17 obese subjects before and after a 10% weight loss were analyzed. RESULTS: A plasma 25OHD level o50 nmol l À 1 was highly prevalent in both lean (45%) and obese (90%) women (Po0.01). Plasma 25OHD increased by 27% after weight loss in the obese individuals (Po0.05). Expression levels of the 25-hydroxylase CYP2J2 and the 1a-hydroxylase CYP27B1 were decreased by 71% (Po0.0001) and 49% (Po0.05), respectively, in SAT of the obese. CYP24A1 did not differ between lean and obese women, but the expression was increased by 79% (Po0.05) after weight loss. CONCLUSION: Obesity is characterized by a decreased expression of the 25-hydroxylase CYP2J2 and the 1a-hydroxylase CYP27B1 in SAT, whereas the catabolic CYP24A1 does not differ between lean and obese women. However, the expression of CYP24A1 is increased after weight loss. Accordingly, AT has the capacity to metabolize VD locally, and this can be dynamically altered during obesity and weight loss. INTRODUCTIONLow levels of circulating 25-hydroxy-vitamin D (25OHD) are associated with increased fat mass and body mass index, 1-5 but the underlying mechanism for this association is not fully elucidated. 6 Vitamin D (VD) is stored in adipose tissue (AT), and release of VD from AT is proposed to serve as an endogenous source of VD during the winter, when cutaneous production is low or absent in several parts of the world. 7 As low circulating levels of 25OHD are common in association with the obese state, 8 several studies have examined the effect of weight loss on circulating levels of 25OHD. However, results are inconsistent. After diet-and exercise-induced weight loss, both increased 9-11 and unaltered 12,13 circulating levels of 25OHD have been reported. Likewise, after major weight loss by bariatric surgery, both temporary 14-16 and long-term increases [16][17][18] in circulating levels of 25OHD have been reported, along with reports of no changes one year after surgery. 13,19 Taken together, these findings indicate that body weight is an important factor for circulating 25OHD levels. Several other explanations for the low levels of 25OHD in obesity have been proposed: a decreased exposure to sun light, 20 ...

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“…While weight loss may be important for the prevention of a number of chronic diseases, a growing body of literature demonstrates that diet-induced weight loss is associated with concurrent reductions in BMD [128][129][130]. Accordingly, several researchers have sought ways to preserve bone during weight loss programs, often with the integration of exercise regimes [131][132][133][134][135][136]. Collectively, these studies suggest that bone loss may be attenuated with exercise.…”

Section: Exercise and Bone Health During Weight Lossmentioning

confidence: 99%

“…Four RCTs have examined the effect of exercise as a bone-preserving weight loss modality [131][132][133]135]. Two of these RCTs assessed bone outcomes using a 3-arm design: exercise-induced weight loss versus diet-induced weight loss versus no-weight loss control [132,133].…”

Section: Exercise and Bone Health During Weight Lossmentioning

confidence: 99%

Physical Exercise for Secondary Osteoporosis

Mina

Alibhai²,

Matthew³

et al. 2012

TOBONEJ

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Bone loss caused by an underlying medical illness or associated treatment is often termed secondary osteoporosis and is a growing concern for a variety of patients. Exercise has demonstrated efficacy in maintaining bone health for individuals with age-related osteoporosis and its application to other clinical populations with specific interest in preserving bones is being increasingly explored. While there are many causes of secondary osteoporosis, only a few clinical populations have been studied for the role of exercise as a non-pharmacologic approach to bone preservation. This article briefly reviews secondary osteoporosis and the effect of exercise on bone health, while highlighting the current exercise intervention literature on bone outcomes for several clinical populations.

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Effect of Weight Loss and Exercise Therapy on Bone Metabolism and Mass in Obese Older Adults: A One-Year Randomized Controlled Trial

Abstract: Weight loss, even when combined with exercise, decreases hip BMD in obese older adults. It is not known whether the beneficial effects of weight loss and exercise on physical function lower the overall risk of falls and fractures, despite the decline in hip BMD.

Cited by 131 publications

References 42 publications

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

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

Expression of vitamin D-metabolizing enzymes in human adipose tissue—the effect of obesity and diet-induced weight loss

Physical Exercise for Secondary Osteoporosis

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