Premenopausal overweight women do not lose bone during moderate weight loss with adequate or higher calcium intake

Riedt, Claudia S; Schlussel, Yvette; Thun, Nancy von; Ambia-Sobhan, Hasina; Stahl, Theodore; Field, M. Paul; Sherrell, Robert M.; Shapses, Sue

doi:10.1093/ajcn/85.4.972

Cited by 66 publications

(63 citation statements)

References 46 publications

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“…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.…”

Section: Discussionmentioning

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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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: Discussionmentioning

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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“…Weight-stable (no change in body weight in past 3 months) women who had been recruited for weight loss and weight maintenance studies within our laboratory from 2002 to 2005 (Riedt et al, 2005(Riedt et al, , 2006(Riedt et al, , 2007. Over a period of 6 months, overweight and moderately obese participants were counseled by a registered dietitian to either maintain their weight (WM group) or to lose a moderate amount of weight (M-WL) using moderate energy restriction of 1200 to 1500 kcal/day and behavior modification.…”

Section: Subjects and Protocolmentioning

confidence: 99%

Blood lead levels and bone turnover with weight reduction in women

Riedt

Buckley

Brolin

et al. 2008

J Expo Sci Environ Epidemiol

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High bone turnover states are known to raise blood lead levels (BPb). Caloric restriction will increase bone turnover, yet it remains unknown if weight reduction increases BPb due to mobilization of skeletal stores. We measured whole blood Pb levels ( 206 Pb) by inductively coupled plasma mass spectrometry in 73 women (age 24-75 years; BMI 23-61 kg/m 2 ) before and after 6 months of severe weight loss (S-WL), moderate weight loss (M-WL), or weight maintenance (WM). Baseline BPb levels were relatively low at 0.2-6.0 mg/dl, and directly associated with age (r ¼ 0.49, Po0.0001). After severe WL (À37.4 ± 9.3 kg, n ¼ 17), BPb increased by 2.1 ± 3.9 mg/dl (Po0.05), resulting in BPb levels of 1.3-12.5 mg/dl. M-WL (À5.6 ± 2.7 kg, n ¼ 39) and WM (0.3±1.3 kg, n ¼ 17) did not result in an increase in BPb levels (0.5±3.2 and 0.0±0.7 mg/dl, M-WL and WM, respectively). BPb levels increased more with greater WL (r ¼ 0.24, Po0.05). Bone turnover markers increased only with severe WL and were directly correlated with WL. At baseline, higher calcium intake was associated with lower BPb (r ¼ À0.273, Po0.02), however, this association was no longer present after 6 months. Severe weight reduction in obese women increases skeletal bone mobilization and BPb, but values remain well below levels defined as Pb overexposure.

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“…Of the studies that have investigated changes in bone mass in response to diet-induced weight loss in overweight or obese adults, the results have been highly variable, with increases, (20)(21)(22)(23)(24) decreases, (25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40) and no change (22,24,26,30,33,(41)(42)(43)(44)(45)(46)(47)(48)(49) in bone mass being reported. Thus, attempting to draw sound conclusions from these mixed results is extremely difficult.…”

Section: Introductionmentioning

confidence: 99%

Does Diet-Induced Weight Loss Lead to Bone Loss in Overweight or Obese Adults? A Systematic Review and Meta-Analysis of Clinical Trials

Zibellini

Seimon

Lee

et al. 2015

Journal of Bone and Mineral Research

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115

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Diet-induced weight loss has been suggested to be harmful to bone health. We conducted a systematic review and meta-analysis (using a random-effects model) to quantify the effect of diet-induced weight loss on bone. We included 41 publications involving overweight or obese but otherwise healthy adults who followed a dietary weight-loss intervention. The primary outcomes examined were changes from baseline in total hip, lumbar spine, and total body bone mineral density (BMD), as assessed by dual-energy X-ray absorptiometry (DXA). Secondary outcomes were markers of bone turnover. Diet-induced weight loss was associated with significant decreases of 0.010 to 0.015 g/cm 2 in total hip BMD for interventions of 6, 12, or 24 (but not 3) months' duration (95% confidence intervals [CIs], -0.014 to -0.005, -0.021 to -0.008, and -0.024 to -0.000 g/cm 2 , at 6, 12, and 24 months, respectively). There was, however, no statistically significant effect of diet-induced weight loss on lumbar spine or whole-body BMD for interventions of 3 to 24 months' duration, except for a significant decrease in total body BMD (-0.011 g/cm 2 ; 95% CI, -0.018 to -0.003 g/cm 2 ) after 6 months. Although no statistically significant changes occurred in serum concentrations of N-terminal propeptide of type I procollagen (P1NP), interventions of 2 or 3 months in duration (but not of 6, 12, or 24 months' duration) induced significant increases in serum concentrations of osteocalcin (0.26 nmol/L; 95% CI, 0.13 to 0.39 nmol/L), C-terminal telopeptide of type I collagen (CTX) (4.72 nmol/L; 95% CI, 2.12 to 7.30 nmol/L) or N-terminal telopeptide of type I collagen (NTX) (3.70 nmol/L; 95% CI, 0.90 to 6.50 nmol/L bone collagen equivalents [BCEs]), indicating an early effect of diet-induced weight loss to promote bone breakdown. These data show that in overweight and obese individuals, a single diet-induced weight-loss intervention induces a small decrease in total hip BMD, but not lumbar spine BMD. This decrease is small in comparison to known metabolic benefits of losing excess weight.

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Premenopausal overweight women do not lose bone during moderate weight loss with adequate or higher calcium intake

Cited by 66 publications

References 46 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

Blood lead levels and bone turnover with weight reduction in women

Does Diet-Induced Weight Loss Lead to Bone Loss in Overweight or Obese Adults? A Systematic Review and Meta-Analysis of Clinical Trials

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