Sex Differences in the Effects of Weight Loss Diets on Bone Mineral Density and Body Composition: POUNDS LOST Trial

Overview

Journal J Clin Endocrinol Metab

Publisher Oxford University Press

Specialty Endocrinology

Date 2015 Apr 1

PMID 25825948

Citations 31

Authors

Amir Tirosh

Russell J de Souza

Frank Sacks

George A Bray

Steven R Smith

Meryl S LeBoff

Affiliations

Soon will be listed here.

Abstract

Context: Weight loss is associated with reduction in bone mineral density (BMD).

Objective: The objective was to address the role of changes in fat mass (FM) and lean mass (LM) in BMD decline in both sexes.

Design: A 2-year randomized controlled trial, the Preventing Overweight Using Novel Dietary Strategies (POUNDS-LOST).

Setting: The setting was the general community.

Patients Or Other Participants: Enrolled were 424 overweight and obese participants (mean age, 52 ± 9 y; 57% females).

Intervention: Intervention included weight loss diets differing in fat, protein, and carbohydrates.

Main Outcome Measures: Main outcome measures were change in spine, total hip (TH), and femoral neck (FN) BMD and sex differences after dietary intervention.

Results: At baseline, a stronger correlation between BMD and body composition measurements was observed in women, primarily with LM (r = 0.419, 0.507, and 0.523 for spine, FN, and TH, respectively; all P < .001). In men, only LM correlated with hip BMD (r = 0.298; P < .001). Mean weight loss at 2 years was -6.9%, without differences among diets. Two-year changes in BMD were 0.005 (P = .04), -0.014 (P < .001), and -0.014 g/cm(2) (P < .001), at the spine, TH, and FN, respectively. These changes directly correlated with changes in LM in women (r = 0.200, 0.324, and 0.260 for spine, FN, and TH, respectively), whereas FM loss correlated only with changes in TH BMD (0.274; P < .001). In men, changes in LM (-0.323; P < .001) and FM (-0.213; P = .027) negatively correlated with changes in spine BMD.

Conclusions: Weight loss diets result in sex-specific effects on BMD. Although men exhibited a paradoxical increase in spine BMD, women tended to decrease in BMD at all sites.

Citing Articles

Sex-specific resilience of neocortex to food restriction.

Padamsey Z, Katsanevaki D, Maeso P, Rizzi M, Osterweil E, Rochefort N Elife. 2024; 12.

PMID: 38976495 PMC: 11230624. DOI: 10.7554/eLife.93052.

The effects of popular diets on bone health in the past decade: a narrative review.

Peng Y, Zhong Z, Huang C, Wang W Front Endocrinol (Lausanne). 2024; 14:1287140.

PMID: 38665424 PMC: 11044027. DOI: 10.3389/fendo.2023.1287140.

The Influences of Macronutrients on Bone Mineral Density, Bone Turnover Markers, and Fracture Risk in Elderly People: A Review of Human Studies.

Je M, Kang K, Yoo J, Kim Y Nutrients. 2023; 15(20).

PMID: 37892460 PMC: 10610213. DOI: 10.3390/nu15204386.

Plasma Levels of Branched Chain Amino Acids, Incident Hip Fractures, and Bone Mineral Density of the Hip and Spine.

Carbone L, Buzkova P, Fink H, Robbins J, Barzilay J, Elam R J Clin Endocrinol Metab. 2023; 108(11):e1358-e1364.

PMID: 37200158 PMC: 11009785. DOI: 10.1210/clinem/dgad275.

Age- and sex-specific effects of a long-term lifestyle intervention on body weight and cardiometabolic health markers in adults with prediabetes: results from the diabetes prevention study PREVIEW.

Zhu R, Craciun I, Bernhards-Werge J, Jalo E, Poppitt S, Silvestre M Diabetologia. 2022; 65(8):1262-1277.

PMID: 35610522 PMC: 9283166. DOI: 10.1007/s00125-022-05716-3.

References

Hinton P, Rector R, Linden M, Warner S, Dellsperger K, Chockalingam A . Weight-loss-associated changes in bone mineral density and bone turnover after partial weight regain with or without aerobic exercise in obese women. Eur J Clin Nutr. 2011; 66(5):606-12. PMC: 3311713. DOI: 10.1038/ejcn.2011.212. View

de Souza R, Bray G, Carey V, Hall K, LeBoff M, Loria C . Effects of 4 weight-loss diets differing in fat, protein, and carbohydrate on fat mass, lean mass, visceral adipose tissue, and hepatic fat: results from the POUNDS LOST trial. Am J Clin Nutr. 2012; 95(3):614-25. PMC: 3278241. DOI: 10.3945/ajcn.111.026328. View

Shapses S, Sukumar D, Schneider S, Schlussel Y, Sherrell R, Field M . Vitamin D supplementation and calcium absorption during caloric restriction: a randomized double-blind trial. Am J Clin Nutr. 2013; 97(3):637-45. PMC: 3578405. DOI: 10.3945/ajcn.112.044909. View

Hamilton K, Fisher G, Roy J, Gower B, Hunter G . The effects of weight loss on relative bone mineral density in premenopausal women. Obesity (Silver Spring). 2013; 21(3):441-8. PMC: 3630243. DOI: 10.1002/oby.20052. View

Kim J, Hsieh M, Soni B, Zayzafoon M, Allison D . Childhood obesity as a risk factor for bone fracture: a mechanistic study. Obesity (Silver Spring). 2013; 21(7):1459-66. PMC: 3740028. DOI: 10.1002/oby.20355. View

Center J, White C . Obesity: Bariatric surgery, weight loss and bone. Nat Rev Endocrinol. 2013; 9(11):630-2. DOI: 10.1038/nrendo.2013.189. View

Ho-Pham L, Nguyen U, Nguyen T . Association between lean mass, fat mass, and bone mineral density: a meta-analysis. J Clin Endocrinol Metab. 2014; 99(1):30-8. DOI: 10.1210/jc.2014-v99i12-30A. View

Jensen L, Kollerup G, QUAADE F, Sorensen O . Bone minerals changes in obese women during a moderate weight loss with and without calcium supplementation. J Bone Miner Res. 2001; 16(1):141-7. DOI: 10.1359/jbmr.2001.16.1.141. View

Sellmeyer D, Stone K, Sebastian A, Cummings S . A high ratio of dietary animal to vegetable protein increases the rate of bone loss and the risk of fracture in postmenopausal women. Study of Osteoporotic Fractures Research Group. Am J Clin Nutr. 2000; 73(1):118-22. DOI: 10.1093/ajcn/73.1.118. View

10.

Beasley J, LaCroix A, Larson J, Huang Y, Neuhouser M, Tinker L . Biomarker-calibrated protein intake and bone health in the Women's Health Initiative clinical trials and observational study. Am J Clin Nutr. 2014; 99(4):934-40. PMC: 3953886. DOI: 10.3945/ajcn.113.076786. View

11.

Proctor D, Melton L, Khosla S, Crowson C, OConnor M, Riggs B . Relative influence of physical activity, muscle mass and strength on bone density. Osteoporos Int. 2001; 11(11):944-52. DOI: 10.1007/s001980070033. View

12.

Shapses S, Von Thun N, Heymsfield S, Ricci T, Ospina M, Pierson Jr R . Bone turnover and density in obese premenopausal women during moderate weight loss and calcium supplementation. J Bone Miner Res. 2001; 16(7):1329-36. DOI: 10.1359/jbmr.2001.16.7.1329. View

13.

Langlois J, Mussolino M, Visser M, Looker A, Harris T, Madans J . Weight loss from maximum body weight among middle-aged and older white women and the risk of hip fracture: the NHANES I epidemiologic follow-up study. Osteoporos Int. 2001; 12(9):763-8. DOI: 10.1007/s001980170053. View

14.

Goldner W, ODorisio T, Dillon J, Mason E . Severe metabolic bone disease as a long-term complication of obesity surgery. Obes Surg. 2002; 12(5):685-92. DOI: 10.1381/096089202321019693. View

15.

Byrne T, Morrissey T, Gatzen C, Benfell K, Nattakom T, Scheltinga M . Anabolic therapy with growth hormone accelerates protein gain in surgical patients requiring nutritional rehabilitation. Ann Surg. 1993; 218(4):400-16; discussion 416-8. PMC: 1242991. DOI: 10.1097/00000658-199310000-00002. View

16.

Jensen L, QUAADE F, Sorensen O . Bone loss accompanying voluntary weight loss in obese humans. J Bone Miner Res. 1994; 9(4):459-63. DOI: 10.1002/jbmr.5650090404. View

17.

Avenell A, Richmond P, Lean M, Reid D . Bone loss associated with a high fibre weight reduction diet in postmenopausal women. Eur J Clin Nutr. 1994; 48(8):561-6. View

18.

Fuleihan G, Testa M, Angell J, Porrino N, LeBoff M . Reproducibility of DXA absorptiometry: a model for bone loss estimates. J Bone Miner Res. 1995; 10(7):1004-14. DOI: 10.1002/jbmr.5650100704. View

19.

Langlois J, Harris T, Looker A, Madans J . Weight change between age 50 years and old age is associated with risk of hip fracture in white women aged 67 years and older. Arch Intern Med. 1996; 156(9):989-94. View

20.

Randell A, Sambrook P, Nguyen T, Lapsley H, Jones G, Kelly P . Direct clinical and welfare costs of osteoporotic fractures in elderly men and women. Osteoporos Int. 1995; 5(6):427-32. DOI: 10.1007/BF01626603. View