Menopause: The Journal of The North American Menopause Society Vol. 21, No. 5, pp. 501/508 DOI: 10.1097/gme.0b013e3182a76fd5 * 2013 by The North American Menopause Society
Does bone loss begin after weight loss ends? Results 2 years after weight loss or regain in postmenopausal women Nancy L. Von Thun, MS,1 Deeptha Sukumar, PhD,1 Steven B. Heymsfield, MD,2 and Sue A. Shapses, PhD1 Abstract Objective: Short-term weight loss is accompanied by bone loss in postmenopausal women. The longer-term impact of weight loss on bone in reduced overweight/obese women compared with women who regained their weight was examined in this study using a case-control design. Methods: Postmenopausal women (N = 42; mean [SD] body mass index, 28.3 [2.8] kg/m2; mean [SD] age, 60.7 [5.5] y) were recruited 2 years after the start of a 6-month weight loss trial; those who maintained their weight (weight loss maintainer [WL-M] group) were matched to a cohort of women who regained their weight (weight loss regainer [WL-R] group). Serum hormones and bone markers were measured in a subset. Bone mineral density (BMD) at the femoral neck, trochanter, spine, radius, and total body, and soft-tissue composition were taken at baseline, 0.5 years, and 2 years. Results: During weight loss, both groups lost 9.3% (3.4%) of body weight, with no significant difference between the groups. After weight loss, weight change was j0.1% (2.7%) and 6.0% (3.3%) in the WL-M (n = 22) and WL-R (n = 20) groups, respectively. After 2 years, both groups lost BMD at the femoral neck and trochanter (P e 0.01), whereas only the WL-M group reduced BMD at the 1/3 radius (P G 0.001). There was greater BMD loss at the trochanter (j6.8% [5.7%]) and 1/3 radius (j4.5% [3.3%]) in the WL-M group compared with the WL-R group after 2 years. Multiple linear regression showed that change in leg fat mass (but not trunk fat) contributed to trochanter BMD loss (P G 0.05). Conclusions: After 2 years, there is no BMD recovery of weight reductionYinduced bone loss, irrespective of weight regain. These data suggest that the period after weight loss may be an important point in time to prevent bone loss for those who maintain weight and those who regain weight. Key Words: Bone Y Body composition Y Caloric restriction Y Postmenopausal Y Weight loss Y Weight cycle.
O
bese and overweight people are strongly encouraged to lose 5% to 15% of their weight to reduce the risk of comorbid conditions. During the menopausal transition, women tend to gain weight and visceral adiposity; therefore, many of these women who were never overweight previously are now encouraged to reduce weight to improve health. However, studies show that weight loss in even obese and overweight women results in bone mineral density (BMD) loss of approximately 1% to 2% with 10% weight reduction and can partially be attenuated with certain interventions.1
Does bone loss begin after weight loss ends? Results 2 years after weight loss or regain in postmenopausal women Nancy L. Von Thun, MS,1 Deeptha Sukumar, PhD,1 Steven B. Heymsfield, MD,2 and Sue A. Shapses, PhD1 Abstract Objective: Short-term weight loss is accompanied by bone loss in postmenopausal women. The longer-term impact of weight loss on bone in reduced overweight/obese women compared with women who regained their weight was examined in this study using a case-control design. Methods: Postmenopausal women (N = 42; mean [SD] body mass index, 28.3 [2.8] kg/m2; mean [SD] age, 60.7 [5.5] y) were recruited 2 years after the start of a 6-month weight loss trial; those who maintained their weight (weight loss maintainer [WL-M] group) were matched to a cohort of women who regained their weight (weight loss regainer [WL-R] group). Serum hormones and bone markers were measured in a subset. Bone mineral density (BMD) at the femoral neck, trochanter, spine, radius, and total body, and soft-tissue composition were taken at baseline, 0.5 years, and 2 years. Results: During weight loss, both groups lost 9.3% (3.4%) of body weight, with no significant difference between the groups. After weight loss, weight change was j0.1% (2.7%) and 6.0% (3.3%) in the WL-M (n = 22) and WL-R (n = 20) groups, respectively. After 2 years, both groups lost BMD at the femoral neck and trochanter (P e 0.01), whereas only the WL-M group reduced BMD at the 1/3 radius (P G 0.001). There was greater BMD loss at the trochanter (j6.8% [5.7%]) and 1/3 radius (j4.5% [3.3%]) in the WL-M group compared with the WL-R group after 2 years. Multiple linear regression showed that change in leg fat mass (but not trunk fat) contributed to trochanter BMD loss (P G 0.05). Conclusions: After 2 years, there is no BMD recovery of weight reductionYinduced bone loss, irrespective of weight regain. These data suggest that the period after weight loss may be an important point in time to prevent bone loss for those who maintain weight and those who regain weight. Key Words: Bone Y Body composition Y Caloric restriction Y Postmenopausal Y Weight loss Y Weight cycle.
O
bese and overweight people are strongly encouraged to lose 5% to 15% of their weight to reduce the risk of comorbid conditions. During the menopausal transition, women tend to gain weight and visceral adiposity; therefore, many of these women who were never overweight previously are now encouraged to reduce weight to improve health. However, studies show that weight loss in even obese and overweight women results in bone mineral density (BMD) loss of approximately 1% to 2% with 10% weight reduction and can partially be attenuated with certain interventions.1
