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Does bone loss begin after weight loss ends? Results 2 years after weight loss or regain in postmenopausal women

Von Thun, Nancy L. MS1; Sukumar, Deeptha PhD1; Heymsfield, Steven B. MD2; Shapses, Sue A. PhD1

doi: 10.1097/GME.0b013e3182a76fd5
Original Articles

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 −0.1% (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 ≤ 0.01), whereas only the WL-M group reduced BMD at the 1/3 radius (P < 0.001). There was greater BMD loss at the trochanter (−6.8% [5.7%]) and 1/3 radius (−4.5% [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 < 0.05).

Conclusions After 2 years, there is no BMD recovery of weight reduction–induced 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.

From the 1Department of Nutritional Sciences, Rutgers University, New Brunswick, NJ; and 2Pennington Biomedical Research Center, Baton Rouge, LA.

Received May 4, 2013; revised and accepted July 18, 2013.

Funding/support: This study was supported by National Institutes of Health grant AG12161 and NJAES 0153866.

Financial disclosure/conflicts of interest: None reported.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal’s Web site (www.menopause.org).

Address correspondence to: Sue A. Shapses, PhD, Department of Nutritional Sciences, Rutgers University, 96 Lipman Drive, New Brunswick, NJ 08901-8525. E-mail: shapses@aesop.rutgers.edu

© 2014 by The North American Menopause Society.