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Randomized Controlled Trial
. 2015 Jun;100(6):2463-71.
doi: 10.1210/jc.2015-1050. Epub 2015 Mar 31.

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

Amir Tirosh  1 , Russell J de Souza  1 , Frank Sacks  1 , George A Bray  1 , Steven R Smith  1 , Meryl S LeBoff  1
Affiliations
Randomized Controlled Trial

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

Amir Tirosh et al. J Clin Endocrinol Metab. 2015 Jun.

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.

Trial registration: ClinicalTrials.gov NCT00072995.

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References

    1. Sacks FM, Bray GA, Carey VJ, et al. Comparison of weight-loss diets with different compositions of fat, protein, and carbohydrates. N Engl J Med. 2009;360:859–873. - PMC - PubMed
    1. Pritchard JE, Nowson CA, Wark JD. Bone loss accompanying diet-induced or exercise-induced weight loss: a randomised controlled study. Int J Obes Relat Metab Disord. 1996;20:513–520. - PubMed
    1. Avenell A, Richmond PR, Lean ME, Reid DM. Bone loss associated with a high fibre weight reduction diet in postmenopausal women. Eur J Clin Nutr. 1994;48:561–566. - PubMed
    1. Jensen LB, Kollerup G, Quaade F, Sørensen OH. Bone minerals changes in obese women during a moderate weight loss with and without calcium supplementation. J Bone Miner Res. 2001;16:141–147. - PubMed
    1. Villareal DT, Fontana L, Weiss EP, et al. Bone mineral density response to caloric restriction-induced weight loss or exercise-induced weight loss: a randomized controlled trial. Arch Intern Med. 2006;166:2502–2510. - PubMed

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