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Randomized Controlled Trial
. 2014 Jun;22(6):726-33.
doi: 10.1016/j.joca.2014.04.002. Epub 2014 Apr 15.

The independent and combined effects of intensive weight loss and exercise training on bone mineral density in overweight and obese older adults with osteoarthritis

D P Beavers  1 , K M Beavers  2 , R F Loeser  3 , N R Walton  4 , M F Lyles  5 , B J Nicklas  6 , S A Shapses  7 , J J Newman  8 , S P Messier  9
Affiliations
Randomized Controlled Trial

The independent and combined effects of intensive weight loss and exercise training on bone mineral density in overweight and obese older adults with osteoarthritis

D P Beavers et al. Osteoarthritis Cartilage. 2014 Jun.

Abstract

Objective: To determine the effects of dietary-induced weight loss (D) and weight loss plus exercise (D + E) compared to exercise alone (E) on bone mineral density (BMD) in older adults with knee osteoarthritis (OA).

Design: Data come from 284 older (66.0 ± 6.2 years), overweight/obese (body mass index (BMI) 33.4 ± 3.7 kg/m2), adults with knee OA enrolled in the Intensive Diet and Exercise for Arthritis (IDEA) study. Participants were randomized to 18 months of walking and strength training (E; n = 95), dietary-induced weight loss targeting 10% of baseline weight (D; n = 88) or a combination of the two (D + E; n = 101). Body weight and composition (DXA), regional BMD, were obtained at baseline and 18 months.

Results: E, D, and D + E groups lost 1.3 ± 4.5 kg, 9.1 ± 8.6 kg and 10.4 ± 8.0 kg, respectively (P < 0.01). Significant treatment effects were observed for BMD in both hip and femoral neck regions, with the D and D + E groups showing similar relative losses compared to E (both P < 0.01). Despite reduced BMD, fewer overall participants had T-scores indicative of osteoporosis after intervention (9 at 18 months vs 10 at baseline). Within the D and D + E groups, changes in hip and femoral neck, but not spine, BMD correlated positively with changes in body weight (r = 0.21 and 0.54 respectively, both P ≤ 0.01).

Conclusions: Weight loss via an intensive dietary intervention, with or without exercise, results in bone loss at the hip and femoral neck in overweight and obese, older adults with OA. Although the exercise intervention did not attenuate weight loss-associated reductions in BMD, classification of osteoporosis and osteopenia remained unchanged.

Clinical trial registration number: NCT00381290.

Keywords: Bone density; Exercise; Obesity; Osteoarthritis; Weight loss.

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Figures

Figure 1
Figure 1
IDEA Bone Consort Diagram
Figure 2a
Figure 2a
Linear association between hip BMD changes and leptin changes
Figure 2b
Figure 2b
Linear association between femoral neck BMD changes and leptin changes.
Figure 2c
Figure 2c
Linear association between spine BMD changes and leptin changes.
See this image and copyright information in PMC

References

    1. Haq I, Murphy E, Dacre J. Osteoarthritis. Postgrad Med J. 2003;79(933):377–383. - PMC - PubMed
    1. Messier SP, Loeser RF, Miller GD, Morgan TM, Rejeski WJ, Sevick MA, et al. Exercise and dietary weight loss in overweight and obese older adults with knee osteoarthritis: the Arthritis, Diet, and Activity Promotion Trial. Arthritis Rheum. 2004;50(5):1501–1510. - PubMed
    1. Messier SP, Mihalko SL, Legault C, Miller GD, Nicklas BJ, DeVita P, et al. Effects of intensive diet and exercise on knee joint loads, inflammation, and clinical outcomes among overweight and obese adults with knee osteoarthritis: the IDEA randomized clinical trial. JAMA. 2013;310(12):1263–1273. - PMC - PubMed
    1. Chaston TB, Dixon JB, O’Brien PE. Changes in fat-free mass during significant weight loss: a systematic review. Int J Obes (Lond) 2007;31(5):743–750. - PubMed
    1. Shapses SA, Sukumar D. Bone metabolism in obesity and weight loss. Annu Rev Nutr. 2012;32:287–309. - PMC - PubMed

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