Effect of weight change on bone mass in female adolescents

Rourke, K.; Brehm, Bonnie J.; Cassell, Cindy; Sethuraman, Gopalan

doi:10.1053/jada.2003.50051

Cited by 22 publications

(18 citation statements)

References 15 publications

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“…In a recent study, extensive BMI gain during puberty was associated with lower increments in aBMD . Exploring the effect of weight change on bone mass in obese female adolescents, Rourke and colleagues found no bone loss, but concluded that reduction of BW induced a reduced bone growth rate over 12‐month follow‐up—results that are comparable to our findings.…”

Section: Discussionsupporting

confidence: 87%

Body Weight and Body Mass Index Influence Bone Mineral Density in Late Adolescence in a Two‐Year Follow‐Up Study. The Tromsø Study: Fit Futures

et al. 2019

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Determinants of bone acquisition in late adolescence and early adulthood are not well-described. This 2-year follow-up study explored the associations of body weight (BW), body mass index (BMI), and changes in weight status with adolescent bone accretion in a sample of 651 adolescents (355 girls and 296 boys) between 15 and 19 years of age from The Tromsø Study: Fit Futures. This Norwegian population-based cohort study was conducted from 2010 to 2011 and was repeated from 2012 to 2013. We measured femoral neck, total hip, and total body bone mineral content and areal bone mineral density (aBMD) by dual-energy X-ray absorptiometry. We measured height, BW, calculated BMI (kg/m 2 ), and collected information on lifestyle at both surveys. Mean BMI (SD) at baseline was 22.17 (3.76) and 22.18 (3.93) in girls and boys, respectively. Through multiple linear regression, baseline BW and BMI were positively associated with ΔaBMD over 2 years of follow-up at all skeletal sites in boys (p < 0.05), but not in girls. ΔBW and ΔBMI predicted ΔaBMD and ΔBMC in both sexes, but the strength of the associations was moderate. Individuals who lost weight during follow-up demonstrated a slowed progression of aBMD accretion compared with those gaining weight, but loss of BW or reduction of BMI during 2 years was not associated with net loss of aBMD. In conclusion, our results confirm that adequate BW for height in late adolescence is important for bone health. Associations between change in weight status and bone accretion during follow-up were moderate and unlikely to have any clinical implication on adolescents of normal weight. Underweight individuals, particularly boys, are at risk of not reaching optimal peak bone mass and could benefit from an increase in BMI.

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Section: Discussionsupporting

confidence: 87%

Body Weight and Body Mass Index Influence Bone Mineral Density in Late Adolescence in a Two‐Year Follow‐Up Study. The Tromsø Study: Fit Futures

et al. 2019

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“…Fewer studies have been conducted in adolescents after bariatric surgery; however, similar significant decreases in BMD and increased bone turnover have been shown . Few prior studies evaluating the effect of nonsurgical weight management and loss on bone outcomes in obese children exist and results are mixed . In comparison to the findings after gastric bypass, the participants in our study did not experience rapid changes in weight or severe caloric restriction.…”

Section: Discussionmentioning

confidence: 56%

Effects of a Randomized Weight Loss Intervention Trial in Obese Adolescents on Tibia and Radius Bone Geometry and Volumetric Density

Kelley

Stettler-Davis

Leonard

et al. 2017

Journal of Bone and Mineral Research

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Obese adolescents have increased fracture risk, but effects of alterations in adiposity on bone accrual and strength in obese adolescents are not understood. We evaluated 12-month changes in trabecular and cortical volumetric bone mineral density (vBMD) and cortical geometry in obese adolescents undergoing a randomized weight management program, and investigated the effect of body composition changes on bone outcomes. Peripheral quantitative computed tomography (pQCT) of the radius and tibia, and whole-body dual-energy X-ray absorptiometry (DXA) scans were obtained at baseline, 6 months, and 12 months in 91 obese adolescents randomized to standard care versus behavioral intervention for weight loss. Longitudinal models assessed effects of body composition changes on bone outcomes, adjusted for age, bone length, and African-American ancestry, and stratified by sex. Secondary analyses included adjustment for physical activity, maturation, vitamin D, and inflammatory biomarkers. Baseline body mass index (BMI) was similar between intervention groups. Twelve-month change in BMI in the standard care group was 1.0 kg/m 2 versus -0.4 kg/m 2 in the behavioral intervention group (p < 0.01). Intervention groups were similar in bone outcomes, so they were combined for subsequent analyses. For the tibia, BMI change was not associated with change in vBMD or structure. Greater baseline lean body mass index (LBMI) associated with higher cortical vBMD in males, trabecular vBMD in females, and polar section modulus (pZ) and periosteal circumference (Peri-C) in both sexes. In females, change in LBMI positively associated with gains in pZ and Peri-C. Baseline visceral adipose tissue (VFAT) was inversely associated with pZ in males and cortical vBMD in females. Change in VFAT did not affect bone outcomes. For the radius, BMI and LBMI changes positively associated with pZ in males. Thus, in obese adolescents, weight loss intervention with modest changes in BMI was not detrimental to radius or tibia bone strength, and changes in lean, but not adiposity, measures were beneficial to bone development.

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“…It is possible that the improvement in physical function associated with exercise during dieting (150, 183) is just as important as increasing BMD to prevent falls and fractures. In children, weight loss may slow bone growth (146), and although it would be expected that exercise would have a positive effect, this has not been specifically addressed.…”

Section: Weight Reduction and Bonementioning

confidence: 99%

Bone Metabolism in Obesity and Weight Loss

2012

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Excess body weight due to obesity has traditionally been considered to have a positive effect on bone; however, more recent findings suggest that bone quality is compromised. Both obesity and caloric restriction increase fracture risk and are regulated by endocrine factors and cytokines that have direct and indirect effects on bone and calcium absorption. Weight reduction will decrease bone mass and mineral density, but this varies by the individual’s age, gender, and adiposity. Dietary modifications, exercise, and medications have been shown to attenuate the bone loss associated with weight reduction. Future obesity and weight loss trials would benefit from assessment of key hormones, adipokine and gut peptides that regulate calcium absorption, and bone mineral density and quality by using sensitive techniques in high-risk populations.

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Effect of weight change on bone mass in female adolescents

Cited by 22 publications

References 15 publications

Body Weight and Body Mass Index Influence Bone Mineral Density in Late Adolescence in a Two‐Year Follow‐Up Study. The Tromsø Study: Fit Futures

Body Weight and Body Mass Index Influence Bone Mineral Density in Late Adolescence in a Two‐Year Follow‐Up Study. The Tromsø Study: Fit Futures

Effects of a Randomized Weight Loss Intervention Trial in Obese Adolescents on Tibia and Radius Bone Geometry and Volumetric Density

Bone Metabolism in Obesity and Weight Loss

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