Weight-loss-associated changes in bone mineral density and bone turnover after partial weight regain with or without aerobic exercise in obese women

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BACKGROUND/OBJECTIVES:Moderate, long-term weight loss results in the loss of bone mass in overweight or obese premenopausal women. However, whether these changes persist during weight maintenance or regain remains to be determined.SUBJECTS/METHODS:Overweight or obese (body mass index: 25.8-42.5 kg/m2) women (n = 40) with at least two risk factors for the metabolic syndrome participated in this 12-month study that examined the effects of prescribed weight loss and regain, with or without exercise, on bone turnover and on bone mineral density (BMD) in a subset of participants (n = 24). During the first 6 month, participants lost ˜ 10% of their initial body weight via energy restriction and supervised aerobic exercise. Following weight loss, participants were randomly assigned to either an exercise or a no exercise treatment for the regain (+ 50% of weight lost) phase. A one-way (time) repeated measures one-factor analysis of variance (RMANOVA) tested the effects of weight loss on BMD and bone turnover, and a two-way RMANOVA (time, exercise) was used to examine the effects of exercise during weight regain.RESULTS:Hip (P = 0.007) and lumbar spine (P = 0.05) BMD decreased with weight loss, and remained reduced after weight regain with or without exercise. Likewise, the weight-loss-associated increases in osteocalcin (P < 0.001) and C-terminal peptide of type I collagen (P < 0.001) persisted following weight regain, independent of exercise.CONCLUSIONS:The results of the present study, which is the first to examine changes in bone mass and turnover during carefully controlled weight regain, suggest that weight-loss-induced perturbations in bone mass and turnover persist after partial weight regain, regardless of whether regular weight-bearing aerobic exercise was continued.European Journal of Clinical Nutrition (2012) 66, 606-612; doi:10.1038/ejcn.2011.212; published online 21 December 2011

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