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

SummaryObjectiveTo 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).DesignData 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.ResultsE, 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).ConclusionsWeight 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 numberNCT00381290

Investigation of the effect of high dairy diet on body mass index and body fat in overweight and obese children

OBJECTIVE To investigate whether an increase in dairy food consumption improves the changes in BMI and adiposity in children on an energy restricted diet. METHODS Overweight and obese children (n = 120, age: 12-18 y, BMI: 27-40 kg/m2) were randomized to receive a calorie restricted diet providing a 500 kcal/d deficit from total energy expenditure and two (n = 40), three (n = 40) or four (n = 40) servings of dairy products/day. Anthropometric measurements in addition to serum hs-CRP and lipid profile were measured at baseline and after 12 weeks. RESULTS Among the 96 children who completed the study, significant reductions in overall BMI, BMI z-score, weight, total body fat percentage and total body fat mass were observed (p 0.05). Overall waist/hip ratio, Serum vitamin D and lipid profile did not change significantly (p > 0.05) apart from a significant increase in HDL-cholesterol (p 0.05). CONCLUSION Increased intake of dairy products does not lead to an augmented change in BMI, weight and body fat in overweight and obese children beyond what is achieved by calorie restriction