Effect of Exercise Modality During Weight Loss on Bone Health in Older Adults With Obesity and Cardiovascular Disease or Metabolic Syndrome: A Randomized Controlled Trial

被引:48
作者
Beavers, Kristen M. [1 ]
Walkup, Michael P. [2 ]
Weaver, Ashley A. [3 ]
Lenchik, Leon [4 ]
Kritchevsky, Stephen B. [5 ]
Nicklas, Barbara J. [5 ]
Ambrosius, Walter T. [2 ]
Stitzel, Joel D. [3 ]
Register, Thomas C. [6 ]
Shapses, Sue A. [7 ]
Marsh, Anthony P. [1 ]
Rejeski, W. Jack [1 ]
机构
[1] Wake Forest Univ, Dept Hlth & Exercise Sci, POB 7868, Winston Salem, NC 27109 USA
[2] Wake Forest Sch Med, Dept Biostat Sci, Winston Salem, NC USA
[3] Wake Forest Sch Med, Dept Bioengn, Winston Salem, NC USA
[4] Wake Forest Sch Med, Dept Radiol, Winston Salem, NC USA
[5] Wake Forest Sch Med, Dept Internal Med, Winston Salem, NC USA
[6] Wake Forest Sch Med, Dept Pathol Comparat Med, Winston Salem, NC USA
[7] Rutgers State Univ, Dept Nutr, New Brunswick, NJ USA
基金
美国国家科学基金会; 美国国家卫生研究院;
关键词
WEIGHT LOSS; BMD; EXERCISE; AGING; HIGH-INTENSITY RESISTANCE; LIFE-STYLE INTERVENTION; FINITE-ELEMENT MODELS; HIP FRACTURE RISK; MINERAL DENSITY; POSTMENOPAUSAL WOMEN; PHYSICAL FUNCTION; OVERWEIGHT; MASS; DIET;
D O I
10.1002/jbmr.3555
中图分类号
R5 [内科学];
学科分类号
100201 [内科学];
摘要
The objective of this study was to determine the ability of either aerobic or resistance training to counter weight-loss-associated bone loss in older adults. There were 187 older adults (67 years, 70% women, 64% white) with obesity (BMI = 34.5 +/- 3.7 kg/m(2)) and cardiovascular disease and/or metabolic syndrome who were randomized to participate in an 18-month, community-based trial, with a follow-up assessment at 30 months. Intervention arms included: weight loss alone (WL; 7% to 10% baseline weight), WL plus aerobic training (WL + AT), and WL plus resistance training (WL + RT), as well as DXA-acquired total hip, femoral neck, and lumbar spine areal bone mineral density (aBMD), and trabecular bone score (TBS). Biomarkers of bone turnover (procollagen type 1 N-terminal propeptide, C-terminal telopeptide of type 1 collagen) were measured at baseline, 6, 18, and 30 (aBMD and TBS only) months. CT-acquired hip and spine volumetric BMD (vBMD), cortical thickness, and bone strength were measured in a subset at baseline (n = 55) and 18 months. Total hip aBMD was reduced by 2% in all groups at 18 months, with a primary analysis showing no significant treatment effects for any DXA, biomarker, or CT outcome. After adjustment for WL and follow-up at 30 months, secondary analyses revealed that total hip [-0.018 (-0.023 to -0.012) g/cm(2) versus -0.025 (-0.031 to -0.019) g/cm(2); p = 0.05] and femoral neck [-0.01 (-0.009 to 0.008) g/cm(2) versus -0.011 (-0.020 to -0.002) g/cm(2); p = 0.06] aBMD estimates were modestly attenuated in the WL + RT group compared with the WL group. Additionally, lumbar spine aBMD was increased in the WL [0.015 (0.007 to 0.024) g/cm(2)] and the WL + RT [0.009 (0.000 to 0.017) g/cm(2)] groups compared with the WL + AT [-0.003 (-0.012 to 0.005)g/cm(2)] group; both p <= 0.01. Community-based exercise does not prevent bone loss during active WL in older adults; however, adding RT may help minimize long-term hip bone loss. (c) 2018 American Society for Bone and Mineral Research.
引用
收藏
页码:2140 / 2149
页数:10
相关论文
共 64 条
[1]
2010 Dietary Guidelines, 2010 DIET GUID
[2]
ALEXEEVA L, 1994, WHO TECH REP SER, V843, P1
[3]
[Anonymous], 2014, STAPP CAR CRASH J
[4]
Weight loss in obese older adults increases serum sclerostin and impairs hip geometry but both are prevented by exercise training [J].
Armamento-Villareal, Reina ;
Sadler, Corinn ;
Napoli, Nicola ;
Shah, Krupa ;
Chode, Suresh ;
Sinacore, David R. ;
Qualls, Clifford ;
Villareal, Dennis T. .
JOURNAL OF BONE AND MINERAL RESEARCH, 2012, 27 (05) :1215-1221
[5]
AVENELL A, 1994, EUR J CLIN NUTR, V48, P561
[6]
Weight Loss Interventions in Older Adults with Obesity: A Systematic Review of Randomized Controlled Trials Since 2005 [J].
Batsis, John A. ;
Gill, Lydia E. ;
Masutani, Rebecca K. ;
Adachi-Mejia, Anna M. ;
Blunt, Heather B. ;
Bagley, Pamela J. ;
Lopez-Jimenez, Francisco ;
Bartels, Stephen J. .
JOURNAL OF THE AMERICAN GERIATRICS SOCIETY, 2017, 65 (02) :257-268
[7]
The independent and combined effects of intensive weight loss and exercise training on bone mineral density in overweight and obese older adults with osteoarthritis [J].
Beavers, D. P. ;
Beavers, K. M. ;
Loeser, R. F. ;
Walton, N. R. ;
Lyles, M. F. ;
Nicklas, B. J. ;
Shapses, S. A. ;
Newman, J. J. ;
Messier, S. P. .
OSTEOARTHRITIS AND CARTILAGE, 2014, 22 (06) :726-733
[8]
Effect of Exercise Type During Intentional Weight Loss on Body Composition in Older Adults with Obesity [J].
Beavers, Kristen M. ;
Ambrosius, Walter T. ;
Rejeski, W. Jack ;
Burdette, Jonathan H. ;
Walkup, Michael P. ;
Sheedy, Jessica L. ;
Nesbit, Beverly A. ;
Gaukstern, Jill E. ;
Nicklas, Barbara J. ;
Marsh, Anthony P. .
OBESITY, 2017, 25 (11) :1823-1829
[9]
Change in Bone Mineral Density During Weight Loss with Resistance Versus Aerobic Exercise Training in Older Adults [J].
Beavers, Kristen M. ;
Beavers, Daniel P. ;
Martin, Sarah B. ;
Marsh, Anthony P. ;
Lyles, Mary F. ;
Lenchik, Leon ;
Shapses, Sue A. ;
Nicklas, Barbara J. .
JOURNALS OF GERONTOLOGY SERIES A-BIOLOGICAL SCIENCES AND MEDICAL SCIENCES, 2017, 72 (11) :1582-1585
[10]
The effect of physical exercise on bone density in middle-aged and older men: A systematic review [J].
Bolam, K. A. ;
van Uffelen, J. G. Z. ;
Taaffe, D. R. .
OSTEOPOROSIS INTERNATIONAL, 2013, 24 (11) :2749-2762