Effect of aerobic or resistance exercise, or both, on bone mineral density and bone metabolism in obese older adults while dieting:​ a randomized controlled trial

Armamento‐Villareal, Reina; Aguirre, Lina; Waters, Debra L.; Napoli, Nicola; Qualls, Clifford; Villareal, Dennis T.

Affiliations

¹Division of Endocrinology, Diabetes, and Metabolism, Baylor College of Medicine, Houston, TX, USA

²Center for Translational Research on Inflammatory Diseases (CTRID), Michael E DeBakey VA Medical Center, Houston, TX, USA

³Medicine Care Line, New Mexico VA Health Care System, Albuquerque, NM, USA

⁴Department of Internal Medicine, University of New Mexico School of Medicine, Albuquerque, NM, USA

⁵Department of Medicine, School of Physiotherapy, University of Otago, Dunedin, New Zealand

⁶Division of Bone and Mineral Diseases, Washington University School of Medicine, St. Louis, MO, USA

⁷Department of Mathematics and Statistics, University of New Mexico School of Medicine, Albuquerque, NM, USA

Abstract and keywords

Weight loss therapy of older adults with obesity is limited by weight loss–induced decrease in bone mineral density (BMD), whichcould exacerbate ongoing age-related bone loss and increase the risk for fractures. Therefore, it is recommended that weight losstherapy of older adults with obesity should include an intervention such as regular exercise to reduce the concomitant bone loss.However, the most appropriate exercise types to combine with weight loss therapy in this older population is unknown. In a random-ized controlled trial, we performed a head-to-head comparison of aerobic or resistance exercise, or both, during matched ~10%weight loss in 160 older adults with obesity. We measured changes in BMD (total hip, femoral neck, trochanter, intertrochanter,one-third radius, lumbar spine) and bone markers. Changes between groups were analyzed using mixed-model repeated measuresanalyses of variance. After 6 months of intensive lifestyle interventions, BMD decreased less in the resistance group (−0.006 g/cm2[−0.7%]) and combination group (−0.012 g/cm2[−1.1%]) than in the aerobic group (−0.027 g/cm2[−2.6%]) (p = 0.001 forbetween-group comparisons). Serum C-telopeptide, procollagen type 1 N-propeptide, and osteocalcin concentrations increasedmore in the aerobic group (33%, 16%, and 16%, respectively) than in the resistance group (7%, 2%, and 0%, respectively) and com-bination group (11%, 2%, and 5%, respectively) (p = 0.004 to 0.048 for between-group comparisons). Multiple regression analysesrevealed that the decline in whole body mass and serum leptin were the independent predictors of the decline in hip BMD (multipleR = 0.45 [p < .001]). These ﬁndings indicate that compared with aerobic exercise, resistance and combined aerobic and resistanceexercise are associated with less weight loss–induced decrease in hip BMD and less weight loss–induced increase in bone turnover.Therefore, both resistance and combined aerobic and resistance exercise can be recommended to protect against bone loss duringweight loss therapy of older adults with obesity. (LITOE ClinicalTrials.gov number NCT01065636.)

Keywords: AGING; BONE‐FAT INTERACTIONS; CLINICAL TRIALS; EXERCISE; NUTRITION

Links

DOI: 10.1002/jbmr.3905

PubMed: 31797417

WoS: 000500710800001

History

Received: 2019-07-15

Revised: 2019-10-14

Accepted: 2019-10-19

Cited Works (2)

Year	Entry
2009	Orwoll ES, Marshall LM, Nielson CM, Cummings SR, Lapidus J, Cauley JA, Ensrud K, Lane N, Hoffmann PR, Kopperdahl DL, Keaveny TM; Osteoporotic Fractures in Men (MrOS) Study Group. Finite element analysis of the proximal femur and hip fracture risk in older men. J Bone Miner Res. March 2009;24(3):475-483.
2013	Cheung AM, Adachi JD, Hanley DA, Kendler DL, Davison KS, Josse R, Brown JP, Ste-Marie L-G, Kremer R, Erlandson MC, Dian L, Burghardt AJ, Boyd SK. High-resolution peripheral quantitative computed tomography for the assessment of bone strength and structure: a review by the Canadian Bone Strength Working Group. Curr Osteoporos Rep. June 2013;11(2):136-146.