title: Weight loss and bone mineral density.
abstract: OBJECTIVE
  Despite evidence that energy deficit produces multiple physiological and metabolic benefits, clinicians are often reluctant to prescribe weight loss in older individuals or those with low bone mineral density (BMD), fearing BMD will be decreased. Confusion exists concerning the effects that weight loss has on bone health.
  
  
  RESULTS
  Bone density is more closely associated with lean mass than total body mass and fat mass. Although rapid or large weight loss is often associated with loss of bone density, slower or smaller weight loss is much less apt to adversely affect BMD, especially when it is accompanied with high intensity resistance and/or impact loading training. Maintenance of calcium and vitamin D intake seems to positively affect BMD during weight loss. Although dual energy X-ray absorptiometry is normally used to evaluate bone density, it may overestimate BMD loss following massive weight loss. Volumetric quantitative computed tomography may be more accurate for tracking bone density changes following large weight loss.
  
  
  CONCLUSIONS
  Moderate weight loss does not necessarily compromise bone health, especially when exercise training is involved. Training strategies that include heavy resistance training and high impact loading that occur with jump training may be especially productive in maintaining, or even increasing bone density with weight loss.
authors.affiliation: Division of Kinesiology, University of Alabama at Birmingham, Birmingham, Alabama, USA.
authors.forename: Gary R
authors.initials: GR
authors.lastname: Hunter
authors.forename: Eric P
authors.initials: EP
authors.lastname: Plaisance
authors.forename: Gordon
authors.initials: G
authors.lastname: Fisher
mesh_terms: D015502:Absorptiometry, Photon / Q000379:methods*; D050110:Bariatric Surgery / Q000009:adverse effects; D015519:Bone Density; D016723:Bone Remodeling; D002136:Calcium, Dietary / Q000627:therapeutic use; D054893:Cone-Beam Computed Tomography / Q000379:methods*; D066273:Diet, Western / Q000009:adverse effects; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D009765:Obesity / Q000517:prevention & control*; D010349:Patient Compliance; D055070:Resistance Training / Q000379:methods; D014807:Vitamin D / Q000627:therapeutic use; D014815:Vitamins / Q000627:therapeutic use; D015431:Weight Loss
chemical_list: D002136:Calcium, Dietary; D014815:Vitamins; D014807:Vitamin D
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