title: Sex Differences in the Effects of Weight Loss Diets on Bone Mineral Density and Body Composition: POUNDS LOST Trial.
abstract: BACKGROUND
  Weight loss is associated with reduction in bone mineral density (BMD).
  
  
  OBJECTIVE
  The objective was to address the role of changes in fat mass (FM) and lean mass (LM) in BMD decline in both sexes.
  
  
  METHODS
  A 2-year randomized controlled trial, the Preventing Overweight Using Novel Dietary Strategies (POUNDS-LOST).
  
  
  METHODS
  The setting was the general community.
  
  
  METHODS
  Enrolled were 424 overweight and obese participants (mean age, 52 ± 9 y; 57% females).
  
  
  METHODS
  Intervention included weight loss diets differing in fat, protein, and carbohydrates.
  
  
  METHODS
  Main outcome measures were change in spine, total hip (TH), and femoral neck (FN) BMD and sex differences after dietary intervention.
  
  
  RESULTS
  At baseline, a stronger correlation between BMD and body composition measurements was observed in women, primarily with LM (r = 0.419, 0.507, and 0.523 for spine, FN, and TH, respectively; all P < .001). In men, only LM correlated with hip BMD (r = 0.298; P < .001). Mean weight loss at 2 years was -6.9%, without differences among diets. Two-year changes in BMD were 0.005 (P = .04), -0.014 (P < .001), and -0.014 g/cm(2) (P < .001), at the spine, TH, and FN, respectively. These changes directly correlated with changes in LM in women (r = 0.200, 0.324, and 0.260 for spine, FN, and TH, respectively), whereas FM loss correlated only with changes in TH BMD (0.274; P < .001). In men, changes in LM (-0.323; P < .001) and FM (-0.213; P = .027) negatively correlated with changes in spine BMD.
  
  
  CONCLUSIONS
  Weight loss diets result in sex-specific effects on BMD. Although men exhibited a paradoxical increase in spine BMD, women tended to decrease in BMD at all sites.
authors.affiliation: Division of Endocrinology, Diabetes, and Hypertension (A.T., M.S.L.), Brigham and Women's Hospital, Boston, Massachusetts 02115; Harvard Medical School (A.T., M.S.L., F.S.), Boston, Massachusetts 02115; Department of Clinical Epidemiology and Biostatistics (R.J.d.S.), McMaster University, Hamilton, Ontario, L8S 4L8 Canada; Channing Laboratory (F.S.), Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts 02115; Department of Nutrition (F.S.), Harvard School of Public Health, Boston, Massachusetts 02115; and Pennington Biomedical Research Center of the Louisiana State University System (G.A.B., S.R.S.), Baton Rouge, Louisiana 70808.
authors.forename: Amir
authors.initials: A
authors.lastname: Tirosh
authors.affiliation: Division of Endocrinology, Diabetes, and Hypertension (A.T., M.S.L.), Brigham and Women's Hospital, Boston, Massachusetts 02115; Harvard Medical School (A.T., M.S.L., F.S.), Boston, Massachusetts 02115; Department of Clinical Epidemiology and Biostatistics (R.J.d.S.), McMaster University, Hamilton, Ontario, L8S 4L8 Canada; Channing Laboratory (F.S.), Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts 02115; Department of Nutrition (F.S.), Harvard School of Public Health, Boston, Massachusetts 02115; and Pennington Biomedical Research Center of the Louisiana State University System (G.A.B., S.R.S.), Baton Rouge, Louisiana 70808.
authors.forename: Russell J
authors.initials: RJ
authors.lastname: de Souza
authors.affiliation: Division of Endocrinology, Diabetes, and Hypertension (A.T., M.S.L.), Brigham and Women's Hospital, Boston, Massachusetts 02115; Harvard Medical School (A.T., M.S.L., F.S.), Boston, Massachusetts 02115; Department of Clinical Epidemiology and Biostatistics (R.J.d.S.), McMaster University, Hamilton, Ontario, L8S 4L8 Canada; Channing Laboratory (F.S.), Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts 02115; Department of Nutrition (F.S.), Harvard School of Public Health, Boston, Massachusetts 02115; and Pennington Biomedical Research Center of the Louisiana State University System (G.A.B., S.R.S.), Baton Rouge, Louisiana 70808.
authors.forename: Frank
authors.initials: F
authors.lastname: Sacks
authors.affiliation: Division of Endocrinology, Diabetes, and Hypertension (A.T., M.S.L.), Brigham and Women's Hospital, Boston, Massachusetts 02115; Harvard Medical School (A.T., M.S.L., F.S.), Boston, Massachusetts 02115; Department of Clinical Epidemiology and Biostatistics (R.J.d.S.), McMaster University, Hamilton, Ontario, L8S 4L8 Canada; Channing Laboratory (F.S.), Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts 02115; Department of Nutrition (F.S.), Harvard School of Public Health, Boston, Massachusetts 02115; and Pennington Biomedical Research Center of the Louisiana State University System (G.A.B., S.R.S.), Baton Rouge, Louisiana 70808.
authors.forename: George A
authors.initials: GA
authors.lastname: Bray
authors.affiliation: Division of Endocrinology, Diabetes, and Hypertension (A.T., M.S.L.), Brigham and Women's Hospital, Boston, Massachusetts 02115; Harvard Medical School (A.T., M.S.L., F.S.), Boston, Massachusetts 02115; Department of Clinical Epidemiology and Biostatistics (R.J.d.S.), McMaster University, Hamilton, Ontario, L8S 4L8 Canada; Channing Laboratory (F.S.), Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts 02115; Department of Nutrition (F.S.), Harvard School of Public Health, Boston, Massachusetts 02115; and Pennington Biomedical Research Center of the Louisiana State University System (G.A.B., S.R.S.), Baton Rouge, Louisiana 70808.
authors.forename: Steven R
authors.initials: SR
authors.lastname: Smith
authors.affiliation: Division of Endocrinology, Diabetes, and Hypertension (A.T., M.S.L.), Brigham and Women's Hospital, Boston, Massachusetts 02115; Harvard Medical School (A.T., M.S.L., F.S.), Boston, Massachusetts 02115; Department of Clinical Epidemiology and Biostatistics (R.J.d.S.), McMaster University, Hamilton, Ontario, L8S 4L8 Canada; Channing Laboratory (F.S.), Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts 02115; Department of Nutrition (F.S.), Harvard School of Public Health, Boston, Massachusetts 02115; and Pennington Biomedical Research Center of the Louisiana State University System (G.A.B., S.R.S.), Baton Rouge, Louisiana 70808.
authors.forename: Meryl S
authors.initials: MS
authors.lastname: LeBoff
mesh_terms: D000328:Adult; D000368:Aged; D001823:Body Composition; D015992:Body Mass Index; D015519:Bone Density; D004038:Diet, Reducing; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000178:diet therapy* / Q000378:metabolism; D050177:Overweight / Q000178:diet therapy* / Q000378:metabolism; D012727:Sex Characteristics; D015431:Weight Loss
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