Weight loss through exercise is better for your bones than dieting

If you have a choice between losing weight by doing more exercise and losing weight by eating less, then the first option is best, for a number of reasons. One reason is less well known and was described in 2006 by nutritionists at Washington University in Archives of Internal Medicine: weight loss by exercising more is better for your bones.

Study
The researchers divided 48 somewhat podgy adults, average age 57, into three groups. One group ate as healthily as possible for one year [HL], the second group went on a calorie-reduced diet for a year [CR] and the third group exercised more for a year [EX]. The subjects in the diet group ate 16-20 percent less than they burned each day; the subjects in the exercise group burned 16-20 percent more than they ate each day.

Results
The diet group lost 11 percent of their bodyweight; the exercise group 8 percent.

At the end of the year the researchers measured the subjects’ bone mass density using X-rays. In the figure immediately below you can see that the more weight the subjects lost, the more bone mass they also lost.

1

The figure above shows the bone mass of the subjects in the exercise group. There is no relationship between the number of kilograms lost and a decrease in bone mass.

Conclusion
“Exercise-induced weight loss is associated with preservation of bone mass density at important clinical sites of fracture”, the researchers write. “Therefore, exercise has the important advantage over calorie restriction by protecting against bone loss.”

“However, because the amount of exercise required to achieve clinically meaningful weight loss is large, a more practical approach for weight reduction is a combination of caloric restriction and exercise. Our results suggest that regular exercise should be included as part of a comprehensive weight loss program to offset the adverse effects of caloric restriction on bone.”

Bone mineral density response to caloric restriction-induced weight loss or exercise-induced weight loss: a randomized controlled trial.

Abstract

BACKGROUND:
Bone loss often accompanies weight loss induced by caloric restriction (CR), but whether bone loss accompanies similar weight loss induced by exercise (EX) is unknown. We tested the hypothesis that EX-induced weight loss is associated with less bone loss compared with CR-induced weight loss.

METHODS:
Forty-eight adults (30 women; 18 men; mean +/- SD age, 57 +/- 3 years; and mean +/- SD body mass index, 27 +/- 2 kg/m2) were randomized to 1 of 3 groups for 1 year: CR group (n = 19), regular EX group (n = 19), or a healthy lifestyle (HL) control group (n = 10). Primary outcome measure was change in hip and spine bone mineral density (BMD). Secondary outcomes were bone markers and hormones.

RESULTS:
Body weight decreased similarly in the CR and EX groups (10.7% +/- 6.3% [-8.2 +/- 4.8 kg] vs 8.4% +/- 6.3% [-6.7 +/- 5.6 kg]; P = .21), whereas weight did not change in the HL group (-1.2% +/- 2.5% [-0.9 +/- 2.0 kg]). Compared with the HL group, the CR group had decreases in BMD at the total hip (-2.2% +/- 3.1% vs 1.2% +/- 2.1%; P = .02) and intertrochanter (-2.1% +/- 3.4% vs 1.7 +/- 2.8%; P = .03). The CR group had a decrease in spine BMD (-2.2% +/- 3.3%; P = .009). Despite weight loss, the EX group did not demonstrate a decrease in BMD at any site. Body weight changes correlated with BMD changes in the CR (R = 0.61; P = .007) but not in the EX group. Bone turnover increased in both CR and EX groups.

CONCLUSIONS:
CR-induced weight loss, but not EX-induced weight loss, is associated with reductions in BMD at clinically important sites of fracture. These data suggest that EX should be an important component of a weight loss program to offset adverse effects of CR on bone.

PMID: 17159017 [PubMed – indexed for MEDLINE]

Source: http://www.ncbi.nlm.nih.gov/pubmed/17159017