Changes in thigh muscle volume predict bone mineral density response to lifestyle therapy in frail, obese older adults

Summary We studied the relationships among strength, muscle mass, and bone mineral density (BMD) with lifestyle change. Lifestyle therapy consisted of exercise, diet, and diet plus exercise. Diet was by caloric restriction to induce and maintain a weight loss of 10 % from baseline body weight. Exerc...

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Bibliographic Details
Published in:Osteoporosis international 2014-02, Vol.25 (2), p.551-558
Main Authors: Armamento-Villareal, R., Aguirre, L., Napoli, N., Shah, K., Hilton, T., Sinacore, D. R., Qualls, C., Villareal, D. T.
Format: Article
Language:English
Subjects:
Aged
Bone density
Bone Density - physiology
Caloric Restriction
Combined Modality Therapy
Endocrinology
Exercise
Exercise Therapy - methods
Female
Frail Elderly
Frailty
Hip Joint - physiopathology
Humans
Knee Joint - physiopathology
Legs
Life Style
Male
Medicine
Medicine & Public Health
Muscle Strength - physiology
Muscle, Skeletal - pathology
Muscle, Skeletal - physiopathology
Muscular system
Obesity
Obesity - pathology
Obesity - physiopathology
Obesity - therapy
Older people
Original Article
Orthopedics
Rheumatology
Thigh - pathology
Weight control
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Summary:Summary We studied the relationships among strength, muscle mass, and bone mineral density (BMD) with lifestyle change. Lifestyle therapy consisted of exercise, diet, and diet plus exercise. Diet was by caloric restriction to induce and maintain a weight loss of 10 % from baseline body weight. Exercise attenuated weight loss-induced muscle and bone losses. Exercise improved strength despite muscle loss in patients on diet and exercise. Changes in strength did not correlate with changes in BMD. However, changes in thigh muscle volume correlated with, and predicted changes in hip BMD. Introduction Losses of hip BMD and lean body mass are major complications of lifestyle therapy in frail, obese older adults; however, the contribution of mechanical strain loss from muscle loss is poorly defined. We determined the effect of changes in thigh muscle volume and muscle strength on BMD in frail, obese older adults undergoing lifestyle therapy aimed at intentional weight loss with or without exercise. Methods One hundred seven obese older adults were randomized to control, diet, exercise, and diet–exercise groups for 1 year. Thigh muscle volume was measured by magnetic resonance imaging, BMD by DXA, knee strength by dynamometry, total strength by one-repetition maximum (1-RM), and bone markers by immunoassay. Results Thigh muscle volume decreased in the diet group (−6.2 ± 4.8 %) and increased in the exercise group (2.7 ± 3.1 %), while it was not significantly different from the control in the diet–exercise group. Changes in hip BMD followed similar pattern as those in thigh muscle volume. Knee extension and flexion increased in the exercise group (23 ± 20 %; 25 ± 19 %) and diet–exercise group (20 ± 19 %; 20.6 ± 27 %) but were unchanged in the control and diet groups. Changes in thigh muscle volume correlated with changes in hip BMD ( r  = 0.55, P  = 
ISSN:0937-941X
1433-2965
DOI:10.1007/s00198-013-2450-2