A new study from the Archives of Internal Medicine suggests that weight loss plus exercise preserves bone health better than dieting without working out.

In a small, but interesting, randomized control trial of three groups of 48 adults, more bone loss occurred in a subgroup that dieted -- compared to a control -- and a subgroup that dieted and exercised. Specifically, bone density in the spine and hip declined about two percent in the diet alone group while there were no changes in bone density for the others.

The diet and exercise group also comparatively experienced some bone build up that compensated for other losses in bone mineral density. Spinal and hip bone build up did not occur in the other groups. The Archives of Internal Medicine is published by the American Medical Association. In the study conducted at Washington University-St. Louis Medical School, one group dieted and another experienced a similar weight control program with the addition of supervised exercise. Both groups reduced their calorie intact by 16 to 20 percent. A third control group was not given any special instructions. The study was for one year and participants were between 50 and 60 years old.

The diet group actually lost an average of three pounds more than the diet and exercise cohort. The diet group lost an average of 18 pounds in 12 months, while the diet and exercise group removed 15 pounds. There was no weight loss for the control group. However, the key point here is the weight loss without exercise was accompanied by an unwanted erosion of bone density in the spine and hip.

A loss of bone mineral density in the spine and hip is important since these are areas where older adults experience fractures. In the U.S., osteoporosis is responsible for more than 1.5 million fractures annually, 700,000 of them in the vertebrae of the spine and 300,000 in hips, at an estimated cost of more than $14 billion each year. Other common fractures occur in wrists, forearms, feet and toes. Bone mineral density (or BMD) is the strongest predictor of fractures caused by osteoporosis.

The study’s eight authors measured bone mineral density through blood tests. They noted the blood test used in the study was more sophisticated than in previous research and it provides more insights about bone loss and build up than have been previously reported. They also reported that while research about diet and bone loss is common, research that measures the combined impact of diet, exercise and bone density is unusual.  

As a result, the study is an example of research with some novel approaches that has practical clinical implications. Although the study’s small sample size means the researchers could not estimate differences among the men and women participants, or generalize the findings to larger populations, the study’s technique may provide a new way to test the impact of dieting and exercise on health.

The results also suggest that during a time of the year when many Americans try to lose weight, exercise and diet provide a better combination. For those of you with New Year’s resolutions to lose weight, MedlinePlus.gov links to a guide to select a weight-loss program provided by the National Institute of Diabetes and Digestive and Kidney Diseases (the NIDDK).

Among other helpful suggestions, the NIDDK website notes that high quality weight-loss programs should include:

• tips to increase moderate exercise
• plans that reduce calories -- but do not forbid specific  foods or food groups
• a slow and steady weight loss, usually ranging from a half pound to two pounds a week
• medical care -- if you plan to lose weight by following a special formula diet, such as very low-calorie regimen
• plus a plan to keep weight off.

The site also provides a range of questions you can ask about a potential weight-loss program, such as:

• do you have to purchase special food, drugs or supplements?
• does the program offer one-on-one counseling or group classes?
• do you have to follow a specific meal plan or keep food records?

To find the NIDDK page, type ‘lose weight’ in the search box on MedlinePlus’ home page and then click ‘Weight control (National Library of Medicine).’ The NIDDK page is listed under ‘From the National Institutes of Health.’

Also listed on the ‘Weight control (National Library of Medicine)’ page is the latest news about diet research, overviews, health check tools, including guides to calculate your daily calorie intake, a link to weight control research and specific information for women, children, teens and seniors. We realize that losing weight is a tough challenge and hope that MedlinePlus’ comprehensive information will ease dieting’s trials and tribulations.

Please see medlineplus.gov for more information. 

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