A three-year lifestyle intervention combining a reduced-calorie Mediterranean diet and increased physical activity has proven effective in mitigating age-related bone mineral density (BMD) loss in older women with metabolic syndrome, according to a recent study. Conducted by researchers from Universitat Rovira i Virgili and collaborators in the PREDIMED-Plus consortium, the study highlights promising strategies to preserve bone health while managing obesity-related conditions.
The research revealed that older women following this weight-loss intervention experienced significant protective effects on their lumbar spine BMD compared to those who adhered to an unrestricted Mediterranean diet. These findings address a growing concern, as low bone mineral density is a major risk factor for osteoporotic fractures, and the global aging population is experiencing an increase in both obesity and related bone health challenges.
While weight loss is commonly recommended to manage obesity, it often leads to reductions in bone mineral density and total bone mineral content, particularly among older adults. Previous studies have suggested that hypocaloric diets, when not coupled with physical activity, may accelerate bone loss, creating a pressing need for interventions that balance weight loss with the preservation of skeletal health.
The study, titled “Mediterranean Diet, Physical Activity, and Bone Health in Older Adults,” was published in JAMA Network Open and presents a secondary analysis within the PREDIMED-Plus trial. This three-year, multicenter, randomized clinical trial, conducted at 23 sites across Spain, involved 924 adults aged 55 to 75 years (49.1% women) who were living with metabolic syndrome and had overweight or obesity.
Participants were randomly assigned to either the intervention group, which followed a Mediterranean diet with a 30% energy reduction and increased physical activity, or a control group, which adhered to an unrestricted Mediterranean diet without additional physical activity. The study assessed bone mineral density at the total femur, lumbar spine (L1–L4), and femoral trochanter, as well as total bone mineral content, at the start of the study, after one year, and again after three years.
Although no overall effect was found on total bone mineral content or the prevalence of low bone mineral density, the intervention group saw statistically significant improvements in lumbar spine BMD, particularly among women. Over the three-year period, lumbar spine BMD improved by 0.9 g/cm² in the intervention group compared to the control group, with women showing a more pronounced improvement of 1.8 g/cm².
Notably, sensitivity analyses that excluded participants using calcium or vitamin D supplements confirmed these results, demonstrating consistent improvements in lumbar spine BMD for women. Additionally, a significant increase in total bone mineral content was observed among women in the intervention group.
The authors conclude that these findings support the use of weight-loss interventions based on a reduced-calorie Mediterranean diet and physical activity to help older women at risk of bone disturbances. This approach offers a feasible strategy to counteract the age-related declines in bone density that often accompany weight loss.
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