OBJECTIVE
To determine whether an intensive lifestyle intervention (ILI) designed to sustain
weight loss and improve physical fitness in overweight or obese persons with type 2
diabetes was associated with bone loss after 4 years of follow-up.
RESEARCH DESIGN AND METHODS
This randomized controlled trial of intensive weight loss compared an ILI with a
diabetes support and education (DSE) group among 1,309 overweight or obese
subjects. Bone mineral density was assessed at baseline and after 1 year and 4
years of intervention.
RESULTS
ILI was effective in producing significant weight loss (5.3% vs. 1.8% in ILI and DSE,
respectively; P < 0.01) and increased fitness (6.4% vs. 20.8%) at year 4. In men, ILI
participants had a greater rate of bone loss during the first year (21.66% vs.
20.09% per year in ILI and DSE, respectively). Differences between groups were
diminished by one-half after 4 years (20.88% vs. 20.05% per year in ILI and DSE,
respectively) but remained significant (P < 0.01). The difference in rate of hip bone
loss between groups over 4 years was related to increased weight loss in ILI.
Among women, the rate of bone loss did not differ between ILI and DSE after 4
years.
CONCLUSIONS
A 4-year weight loss intervention was significantly associated with a modest increase in bone loss at the hip in men but not in women.