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Addition of Aerobic Exercise to a Weight Loss Program Increases BMD, with an Associated Reduction in Inflammation in Overweight Postmenopausal Women

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Abstract

Increased inflammation and weight loss are associated with a reduction in bone mineral density (BMD). Aerobic exercise may minimize the loss of bone and weight loss may contribute to a decrease in cytokines. We tested the hypothesis that aerobic exercise in combination with a weight loss program would decrease circulating concentrations of inflammatory markers, thus mediating changes in BMD. This was a nonrandomized controlled trial. Eighty-six overweight and obese postmenopausal women (50–70 years of age; BMI, 25–40 kg/m2) participated in a weight loss (WL; n = 40) or weight loss plus walking (WL + AEX; n = 46) program. Outcome measures included BMD and bone mineral content of the femoral neck and lumbar spine measured by dual energy X-ray absorptiometry, interleukin-6, tumor necrosis factor-α, soluble receptors of IL-6, and TNF-α (sTNFR1 and sTNFR2; receptors in a subset of the population), VO2 max, fat mass, and lean mass. Weight decreased in the WL (p < 0.001) and WL + AEX (p < 0.001) groups. VO2 max increased (p < 0.001) after WL + AEX. There was a 2% increase in femoral neck BMD in the WL + AEX group (p = 0.001), which was significantly different from the WL group. The change in sTNFR1 was significantly associated with the change in femoral neck BMD (p < 0.05). The change in VO2 max was an independent predictor of the change in femoral neck BMD. Our findings suggest that the addition of aerobic exercise is recommended to decrease inflammation and increase BMD during weight loss in overweight postmenopausal women.

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Acknowledgments

This work received funding from the Baltimore Veterans Medical Research Service; the Baltimore Veterans Affairs Geriatric Research, Education, and Clinical Center; National Institutes on Aging Grants T32 AG-00219, R01-AG-18408, R01-AG-019310, R29-AG-14066, and K01-AG-00747; National Institutes of Health Grant P01-DK-072488; and National Institute of Nursing Research Grant R01 NR-03514. We thank the women who participated in the study, Karin Murphy for her technical assistance, and Dr. Andrew Goldberg for his support.

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Authors and Affiliations

  1. University of Maryland School of Medicine and the Geriatric Research, Education and Clinical Center of the Baltimore Veterans Affairs Medical Center, GRECC (BT/18/GR), 10 North Greene Street, Baltimore, MD, 21201-1524, USA

    Natalie E. Silverman & Alice S. Ryan

  2. Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, 27157, USA

    Barbara J. Nicklas

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  1. Natalie E. Silverman
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  2. Barbara J. Nicklas
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Correspondence to Alice S. Ryan.

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Silverman, N.E., Nicklas, B.J. & Ryan, A.S. Addition of Aerobic Exercise to a Weight Loss Program Increases BMD, with an Associated Reduction in Inflammation in Overweight Postmenopausal Women. Calcif Tissue Int 84, 257–265 (2009). https://doi.org/10.1007/s00223-009-9232-z

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