Lean mass appears to be more strongly associated with bone health than fat mass in urban black South African women
- 195 Downloads
To examine the association between body composition (fat mass, lean mass and body mass index, BMI) and bone health (bone mineral density, BMD and fracture risk) in urban black South African women.
A cross sectional study examining associations between body composition, dietary intake (food frequency questionnaire), habitual physical activity (Activity energy expenditure (AEE) measured using an accelerometer with combined heart rate monitor and physical activity questionnaire) and bone health (BMD using dual-energy X ray absorptiometry, DXA and fracture risk).
Urban community dwellers from Ikageng in the North-West Province of South Africa.
One hundred and eighty nine (189) healthy postmenopausal women aged ≥43 years.
Fat mass and lean mass were significantly associated with BMD and fracture risk when adjusted for potential confounders. However, lean mass and not fat mass remained significantly associated with femoral neck BMD (β = 0.49, p <0.001), spine BMD (β = 0.48, p< 0.0001) and hip BMD (β = 0.59, p< 0.0001). Lean mass was also negatively associated with fracture risk (β = −0.19 p =0.04) when both lean and fat mass were in the same model.
Lean mass and fat mass were positively associated with femoral neck, spine and hip BMDs and negatively associated with fracture risk in urban black South African women. Our finding suggests that increasing lean mass rather than fat mass is beneficial to bone health. Our study emphasises the importance of positive lifestyle changes, intake of calcium from dairy and adequate weight to maintain and improve bone health of postmenopausal women.
Key wordsLean mass fat mass bone mineral density fracture risk African women
Unable to display preview. Download preview PDF.
- 2.Kanis JA, on behalf of the WHO scientific group. Assessment of osteoporosis at the primary health-care level. Technical report. WHO Collaborating Centre, University of Sheffield, UK 2008;1 339Google Scholar
- 3.WHO: Obesity and overweight http://www.who.int/mediacentre/factsheets/fs311/en/. Accessed 15 November 2013
- 4.Shisana O, Labadarios D, Rehle T, Simbayi L, Zuma K, Dhansay A, et a. South African National Health and Nutrition Examination Survey (SANHANES-1). HSRC Press; Cape Town 2013;136–140Google Scholar
- 12.Liu Y, Xu Y, Wen Y, Guan K, Ling W, He L, Su Y, Chen Y. Association of Weight-Adjusted Body Fat and Fat Distribution with Bone Mineral Density in Middle-Aged Chinese Adults: A Cross-Sectional Study. PLoS ONE 2013;8 (5): e63339. doi: 10.1371/journal.pone.0063339 PubMedCentralPubMedCrossRefGoogle Scholar
- 15.Vorster HJ, Venter CS, Kruger MC, Vorster HH, Kruger HS. Impact of urbanisation on risk factors for osteoporosis in postmenopausal black South African women. J Endocrin Metab Diabet S Afr 2002;7:92–99Google Scholar
- 16.Kruger MC, De Winter RM, Becker PJ, Vorster HH. Changes in markers of bone turnover following urbanisation of black South African women. J Endocrinol Metab Diabet S Afr 2004;9:8–14Google Scholar
- 19.George JA., Micklesfield L, Norris S, Crowther N. The association between body composition, 25 (OH) D and PTH, and bone mineral density in black African and Asian Indian population groups. J Clin Endocrinol Metab, 2014. http://dx.doi.org/10.1210/jc.2013-3968Google Scholar
- 22.Marfell-Jones M, Olds T, Stewart A, Carter L. International standards for anthropometric assessment. Australia: The international society for the advancement of Kinanthropometry, 2006Google Scholar
- 23.Kanis JA, Adachi JD, Cooper C, Harvey N, Clark P, Cummings SR, Diaz-Curiel M, Hiligsmann M, Papaioannou A, Pierroz DD, Silverman SL, Szulc P, and the Epidemiology and Quality of Life Working Group of IOF. Standardising the descriptive epidemiology of osteoporosis: Recommendations from the Epidemiology and Quality of Life Working Group of IOF. Osteoporos Int 2013;24:2763–2764PubMedCrossRefGoogle Scholar
- 24.Hough S, Ascott-Evans B, Brown SL. NOFSA guideline for the diagnosis and management of osteoporosis: Guideline abstract. J Endocrinol, Metab Diabet S Afr 2010;15(3):107–108Google Scholar
- 26.Wentzel-Viljoen E, Laubscher R, Kruger A. Using different approaches to assess the reproducibility of a culturally sensitive quantified food frequency questionnaire. S Afr J Clin Nutr 2011;24:143–148Google Scholar
- 27.Kruger HS, Venter CS, Steyn HS. A standardised physical activity questionnaire for a population in transition: the Thusa study. Afr J Phys Health Education Recreat Dance 2000;6:54–64Google Scholar
- 28.Wolmarans P, Danster N, Dalton A, Rossouw K, Schonfeldt H (eds). Condensed food composition tables for South Africa. Medical Research Council, Parow Valley, Cape Town 2010;1–126Google Scholar
- 32.Miles J & Shevlin M (2001) Applying regression and correlation: a guide for students and researchers. Sage, London, 2001Google Scholar
- 40.De Laet, C, Kanis JA, McCloskey EV, Odén A, Johanson H, Johnell O, Delmas P, Eisman JA, Kroger H, Fujiwara S, Garnero P, Mellstrom D, Melton III, L.J, Meunier PJ, Reeve J, Silman A, Tenenhouse A, Pols HAP. Body mass index as a predictor of fracture risk: A meta-analysis. Osteoporos Int 2005;16:1330–1338PubMedCrossRefGoogle Scholar
- 44.Minghetti PP, Norman AW. 1,25(OH)2-vitamin D3 receptors: gene regulation and genetic circuitry. Federation of Am Soc for Experimental Biol J 1988;2:3043–3053Google Scholar
- 45.NIH. Calcium: Dietary supplements fact sheets, 2013. http://ods.od.nih.gov/factsheets/Calcium-HealthProfessional. Accessed 10th February 2014Google Scholar
- 56.Muir JM, Ye C, Bhandari M, Thabane L, Adachi JD. The effect of regular physical activity on bone mineral density in post-menopausal women aged 75 and over: A retrospective analysis from the Canadian multicentre osteoporosis study. BMC Musculoskelet Disord, 2013;doi: 10.1186/1471-2474-14-253 Google Scholar