Skip to main content
SpringerLink
Log in

Impact of increased overweight on the projected prevalence of osteoporosis in older women

  • Original Article
  • Published:
Osteoporosis International Aims and scope Submit manuscript

Abstract

Introduction

Overweight is increasing worldwide, but particularly in the United States of America. Higher body weight is associated with higher bone density, so our goal was to estimate whether the higher prevalence of overweight is likely to reduce osteoporosis among older women.

Methods

We calculated the prevalence of osteoporosis by weight status in older women using data from the third National Health and Nutrition Examination Survey (NHANES III, 1988–94). We defined overweight as a body mass index (BMI) ≥25 and osteoporosis as a femur neck bone mineral density (BMD) value 2.5 standard deviations or more below the mean of that of young women. To estimate the expected prevalence of osteoporosis, we applied the prevalence of osteoporosis by weight status from NHANES III to the corresponding weight status prevalence from NHANES 1999–2002.

Results

Of older women in NHANES 1999–2002, 68% were overweight compared to 62% in NHANES III. Overweight status was significantly related to osteoporosis prevalence (P < 0.001). However, the expected prevalence of osteoporosis in NHANES 1999–2002 was only slightly lower than that seen in NHANES III (16.8% vs 18.1%, respectively).

Conclusions

The increasing prevalence of overweight among older US women appears unlikely to be accompanied by a significant reduction in osteoporosis.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. National Osteoporosis Foundation (2002) America’s bone health: the state of osteoporosis and low bone mass in our nation. National Osteoporosis Foundation, Washington, DC

  2. Looker AC, Orwoll ES, Johnston CC Jr, et al (1997) Prevalence of low femoral bone density in older adults from NHANES III. J Bone Miner Res 12:1761–1768

    Article  PubMed  CAS  Google Scholar 

  3. Hedley AA, Ogden CL, Johnson CL, et al (2004) Prevalence of overweight and obesity among US children, adolescents and adults 1999–2002. JAMA 291:2847–2850

    Article  PubMed  CAS  Google Scholar 

  4. Flegal KM, Carroll MD, Kuczmarski RJ, Johnson CL (1998) Overweight and obesity in the United States: prevalence and trends, 1960–1994. Int J Obes 22:39–47

    Article  CAS  Google Scholar 

  5. Edelstein SL, Barrett-Connor E (1993) Relation between body size and bone mineral density in elderly men and women. Am J Epidemiol 138:160–169

    PubMed  CAS  Google Scholar 

  6. Felson DT, Zhang Y, Hannan MT, Anderson JJ (1993) Effects of weight and body mass index on bone mineral density in men and women: the Framingham Study. J Bone Miner Res 8:567–573

    PubMed  CAS  Google Scholar 

  7. Bauer DC, Browner WS, Cauley JA, et al (1993) Factors associated with appendicular bone mass in older women. The Study of Osteoporotic Fractures Research Group. Ann Intern Med 118:657–665

    PubMed  CAS  Google Scholar 

  8. Glauber HS, Vollmer WM, Nevitt MC, et al (1995) Body weight versus body fat distribution, adiposity, and frame size as predictors of bone density. J Clin Endocrinol Metab 80:1118–1123

    Article  PubMed  CAS  Google Scholar 

  9. Holbrook TL, Barrett-Connor E (1993) The association of lifetime weight and weight control patterns with bone mineral density in an adult community. Bone Miner 20:141–149

    Article  PubMed  CAS  Google Scholar 

  10. Plan and Operation of the Third National Health and Nutrition Examination Survey (1994) 1988–94: series 1: programs and collection procedures. Vital Health Stat 1 32:1–407

  11. National Center for Health Statistics NCHS definitions: Race. Available at http://www.cdc.gov/nchs/datawh/nchsdefs/race.htm. Accessed 2 September 2005

  12. Wahner H, Looker A, Dunn W, et al (1994) Quality control of bone densitometry in a national health survey (NHANES III) using three mobile examination centers. J Bone Miner Res 9:951–960

    PubMed  CAS  Google Scholar 

  13. World Health Organization (1994) Assessment of fracture risk and its application to screening for postmenopausal osteoporosis. Technical Report Series No. 843. WHO, Geneva Switzerland

  14. Shah BV, Barnwell BG, Hunt PN, et al (1991) SUDAAN User’s Manual, Release 5.50. Research Triangle Institute, Research Triangle Park, NC

  15. Niewenweg R, Smit ML, Walenkamp JE, et al (2003) Adult height corrected for shrinking and secular trend. Ann Hum Biol 30:563–569

    Article  PubMed  CAS  Google Scholar 

  16. Schenker N, Gentleman JF (2001) On judging the significance of differences by examining overlap between confidence intervals. Am Statistician 55:182–186

    Article  Google Scholar 

  17. Dargent-Molina P, Poitiers F, Breart G for the EPIDOS group (2000) In elderly women weight is the best predictor of a very low bone mineral density: evidence from the EPIDOS Study. Osteoporos Int 11:881–888

    Article  PubMed  CAS  Google Scholar 

  18. Barrera G, Bunout D, Gattas V, et al (2004) A high body mass index protects against femoral neck osteoporosis in healthy elderly subjects. Nutrition 20:769–771

    Article  PubMed  Google Scholar 

  19. Albala C, Yanez M, Devoto E, et al (1996) Obesity as a protective factor for postmenopausal osteoporosis. Int J Obes 20:1027–1032

    CAS  Google Scholar 

  20. Kleerekoper M, Nelson DA, Peterson EL, et al (1994) Body composition and gonadal steroids in older white and black women. J Clin Endocrinol Metab 79:775–779

    Article  PubMed  CAS  Google Scholar 

  21. Khosla S, Atkinson EJ, Riggs BL, et al (1996). Relationship between body composition and bone mass in women. J Bone Miner Res 11:857–863

    Article  PubMed  CAS  Google Scholar 

  22. Gallagher D, Visser M, Sepulveda D, et al (1996) How useful is body mass index for comparison of body fatness across age, sex, and ethnic groups? Am J Epidemiol 143:228–239

    PubMed  CAS  Google Scholar 

  23. Reid IR (2002) Relationships among body mass, its components, and bone. Bone 31:547–555

    Article  PubMed  CAS  Google Scholar 

  24. Twomey LT, Taylor JR (1987) Age changes in lumbar vertebrae and intervertebral discs. Clin Orthop Relat Res 224:97–104

    PubMed  Google Scholar 

  25. Rockhill B, Newman B, Weinberg C (1998) Use and misuse of population attributable fractions. Am J Public Health 88:15–19

    PubMed  CAS  Google Scholar 

  26. De Laet C, Kanis J, Oden A, et al (2005) Body mass index as a predictor of fracture risk: a meta-analysis. Osteoporos Int 16:1330–1338

    Article  PubMed  Google Scholar 

  27. National Center for Health Statistics. Health, United States (2004) With chartbook on trends in the health of Americans. Hyattsville MD: National Center for Health Statistics; 2004. Available at:http://www.cdc.gov/nchs/data/hus/hus04.pdf. Accessed 22 June 2005

  28. Bialostosky K, Wright JD, Kennedy-Stephenson J, et al (2002) Dietary intake of macronutrients, micronutrients, and other dietary constituents: United States 1988–94. series 11: data from the National Health and Nutrition Examination Survey. Vital Health Stat 11 245:1–155

    PubMed  Google Scholar 

  29. Ervin RB, Wang CY, Wright JD, et al (2004) Dietary intake of selected minerals for the United States population: 1999–2000. Advance Data from Vital and Health Statistics 341:1–8

    PubMed  Google Scholar 

  30. Stafford RS, Drieling RL, Hersh AL (2004) National trends in osteoporosis visits and osteoporosis treatment, 1988–2003. Arch Intern Med 164:1525–1530

    Article  PubMed  Google Scholar 

  31. Jaglal S, Weller I, Mamdani M, et al (2005) Population trends in BMD testing, treatment and hip and wrist fracture rates: are the hip fracture projections wrong? J Bone Miner Res 20:898–905

    Article  PubMed  Google Scholar 

  32. Newman ED, Ayoub WT, Starkey RH, et al (2003) Osteoporosis disease management in a rural health care population: hip fracture reduction and reduced costs in postmenopausal women after 5 years. Osteoporos Int 14:146–151

    PubMed  CAS  Google Scholar 

  33. Melton LJ 3rd, Kanis JA, Johnell O (2005). Potential impact of osteoporosis treatment on hip fracture trends. J Bone Miner Res 20:895–897

    Article  PubMed  Google Scholar 

  34. Elliot-Gibson V, Bogoch ER, Jamal SA, et al (2004) Practice patterns in the diagnosis and treatment of osteoporosis after a fragility fracture: a systematic review. Osteoporos Int 15:767–778

    Article  PubMed  CAS  Google Scholar 

  35. Tosteson ANA, Grove MR, Hammond CS, et al (2003) Early discontinuation of treatment for osteoporosis. Am J Med 115:209–216

    Article  PubMed  Google Scholar 

  36. McCombs JS, Thiebaud P, McLaughlin-Miley C, et al (2005) Compliance with drug therapies for the treatment and prevention of osteoporosis. Maturitas 48:271–287

    Article  CAS  Google Scholar 

Download references

Acknowledgments

The findings and conclusions in this report are those of the authors and do not necessarily represent the views of the Centers for Disease Control and Prevention.

Author information

Authors and Affiliations

  1. National Center for Health Statistics, Centers for Disease Control and Prevention, Room 4201, 3311 Toledo Rd, Hyattsville, MD, 20782, USA

    A. C. Looker & K. M. Flegal

  2. Department of Health Sciences Research, Mayo Clinic College of Medicine, Rochester, MN, USA

    L. J. Melton III

Authors
  1. A. C. Looker
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. K. M. Flegal
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. L. J. Melton III
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to A. C. Looker.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Looker, A.C., Flegal, K.M. & Melton, L.J. Impact of increased overweight on the projected prevalence of osteoporosis in older women. Osteoporos Int 18, 307–313 (2007). https://doi.org/10.1007/s00198-006-0241-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00198-006-0241-8

Keywords

Search

Navigation