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Does recalled dieting increase the risk of non-vertebral osteoporotic fractures? The Tromsø Study

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Abstract

Summary

The risk of non-vertebral osteoporotic fractures increased by increasing recalled amount of weight loss when dieting in women aged ≥46 years and in those with BMI <25 kg/m2 participating in the Tromsø Study (1994/1995–2009). The increased risk was present both in women with few and several episodes of recalled dieting.

Introduction

The influence of repeated dieting on bone health is uncertain. This study aims to investigate whether recalled dieting is a risk factor for non-vertebral osteoporotic fractures.

Methods

In 1994/1995 weight and height were measured in all participants aged 25–69 years in the population-based Tromsø Study. Information about socioeconomic background, diseases and lifestyle factors was collected by questionnaires—including number of recalled dieting episodes and largest amount of weight loss when dieting. The participating 20,745 women and men were followed for 15 years, fractures were registered from X-ray archives and analysed by Cox’s proportional hazards models.

Results

Among those who recalled dieting, 975 women and 364 men suffered a non-vertebral osteoporotic fracture during follow-up. Compared to women without recalled weight loss when dieting, women who reported their largest weight loss of 11 kg or more had a hazard ratio (HR) = 1.48 (95% CI 1.13–1.94) for osteoporotic fracture, adjusted for age, marital status, body mass index, height, education, physical activity, smoking, alcohol intake, history of cardiovascular disease and psychological distress. The increased risk was statistically significant only in women aged ≥46 years and in those with BMI <25 kg/m2. Women who recalled ≥11 dieting episodes had HR = 1.73 (CI 1.11–2.68) for osteoporotic fracture compared to those with no recalled episodes. Dieting was not associated with risk of fractures in men, but the number of fractures was low.

Conclusions

The increased risk of non-vertebral osteoporotic fractures by recalled dieting in women indicates that maintenance of a stable weight may have beneficial effects on fracture risk.

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Abbreviations

CI:

Confidence interval

HR:

Hazard ratio

BMI:

Body mass index (weight/height2)

BMD:

Bone mineral density

BMC:

Bone mineral content

CER:

Cognitive eating restraint

RCT:

Randomized controlled trials

CONOR:

Cohort of Norway

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Acknowledgements

The authors acknowledge Jan Størmer, MD, specialist in radiology, for the assistance in retrieving the fracture data from the X-ray reports; Gro K.R. Berntsen, MD, PhD, senior researcher, for collecting and quality assessment of the BMD data and the Tromsø Study group headed by Inger Njølstad, MD, PhD, professor, for providing the data for this study.

Conflicts of interest

None.

Funding

The study was funded from several official sources, among them the Northern Norwegian Regional Health Authorities, the Norwegian Research Council and the Norwegian Osteoporosis Society.

Author information

Authors and Affiliations

  1. Division of Epidemiology, Norwegian Institute of Public Health, PO Box 4404, 0403, Oslo, Norway

    A. J. Søgaard & H. E. Meyer

  2. Institute of Health and Society, Department of Community Medicine, University of Oslo, Oslo, Norway

    H. E. Meyer

  3. Department of Health and Care Sciences, University of Tromsø, Tromsø, Norway

    L. A. Ahmed, L. Jørgensen & N. Emaus

  4. Department of Community Medicine, University of Tromsø, Tromsø, Norway

    L. Jørgensen

  5. Department of Clinical Therapeutic Services, University Hospital of North Norway, Tromsø, Norway

    L. Jørgensen

  6. Department of Clinical Medicine, University of Tromsø, Tromsø, Norway

    Å. Bjørnerem & R. M. Joakimsen

  7. Department of Obstetrics and Gynecology, University Hospital of North Norway, Tromsø, Norway

    Å. Bjørnerem

  8. Department of Public Health and Primary Health Care, University of Bergen, Bergen, Norway

    N. Emaus

Authors
  1. A. J. Søgaard
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  2. H. E. Meyer
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  7. N. Emaus
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Corresponding author

Correspondence to A. J. Søgaard.

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Søgaard, A.J., Meyer, H.E., Ahmed, L.A. et al. Does recalled dieting increase the risk of non-vertebral osteoporotic fractures? The Tromsø Study. Osteoporos Int 23, 2835–2845 (2012). https://doi.org/10.1007/s00198-012-1916-y

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  • DOI: https://doi.org/10.1007/s00198-012-1916-y

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