Obesity Linked to Lower Bone Mass in Younger Adults

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Obesity Linked to Lower Bone Mass in Younger Adults

Greater body fat was linked to weaker bones in younger adults, while greater lean mass was linked to stronger bones, according to a new study published in the Journal of Clinical Endocrinology & Metabolism.

Researchers have long known that there are links between metabolic health — like body composition and blood glucose control — and bone health. Higher blood glucose levels have been linked to a higher risk for bone fractures in people with type 2 diabetes, with one study finding that blood glucose control was the single biggest modifiable risk factor for bone fractures in people with type 2. Obese men with type 2 diabetes have also been shown to have reduced bone strength, compared with men without diabetes who either were or were not obese. Bone density has been linked not just to metabolic health, but also to cardiovascular health — with higher bone density linked to a lower risk for cardiovascular events like a heart attack or stroke in women. Research has also shown that in older adults, eating more protein — which can contribute to lean body mass — is linked to better bone health and a lower fracture risk.

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For the latest study, researchers looked at data from 10,814 adults ages 20 to 59 who took part in the U.S. National Health and Nutrition Examination Survey (NHANES) between 2011 and 2018. Participants’ body composition was measured through indexes of both lean mass and fat mass, and this data was compared with their total body bone mineral density. In making this comparison, the researchers adjusted for a number of other factors known to affect bone density, including age, sex, race or ethnicity, height, and smoking status.

Lean mass linked to higher bone density

The researchers found that for every single-unit increase (1 kilogram per square meter) in lean mass, participants tended to have a bone density measure, called a T score, that was 0.19 higher. At the same time, for every similar increase in fat mass, they tended to have a T score than was 0.10 lower — demonstrating a significant effect of both lean and fat mass on bone density. The link between greater fat mass and lower bone density was especially apparent after adjusting for how much lean mass participants had — which means that if someone had high amounts of both lean and fat mass, the effect of the fat mass on lowering bone density would be expected to be less than if someone had a high amount of fat mass but no similar increase in lean mass.

The relationship between lean mass and bone density was similar in men and women, but fat mass was more strongly linked to bone density in men than in women. While each single-unit increase in fat mass was linked to a T score than was 0.13 lower in men, a similar increase in fat mass was linked to a T score decrease of only 0.08 in women.

“Our results emphasize the importance of bone health in obesity and may explain site-specific increases in fracture rates in some studies of obese subjects,” the researchers wrote. But it’s still not clear exactly why different types of body mass are linked to higher or lower bone density, or why these relationships appear to be different in men and women. Future research may lead to a better understanding of what’s going on inside the body that leads to higher or lower bone density in these cases — and possibly also to treatments for low bone density that are targeted to people with different body compositions.

Want to learn more about maintaining healthy bones? Read “Better Bone Health With Diabetes,” “Boost Your Bone Health,” and “Diabetes, Bones.”

Quinn Phillips

Quinn Phillips

Quinn Phillips on social media

A freelance health writer and editor based in Wisconsin, Phillips has a degree from Harvard University. He is a former Editorial Assistant for Diabetes Self-Management and has years of experience covering diabetes and related health conditions. Phillips writes on a variety of topics, but is especially interested in the intersection of health and public policy.

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