The authors declare that they have no competing interests.
TRS participated in the design of the study and was involved in the data collection and analysis, and drafted the article. RF and MAM were involved in the data collection. PMS conceived the study, participated in its design and coordination, was involved in the data analysis and helped to draft the manuscript. All authors read and approved the final manuscript.
The aim of this study was to investigate whether body composition, dietary pattern and habitual physical activity are associated with BMD according to time since menopause in women from Southern Brazil with no clinical evidence of disease.
99 participants were enrolled and anthropometry, body composition and BMD by dual energy x-ray absorptiometry, rest metabolic rate by indirect calorimetry, dietary pattern by semi quantitative food frequency questionnaire and habitual physical activity by pedometer were performed.
Mean age was 55.2 ± 4.9 years and mean time since menopause was 6.8 ± 1.0 years. Weight, BMI, lean and fat mass and RMR were higher in women with less than 5 years since menopause with normal versus low bone mass. No differences were found in the studied variables between participants with normal or low bone mass and more than 5 years of menopause. Women with > 5 years since menopause had higher prevalence of osteoporosis, as well as lower BMD in all sites when compared to those with less time since menopause. Calories, carbohydrate, protein, fat and micronutrients intake were similar between groups. When the sample was adjusted for time since menopause, the odds ratio (OR) for low bone mass was 5.21 (95 % CI 1.57–17.25, P = 0.004) for BMI <25 kg/m2, for lean mass <37.5 Kg an OR of 4.4 (95 % CI 1.64–11.80, P = 0.004, for fat mass <26.0 Kg an OR of 3.39 (95 % CI 1.29–8.85, P = 0.010) and for the intake of vitamin A < 700 mcg/day an OR of 3.00 (95 % CI 1.13–7.94, P = 0.012). Low meat and eggs intake or low protein intake did not influence the odds ratio for low bone mass.
In this cross-sectional study with postmenopausal women with no clinical evidence of disease, time since menopause, low lean and fat mass were associated with low bone mass. Calories and macronutrients intake as well as habitual physical activity did not interfere with BMD, but participants were mostly sedentary. Further studies are needed in order to determine whether the adequate intake of specific food groups and the type of physical activity could attenuate the time since menopause impact on BMD.
The North American Menopause Society. Management of osteoporosis in postmenopausal women. Menopause. 2010;17:25–54. CrossRef
DIPART (Vitamin D Individual Patient Analysis of Randomized Trials) Group. Patient level pooled analysis of 68500 patientes from seven major vitamin D fracture trials in US and Europe. BMJ. 2010;340:b5463. CrossRef
Avenell A, Gillespie WJ, Gillespie LD, O’Connell D. Vitamin D and vitamin D analogues for preventing fractures associated with involutional and post-menopausal osteoporosis. Cochrane Dataset Syst Rev. 2009;2, CD000227.
Bischoff-Ferrari HA, Dawson-Hughes B, Baron JA, Burckhardt P, Li R, Spiegelman D, et al. Calcium intake and hip fracture risk in men and women: a meta-analysis of prospective cohort studies and randomized controlled trials. Am J Clin Nutr. 2007;86:1780–90. PubMed
Macdonald HM, New SA, Golden MH, Campbell MK, Reid DM. Nutritional associations with bone loss during the menopausal transition: evidence of a beneficial effect of calcium, alcohol, and fruit and vegetable nutrients and of a detrimental effect of fatty acids. Am J Clin Nutr. 2004;79:155–65. PubMed
Center for Studies and Research in Food: Brazilian table of food composition. Campinas: NEPA-UNICAMP; 2011. http://www.unicamp.br/nepa/taco/contar/taco_4_edicao_ampliada_e_revisada
Fernandes CE, Pinho-Neto JSL, Gebara OCE, Santos Filho RD, Pinto Neto AM. I Diretriz Brasileira sobre Prevenção de Doenças Cardiovasculares em Mulheres Climatéricas e a Influência da Terapia de Reposição Hormonal (TRH) da Sociedade Brasileira de Cardiologia (SBC) e da Associação Brasileira do Climatério (SOBRAC). Arq Bras Cardiol. 2008;91 Suppl 1:1–23.
Colpani V, Oppermann K, Spritzer PM. Association between habitual physical activity and lower cardiovascular risk in premenopausal, perimenopausal, and postmenopausal women: a population-based study. Menopause. 2013;20:525–31. PubMed
Sheng Z, Xu K, Ou Y, Dai R, Luo X, Liu S, et al. Relationship of body composition with prevalence of osteoporosis in central south Chinese postmenopausal women. Clin Endocrinol. 2011;74:319–24. CrossRef
Pouilles JM, Tremollieres F, Ribot C. Vertebral bone loss in perimenopause: results of a 7-year longitudinal study. Presse Med. 1996;25:277–80. PubMed
Reid IR, Ames R, Evans MC, Sharpe S, Gamble G, France JT, et al. Determinants of total body and regional bone mineral density in normal postmenopausal women-a key role for fat mass. J Clin Endocrinol Metab. 1992;75(1):45–51. PubMed
Doyle-Lucas AF, Akers JD, Davy BM. Energetic efficiency, menstrual irregularity, and bone mineral density in elite professional female ballet dancers. J Dance Med Sci. 2010;14:146–54. PubMed
Hodson L, Harnden K, Banerjee R, Real B, Marinou K, Karpe K, et al. Lower resting and total energy expenditure in postmenopausal compared with premenopausal women matched for abdominal obesity. J Nutr Sci. 2014;3(e3):1–9.
Warensjo E, Byberg L, Melhus H, Gedeborg R, Mallmin H, Wolk A, et al. Dietary calcium intake and risk of fracture and osteoporosis: prospective longitudinal cohort study. BMJ. 2011;342:d1473.o. CrossRef
Heaney RP, Layman DK. Amount and type of protein influences bone health. Am J Clin Nutr. 2008;87 Suppl 5:1567–70.
Wattanapenpaiboon N, Lukito W, Wahlqvist ML, Strauss BJ. Dietary carotenoid intake as a predictor of bone mineral density. Asia Pac J Clin Nutr. 2003;12(4):467–73. PubMed
- Associations between body composition and lifestyle factors with bone mineral density according to time since menopause in women from Southern Brazil: a cross-sectional study
Thaís R. Silva
Maria A. Maturana
Poli M. Spritzer
- BioMed Central
Neu im Fachgebiet Innere Medizin
Meistgelesene Bücher aus der Inneren Medizin
Mail Icon II