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Gender & Obesity Effects on Bone Mineral Density

Men with obesity can experience a negative association with a bone mineral density even more so than women. 
It is conventionally believed that being overweight or obese denoted by having high bone mineral density (BMD) may decrease the chance of getting osteoporosis. This protective effect is called the "obesity paradox", in which obesity in patients with several chronic diseases and fractures may be protective. However, if it is based on the percentage of body fat, specifically abdominal fat, this theory has been challenged. Some studies find that fat mass on the abdomen may be a risk factor, as are other comorbidities of obesity, such as developing several kinds of health problems, all types of diabetes, liver problems, and reduced high-density lipoprotein cholesterol. 
Bone mineral density (BMD) is used to diagnose a person to have osteoporosis. These findings suggest that people with obesity, both men and women, could benefit from osteoporosis screenings. For simplicity, an increase in body weight, like in obese people, also increases BMD, which is good for the bones.  While a reduction in body weight is associated with low BMD and poor bone health, the denser the bones are, the stronger they are and less likely to break, which has a negative result for osteoporosis. 
The current study is based on BMD and body composition data from over 10,000 people from the National Health and Nutrition Examination Survey. It is concluded that there was a strong positive link between lean mass and bone mineral density both in men and women, but research discloses that men with high levels of fat have a high BMD compared to normal weighted men, even more so than in women, particularly during the post-menopausal stage. Fortunately for men, decreased bone mass occurs more slowly than it does in women until around the age of 65. A prompt diagnosis takes on added importance if other risk factors are involved. For men, this includes age, family history, previous fractures, loss of height, and use of certain medications, including steroids, anti-depressants, and treatments for prostate cancer, among others. 
Conflicting views on the studies of bone microarchitecture and the role of obesity can cause confusion. Based on studies, weight loss is associated with bone loss. In recommending weight loss to the patient, the case of each one and the risk factor identified herein should be considered. Some data indicates intentional weight loss can result in negative skeletal health outcomes, though this appears specific to older adults with obesity. On the other hand, more recent evidence recommends strength training in combination with caloric restriction as a means of mitigating bone and muscle loss. A comprehensive Very Low-Calorie Diet (VLCD) could make a patient lose about three to five pounds per week. This weight loss can improve fast serious health conditions such as diabetes, hypertension, and high cholesterol, including complications associated with osteoporosis. 


Condensed from Robard Corporation article by Andrea M Pampaloni, Ph.D: How is Bone Mineral Density Affected by Gender & Obesity


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