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Gaining And Losing Weight Linked With Increased Fracture Risk

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Both weight gain and weight loss can put older women at greater risk of fracture, but in different parts of the body, a new study suggests.

The findings challenge the traditional view that weight gain protects against fractures, according to the paper published in the British Medical Journal.

The research included data on over 120,000 healthy post-menopausal women who were followed for an average of 11 years.

Each year, participants were weighed and asked to report fractures of the upper limb (hand, wrist, elbow, upper arm, shoulder), lower limb (foot, knee, upper leg except hip, ankle), and central body (hip, pelvis and spine). Each woman´s body weight was categorised as stable (a change of less than 5% from initial weight), weight loss (a decrease of 5% or more since initial examination), or weight gain (an increase of 5% or more since initial examination).

Results at the third annual visit showed that, compared with stable weight, weight loss was associated with a 65% increase in hip fracture, a 9% increase in upper limb fracture and a 30% increase in central body fracture.

Weight gain was associated with a 10% increase in upper limb fractures and an 18% increase in lower limb fractures, but no difference in central body fractures, compared with women who had stable weight.

The researchers also wanted to understand how fracture patterns differ after intentional and unintentional weight loss in post-menopausal women. They found that, compared with stable weight, unintentional weight loss was associated with an increased risk of hip and spine fractures, whereas intentional weight loss was associated with an increased risk of lower limb fractures, but a decreased risk of hip fractures.

“Clinicians should be aware that even intentional weight loss is associated with increased rates of lower limb fractures. Weight loss intervention trials should consider potential effects on the incidence of fracture,” the researchers concluded.

An accompanying editorial by Juliet Compston, emeritus professor of bone medicine at Cambridge University, said that the increase in fracture risk “emphasises the need for measures to prevent bone loss during interventions to reduce weight.”

She added: “Exercise training programmes provide one such approach and warrant further investigation.”