Jiang Bryan C, Villareal Dennis T
a Center for Translational Research in Inflammatory Diseases (CTRID) , Michael E DeBakey VA Medical Center , Houston , TX , USA.
b Department of Medicine-Endocrinology, Metabolism, and Diabetes , Baylor College of Medicine , Houston , TX , USA.
J Nutr Gerontol Geriatr. 2019 Jan-Mar;38(1):100-114. doi: 10.1080/21551197.2018.1564721. Epub 2019 Feb 22.
Obesity in older adults is a growing public health problem, yet the appropriate treatment remains controversial partly due to evidence that weight loss reduces bone mass and may increase fracture risk. The purpose of this review is to summarize the research to date on the effects of diet-induced weight loss on bone health in obese (body mass index 30 kg/m and above) older (aged 65 years or older) adults. Observational studies have shown that weight loss in this population decreases total hip bone mineral density and increases the risk of frailty fractures (composite of proximal femur, pelvis, and proximal humerus fractures). Randomized controlled trials have largely confirmed these earlier observations but have also shown that exercise, particularly progressive resistance training, can attenuate or even alleviate this bone loss. Further research incorporating outcomes concerning bone quality and mass are needed to identify the optimal exercise and nutritional regimens to counteract the bone loss.
老年人肥胖是一个日益严重的公共卫生问题，但由于有证据表明体重减轻会降低骨量并可能增加骨折风险，因此适当的治疗方法仍存在争议。本综述的目的是总结迄今为止关于饮食诱导的体重减轻对肥胖（体重指数30kg/m及以上）老年人（65岁及以上）骨骼健康影响的研究。观察性研究表明，该人群体重减轻会降低全髋骨矿物质密度，并增加脆性骨折（股骨近端、骨盆和肱骨近端骨折的综合）风险。随机对照试验在很大程度上证实了这些早期观察结果，但也表明运动，尤其是渐进性抗阻训练，可以减轻甚至缓解这种骨质流失。需要进一步开展纳入有关骨质量和骨量结果的研究，以确定抵消骨质流失的最佳运动和营养方案。
