Mediterranean Diet and Exercise Boost Bone Health in Seniors

TOPLINE:

Compared with a conventional ad libitum Mediterranean diet, an energy-restricted Mediterranean diet along with physical activity helped preserve bone mineral density (BMD) during weight loss in older women with metabolic syndrome, showing the most benefits at the lumbar level over a 3-year period.

METHODOLOGY:

• Individuals with obesity and older adults exhibit increased vulnerability to osteoporotic fractures; therefore, weight-loss strategies should consider the effects of diet and physical activity on bone health.
• Researchers conducted a secondary analysis of the PREDIMED-Plus trial to evaluate the effects of an energy-reduced Mediterranean diet combined with physical activity on age-related BMD, bone mineral content (BMC), and low BMD prevalence in older adults with metabolic syndrome and overweight or obesity.
• The study included 924 individuals aged 55-75 years (49.1% women) from four centers in Spain randomly assigned to either an intervention group following an energy-reduced Mediterranean diet and increased physical activity or a control group following an ad libitum Mediterranean diet with no specific physical activity recommendations.
• Participants were required to meet at least three criteria for metabolic syndrome as defined by the International Diabetes Federation and other organizations: Hypertension; high triglyceride, low high-density lipoprotein, and high fasting glucose levels; and central obesity.
• BMD (measured at the total femur, lumbar spine [L1-L4], and femoral trochanter) and total BMC were determined using dual-energy x-ray absorptiometry scanners at baseline, 1 year, and 3 years.

TAKEAWAY:

• The reduction in total body weight was greater in the intervention group than in the control group over 3 years, with between-group differences of −2.8 kg (95% CI, −3.3 to −2.2 kg) after 1 year and −2.2 kg (95% CI, −2.7 to −1.6 kg) after 3 years.
• The intervention group experienced an increase in BMD in the lumbar spine compared with the control group, with a between-group difference of 0.9 g/cm² (95% CI, 0.1-1.8 g/cm²) after 3 years.
• A protective effect of the intervention on BMD was observed in women, with a between-group difference of 1.8 g/cm² (95% CI, 0.6-2.9 g/cm²) after 3 years ; no significant effects were seen in men.
• The intervention showed no effect on the total BMC, and the prevalence of low BMD remained unchanged over 3 years.

IN PRACTICE:

“These findings support the use of weight-loss lifestyle interventions based on an energy-reduced Mediterranean diet and physical activity promotion for older women at risk of bone disturbances as a feasible strategy to preserve the effects of possible concomitant weight loss on age-related decreases in BMD decline,” the authors wrote.

SOURCE:

This study was led by Hector Vazquez-Lorente, PhD, and Jesus F. Garcia-Gavilan, PhD, from the Universitat Rovira i Virgili, Reus, Spain. It was published online on April 8, 2025, in JAMA Network Open.

LIMITATIONS:

This study was based on a subsample of individuals who agreed to participate in dual-energy x-ray absorptiometry measurements. Results may have limited generalizability beyond the studied population. There were some losses to follow-up resulting in missing data. Data on femoral neck BMD were not obtained through dual-energy x-ray absorptiometry measurements.

DISCLOSURES:

This study was supported by grants from the official Spanish institutions for funding scientific biomedical research, Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición, and Instituto de Salud Carlos III through the Fondo de Investigacón para la Salud. Additional funding came from the European Research Council, Recercaixa, and other sources. Some authors received grants, travel reimbursement, consulting fees, and nonfinancial support and declared having other ties with the Ministry of Universities of Spain, and several pharmaceutical companies and institutions.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.