Influence of adipose tissue mass on bone mass in an overweight or obese population: systematic review and meta-analysis

Context: The scientific literature shows conflicting evidence about the relationship between adiposity and bone mass in overweight and obese populations. Objective: The aim of this review was to quantify the correlation between adipose mass (absolute and relative) and bone mineral density (BMD) in overweight and obese populations. Data Sources: Three databases were searched electronically. In addition, reference lists of relevant articles were screened. Study Selection: A total of 16 studies, comprising 2587 participants and 75 correlation coefficients were selected for inclusion in the review. Data Extraction: Data were extracted from each study using a standardized form. Results: Multilevel modeling indicated opposing relationships between BMD and adiposity: absolute adiposity correlated positively, and relative adiposity negatively, with BMD. Sex and age were the primary moderators of these relationships. Strong evidence supported a negative relationship between relative adipose mass and BMD in men (R = −0.37; 95%CI, −0.57 to −0.12) and in those aged less than 25 years (R = −0.28; 95%CI, −0.45 to −0.08). Conclusion: To prevent bone loss in overweight and obese populations, nutrition- and exercise-based interventions that focus on a controlled reduction of adipose mass with concomitant preservation of lean mass are recommended. Systematic Review Registration: PROSPERO no. CRD42015024313.