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American Journal of Epidemiology Advance Access originally published online on January 27, 2009
American Journal of Epidemiology 2009 169(7):877-886; doi:10.1093/aje/kwn407
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American Journal of Epidemiology © The Author 2009. Published by the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org.

ORIGINAL CONTRIBUTIONS

Lifestyle Impact on Lifetime Bone Loss in Women and Men

The Tromsø Study

Tom Wilsgaard, Nina Emaus, Luai Awad Ahmed, Guri Grimnes, Ragnar Martin Joakimsen, Tone Kristin Omsland and Gro Rosvold Berntsen

Correspondence to Dr. Tom Wilsgaard, Institute of Community Medicine, University of Tromsø, NO-9037 Tromsø, Norway (e-mail: tom.wilsgaard{at}ism.uit.no).

Received for publication October 10, 2008. Accepted for publication December 11, 2008.

A physically active, nonsmoking lifestyle with weight maintenance positively influences bone health. The authors estimated the effect of lifestyles on peak bone mass and lifetime bone loss in the Tromsø Study, Norway. Bone mineral density (BMD) was measured at distal and ultradistal forearm sites with single x-ray absorptiometric devices in 7,948 men and women aged 24–84 years in 1994–1995 and repeated in 2001 in 6,182 subjects. BMD was significantly higher at peak than at old age. However, the difference, estimated as lifetime loss, varied between lifestyle groups. Lifetime loss in nonsmoking, physically active men with a body mass index of 25 kg/m2 compared with smoking, inactive, and lean men was 15.9% and 25.9% at the distal site and 17.5% and 29.7% at the ultradistal site, respectively. In women, the corresponding loss estimates were 34.4% and 45.7% and 35.6% and 55.7%, respectively. The differences in BMD at the age of 80 years correspond to an increased forearm fracture risk of 69% in men and 85% in women with greatest bone loss. A lifestyle including nonsmoking, a high physical activity level, and a high body weight reduces bone loss and fracture risk in both sexes, with increasing effect from peak bone mass to old age.

bone density; densitometry; follow-up studies; life style; longitudinal studies; osteoporosis

Abbreviations: BMD, bone mineral density; BMI, body mass index


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