How Obesity Increases a Woman's Risk of Bone Fractures
How Obesity Increases a Woman’s Risk of Bone Fractures

recent study has concluded that obesity increases a woman's risk of bone fractures. In this study, 20,000 overweight patients between the ages of 40 and 70 were followed for seven years. 

This study found that 497 (2.48%) women suffered a fracture compared to 323 (1.62%) men. "There were 415 major osteoporotic fractures (hip, spine, wrist or leg), 260 in women and 155 in men. There were 353 leg fractures (ankle, foot, shin), 219 in women and 134 in men. There were 203 arm fractures (wrist, forearm or elbow), 141 in women and 62 in men." - U.S. News & World Report

Not surprisingly, women with a larger waist circumference, implying a higher BMI, had an increased risk of bone fractures. For every two inches of waist circumference, the fracture rate increased by 3% to 7%. Compared to their counterpart, there was no significant correlation between waist circumference/BMI and fracture rate in men. 

Why Obesity Increases a Woman's Risk of Bone Fractures

Evidence has been presented that shows a connection between obesity and fracture rate. Although the exact means by which obesity increases a woman's risk of bone fractures is unclear, it is believed to be a result of many factors. These include body weight, fat mass, bone resorption (the process by which cells break down tissue in bones), the prevalence of inflammatory cytokines, oxidative stress, and vitamin deficiencies. 

Similarly, findings show a link between fat intake/fat mass and a patient's fracture rate. Fat mass is proven to increase adipogenesis, the process by which fat cells develop and accumulate as adipose tissue at various sites in the body. And adipogenesis reduces bone mass in obese individuals. 

Obesity is a complex disease that affects many aspects of the body, leading to a deterioration in health. Although bone health is affected by fat intake, nutritional deficiencies can also play a role in fracture rates. Calcium and vitamin D, which affect bone health, are two nutritional deficiencies in obese patients.

The Impact of Calcium and Vitamin D on Bone Health

Calcium and Vitamin D are two common vitamin deficiencies in obese patients. Calcium is the most abundant mineral in the body and supports bone health, blood vessels, muscle function, hormone secretion, and nerve transmission. Patients who are calcium deficient may experience muscle aches, fatigue, dental problems, and bone breakage.

Vitamin D is essential for promoting calcium absorption, immunity, and cellular function. Vitamin D is found in very few foods and is absorbed from the sun through the skin. Patients who are vitamin D deficient may experience bone or muscle pain and chronic cramping or body aches.

Calcium and vitamin D work together to support your bones. In obese patients, when nutritional needs are not met, there is an increased risk of long-term vitamin deficiencies. These include the risk of calcium and vitamin D, ultimately impacting bone health. 

Women are more likely to be calcium deficient compared to men. This is especially true in women with dysregulated estrogen levels, which play a vital role in calcium absorption. As discussed previously, obesity can lead to estrogen dysregulation. Therefore, it is likely that obesity increases a woman's risk of bone fractures due to impaired calcium absorption. 

Although the exact correlation between obesity and bone health is not precisely known, it is understood to be a complex array of issues requiring further research to determine how obesity increases a woman's risk of bone fracture. 

Mike Blaney, MD
Dr. Mike Blaney is a board-certified surgeon with over 20 years of experience in general and bariatric surgery. He is the founding physician of Live Healthy MD which has since been acquired by HCA and now operates under the name Doctors Specialists – Bariatrics and Surgical. Dr. Blaney is co-founder and CEO of Bariatric Centers of America and is fueled by a passion to cure the disease of obesity.
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