Abdominal fat linked to low bone density

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  • Contrary to the notion that higher-BMI people enjoy some protection from osteoporosis, abdominal fat may be an independent risk factor for low bone mineral density (BMD).
  • Fat distribution, not just BMI, should be taken into account with measures like waist circumference.

Why this matters

  • Despite NHANES data suggesting a protective effect of higher BMI against osteoporosis, the relationship between fat distribution and skeletal health remains unclear.

Key results

  • BMI and whole-body and lumbar BMD were positively correlated (P<.001 and P<.001).
  • However, abdominal adiposity was significantly negatively associated with lumbar and whole-body BMD, despite adjustment for age, race, BMI, and physical activity (whole-body [men], P<.001; lumbar [men], P<.001; whole-body [women], P=.040; lumbar [women], P=.011).

Study design

  • 5268 adults from NHANES 2003/2004 and 2005/2006 underwent assessment of BMI, adiposity, objectively measured physical activity, and whole-body and lumbar BMD.
  • Funding: None.


  • Cross-sectional study does not reveal causal relationships.
  • Lean mass, hip BMD, and nutritional status not assessed.