Soft tissues and bone health in sedentary women: A cross-sectional study


  • Esther Ubago-Guisado University of Castilla-La Mancha, Spain
  • Javier Sánchez-Sánchez University of Castilla-La Mancha European University, Spain
  • Sara Vila-Maldonado University of Castilla-La Mancha, Spain
  • Leonor Gallardo University of Castilla-La Mancha, Spain



Bone mass, DXA, Menopause, Osteoporosis


Lean mass is a strong determinant of bone mass, however, there is controversial surrounding the role of fat mass. The aim of this study was to examine the association between lean mass and fat mass with bone mass in middle-aged sedentary women, including relevant covariates. A cross-sectional study was performed on a total of 55 healthy and sedentary women. Dual energy x-ray absorptiometry was used to measure bone mineral content and areal bone mineral density at the whole body, lumbar spine and hip. The relationships between lean and fat mass with bone outcomes were analysed using three regression models: model 0 using unadjusted data, model 1 was adjusted by age and stature and model 2 added lean mass or fat mass (depending on the predictor). Lean mass was positively associated with most bone mineral content and areal bone mineral density outcomes in models 0 and 1, and the majority of these associations remained significant in model 2 (after adjusted by fat mass). Fat mass was positively associated with some of the bone mineral content and areal bone mineral density outcomes in models 0 and 1, and interestingly all associations disappeared in model 2 (after adjusted by lean mass). The main finding of this study was that lean mass was positively related to bone outcomes, independent of age, stature and fat mass in middle-aged sedentary women. In addition, the association between fat mass and bone outcomes seems to be explained by lean mass.


European University of Madrid (Spain)


Download data is not yet available.


Ahmad, T., Chasman, D. I., Mora, S., Pare, G., Cook, N. R., Buring, J. E., . . . Lee, I. M. (2010). The Fat-Mass and Obesity-Associated (FTO) gene, physical activity, and risk of incident cardiovascular events in white women. Am Heart J, 160(6), 1163-1169.

Benetos, A., Zervoudaki, A., Kearney-Schwartz, A., Perret-Guillaume, C., Pascal-Vigneron, V., Lacolley, P., . . . Weryha, G. (2009). Effects of lean and fat mass on bone mineral density and arterial stiffness in elderly men. Osteoporos Int, 20(8), 1385-1391.

Capozza, R. F., Cointry, G. R., Cure-Ramirez, P., Ferretti, J. L., & Cure-Cure, C. (2004). A DXA study of muscle-bone relationships in the whole body and limbs of 2512 normal men and pre- and post-menopausal women. Bone, 35(1), 283-295.

Center, J. R., Nguyen, T. V., Schneider, D., Sambrook, P. N., & Eisman, J. A. (1999). Mortality after all major types of osteoporotic fracture in men and women: an observational study. The Lancet, 353(9156), 878-882.

Cruz, J. G., Martínez, R. F., Martínez, J. G., Gutiérrez, E. S., Serrano, M. E., & De las Deses, C. D. H. (2009). Osteoporosis. Conceptos básicos para la práctica diaria. Rev Esp Med Quir, 14(3), 128-140.

Chen, Z., Lohman, T. G., Stini, W. A., Ritenbaugh, C., & Aickin, M. (1997). Fat or lean tissue mass: which one is the major determinant of bone mineral mass in healthy postmenopausal women? J Bone Miner Res, 12(1), 144-151.

Douchi, T., Matsuo, T., Uto, H., Kuwahata, T., Oki, T., & Nagata, Y. (2003). Lean body mass and bone mineral density in physically exercising postmenopausal women. Maturitas, 45(3), 185-190.

Forwood, M. R., & Larsen, J. A. (2000). Exercise recommendations for osteoporosis. A position statement of the Australian and New Zealand Bone and Mineral Society. Aust Fam Physician, 29(8), 761-764.

Gerdhem, P., Ringsberg, K. A., Akesson, K., & Obrant, K. J. (2003). Influence of muscle strength, physical activity and weight on bone mass in a population-based sample of 1004 elderly women. Osteoporos Int, 14(9), 768-772.

Gjesdal, C. G., Halse, J. I., Eide, G. E., Brun, J. G., & Tell, G. S. (2008). Impact of lean mass and fat mass on bone mineral density: The Hordaland Health Study. Maturitas, 59(2), 191-200.

Gnudi, S., Sitta, E., & Fiumi, N. (2007). Relationship between body composition and bone mineral density in women with and without osteoporosis: relative contribution of lean and fat mass. J Bone Miner Metab, 25(5), 326-332.

Gómez-Cabello, A., Ara, I., González-Agüero, A., Casajús, J. A., & Vicente-Rodríguez, G. (2013). Fat mass influence on bone mass is mediated by the independent association between lean mass and bone mass among elderly women: A cross-sectional study. Maturitas, 74(1), 44-53.

Gómez-Cabello, A., Vicente-Rodríguez, G., Pindado, M., Vila, S., Casajús, J. A., Pradas de la Fuente, F., & Ara, I. (2012). Mayor riesgo de obesidad y obesidad central en mujeres post-menopáusicas sedentarias. Nutr Hosp, 27(3), 865-870.

Gullberg, B., Johnell, O., & Kanis, J. A. (1997). World-wide projections for hip fracture. Osteoporos Int, 7(5), 407-413.

Ho-Pham, L. T., Nguyen, U. D. T., & Nguyen, T. V. (2014). Association between lean mass, fat mass, and bone mineral density: a meta-analysis. J Clin Endocrinol Metab, 99(1), 30-38.

Hsu, Y. H., Venners, S. A., Terwedow, H. A., Feng, Y., Niu, T., Li, Z., . . . Xu, X. (2006). Relation of body composition, fat mass, and serum lipids to osteoporotic fractures and bone mineral density in Chinese men and women. Am J Clin Nutr, 83(1), 146-154.

Ijuin, M., Douchi, T., Matsuo, T., Yamamoto, S., Uto, H., & Nagata, Y. (2002). Difference in the effects of body composition on bone mineral density between pre-and postmenopausal women. Maturitas, 43(4), 239-244.

Khosla, S., Atkinson, E. J., Riggs, B. L., & Melton, L. J. (1996). Relationship between body composition and bone mass in women. J Bone Miner Res, 11(6), 857-863.

Kontulainen, S., Heinonen, A., Kannus, P., Pasanen, M., Sievanen, H., & Vuori, I. (2004). Former exercisers of an 18-month intervention display residual aBMD benefits compared with control women 3.5 years post-intervention: a follow-up of a randomized controlled high-impact trial. Osteoporos Int, 15(3), 248-251.

Li, S., Wagner, R., Holm, K., Lehotsky, J., & Zinaman, M. J. (2004). Relationship between soft tissue body composition and bone mass in perimenopausal women. Maturitas, 47(2), 99-105.

Lindsay, R., Cosman, F., Herrington, B. S., & Himmelstein, S. (1992). Bone mass and body composition in normal women. J Bone Miner Res, 7(1), 55-63.

MacInnis, R. J., Cassar, C., Nowson, C. A., Paton, L. M., Flicker, L., Hopper, J. L., . . . Wark, J. D. (2003). Determinants of bone density in 30- to 65-year-old women: a co-twin study. J Bone Miner Res, 18(9), 1650-1656.

Makovey, J., Naganathan, V., & Sambrook, P. (2005). Gender differences in relationships between body composition components, their distribution and bone mineral density: a cross-sectional opposite sex twin study. Osteoporos Int, 16(12), 1495-1505.

Rauch, F., Bailey, D. A., Baxter-Jones, A. D., Mirwald, R., & Faulkner, R. A. (2004). The 'muscle-bone unit'during the pubertal growth spurt. Bone, 34(5), 771-775.

Reid, I. R., Ames, R., Evans, M. C., Sharpe, S., Gamble, G., France, J. T., . . . Cundy, T. F. (1992). Determinants of total body and regional bone mineral density in normal postmenopausal women--a key role for fat mass. J Clin Endocrinol Metab, 75(1), 45-51.

Reid, I. R., Legge, M., Stapleton, J. P., Evans, M. C., & Grey, A. B. (1995). Regular exercise dissociates fat mass and bone density in premenopausal women. J Clin Endocrinol Metab, 80(6), 1764-1768.

Reppe, S., Refvem, H., Gautvik, V. T., Olstad, O. K., Hovring, P. I., Reinholt, F. P., . . . Gautvik, K. M. (2010). Eight genes are highly associated with BMD variation in postmenopausal Caucasian women. Bone, 46(3), 604-612.

Robbins, J., Aragaki, A. K., Kooperberg, C., Watts, N., Wactawski-Wende, J., Jackson, R. D., . . . Cauley, J. (2007). Factors associated with 5-year risk of hip fracture in postmenopausal women. JAMA, 298(20), 2389-2398.

Schoenau, E., & Frost, H. M. (2002). The "muscle-bone unit" in children and adolescents. Calcif Tissue Int, 70(5), 405-407.

Taaffe, D. R., Cauley, J. A., Danielson, M., Nevitt, M. C., Lang, T. F., Bauer, D. C., & Harris, T. B. (2001). Race and sex effects on the association between muscle strength, soft tissue, and bone mineral density in healthy elders: the Health, Aging, and Body Composition Study. J Bone Miner Res, 16(7), 1343-1352.

Travison, T. G., Araujo, A. B., Esche, G. R., Beck, T. J., & McKinlay, J. B. (2008). Lean mass and not fat mass is associated with male proximal femur strength. J Bone Miner Res, 23(2), 189-198.

Vicente-Rodríguez, G., Urzanqui, A., Mesana, M. I., Ortega, F. B., Ruiz, J. R., Ezquerra, J., . . . Gonzalez-Gross, M. (2008). Physical fitness effect on bone mass is mediated by the independent association between lean mass and bone mass through adolescence: a cross-sectional study. J Bone Miner Metab, 26(3), 288-294.

Wallace, B. A., & Cumming, R. G. (2000). Systematic review of randomized trials of the effect of exercise on bone mass in pre-and postmenopausal women. Calcif Tissue Int, 67(1), 10-18.

Wang, M. C., Bachrach, L. K., Van Loan, M., Hudes, M., Flegal, K. M., & Crawford, P. B. (2005). The relative contributions of lean tissue mass and fat mass to bone density in young women. Bone, 37(4), 474-481.

Wolff, I., Van Croonenborg, J. J., Kemper, H. C. G., Kostense, P. J., & Twisk, J. W. R. (1999). The effect of exercise training programs on bone mass: a meta-analysis of published controlled trials in pre- and postmenopausal women. Osteoporos Int, 9(1), 1-12.

World Health Organization. (2010). Global recommendations on physical activity for health. Ginebra: World Health Organization.

Yoo, H. J., Park, M. S., Yang, S. J., Kim, T. N., Lim, K. I., Kang, H. J., . . . Choi, K. M. (2012). The differential relationship between fat mass and bone mineral density by gender and menopausal status. J Bone Miner Metab, 30(1), 47-53.

Zhao, L. J., Jiang, H., Papasian, C. J., Maulik, D., Drees, B., Hamilton, J., & Deng, H. W. (2008). Correlation of obesity and osteoporosis: effect of fat mass on the determination of osteoporosis. J Bone Miner Res, 23(1), 17-29.

Zhao, L. J., Liu, Y. J., Liu, P. Y., Hamilton, J., Recker, R. R., & Deng, H. W. (2007). Relationship of obesity with osteoporosis. J Clin Endocrinol Metab, 92(5), 1640-1646.

Zhao, R., Zhao, M., & Zhang, L. (2014). Efficiency of jumping exercise in improving bone mineral density among premenopausal women: a meta-analysis. Sports Med, 44(10), 1393-1402.


Statistics RUA



How to Cite

Ubago-Guisado, E., Sánchez-Sánchez, J., Vila-Maldonado, S., & Gallardo, L. (2019). Soft tissues and bone health in sedentary women: A cross-sectional study. Journal of Human Sport and Exercise, 14(2), 469–479.



Sport Medicine, Nutrition & Health

Most read articles by the same author(s)