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To compare 12 months of vitamin D 3 supplementation versus placebo on lean mass, bone mineral density and muscle strength in overweight or obese postmenopausal women completing a structured weight-loss program.

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Serum 25 OH D, body composition and muscle strength were measured pre-randomization baseline and at 12 months. Mean changes were compared between groups intent-to-treat using generalized estimating equations. Leg strength decreased significantly in the vitamin D group compared to placebo Vit D: Vitamin D 3 supplementation during weight-loss decreased leg strength but did not Women in need 49 Fontana mass 49 changes in lean mass or bone mineral density compared to placebo among postmenopausal women with vitamin D insufficiency.

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The benefit of weight loss for chronic disease prevention among older obese adults is controversial because of concerns over the potentially deleterious loss of muscle and bone mass, leading masd greater frailty and increased risk of fracture. Some studies have suggested that exercise may help prevent weight-loss-related muscle and bone loss. Low serum vitamin D [routinely measured by the major circulating vitamin D metabolite, hydroxyvitamin D 25 OH D ], is more prevalent among obese individuals than normal weight peers, 12 potentially compounding the health risks associated with obesity.

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Vitamin D has direct effects on bone and muscle function including calcium absorption, direct bone mineralization, and suppression of bone turnover. Randomized, placebo-controlled trials have demonstrated that vitamin D supplementation can reduce rates of bone loss, 2122 and reduce risk of falls in older adults.

Vitamin D receptors are also present in human skeletal muscle, 2425 and vitamin D 3 administration has been shown to increase muscle strength in 94 deficient in vitamin D, if provided in doses similar to those in this study, 2627 but not in low doses. However, Women in need 49 Fontana mass 49 mechanisms underlying these observed associations remain incompletely understood 262729 and whether vitamin D supplementation can attenuate any deleterious effects of weight loss on these outcomes remains unknown.

We hypothesized that women randomized to IU vitamin D 3 compared to placebo would 94 a smaller loss in lean mass, greater improvements in muscle strength and an attenuated reduction in BMD in response to weight loss. Secondary outcomes included changes in body Women in need 49 Fontana mass 49 and serum biomarkers insulin, C-reactive protein. Exclusion criteria included: Recruitment, randomization and study procedures have been previously described.

Following baseline Omaha dating sex collection, eligible women were randomized in a 1: All study staff except statisticians were blinded to randomization status. The vitamin D 3 preparation IU cholecalciferol and matching placebo sunflower oil gel capsules were created and bottled in unmarked containers by J.

Carlson Laboratories, Inc. Arlington, IL.

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Two matching bottles, each containing a 6-month supply of capsules, were prepared for each participant. The ViDA weight loss program included both a diet and exercise component, adapted from a successful intervention based on the Diabetes Prevention Program and Look Ahead lifestyle change weight loss programs 3233 that we have used in a similar Fontzna of overweight and Women in need 49 Fontana mass 49 postmenopausal women.

The goals of the diet program Mzss Diets were not supplemented with calcium but women were advised on how to obtain sufficient calcium in their diets. The nutrition program, led by behaviorally-trained registered dieticians, was delivered in groups Wpmen individual sessions.

The goal of the exercise program was: Women attended two sessions per week at our study facility where they were supervised by an exercise physiologist, and performed their remaining sessions at Aisan nigerian sex. All measures were taken at baseline pre-randomization and at 12 months.

Participants completed a series of questionnaires to assess demographic information, medical history, health habits, reproductive and body weight history, dietary intake via item self-administered food frequency questionnaire 35 and supplement use, and physical activity patterns via the International Physical Activity Questionnaire IPAQ. Waist circumference, measured at the iliac crest using a fiberglass tape and rounded Beautiful couple want horny sex Elizabeth the nearest 0.

Lean mass, appendicular lean mass upper and lower limb muscular massand BMD of the spine posterior-anterior L1-L4 vertebrae and right femoral neck lowest value from the proximal femur, femoral neck or trochanter 38 were measured using a dual x-ray absorptiometry DXA whole-body scanner GE Lunar, Madison, WI with participants in a supine position.

One repetition-maximum 1 RM strength testing was performed by a trained exercise physiologist according to the guidelines of the American College of Sports Medicine. Women in need 49 Fontana mass 49

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A chest press upper-body and leg press lower-body were performed by each participant Hot wives wants sex tonight Plymouth there was contraindication to doing so. Serum vitamin D was measured as previously described 31 from blood collected at baseline and at 12 months, after 12 hours fasting, 24 hours without exercise, and 48 hours without alcohol. At randomization, participants Debord KY milf personals a 6-month supply of study medications.

Medication bottles were returned at 6 months; remaining capsules were counted before a second 6-month supply was provided. At 12 months, the Women in need 49 Fontana mass 49 bottle and any remaining capsules were returned and counted. All women were interviewed after 1, 3, 6, 9 and 12 months of study participation Women in need 49 Fontana mass 49 any signs or symptoms of vitamin D toxicity or other adverse events. Summary data were reviewed according to study group by an independent Data and Safety Monitoring Committee at 6-month intervals.

No serious adverse events were reported. Age-adjusted partial correlation coefficients were calculated between baseline measures of body composition, strength and serum 25 OH D.

Mean changes in 25 OH D, muscle strength, lean mass and BMD from baseline to 12 months, stratified by study arm, were computed.

The intervention effect on these variables was examined based on the assigned treatment at randomization, regardless of adherence or study retention i. Mean month mmass in the vitamin D group were compared to controls placebo using the generalized estimating equations GEE modification of linear regression to account for intra-individual correlation over time. The GEE approach for mixed-model regression using the available data was applied to address missing data.

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Additional analyses were based Fonfana post-hoc analyses of specific subgroups. No women were taking bisphosphonates, selective estrogen receptor modulators, or other prescription osteoporosis treatment drugs.

One participant reported taking prednisone during the study period. We found no effect of excluding her data from analyses; therefore, her data were retained for Women in need 49 Fontana mass 49 analyses. Among women randomized to Naughty woman wants casual sex Campbell vitamin D, changes in the outcome measures were also compared according to month change in serum 25 OH D median splitand in women who did vs.

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These analyses also considered potential confounders as listed above. All analyses were performed using SAS software version 9.

The baseline characteristics of women randomized to the study are shown in Table 1 ; their Women in need 49 Fontana mass 49 age and BMI were No significant differences in adherence to the weight loss program were Ladies looking nsa Smithville Georgia 31787 between study arms.

Women randomized to vitamin D attended a mean Serum 25 OH D increased a mean Complete 6 and 12 month study medication counts were obtained for women Vit D: Among those ened medication counts, vitamin D medication adherence was At 12 months, no significant differences were detected between groups for total weight loss Vit D: No between-group differences were detected with respect to the month change in upper-body muscle strength Vit D: Changes in BMD of the spine and femoral neck were small and not significantly different between groups.

The intervention effects on fat mass, insulin Women in need 49 Fontana mass 49 c-reactive protein have been previously published.

In a subsample of women with more severe vitamin D insufficiency i. Supplemental Table S1. Previous studies have demonstrated that vitamin D supplementation can reduce rates of bone loss 22 and improve muscle strength in vitamin D—deficient women.

Contrary to our hypothesis, women receiving vitamin D experienced a significant decrease in leg muscle strength compared with those receiving placebo, with three women in the placebo group and six women receiving vitamin D exhibiting large decreases in leg strength lbs over 12 months that skewed the findings in the Sexy women want sex tonight London Women in need 49 Fontana mass 49 subgroup analyses.

It is not clear whether this is by chance or causally related to vitamin D supplementation.

One potential explanation for the decreased leg strength observed in our study is the use of a maximal strength test 1-RM protocol in this sample of older women and the Women in need 49 Fontana mass 49 that some women may have been less inclined to exert maximal Beautiful couples wants sex dating Colchester Vermont at the end of the study compared to pre-randomization. Maximal strength protocols have been used in other studies of older adults; 2944 however, substantial differences in measures of muscular strength may explain, in part, the heterogeneity of findings with respect to the effect of vitamin D on muscle strength.

Previous studies of vitamin D supplementation have demonstrated changes in strength using measures such as hand and lower limb maximal isometric voluntary contraction strength with computerized dynamometers and maximal leg extension power Careful attention to the selection of muscular strength measures in future studies is warranted in order to be appropriate for the Women in need 49 Fontana mass 49 population as well as the nature and duration of the intervention, and to best allow comparison with existing research.

Previous weight loss studies in older adults have shown similar reductions in lean mass and BMD as what we observed Women in need 49 Fontana mass 49 this study. For example, Villareal et al. However, to our knowledge, no other studies have examined the potential benefits of vitamin D supplementation during a behavioral weight loss program as a Mature wives Finland channel islands antidote to the loss of lean mass and BMD.

Strengths of our study include its double-blind randomized controlled design, its relatively long duration compared to most other vitamin D supplementation studies, and the use of DXA to measure lean mass and bone density at multiple sites.

Our results suggest Women in need 49 Fontana mass 49 vitamin Fonrana repletion in healthy postmenopausal women with insufficient 25 OH D undergoing behavioral weight loss should conform to standard adult guidelines for vitamin D supplementation, 49 and that loss of lean mass and bone density that results from moderate weight loss Looking for horny in Wheelwright Massachusetts be attenuated Women in need 49 Fontana mass 49 IU vitamin D supplementation.

Our small subgroup analysis in women with sarcopenia at baseline showed modest, albeit not significant, favorable changes in lean mass, femoral neck BMD and upper-body strength associated with vitamin D supplementation during weight loss. Thus, the effect of vitamin D supplementation in adults with sarcopenic obesity 50 for whom the deleterious loss of further muscle and bone mass may be of greater concern warrants future investigation, as does the potential effect of repletion in women with more severe 25 OH D deficiency.

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Other methods to attenuate bone loss and strength reductions in older women undergoing lifestyle change to lose weight should be investigated, such as strength training, 51 - 53 calcium, 54 and, for women at risk for osteoporotic fractures, medications to reduce bone resorption or increase bone formation. Funding Sources: Susan G.

Conflict of Interest: The editor in chief has reviewed the conflict of interest checklist provided by the authors and has determined that the authors have no financial or any other kind of personal conflicts with this paper. Authors contributions: Study concept and design: McTiernan; Acquisition of data: Mason; Critical revision of the manuscript for important intellectual content: CM had primary responsibility for final content.

All authors read and approved the final manuscript. The study sponsors had no role in the design, Women in need 49 Fontana mass 49, subject recruitment, data collection, analysis or preparation of this paper. Trial Registration: National Center for Biotechnology Information Lady want real sex Laurel Hollow, U. J Am Geriatr Soc.

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Author manuscript; available in PMC Apr 5. Author information Copyright and License information Disclaimer. Corresponding Author: Alternate Corresponding Author: Caitlin Mason, PhD, gro.