Body Composition Assessment in Adult Females with Anorexia Nervosa and Bulimia Nervosa-A Cross-Sectional Study Comparing Dual-Energy X-Ray Absorptiometry Scan and Isotopic Dilution of Deuterium.

BACKGROUND: Eating disorders (EDs) compromise individuals' nutritional status, affecting, among other organs and systems, bone health. OBJECTIVES: This study aimed to assess and compare bone mineral density (BMD) from DXA scan and deuterium (D2O) dilution of adult females with anorexia nervosa (AN) and bulimia nervosa (BN). METHODS: This was a cross-sectional study with 53 female participants (18-49 y) with a diagnosis of AN (n = 25) or BN (n = 28). DXA scan was performed to assess BMD, FM, and FFM, and D2O dilution was used to assess total body water (TBW), FM, and FFM. Interviews/questionnaires were used to assess symptoms, illness trajectory, and physical activity. t-test, chi-square test, Pearson's linear correlation, linear regressions, and Bland-Altman analyses were performed, with a significance level of 5%. RESULTS: TBW below the recommended level for adult females (≥ 45%) was more frequent in BN (60%) compared with AN (21%; P = 0.013). FM index (FMI) (soft tissue only) (t-test P = 0.06), and FFM index (FFMI) (t-test P = 0.08) agreed between DXA scan and D2O dilution. Only FFMI did not show systematic bias of proportion (ß: -0.2, P = 0.177). The diagnosis of BN, binge-eating episodes, and physical activity in AN were associated with the differences in the methods' results. FMI was positively associated with BMD in AN, and both FMI and FFMI were positively associated with BMD in BN. CONCLUSIONS: In adult females with EDs, DXA scan and D2O dilution achieved agreement for FMI and FFMI. Changes in FM and FFM are important in understanding the mechanisms behind bone loss in EDs. Protocols for body composition assessment in EDs can help to minimize the effect of the ED diagnosis, ED behaviors (that is, excessive exercise and purging behaviors), and weight on the accuracy of measurements.

Low fatness, reduced fat intake and adequate plasmatic concentrations of LDL-cholesterol are associated with high bone mineral density in women: a cross-sectional study with control group.

BACKGROUND: Several parameters are associated with high bone mineral density (BMD), such as overweight, black background, intense physical activity (PA), greater calcium intake and some medications. The objectives are to evaluate the prevalence and the main aspects associated with high BMD in healthy women. METHODS: After reviewing the database of approximately 21,500 BMD scans performed in the metropolitan area of São Paulo, Brazil, from June 2005 to October 2010, high BMD (over 1400 g/cm² at lumbar spine and/or above 1200 g/cm² at femoral neck) was found in 421 exams. Exclusion criteria were age below 30 or above 60 years, black ethnicity, pregnant or obese women, disease and/or medications known to interfere with bone metabolism. A total of 40 women with high BMD were included and matched with 40 healthy women with normal BMD, paired to weight, age, skin color and menopausal status. Medical history, food intake and PA were assessed through validated questionnaires. Body composition was evaluated through a GE-Lunar DPX MD + bone densitometer. Radiography of the thoracic and lumbar spine was carried out to exclude degenerative alterations or fractures. Biochemical parameters included both lipid and hormonal profiles, along with mineral and bone metabolism. Statistical analysis included parametric and nonparametric tests and linear regression models. P < 0.05 was considered significant. RESULTS: The mean age was 50.9 (8.3) years. There was no significant difference between groups in relation to PA, smoking, intake of calcium and vitamin D, as well as laboratory tests, except serum C-telopeptide of type I collagen (s-CTX), which was lower in the high BMD group (p = 0.04). In the final model of multivariate regression, a lower fat intake and body fatness as well a better profile of LDL-cholesterol predicted almost 35% of high BMD in women. (adjusted R2 = 0.347; p < 0.001). In addition, greater amounts of lean mass and higher IGF-1 serum concentrations played a protective role, regardless age and weight. CONCLUSION: Our results demonstrate the potential deleterious effect of lipid metabolism-related components, including fat intake and body fatness and worse lipid profile, on bone mass and metabolism in healthy women.

Is a lower dose of vitamin D supplementation enough to increase 25(OH)D status in a sunny country?

BACKGROUND: Calcium and vitamin D are essential nutrients for bone metabolism Vitamin D can either be obtained from dietary sources or cutaneous synthesis. The study was conducted in subtropic weather; therefore, some might believe that the levels of solar radiation would be sufficient in this area. AIM OF THE STUDY: To evaluate calcium and vitamin D supplementation in postmenopausal women with osteoporosis living in a sunny country. METHODS: A 3-month controlled clinical trial with 64 postmenopausal women with osteoporosis, mean age 62 + or - 8 years. They were randomly assigned to either the supplement group, who received 1,200 mg of calcium carbonate and 400 IU (10 microg) of vitamin D(3,) or the control group. Dietary intake assessment was performed, bone mineral density and body composition were measured, and biochemical markers of bone metabolism were analyzed. RESULTS: Considering all participants at baseline, serum vitamin D was under 75 nmol/l in 91.4% of the participants. The concentration of serum 25(OH)D increased significantly (p = 0.023) after 3 months of supplementation from 46.67 + or - 13.97 to 59.47 + or - 17.50 nmol/l. However, the dose given was limited in effect, and 86.2% of the supplement group did not reach optimal levels of 25(OH)D. Parathyroid hormone was elevated in 22.4% of the study group. After the intervention period, mean parathyroid hormone tended to decrease in the supplement group (p = 0.063). CONCLUSION: The dose given (400 IU/day) was not enough to achieve 25(OH)D concentration, considered optimal for bone health.

Correlations among vitamin K intake, body fat, lipid profile and glucose homeostasis in adults and the elderly.

Objective Recent research has investigated the possible inverse relationship between vitamin K intake and body fat. In addition, an increasing number of studies are supporting a key role for this vitamin in improving lipid profile and insulin sensitivity and reducing the risk of type 2 diabetes mellitus, but little is known about what mechanisms would be involved. Thus, the objective of this study was to investigate the relationship between vitamin K intake (in the form of phylloquinone - PK), body fat, lipid profile and markers of glucose homeostasis in adults and the elderly. Subjects and methods A cross-sectional study with 298 participants (46% men) in the São Paulo Health Survey 2014-2015. Spearman correlations were performed to evaluate the associations between vitamin K intake and the biochemical and body composition measures. Results Among normal-weight male adults (n = 15), PK intake presented a positive correlation with the quantitative insulin sensitivity check index (QUICKI) (r = 0.525; p = 0.045). Among men with high fat mass index (FMI) (n = 101), PK intake had a negative correlation with homeostasis model assessment estimate for ß-cell function (HOMA-ß) (r = -0.227; p = 0.022). In women with high FMI (n = 122), PK intake had a negative correlation with HOMA-ß (r = -0.199, p = 0.032) and insulin (r = -0.207, p = 0.026). No correlations were found between PK intake and lipid profile. Conclusions Our findings support a potential relationship among PK intake, body fat and markers of glucose homeostasis in adults and the elderly.

Nutrient intakes related to osteoporotic fractures in men and women--the Brazilian Osteoporosis Study (BRAZOS).

BACKGROUND: Adequate nutrition plays an important role in bone mass accrual and maintenance and has been demonstrated as a significant tool for the prevention of fractures in individuals with osteoporosis. OBJECTIVE: The aim of the present study was to evaluate bone health-related nutrients intake and its association with osteoporotic fractures in a representative sample of 2344 individuals aged 40 years or older in Brazil. METHODS: In a transversal population-based study, a total of 2420 individuals over 40 years old were evaluated from March to April 2006. Participants were men and women from all socio-economic classes and education levels living around the Brazilian territory Individuals responded a questionnaire including self reported fractures as well a 24-hour food recall. Nutrient intakes were evaluated by Nutrition Data System for Research software (NDSR, University of Minnesota, 2007). Low trauma fracture was defined as that resulting of a fall from standing height or less. Nutrient intakes adequacies were performed by using the DRI's proposed values. Statistical analysis comprises Oneway ANCOVA adjusted by age and use of nutritional supplements and multiple logistic regression. SAS software was used for statistical analysis. RESULTS: Fractures was reported by 13% of men and 15% of women. Women with fractures presented significantly higher calcium, phosphorus and magnesium intakes. However, in all regions and socio-economical levels mean intakes of bone related nutrients were below the recommended levels. It was demonstrated that for every 100 mg/phosphorus increase the risk of fractures by 9% (OR 1.09; IC95% 1.05-1.13, p < 0.001). CONCLUSION: The results demonstrated inadequacies in bone related nutrients in our population as well that an increase in phosphorus intake is related to bone fractures.

Prudent diet is associated with low sleepiness among short-haul truck drivers.

OBJECTIVES: The lifestyle of postindustrial society has undergone major shifts characterized by changes in demographic and epidemiologic profiles, eating habits, and job structures, with irregular working hours, particularly night shifts. The investigation of dietary patterns is of great importance for the discussion and devising of effective dietary strategies for shift and night workers in general, particularly in view of the increased sleepiness reported during night work. OBJECTIVE: We aimed to determine the association between dietary patterns of Brazilian truck drivers and sleepiness levels, according to work shift. METHODS: A cross-sectional study of 52 drivers (25 long haul and 27 short haul) at a freight company was carried out. This study entailed application of a structured questionnaire collecting sociodemographic, lifestyle, and nutritional status data. Assessment of dietary intake using a 24-h dietary recall and an evaluation of sleepiness by the Karolinska Sleepiness Scale were performed. The principal components of the diet were analyzed by factor analysis to derive dietary patterns. A linear mixed model was then applied to determine a model for sleepiness levels of the drivers as a function of dietary pattern, time of day, and work shift. RESULTS: Three intake patterns were derived: traditional, prudent, and Western. Associations of time of day (F = 23.629, P < 0.01) and shift type (F = 42.218, P < 0.01) on sleepiness were found. An association between diet and sleepiness was also evident, where the prudent pattern was associated with low sleepiness among short-haul truck drivers (F = 3.865, P = 0.02). CONCLUSIONS: The results of the present study revealed an association between dietary patterns and short-haul driving, in which the healthy pattern produced low sleepiness during the day. The sleepiness curve of long-haul drivers appears to have a flattening pattern, probably because of irregular working times.

Vitamin D and blood pressure connection: update on epidemiologic, clinical, and mechanistic evidence.

Hypertension is an important risk factor for cardiovascular and kidney disease. High blood pressure is a growing public health problem that is expected to affect 1.6 billion people worldwide by the year 2025. In light of emerging evidence of a widespread global problem of vitamin D deficiency, there has been increasing interest concerning the role of vitamin D in chronic disease. The recent publication of several studies, highlighted in this brief review, supports an association between vitamin D status and blood pressure. It remains to be determined what level of vitamin D status needs to be achieved in different subpopulations to assure the maximum benefit of vitamin D status on blood pressure.

Dietary calcium intake and overweight: an epidemiologic view.

OBJECTIVE: We evaluated the relation between overweight and calcium intake in adults living in the municipality of São Paulo, Brazil. METHODS: This was a cross-sectional population-based study on a sample of 1459 adults that was obtained by multistage cluster sampling. Dietary intake was measured by the 24-h recall method. Poisson's and linear regression analyses were performed to evaluate the relation between overweight and quartiles of calcium intake adjusted for energy. RESULTS: The prevalence of overweight was 43.1% and the average adjusted calcium intake was 448.6 mg. In the linear regression analyses, the regression coefficient for adjusted calcium was significant and negative (P = 0.019, beta(1) = -0.0001). Although evaluated by quartiles, the prevalence ratio for overweight in the first quartile of calcium intake was 1.24 (95% confidence interval 1.00-1.54) and that in the second quartile was 1.24 (95% confidence interval 1.03-1.49). CONCLUSION: In the present study, calcium intake showed a significant negative association with body mass index.

Vitamin D status and the metabolic syndrome.

The identification of vitamin D receptor expression in different tissues suggests a widespread role for vitamin D action beyond its classical function in bone and mineral metabolism. Recently, the importance of vitamin D status as a risk factor in the development of metabolic syndrome has been the focus of several studies.

Association between 25-hydroxyvitamin D and inflammatory biomarker levels in a cross-sectional population-based study, São Paulo, Brazil.

Besides the classic vitamin D function on bone homeostasis, there are bodies of evidence showing that adequate status of vitamin D can modulate inflammation. We hypothesized that higher plasma levels of 25-hydroxyvitamin D (25[OH]D) would correlate with lower plasma levels of proinflammatory cytokines, acute-phase proteins, and soluble adhesion molecules and higher plasma levels of anti-inflammatory cytokines. We included all adults (age, 20-59 years) of the population-based, cross-sectional study, Health Survey-São Paulo, conducted in São Paulo (Brazil) in the study (n = 281). Anthropometric parameters, blood pressure measurements, and a fasting blood sample were collected by trained fieldworkers. Serum 25(OH)D concentration, plasma inflammatory biomarker levels (C-reactive protein, interleukin [IL]-1ß, IL-6, IL-8, IL-10, tumor necrosis factor [TNF] α, IL-12p70, adiponectin, monocyte chemoattractant protein-1, soluble intercellular adhesion molecule-1, and soluble vascular cell adhesion molecule-1), and plasma blood lipid parameters were evaluated. The prevalence of vitamin D inadequacy (<50 nmol/L) was 65.5%. Inadequate participants were younger, with lower body mass index (BMI), systolic and diastolic blood pressures, triglyceride, and total cholesterol levels as well as low-density lipoprotein cholesterol, compared with individuals adequate for vitamin D status. After adjustment, plasma concentration of soluble intercellular adhesion molecule-1 was statistically higher among adequate participants. Stratifying for BMI categories, a negative association was observed between plasma IL-6 and TNF-α levels and serum 25(OH)D concentration in normal-weight participants, whereas a negative association was detected between plasma adiponectin level and serum 25(OH)D concentration in overweight participants. The present findings suggest that BMI interacts with serum 25(OH)D levels, modulating inflammatory response and affecting plasma IL-6, TNF-α, and adiponectin levels. These data indicate that BMI plays a determinant role in the vitamin D-inflammation axis.

Relationships between n-3 polyunsaturated fatty acid intake, serum 25 hydroxyvitamin D, food consumption, and nutritional status among adolescents.

We have hypothesized that higher n-3 polyunsaturated fatty acid (PUFA) intake is associated with better lipid profile, higher 25 hydroxyvitamin D (25(OH)D) serum concentrations, and healthy food consumption and nutritional status. Thus, this study aimed to evaluate the relationships between n-3 PUFA intake, serum 25(OH)D, lipid profile, nutritional status, and food consumption among adolescents. A total of 198 Brazilian adolescents (51% male), with mean age of 16.3 ± 1.4 years, were enrolled in this cross-sectional study. Blood was collected for 25(OH)D and lipid profile serum measurement. Weight and height were measured, and food consumption was accessed by a 24-hour food record (n = 69). Analysis of variance, the Student t test, and Pearson correlation were performed using SPSS software (SPSS, Chicago, IL, USA). The prevalence of vitamin D inadequacy (25(OH)D, <30 ng/mL) was 71.7%. Serum 25(OH)D negatively correlated with body mass index (r = -0.294; P < .0001) and positively correlated with high-density lipoprotein cholesterol (r = 0.323; P < .0001). N-3 PUFA intake negatively correlated with body mass index (r = -0.286; P = .017), total cholesterol (r = -0.292; P = .015), and low-density lipoprotein cholesterol (r = -0.333; P = .005) and positively correlated with the intake of fat meats and eggs (r = 0.391; P = .006), vegetable proteins (r = 0.297; P = .048), fats/oils (r = 0.574; P < .001), and refined cereals (r = 0.351; P = .006). Vitamin D status and n-3 PUFA intake were related with better nutritional status and favorable lipid profile. Food groups usually found in Brazilian traditional meals (characterized by rice, beans, meat, and vegetables) were associated with higher n-3 PUFA intake, which may contribute to prevent the development of noncommunicable diseases in adolescence and adulthood.

Stop dietary calcium restriction in kidney stone-forming patients.

Epidemiologic studies have demonstrated an increased incidence of kidney stones in individuals with low calcium intake. More recently, a 5-year clinical study found the recurrence of kidney stones was higher in stone-formers on a low dietary calcium treatment. Considering these important new findings, and the known adverse effect on bone mass, dietary calcium restriction should be avoided in kidney stone-forming individuals.

Prevalence and correlates of calcium and vitamin D status adequacy in adolescents, adults, and elderly from the Health Survey-São Paulo.

OBJECTIVE: In addition to the importance of adequate calcium and vitamin D status for health and prevention of several chronic diseases, a high prevalence of both nutrient inadequacy and 25-hydroxyvitamin D (25[OH]D) insufficiency has been observed. The aim of this study was to estimate calcium and vitamin D status correlates and adequacy from a population-based epidemiologic study. METHODS: This is a subsample of a cross-sectional study of a representative sample of individuals living in São Paulo that includes 636 participants. A 24-h dietary record and a blood sample were collected. Nutrient adequacy was estimated by adjusting for the within-person variance of the nutrient intake. Serum concentration of 25(OH)D was measured by high-performance liquid chromatography and considered adequate when ≥ 50 nmol/L. RESULTS: Calcium and vitamin D intake decrease according to life stages in both men and women, and increases with family income and educational level. The prevalence of calcium intake inadequacy is higher than 70% and almost 100% for vitamin D. The highest 25(OH)D concentration was observed in the fall-51.7 (20.4) nmol/L-and lowest in the summer-30.1 (8.8) nmol/L. Sex, body mass index, physical activity, alcohol and smoking habits, life stage, family income, skin color, waist circumference, and season of the year could explain 22% of the variability of 25(OH)D. CONCLUSIONS: The present study demonstrates important inadequacies regarding the nutritional status of calcium and vitamin D and indicates an urgent need not only for health professionals, but also for government and food industries to undertake new initiatives that could result in a real improvement in terms of calcium and vitamin D nutrition.

Evaluating the links between intake of milk/dairy products and cancer.

Milk and dairy products are widely recommended as part of a healthy diet. These products, however, can contain hormones such as insulin-like growth factor 1, and some studies have suggested that a high intake of milk and dairy products may increase the risk of cancer. This review examines recent studies on this topic, with the evidence suggesting that the recommended intake of milk and dairy products (3 servings/day) is safe and, importantly, does not seem to increase the risk of cancer. On the basis of the studies included in this review, cultured milk, yogurt, and low-fat dairy products should be preferred as the milk and dairy products of choice.

Current perspectives on vitamin D, immune system, and chronic diseases.

Accumulating data support that vitamin D possesses several biological and molecular actions apart from its role in calcium homeostasis. Immune cells express vitamin D receptor and are capable of metabolizing vitamin D. Within this context, experimental studies show that vitamin D modulates immune and inflammatory responses. Epidemiologic evidence linking poor vitamin D status to autoimmune diseases, type 2 diabetes, and cardiovascular disease suggests that insufficient vitamin D may be involved in the etiology of such disorders. Given the impact of immune and inflammatory abnormalities in the development of chronic diseases, including autoimmune disorders, it is possible that vitamin D might reduce chronic disease risk by modulating the immune system.

Folate, vitamin B6 and vitamin B12 in adolescence: serum concentrations, prevalence of inadequate intakes and sources in food.

OBJECTIVE: To investigate serum concentrations and the prevalence of inadequate folate intake and also vitamin B6 and vitamin B12 intakes and to identify those foods that make a major contribution to intake levels of these nutrients. METHODS: This was a cross-sectional, observational study of adolescents of both sexes aged 16 to 19 years from the town of Indaiatuba, SP, Brazil. Data collection was by non-consecutive 3-day dietary record. The samples' habitual diet was estimated by removing intraindividual variability, and the prevalence rates of inadequate intakes were calculated using the estimated average requirement as cutoff points. Biochemical assays for folate, vitamin B6 and vitamin B12 were conducted in accordance with the methods accepted in the literature. RESULTS: The study sample comprised 99 adolescents, the majority of whom were female (58.6%), with a mean age of 17.6 [standard deviation, (SD) 0.9]. Mean serum concentrations for folate, vitamin B6 and vitamin B12 were 9.2 (SD 3.4) ng/mL, 18.7 (SD 5.1) nmol/L and 397.5 (SD 188.4) pg/mL, respectively; and the prevalence rates of inadequate intake for these vitamins were 15.2, 10.2 and < 1%, respectively. The foods that made a major contribution to vitamin intakes were French bread, pasta and beans for folate; white rice, chicken and beef for vitamin B6; and lean beef, whole milk and fatty beef for vitamin B12. CONCLUSIONS: The prevalence rates of inadequate folate, vitamin B6 and vitamin B12 intakes were low, which is possibly the result of improved access to and availability of foods that are dietary sources of these vitamins. Beans, which are a part of the traditional Brazilian diet, remain one of the primary food items that contribute to folate intake, even after mandatory fortification with folic acid in Brazil.

Role of vitamins and minerals in prevention and management of type 2 diabetes mellitus.

Vitamins and minerals play an important role in glucose metabolism, so understanding the impact of vitamin and mineral deficiencies and the potential utility of supplementation is relevant to the prevention and/or management of type 2 diabetes mellitus (DM). This review investigates current evidence for relationships between selected nutrients - vitamin B complex, antioxidants (vitamin A, C, E and carotenoids), calcium, vitamin D, vitamin K, magnesium, sodium, and potassium - and glucose metabolism. The investigation reveals current evidence is not strong enough for supplementation with minerals and vitamins to be recommended on a large scale for the prevention or management of DM. In order to prevent deficiencies and maintain health, the majority of diabetic individuals should receive daily vitamins and minerals within the ranges of recommended values from consumption of natural food sources and/or fortified foods. Further studies including large samples and longer follow-up periods are necessary to ascertain the benefits of mineral and vitamin supplementation to subsets of individuals who are at increased risk for DM or its complications.

The burden of osteoporosis in Brazil: regional data from fractures in adult men and women--the Brazilian Osteoporosis Study (BRAZOS).

OBJECTIVES: The BRAZOS (The Brazilian Osteoporosis Study) study is the first epidemiological and population-based study carried out in a representative sample of Brazilian men and women, 40 years or older, with the objective of identifying the prevalence and main clinical risk factors (CRF) associated with low-impact fractures. This report shows the main results according to each region of the country. PATIENTS AND METHODS: A total of 2,420 subjects (70% women) from 150 different cities in five geographic regions in Brazil, and from all different socio-economical classes were included in this study. Anthropometrical data, as well life style, previous fractures, nutritional status, physical activity, falls, and quality of life were evaluated by a quantitative individual survey. Low-impact fracture was defined as that resulting from a fall no greater than standing height of an individual. A P < 0.05 was considered significant. RESULTS: Statistically significant differences in the prevalence of fractures among the five Brazilian regions according to gender or social class were not observed. However, in women, a higher incidence of fractures was observed in metropolitan areas than in rural areas, and a tendency for a higher frequency of fractures was observed in men from Northeastern states. Statistically significant differences among men from metropolitan areas or rural areas were not observed. CONCLUSIONS: Significant differences in the prevalence of low-impact fractures among the five different regions of Brazil were not observed, as well as its frequency or relevance of risk factors.

Misreporting of dietary energy intake in adolescents.

OBJECTIVES: To examine the prevalence of under and overreporting of energy intake in adolescents and their associated factors. METHODS: Cross-sectional study with 96 postpubertal adolescents (47 normal-weight and 49 obese), mean age of 16.6±1.3 years. Weight and height were measured, and body mass index was calculated. Body composition was assessed by dual energy X-ray absorptiometry. Dietary intake was evaluated by a 3-day dietary record. Biochemical assessment was performed (serum total cholesterol, LDL-cholesterol, HDL-cholesterol, plasma glucose, and insulin). Underreporters reported energy intake < 1.35 x basal metabolic rate (BMR), whereas overreporters reported energy intake > 2.4 x BMR. RESULTS: Energy intake misreporting (under or overreporting) was identified in 65.6% of adolescents (64.6 and 1% of under and overreporting, respectively). Obese adolescents were 5.0 times more likely to underreport energy intake (95%CI 2.0-12.7) than normal-weight participants. Underreporters showed higher rates of insufficient intake of carbohydrate (19.3 vs. 12.1%, p = 0.046) and lipids (11.3 vs. 0%, p < 0.001) than plausible reporters. Cholesterol intake was also lower in underreporters (p = 0.017). There were no significant differences in body composition and biochemical parameters in relation to misreporting. CONCLUSIONS: The results obtained demonstrated a high percentage of misreporting of energy intake among adolescents, especially among obese subjects, which suggests that energy-adjusted nutrient intake values should be employed in diet-disease risk analysis in order to contribute to a reduction in errors associated with misreporting.

Influence of body composition on bone mass in postmenopausal osteoporotic women.

We aimed at evaluating the relationship of lean and fat mass to bone mass in osteoporotic postmenopausal women. We invited 65 women who were being treated at the São Paulo Hospital osteoporosis outpatients' clinic to participate. Body composition and bone mineral density (BMD) measurements were performed using Dual-energy X-ray absorptiometry methodology (DXA). The mean age and weight were 69.7±6.4 years and 56.3±7.6 kg, respectively. Accordingly to the body mass index (BMI), 52.8% were of normal weight and 47.1% of the patients were overweight. Overweight women had significantly higher bone mass. Similarly, skeletal muscle index (SMI) showed a positive effect on BMD measurements and women with sarcopenia had significantly lower BMD measurements in total femur and femoral neck. In multiple regression analysis only lean mass and age, after adjustments to fat mass and BMI, were able to predict total body bone mineral content (BMC) (R(2)=28%). Also lean mass adjusted to age and BMI were able to predict femoral neck BMD (R(2)=14%). On the other hand, none of the components of the body composition (lean mass or fat mass) contributed significantly to explaining total femur BMD and neither body composition measurements were associated with spine BMD. These findings suggest that lean mass has a relevant role in BMC and BMD measurements. In addition, lower BMI and lean mass loss (sarcopenia) is associated to lower BMC and BMD of femoral neck and total femur and possible higher risk of osteoporotic fracture.