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Changes in bone mineral density are impacted by changes in fat mass but not physical activity or race in older women.

Data suggests that physical activity, soft tissue, and race impact bone mineral density (BMD) with aging. The primary aim of this study was to explore the impact of race and changes in body composition and physical activity on lumbar spine (LS) and proximal femur (PF) BMD over two years. White (n=143) and black women (n=53; all = 68±6 y & 28±5 kg/m2) were assessed for BMD and body composition via DXA. Physical activity was determined by questionnaire. Weight reduced by 0.6±3.9 kg (p = 0.04) with no change in fat mass (p = 0.96) and a loss of lean mass (‐0.40±1.7 kg, p = 0.001). PF BMD decreased (−0.011±0.022 g/cm2, p<0.001) with no change in LS BMD (p = 0.40). No BMD changes were impacted by race or physical activity (all p > 0.05). Change in LS BMD was not impacted by change in weight, fat or lean mass (all p > 0.05). Changes in PF BMD were positively related to change in weight, fat and lean mass (r range = 0.23 to 0.32, all p < 0.05). Utilizing stepwise linear regression, weight change was the only predictor of PF BMD change (R2 = 10.2%); however, when assessing body composition, change in fat mass was the only predictor (R2 = 7.7%, p < 0.001) while a trend existed for change in lean mass (p = 0.08). Our results indicate current physical activity and race do not influence BMD change over 2 years; however, changes in body composition influences BMD with fat mass being the most important soft tissue determinant in older women.