Bone mineral density and nutritional profile in morbidly obese women

Morbid obesity may be associated with malnutrition. Because it is important to assess the preoperative nutritional/metabolic status and bone mineral density of these patients, this study was designed aiming to evaluate bone metabolism/mineral density and nutritional profile in morbidly obese women.

Thirty-three morbidly obese women in preoperative care for obesity surgery were enrolled. Blood samples were drawn to determine nutritional and metabolic status, and dual-energy X-ray absorptiometry (DXA) was performed to evaluate bone mineral density; 24-h recall and food frequency questionnaire (FFQ) were also evaluated.

Twenty-seven (81.8%) women were premenopausal and six (18.2%) were postmenopausal. The mean body mass index was 43.2 ± 4.8 kg/m(2), and 91% were Caucasian. Insulin-resistant subjects comprised 81.8% of the sample. The median (25-75 percentile) of the total intake of 24-h recall was 3,081 (2,718-3,737) and for FFQ 2,685 (2,284-4,400) calories. FFQ underestimated total energy value intake. The median of calcium was higher when evaluated by the FFQ as compared with the 24-h recall. Protein and lipid intakes were lower if evaluated by the FFQ as compared to the 24-h recall. Vitamin D levels were low in 18 (81.8%) patients. In one premenopausal woman, bone mineral density was low in the lumbar spine (L1-L4), and in one postmenopausal woman it was low in L1-L4, femoral neck and 1/3 proximal radius.

In this study, the nutritional status of morbidly obese women was good, except for markers of bone metabolism, with no detectable differences between pre- and postmenopausal women.