***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND Studies of weight loss and changes in bone mineral density ( BMD ) have primarily been short-term trials in obese subjects . OBJECTIVE We examined the effects of a 5-yr intervention design ed to prevent menopausal weight gain or promote modest weight loss on BMD in premenopausal women participating in the Women 's Healthy Lifestyle Project . DESIGN We enrolled 373 premenopausal women ( age 44 - 50 yr ) and r and omly assigned them to either lifestyle intervention ( 175 women , low-fat dietary modification , weight loss , and physical activity intervention ) or control group ( 198 women ) .  BMD and body weight were measured at baseline , annual follow-up visits ( 18 , 30 , 42 , and 54 months ) , and two postintervention follow-ups ( 66 and 78 months ) . BMD was measured by dual x-ray absorptiometry . RESULTS Over the 54 months of intervention , women in the intervention group lost 0.4 kg , whereas control women gained 2.6 kg ( P = 0.011 ) . The intervention group experienced significantly greater hip bone loss ( -0.20%/yr ) than the control group ( -0.03%/yr ) . During the postintervention , differences in rates of bone loss disappeared . When considering both menopausal status and use of hormone therapy ( HT ) , the annualized BMD changes were lower in women reporting HT use ; nevertheless , among women on HT , those who lost more than 3 % body weight experienced greater total hip BMD loss ( -0.25%/yr ) compared with those who gained weight ( -0.02%/yr ) ( P = 0.025 ) . CONCLUSIONS Women r and omized to a lifestyle intervention aim ed at preventing menopausal weight gain or promoting modest weight loss experienced greater rates of hip bone loss than control women The aim of this study was to examine the association of exercise frequency and calcium intake ( CI ) with change in regional and total bone mineral density ( BMD ) in a group of postmenopausal women completing 4 years of progressive strength training . One hundred sixty-seven calcium-supplemented ( 800 mg/day ) sedentary women ( 56.1±4.5 years ) r and omized to a progressive strength training exercise program or to control were followed for 4 years . Fifty-four percent of the women were using hormone therapy ( HT ) at baseline . At 1 year , controls were permitted to begin the exercise program ( crossovers ) . The final sample included 23 controls , 55 crossovers , and 89 r and omized exercisers . Exercisers were instructed to complete two sets of six to eight repetitions of exercises at 70–80 % of one repetition maximum , three times weekly . BMD was measured at baseline and thereafter annually using dual-energy X-ray absorptiometry . Four-year percentage exercise frequency ( ExFreq ) averaged 26.8%±20.1 % for crossovers ( including the first year at 0 % ) , and 50.4%±26.7 % for exercisers . Four-year total CI averaged 1,635±367 mg/day and supplemental calcium intake , 711±174 mg/day . In adjusted multiple linear regression models , ExFreq was positively and significantly related to changes in femur trochanter ( FT ) and neck ( FN ) , lumbar spine ( LS ) , and total body ( TB ) BMD . Among HT  users , FT BMD increased 1.5 % , and FN and LS BMD , 1.2 % ( p < 0.01 ) for each st and ard deviation ( SD ) of percentage ExFreq ( 29.5 % or 0.9 days/week ) . HT non-users gained 1.9 % and 2.3 % BMD at FT and FN , respectively , ( p < 0.05 ) for every SD of CI . The significant , positive , association between BMD change and ExFreq supports the long-term usefulness of strength training exercise for the prevention of osteoporosis in postmenopausal women , especially HT users . The positive relationship of CI to change in BMD among postmenopausal women not using HT  has clinical implication s in light of recent evidence of an increased health risk associated with HT Whole-body electromyostimulation ( WB-EMS ) has been shown to be effective in increasing muscle strength and mass in elderly women . Because of the interaction of muscles and bones , these adaptions might be related to changes in bone parameters . 76 community-living osteopenic women 70 years and older were r and omly assigned to either a WB-EMS group ( n = 38 ) or a control group ( CG : n = 38 ) . The WB-EMS group performed 3 sessions every 14 days for one year while the CG performed gymnastics containing identical exercises without EMS . Primary study endpoints were bone mineral density ( BMD ) at lumbar spine ( LS ) and total hip ( thip ) as assessed by DXA . After 54 weeks of intervention , borderline nonsignificant intergroup differences were determined for LS-BMD  ( WB-EMS : 0.6 ± 2.5 % versus CG −0.7 ± 2.5 % , P = .051 ) but not for thip-BMD  ( WB-EMS : −1.1 ± 1.9 % versus CG : −0.8 ± 2.3 % , P = .771 ) . With respect to secondary endpoints , there was a gain in lean body mass ( LBM ) of 1.5 % ( P = .006 ) and an increase in grip strength of 8.4 % ( P = .000 ) in the WB-EMS group compared to CG . WB-EMS effects on bone are less pronounced than previously reported effects on muscle mass . However , for subjects unable or unwilling to perform intense exercise programs , WB-EMS may be an option for maintaining BMD at the LS BACKGROUND Higher protein diets are promoted for effective weight loss . Striated tissues in omnivorous diets contain high- quality protein , but limited data exist regarding their effects on bone . METHODS To examine the effects of energy restriction-induced weight loss with higher protein omnivorous diets versus lower protein vegetarian diets on  bone mineral density  in overweight postmenopausal women , two r and omized controlled feeding studies were conducted . In Study 1 , 28 women consumed 750 kcal/day energy deficit diets with 18 % energy from protein via lacto-ovo vegetarian sources ( normal protein , n = 15 ) or 30 % energy from protein with 40 % of protein from lean pork ( higher protein , n = 13 , omnivorous ) for 12 weeks . In Study 2 , 54 women consumed their habitual diet ( control , n = 11 ) or 1,250 kcal/day diets with 16 % energy from nonmeat protein sources ( n = 14 ) or 26 % energy from protein , including chicken ( n = 15 ) or beef ( n = 14 ) for 9 weeks . RESULTS Study 1 : With weight loss ( normal protein -11.2 % , higher protein -10.1 % ) , bone mineral density was not significantly changed in normal protein ( -0.003 ± 0.003 g/cm(2 ) , -0.3 % ) but decreased in higher protein ( -0.0167 ± 0.004 g/cm(2 ) , -1 . 4 % , group-by-time p < .05 ) . Study 2 : The control , nonmeat , chicken , and beef groups lost 1.5 % , 7.7 % , 10.4 % , and 8.1 % weight and 0.0 % , 0.4 % , 1.1 % , and 1.4 % bone mineral density , respectively . The change of bone mineral density was significant for chicken and beef compared with the control ( group-by-time , p < .05 ) . Markers of calcium metabolism and bone homeostasis in blood and urine were not changed over time or differentially affected by diet . CONCLUSION Consumption of higher protein omnivorous diets promoted decreased bone mineral density after weight loss in overweight postmenopausal women Purpose : Patients with monoclonal gammopathy of undetermined significance ( MGUS ) have increased rates of bone resorption , osteopenia , osteoporosis , and risk of fractures . This study was undertaken to determine the efficacy and safety of zoledronic acid for patients with MGUS and enhanced bone loss . Experimental Design : In this phase II open-label study , 54 patients with MGUS and osteopenia or osteoporosis were administered zoledronic acid 4 mg i.v . at 0 , 6 , and 12 months . The primary efficacy end point was bone mineral density , assessed using a dual-energy X-ray absorptiometry scan in the lumbar (L)-spine done at screening and at 13 months ( 1 month after the final zoledronic acid infusion ) . Results : At study end for all patients ( N = 54 ) , L-spine T-scores improved by a median of + 0.27 ( range , −0.38 to + 3.91 ) , corresponding to a median increase in bone mineral density of + 15.0 % ( range , −18.0 % to + 1,140.0 % ; P < 0.0001 ) . Hip T-scores improved by a median of + 0.10 ( range , −2.40 to + 2.03 ) , corresponding to a median increase of + 6.0 % ( range , −350.0 % to + 165.0 % ) . During the study , no new fractures , osteonecrosis of the jaw , or significant renal adverse events were reported . Conclusions : Zoledronic acid administered i.v . at a dosage of 4 mg every 6 months for three doses total was well-tolerated and substantially improved bone mineral density for patients with MGUS and bone loss .  Zoledronic acid may be effective for the prevention of new fractures in this high-risk population Bone turnover is increased during weight loss in postmenopausal women and can be suppressed with calcium supplementation . In this study , we assessed the influence of energy restriction with and without calcium supplementation ( 1 g/day ) in premenopausal women . Thirty-eight obese premenopausal women ( body mass index [ BMI ] of 35.0 + /- 3.9 kg/m2 ) completed a 6-month study of either moderate weight loss or weight maintenance . During weight loss , women were r and omly assigned to either a calcium supplementation ( n = 14 ) or placebo group ( n = 14 ) and lost 7.5 + /- 2.5 % of their body weight . The control group of women ( n = 10 ) maintained their body weight . Total body and lumbar bone mineral density ( LBMD ) and content were measured by dual-energy X-ray absorptiometry ( DXA ) at baseline and after weight loss . Throughout the study , blood and urine sample s were collected to measure bone turnover markers and hormones . During moderate energy restriction , dietary calcium intake decreased ( p < 0.05 ) and the bone resorption marker deoxypyridinoline ( DPD ) increased slightly ( p < or = 0.05 ) without evidence of bone loss .  Calcium supplementation during weight loss tended to increase lumbar BMD by 1.7 % ( p = 0.05 ) compared with the placebo or weight maintenance groups . In contrast to our previous findings in postmenopausal women , premenopausal obese women who consume a low calcium diet do not lose bone over a 6-month period , whether their weight is stable or decreasing moderately Physical exercise has a favorable impact on bones , but optimum training strategies are still under discussion . In this study , we compared the effect of slow and fast resistance exercises on various osteodensitometric parameters .  Fifty-three postmenopausal women were r and omly assigned to a strength training ( ST ) or a power training group ( PT ) . Both groups carried out a progressive resistance training , a gymnastics session , and a home training over a period of 12 mo . During the resistance training , the ST group used slow and the PT group fast movements ; otherwise there were no training differences . All subjects were supplemented with Ca and vitamin D. At baseline and after 12 mo , bone mineral density ( BMD ) was measured at the lumbar spine , proximal femur , and distal forearm by dual-energy X-ray absorptiometry . We also measured anthropometric data and maximum static strength . Frequency and grade of pain were assessed by question naire . After 12 mo , significant between-group differences were observed for BMD at the lumbar spine ( P < 0.05 ) and the total hip ( P < 0.05 ) . Whereas the PT group maintained BMD at the spine ( + 0.7 + /- 2.1 % , not significant ) and the total hip ( 0.0 + /- 1.7 % , not significant ) , the ST group lost significantly at both sites ( spine : -0.9 + /- 1.9 % ; P < 0.05 ; total hip : -1.2 + /- 1.5 % ; P < 0.01 ) . No significant between-group differences were observed for anthropometric data , maximum strength , BMD of the forearm , or frequency and grade of pain . These findings suggest that power training is more effective than strength training in reducing bone loss in postmenopausal women BACKGROUND / OBJECTIVES : Moderate , long-term weight loss results in the loss of bone mass in overweight or obese premenop 
    Output:
    
Weight reduction results in reduced BMD at the hip , but has less effect on the spine .
BMD in the hip site decreased after more than 4 months , especially in those who were obese .
Moreover , calorie restriction interventions longer than 13 months showed a significant decreased in lumbar spine BMD .
Conclusion Weight loss led to significant decreases at the hip and lumbar spine BMD but not at the total .
Weight loss response following calorie restriction result ed in a decrease in hip and lumbar spine bone density especially more than 1 year ; whereas an exercise-induced weight loss did not