Following a low-calorie Mediterranean diet and regular physical activity mitigates the decline in bone health in older adults with metabolic syndrome , especially women. These are the main conclusions of a study led by a research team from the Rovira i Virgili University (URV) published in the scientific journal JAMA Network Open.

The study included 924 men and women aged 55 to 75 with overweight or obesity and metabolic syndrome, who were followed for three years at four research centers in Spain. They were randomly assigned to two groups: the first followed a low-calorie Mediterranean diet combined with physical activity. The second followed a Mediterranean diet without calorie restrictions or specific physical activity recommendations. Participants in both groups underwent serial bone densitometry scans to assess bone mineral density in different areas of the body.

The results showed that women in the first group had better preservation of bone mineral density in the lumbar spine, along with moderate weight loss after three years of follow-up, compared to the second group. “This type of lifestyle intervention based on moderate weight loss through a low-calorie Mediterranean diet and physical exercise may be a useful strategy to prevent bone health loss associated with weight loss and aging ,” says Héctor Vázquez-Lorente, a CIBEROBN researcher in the Department of Biochemistry.

Bone deterioration during aging is one of society’s main public health problems. This study shows that “it is possible to mitigate this process by offering an effective strategy to promote healthier aging, especially in older women ,” comments Jordi Salas-Salvadó, principal investigator at CIBEROBN, professor of Nutrition at the URV, and principal investigator of the study.

The loss of bone mineral density is a key factor in the development of osteoporosis, especially in postmenopausal women, increasing the risk of fractures, reducing quality of life, and increasing morbidity and mortality. “The relationship between weight loss and bone health is a constant concern in clinical research. Our results tell us that not all weight loss strategies negatively affect bone density ,” comments Jesús F. García Gavilán, CIBEROBN researcher and co-lead author of the study.

The research is part of the PREDIMED-Plus project, a pioneering multicenter clinical trial evaluating the impact of a lifestyle intervention on cardiovascular disease prevention and weight loss in older adults. It has included the participation and support of various institutions, including the Pere Virgili Health Research Institute (IISPV) and the Biomedical Research Network Center for the Pathophysiology of Obesity and Nutrition (CIBEROBN) of the Carlos III Health Institute.

Bibliographic reference: Vázquez-Lorente H et al. Mediterranean Diet, Physical Activity, and Bone Health in Older Adults: A Randomized Clinical Trial . JAMA Network Open, 2025. DOI: 10.1001/jamanetworkopen.2025.3710