The Study: Body mass index and waist circumference in early adulthood are associated with thoracolumbar spine shape at age 60-64: The Medical Research Council National Survey of Health and Development.                   

The Facts:

a. “This study investigated associations between measures of adiposity from age 36 and spine shape at 60±64 years.”

b. Both vertebral shape and spinal column curves vary from person to person and can change during life.

c. “…heavy body weight or large increases in weight, especially over a lifetime, may

result in adaptations to vertebral, and, hence spinal, shape.”

d. 1529 subjects were used in the study 

e. The subjects received a DXA scan in the supine position.

f. They looked at lumbar lordosis and thoracic kyphosis.

g. “Total and central adiposity in early adulthood appeared to have the strongest relationships with current spine shape.”

h. “Thus, having a greater BMI, a larger waist circumference and becoming overweight earlier in adulthood appeared to be more strongly related to an increasing unevenness of the lumbar lordosis and the size of the vertebrae.”

i. “Our results suggest that men who had greater lean mass were more likely to have a curvier lumbar spine while those with more fat mass and central adiposity had a flatter lordosis.”

j. “Postural changes may explain the flatter lumbar curve in men with central adiposity. The clinical definition of a sway-back posture, where the trunk leans backward relative to the pelvis, includes a reduced lumbar lordosis and posterior pelvic tilt [3 , 27 , 28 ] and has been related to increased fat infiltration in the lumbar erector spinae and multifidus muscles [29 ].”

Take Home:

Subjects with more central obesity and greater fat mass tended to have reduced lumbar lordosis than those with less fat mass and greater lean mass.

Reviewer's Comments:

First, I find it very heartening that this type of study was done on such a large group of people. It isn’t the result that I might have expected but it is the result they got. It is a complex paper with a lot of context and I suggest that you read it and come to your own conclusions. I think this is just one paper that will give us greater insight to the  various factors that can change vertebral and spinal alignment. What I think is most important is the continued interest in spinal shape and structure. I hope this interest continues in the scientific arena.  

Reviewer:  Roger Coleman DC 

Editor: Mark R. Payne DC

Reference: Anastasia V Pavlova, Stella G Muthuri, Rachel Cooper et.al. Body mass index and waist circumference in early adulthood are associated with thoracolumbar spine shape at age 60-64: The Medical Research Council National Survey of Health and Development. PLoS One 2018 Jun 14;13(6):e0197570. doi:10.1371/journal.pone. 0197570.eCollection 2018. 

Link to Abstract: https://pubmed.ncbi.nlm.nih.gov/29902185/

Link to Article:   https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6002244/pdf/pone.0197570.pdf