• Petteri Oura, Jaakko Niinimäki, Jaro Karppinen, and Marjukka Nurkkala.
• Center for Life Course Health Research, Faculty of Medicine, University of Oulu, Oulu, Finland.
• Spine. 2019 Nov 1; 44 (21): E1264-E1271.

Study DesignA population-based birth cohort study.ObjectiveTo evaluate the associations of eating behavior traits and weight loss attempts with vertebral size among the general Northern Finnish population.Summary Of Background DataVertebral fragility fractures are a typical manifestation of osteoporosis, and small vertebral dimensions are a well-established risk factor for vertebral fracturing. Previous studies have associated cognitive eating restraint and diet-induced weight loss with deteriorated bone quality at various skeletal sites, but data on vertebral geometry are lacking.MethodsThis study of 1338 middle-aged Northern Finns evaluated the associations of eating behavior traits (flexible and rigid cognitive restraint of eating, uncontrolled eating, emotional eating; assessed by the Three-Factor Eating Questionnaire-18) and weight loss attempts (assessed by a separate questionnaire item) with magnetic resonance imaging-derived vertebral cross-sectional area (CSA). Sex-stratified linear regression models were used to analyze the data, taking body mass index, leisure-time physical activity, general diet, smoking, and socioeconomic status as potential confounders.ResultsWomen with rigid or rigid-and-flexible cognitive eating restraints had 3.2% to 3.4% smaller vertebral CSA than those with no cognitive restraint (P ≤ 0.05). Similarly, the women who reported multiple weight loss attempts in adulthood and midlife had 3.5% smaller vertebral size than those who did not (P = 0.03). Other consistent findings were not obtained from either sex.ConclusionRigid cognitive eating restraint and multiple weight loss attempts predict small vertebral size and thus decreased spinal health among middle-aged women, but not among men. Future longitudinal studies should confirm these findings.Level Of Evidence3.

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