Weighted Vest Use or Resistance Exercise to Offset Weight Loss-Associated Bone Loss in Older Adults: A Randomized Clinical Trial
Abstract
IMPORTANCE: Weight loss (WL) in older adults is associated with bone loss, increasing the risk of fracture. Because skeletal tissue is responsive to mechanical stress, replacing lost weight externally may be an innovative way to minimize WL-associated bone loss in this population.
OBJECTIVE: To examine the effect of 12 months of weighted vest use during WL on indicators of bone health compared with WL alone and WL plus resistance training (RT).
DESIGN, SETTING, AND PARTICIPANTS: This single-blind, 12-month randomized clinical trial of older adults living with obesity was conducted at an academic medical center from September 1, 2019, to April 30, 2024.
INTERVENTIONS: WL (caloric restriction targeting 10% WL with adequate calcium, vitamin D, and protein), WL plus weighted vest (WL+VEST; 8 h/d, weight replacement titrated up to 10% total WL), or WL plus progressive RT (WL+RT; supervised 3 sessions weekly).
MAIN OUTCOMES AND MEASURES: Main outcomes included 12-month change in computed tomography-acquired trabecular volumetric bone mineral density (vBMD) and dual-energy X-ray absorptiometry-acquired areal bone mineral density (aBMD) of the total hip. Secondary outcomes included change in additional computed tomography- and dual-energy X-ray absorptiometry-acquired measures of musculoskeletal health and bone turnover biomarkers.
RESULTS: A total of 150 older (mean [SD] age, 66.4 [4.6] years) adults (112 [74.7%] women) living with obesity (mean [SD] body mass index, 33.6 [3.3])…
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Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design.
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