Sport Weight Vest

Can the use of weighted vests or resistance training offset bone loss associated with weight loss in older adults: a randomized clinical trial

Importance: Weight loss (WL) in older adults is associated with bone loss, thereby increasing the risk of fractures. Since bone tissue is responsive to mechanical stress, replacing the lost weight through external means may be an innovative approach to minimize WL-related bone loss in this population. Objective: To compare the effects of using a weighted vest, WL alone, and WL combined with resistance training (RT) on skeletal health markers during a 12-month WL period. Design, Setting, and Participants: This single-blind, 12-month randomized clinical trial targeting obese older adults was conducted at an academic medical center from September 1, 2019, to April 30, 2024. Interventions: WL alone (calorie restriction targeting 10% WL, with adequate intake of calcium, vitamin D, and protein), WL plus weighted vest (WL+VEST; 8 hours/day, with weight gradually increased to 10% of total WL), or WL plus progressive RT (WL+RT; supervised three times weekly). Primary outcome measures: Primary outcome measures included changes in hip trabecular bone mineral density (vBMD) measured by computed tomography (CT) and total hip bone mineral density (aBMD) measured by dual-energy X-ray absorptiometry (DXA) over 12 months. Secondary outcome measures included other CT and DXA-measured musculoskeletal health indicators and changes in bone turnover biomarkers. Results: A total of 150 obese older adults were enrolled (mean [SD] age, 66.4 [4.6] years; 112 [74.7%] were female; mean [SD] body mass index 33.6), were randomly assigned (50 to WL, 50 to WL+VEST, 50 to WL+RT), with 133 (88.7%) completing the trial. All groups achieved similar and significant WL, with weight loss ranging from 9.0% to 11.2%.