Abstract
BackgroundTo examine the effects of daily weighted vest use during a dietary weight loss intervention, on (a) hip and spine bone mineral density (aBMD), and (b) biomarkers of bone turnover, in older adults with obesity.Methods37 older (70.1 ± 3.0 years) adults with obesity (BMI=35.3 ± 2.9) underwent a 22 week dietary weight loss intervention (1100–1300 kcal/day) with (Diet+Vest; n=20) or without (Diet; n=17) weighted vest use (goal: 10+ h/day; weight added incrementally based on amount of weight lost). Total body weight; DXA-acquired aBMD of the total hip, femoral neck and lumbar spine; and biomarkers of bone turnover (OC, BALP, P1NP, CTX) were measured at baseline and follow up. General linear models, adjusted for baseline values of the outcome and gender, were used to examine intervention effects.ResultsAverage weight loss was significant in both groups (−11.2 ± 4.4 kg and −11.0 ± 6.3 kg, Diet+Vest and Diet groups, respectively), with no difference between groups (p=0.91). Average weighted vest use was 6.7 ± 2.2 h/day. No significant changes in aBMD or biomarkers were observed, although trends were noted for total hip aBMD and BALP. Loss in total hip aBMD was greater in the Diet group compared with Diet+Vest (Δ: −18.7 [29.3, −8.1] mg/cm2 versus −6.1 [−15.7, 3.5] mg/cm2; p=0.08). BALP increased in the Diet+Vest group by 3.8% (Δ: 0.59 [−0.33, 1.50] μg/L) and decreased by −4.6% in the Diet group (Δ: −0.70 [−1.70, 0.31] μg/L, p=0.07).ConclusionWeighted vest use during weight loss may attenuate loss of hip aBMD and increase bone formation in older adults with obesity. Further study is warranted.
Highlights
Recommendation for intentional weight loss in advanced aged individuals (i.e., 65+ years) remains controversial due to weight loss-associated loss of bone mass [1,2,3,4] and potential exacerbation of age-related osteoporotic fracture risk [5,6,7,8]
No significant changes in aBMD or biomarkers were observed, trends were noted for total hip aBMD and Bone Specific Alkaline Phosphatase (BALP)
Loss in total hip aBMD was greater in the different between groups (Diet) group compared with Diet+Vest (Δ: −18.7 [29.3, −8.1] mg/cm2 versus −6.1 [−15.7, 3.5] mg/cm2; p=0.08)
Summary
Recommendation for intentional weight loss in advanced aged individuals (i.e., 65+ years) remains controversial due to weight loss-associated loss of bone mass [1,2,3,4] and potential exacerbation of age-related osteoporotic fracture risk [5,6,7,8]. One potential strategy to preserve bone health during a diet induced weight loss program is to add weight-bearing exercise. The osteogenic effect of exercise in weight stable older adults is well recognized [9] and is attributed to the increased mechanical stress placed on bone tissue [10]. Data from randomized controlled trials (RCTs) designed to assess the effect of exercise on bone mass during weight loss are limited, with mixed findings reported [11,12,13]. Compliance may be a primary factor explaining discrepant trial findings [15], and speaks to the larger issue of identification of translatable weight loss countermeasures to minimize bone loss. To examine the effects of daily weighted vest use during a dietary weight loss intervention, on (a) hip and spine bone mineral density (aBMD), and (b) biomarkers of bone turnover, in older adults with obesity
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