Weighted vest use or resistance exercise to offset muscle loss in older adults: secondary findings from the INVEST in bone health RCT.
Level 2 - randomized trial
Randomized controlled trial (secondary analysis)
PubMed 41761582 · doi:10.1093/gerona/glag062
What was done
This secondary analysis of the INVEST in Bone Health trial evaluated 150 older adults with overweight or obesity (mean age 66.4 ± 4.6 years, 75% female, 69% white) randomized to 12 months of weight loss alone (WL, n = 50), weight loss plus resistance training (WL + RT, n = 50), or weight loss plus weighted vest use (WL + VEST, n = 50). Computed tomography (CT) and dual-energy x-ray absorptiometry (DXA) scans at baseline, 6 months, and 12 months measured lean and fat mass, muscle cross-sectional area (CSA), muscle density, and intermuscular adipose tissue (IMAT).
What was found
All groups achieved similar weight loss (~10%). At 12 months, WL + RT increased mid-thigh muscle CSA (0.5%, p < .05), increased muscle density (3.7%-5.9%, p < .03), and decreased IMAT (20%-22%, p < .05) and fat mass (22%-26.8%, all p < .061). WL + VEST showed a non-significant trend toward improved trunk muscle density compared to WL alone (4.2%, p = .08), but differences between WL + VEST and WL were not statistically significant across measures (all p > .05). Across participants, weight loss correlated with increased muscle density (r < 0, p < .001) but reduced muscle CSA and IMAT (r > 0, p < .001).
Why it matters
Weight reduction in older adults typically leads to muscle loss alongside fat loss. These results demonstrate that adding progressive resistance training offsets muscle area loss and reduces intermuscular fat during weight loss, whereas weighted vest use offers minimal advantage over weight loss alone.
Limits
This was a secondary analysis rather than a primary-endpoint trial. The sample was predominantly female (75%) and white (69%). The abstract does not report adherence rates to the weighted vest intervention, resistance training compliance, or functional strength outcomes.
Cited by
- supports Walking with a weighted vest does not provide an adequate stimulus to improve muscle mass or bone density.