Effects of weighted vest on bone health and body fat in middle-aged and older adults: a systematic review and meta-analysis.
Level 1 - systematic review of randomized trials
Systematic review and meta-analysis of randomized controlled trials
PubMed 42601514 · doi:10.1007/s00198-026-08196-y
What was done
Systematic review and meta-analysis of nine randomized controlled trials (368 middle-aged and older participants) evaluating weighted vest interventions against usual activity or exercise alone. Outcomes included bone mineral density (BMD), bone turnover markers, and body fat mass. Searches spanned PubMed, Embase, Cochrane Library, Web of Science, and Scopus through March 9, 2026. Meta-analyses used fixed-effect models where feasible or narrative synthesis, with GRADE used to assess evidence certainty.
What was found
Vest plus exercise significantly improved femoral neck BMD (SMD = 0.59, 95% CI: 0.05 to 1.13, P = 0.03; I² = 37%) and lumbar spine BMD (SMD = 0.73, 95% CI: 0.29 to 1.16, P = 0.001; I² = 0%) compared to usual activity. Vest plus exercise also reduced body fat mass compared to usual activity (MD = -2.67 kg, 95% CI: -4.08 to -1.27, P = 0.0002) and compared to exercise alone (MD = -0.73 kg, 95% CI: -1.20 to -0.27, P = 0.002). Adding a vest to exercise alone did not show a statistically significant BMD benefit over exercise alone based on a single study. Body fat evidence had high certainty; other outcomes were low to moderate certainty.
Why it matters
Weighted vests worn during exercise enhance fat loss and improve bone density relative to inactivity, but add only modest additional fat loss and no confirmed skeletal benefit beyond exercise alone.
Limits
The overall sample size was small across nine trials (368 participants). The direct additive comparison of vest plus exercise versus exercise alone for BMD relied on a single trial. Evidence certainty was low to moderate for bone outcomes, and bone turnover marker data were not quantified in the abstract.
Cited by
- supports Walking with a weighted vest does not provide an adequate stimulus to improve muscle mass or bone density.