Department of Internal Medicine-Geriatrics and Gerontology, Wake Forest School of Medicine, Winston-Salem, NC, United States of America.
Department of Biostatistics and Data Science, Wake Forest School of Medicine, Winston-Salem, NC, United States of America.
Contemp Clin Trials. 2021 May;104:106326. doi: 10.1016/j.cct.2021.106326. Epub 2021 Feb 22.
Achievement of 5-10% weight loss (WL) among older adults living with obesity considerably improves prognosis of health-related outcomes; however, concomitant declines in bone mineral density (BMD) limit overall benefit by increasing fracture risk. Declines in mechanical loading contribute to WL-associated BMD loss, with pilot data signaling the addition of external weight replacement (via weighted vest use) during intentional WL mitigates bone loss at weight bearing sites to a similar degree as resistance exercise training (RT). Definitive data in support of weighted vest use as a potential strategy to mitigate WL-associated bone loss in this population are needed.
In the Incorporating Nutrition, Vests, Education, and Strength Training (INVEST) in Bone Health trial (NCT04076618), 192 older adults (60-85 years) who are overweight (BMI ≥ 27 kg/m) with at least one obesity-related risk factor or obese (BMI = 30-40 kg/m) will be randomly assigned to participate in one of three 12-month intervention groups: WL alone, WL + weighted vest use (WL + VEST), or WL + RT. The primary aim is to determine the effects of WL + VEST compared to WL alone and WL + RT on indicators of bone health and subsequent fracture risk.
Determining effective, translatable strategies that minimize bone loss during intentional WL among older adults holds public health potential. The INVEST in Bone Health trial offers an innovative approach for increasing mechanical stress during intentional WL in the absence of RT. If successful, findings from this study will provide evidence in support of a scalable solution to minimize bone loss during intentional WL among older adults with obesity.
肥胖的老年人如果能减轻 5%-10%的体重（WL），其健康相关结果的预后会有显著改善；但与此同时，骨密度（BMD）的下降会增加骨折风险，从而限制了整体获益。机械负荷的下降导致 WL 相关的 BMD 损失，初步数据表明，在有意 WL 期间增加外部重量替代（通过使用负重背心）可以将承重部位的骨丢失程度降低到与阻力运动训练（RT）相似的程度。需要明确的数据来支持在该人群中使用负重背心作为减轻 WL 相关骨丢失的潜在策略。
在纳入营养、背心、教育和力量训练（INVEST）在骨健康试验（NCT04076618）中，192 名超重（BMI≥27kg/m）的老年人（60-85 岁），至少有一个肥胖相关的危险因素，或肥胖（BMI=30-40kg/m），将被随机分配到以下三个为期 12 个月的干预组中的一个：单独 WL、WL+负重背心使用（WL+VEST）或 WL+RT。主要目的是确定 WL+VEST 与单独 WL 和 WL+RT 相比对骨健康指标和随后的骨折风险的影响。
确定有效、可转化的策略，最大限度地减少老年人在有意 WL 期间的骨丢失，具有公共卫生潜力。INVEST 在骨健康试验为在没有 RT 的情况下增加有意 WL 期间的机械应激提供了一种创新方法。如果成功，这项研究的结果将为支持在肥胖的老年人中减轻有意 WL 期间的骨丢失提供一个可扩展的解决方案提供证据。
