TY - JOUR
T1 - Effect of Exercise Modality During Weight Loss on Bone Health in Older Adults With Obesity and Cardiovascular Disease or Metabolic Syndrome
T2 - A Randomized Controlled Trial
AU - Beavers, Kristen M.
AU - Walkup, Michael P.
AU - Weaver, Ashley A.
AU - Lenchik, Leon
AU - Kritchevsky, Stephen B.
AU - Nicklas, Barbara J.
AU - Ambrosius, Walter T.
AU - Stitzel, Joel D.
AU - Register, Thomas C.
AU - Shapses, Sue A.
AU - Marsh, Anthony P.
AU - Rejeski, W. Jack
N1 - Funding Information:
This study was funded by a grant from National Institutes of Health/National Heart, Lung and Blood Institute, R18 HL076441, awarded to WJR and APM. Partial support was also provided by a National Institutes on Aging grant, P30 AG021332 (PI: SBK) and K01 AG047921 (PI: KMB), as well as a National Science Foundation Research Experiences for Undergraduates grant (1559700) to JDS and AAW. Additionally, we are indebted to our participants, our project manager and registered dietitian, Beverly Nesbit, our lead interventionist, Jillian Gaukstern, our lead assessor, Jessica Sheedy, and our DXA technician, Sherri Ford, for their contributions related to the conduct of the trial and quality of the data. Lastly, we gratefully acknowledge Samantha Schoell, Divya Jain, and Elizabeth Lopez for their help in generating the CT data.
Funding Information:
This study was funded by a grant from National Institutes of Health/National Heart, Lung and Blood Institute, R18 HL076441, awarded to WJR and APM. Partial support was also provided by a National Institutes on Aging grant, P30 AG021332 (PI: SBK) and K01 AG047921 (PI: KMB), as well as a National Science Foundation Research Experiences for Undergraduates grant (1559700) to JDS and AAW. Additionally, we are indebted to our participants, our project manager and registered dietitian, Beverly Nesbit, our lead interventionist, Jillian Gaukstern, our lead assessor, Jessica Sheedy, and our DXA technician, Sherri Ford, for their contributions related to the conduct of the trial and quality of the data. Lastly, we gratefully acknowledge Samantha Schoell, Divya Jain, and Elizabeth Lopez for their help in generating the CT data. Authors’ Roles: Study design: WJR, APM, and WTA. Study conduct and data collection: WJR, APM, KMB, AAW, JDS, and LL. Data analysis: MPW and WTA. Data interpretation: KMB, MPW, AAW, LL, SBK, BJN, WTA, JDS, TCR, SAS, APM, and WJR. Drafting manuscript: KMB. Revising manuscript content: KMB, MPW, AAW, LL, SBK, BJN, WTA, JDS, TCR, SAS, APM, and WJR. All authors approved the final version. MPW, WTA, and KMB take responsibility for the integrity of the data analysis.
Publisher Copyright:
© 2018 American Society for Bone and Mineral Research
PY - 2018/12
Y1 - 2018/12
N2 - The objective of this study was to determine the ability of either aerobic or resistance training to counter weight-loss-associated bone loss in older adults. There were 187 older adults (67 years, 70% women, 64% white) with obesity (BMI = 34.5 ± 3.7 kg/m 2 ) and cardiovascular disease and/or metabolic syndrome who were randomized to participate in an 18-month, community-based trial, with a follow-up assessment at 30 months. Intervention arms included: weight loss alone (WL; 7% to 10% baseline weight), WL plus aerobic training (WL + AT), and WL plus resistance training (WL + RT), as well as DXA-acquired total hip, femoral neck, and lumbar spine areal bone mineral density (aBMD), and trabecular bone score (TBS). Biomarkers of bone turnover (procollagen type 1 N-terminal propeptide, C-terminal telopeptide of type 1 collagen) were measured at baseline, 6, 18, and 30 (aBMD and TBS only) months. CT-acquired hip and spine volumetric BMD (vBMD), cortical thickness, and bone strength were measured in a subset at baseline (n = 55) and 18 months. Total hip aBMD was reduced by 2% in all groups at 18 months, with a primary analysis showing no significant treatment effects for any DXA, biomarker, or CT outcome. After adjustment for WL and follow-up at 30 months, secondary analyses revealed that total hip [−0.018 (−0.023 to −0.012) g/cm 2 versus −0.025 (−0.031 to −0.019) g/cm 2 ; p = 0.05] and femoral neck [−0.01 (−0.009 to 0.008) g/cm 2 versus −0.011 (−0.020 to −0.002) g/cm 2 ; p = 0.06] aBMD estimates were modestly attenuated in the WL + RT group compared with the WL group. Additionally, lumbar spine aBMD was increased in the WL [0.015 (0.007 to 0.024) g/cm 2 ] and the WL + RT [0.009 (0.000 to 0.017) g/cm 2 ] groups compared with the WL + AT [−0.003 (−0.012 to 0.005)g/cm 2 ] group; both p ≤ 0.01. Community-based exercise does not prevent bone loss during active WL in older adults; however, adding RT may help minimize long-term hip bone loss.
AB - The objective of this study was to determine the ability of either aerobic or resistance training to counter weight-loss-associated bone loss in older adults. There were 187 older adults (67 years, 70% women, 64% white) with obesity (BMI = 34.5 ± 3.7 kg/m 2 ) and cardiovascular disease and/or metabolic syndrome who were randomized to participate in an 18-month, community-based trial, with a follow-up assessment at 30 months. Intervention arms included: weight loss alone (WL; 7% to 10% baseline weight), WL plus aerobic training (WL + AT), and WL plus resistance training (WL + RT), as well as DXA-acquired total hip, femoral neck, and lumbar spine areal bone mineral density (aBMD), and trabecular bone score (TBS). Biomarkers of bone turnover (procollagen type 1 N-terminal propeptide, C-terminal telopeptide of type 1 collagen) were measured at baseline, 6, 18, and 30 (aBMD and TBS only) months. CT-acquired hip and spine volumetric BMD (vBMD), cortical thickness, and bone strength were measured in a subset at baseline (n = 55) and 18 months. Total hip aBMD was reduced by 2% in all groups at 18 months, with a primary analysis showing no significant treatment effects for any DXA, biomarker, or CT outcome. After adjustment for WL and follow-up at 30 months, secondary analyses revealed that total hip [−0.018 (−0.023 to −0.012) g/cm 2 versus −0.025 (−0.031 to −0.019) g/cm 2 ; p = 0.05] and femoral neck [−0.01 (−0.009 to 0.008) g/cm 2 versus −0.011 (−0.020 to −0.002) g/cm 2 ; p = 0.06] aBMD estimates were modestly attenuated in the WL + RT group compared with the WL group. Additionally, lumbar spine aBMD was increased in the WL [0.015 (0.007 to 0.024) g/cm 2 ] and the WL + RT [0.009 (0.000 to 0.017) g/cm 2 ] groups compared with the WL + AT [−0.003 (−0.012 to 0.005)g/cm 2 ] group; both p ≤ 0.01. Community-based exercise does not prevent bone loss during active WL in older adults; however, adding RT may help minimize long-term hip bone loss.
KW - AGING
KW - BMD
KW - EXERCISE
KW - WEIGHT LOSS
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U2 - 10.1002/jbmr.3555
DO - 10.1002/jbmr.3555
M3 - Article
C2 - 30088288
AN - SCOPUS:85053183631
SN - 0884-0431
VL - 33
SP - 2140
EP - 2149
JO - Journal of Bone and Mineral Research
JF - Journal of Bone and Mineral Research
IS - 12
ER -