Saturday, September 13, 2025 9/13/2025

Exercise and Bisphosphonate Use to Minimize Weight Loss Associated Bone Loss among Older Adults

Award Number: R01AG074979
ORGANIZATION: NATIONAL INSTITUTE ON AGING
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 09/01/2022
PERIOD OF PERFORMANCE END DATE: 08/31/2027

Group Awards By:

View Award Description

Exercise and Bisphosphonate Use to Minimize Weight Loss Associated Bone Loss among Older Adults - PROJECT SUMMARY Despite adverse metabolic and functional consequences of obesity, dietary weight loss (WL) recommendation remains controversial for older adults due to WL associated reduction in bone mineral density (BMD) and increased risk of osteoporotic fracture. Several studies show a positive effect of exercise on BMD in weight- stable, older adults; however, literature examining the ability of exercise to preserve bone during dietary WL is surprisingly equivocal. Discordant findings may be due to varying exercise prescriptions, with recent data from our group suggestive of a superior ability of progressive resistance training (RT) to minimize bone loss during dietary WL, as compared to aerobic training. Nevertheless, some bone loss still occurs with RT, prompting the consideration of alternate or adjuvant osteoprotective strategies. Pharmacotherapy represents another countermeasure strategy, and several medications are FDA-approved to prevent and treat osteoporosis. Bisphosphonates, in particular, are a promising choice as they decrease bone resorption (which is upregulated during WL) and also appear to blunt the catabolic effect of acute exercise on bone, thereby signaling the potential for additive effects during WL — though these hypotheses have not been formally tested. To address these knowledge gaps, the proposed 12 month, 2x2 factorial randomized controlled trial will compare the independent and combined effects of RT plus bone loading exercise and bisphosphonate use on dietary WL associated bone loss among 392 older (60+ years) adults with obesity (BMI=30-40 kg/m2) who are also at risk for low BMD (total hip T-score: 0 to -2.2) at Wake Forest University and The University of Colorado-Anschutz Medical Campus. All participants will receive the same group-mediated dietary WL intervention and be randomized to one of four groups: no RT and placebo capsules (NoRT+PL); progressive RT plus bone-loading exercises and placebo capsules (RT++PL); no RT and bisphosphonate capsules (70 mg weekly oral alendronate; NoRT+BIS); or progressive RT plus bone-loading exercises and bisphosphonate capsules (RT++BIS). Due to its robust change following dietary WL and clinical utility in predicting fracture, our primary outcome is change in total hip aBMD measured via dual x-ray absorptiometry (DXA). This will be complemented by DXA assessment at other skeletal sites, as well as high resolution peripheral quantitative computed tomography (HR-pQCT) derived compartmental volumetric (v)BMD, trabecular bone microarchitecture, cortical thickness/porosity, and strength at the distal radius and tibia — allowing for assessment of intervention effectiveness on novel measures of bone quality. Finally, assessment of biomarkers of bone turnover and metabolism will provide insight into the roles of RT+ and BIS on the bone remodeling unit during dietary WL.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2025 ( Subtotal = $1,228,924 )
2025	2025	WAKE FOREST UNIVERSITY	1834 WAKE FOREST RD	WINSTON SALEM	NC	27109	FORSYTH	USA	Aging Research	001	4	8/12/2025	NON-COMPETING CONTINUATION	$1,228,924
2025	2024	WAKE FOREST UNIVERSITY	1834 WAKE FOREST RD	WINSTON SALEM	NC	27109	FORSYTH	USA	Aging Research	000	3	8/6/2025	NON-COMPETING CONTINUATION	$0
														Subtotal = $1,228,924

Issue Date FY: 2024 ( Subtotal = $1,492,636 )
2024	2024	WAKE FOREST UNIVERSITY	1834 WAKE FOREST RD	WINSTON SALEM	NC	27109	FORSYTH	USA	Aging Research	000	3	8/29/2024	NON-COMPETING CONTINUATION	$1,492,636
2024	2024	WAKE FOREST UNIVERSITY	1834 WAKE FOREST RD	WINSTON SALEM	NC	27109	FORSYTH	USA	Aging Research	001	3	9/19/2024	NON-COMPETING CONTINUATION	$0
														Subtotal = $1,492,636

Issue Date FY: 2023 ( Subtotal = $1,491,062 )
2023	2023	WAKE FOREST UNIVERSITY	1834 WAKE FOREST RD	WINSTON SALEM	NC	27109	FORSYTH	USA	Aging Research	001	2	8/31/2023	NON-COMPETING CONTINUATION	$1,491,062
2023	2022	WAKE FOREST UNIVERSITY	1834 WAKE FOREST RD	WINSTON SALEM	NC	27109	FORSYTH	USA	Aging Research	000	1	3/28/2023	NEW	$0
														Subtotal = $1,491,062

Issue Date FY: 2022 ( Subtotal = $1,385,260 )
2022	2022	WAKE FOREST UNIVERSITY	1834 WAKE FOREST RD	WINSTON SALEM	NC	27109	FORSYTH	USA	Aging Research	000	1	8/25/2022	NEW	$1,385,260
														Subtotal = $1,385,260

Grand Total All Awards = $5,597,882

Top

All Categories

About

Search

Reports

Data Submission

Award Information

Exercise and Bisphosphonate Use to Minimize Weight Loss Associated Bone Loss among Older Adults

Award Number: R01AG074979

ORGANIZATION: NATIONAL INSTITUTE ON AGING

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

PERIOD OF PERFORMANCE START DATE: 09/01/2022

PERIOD OF PERFORMANCE END DATE: 08/31/2027

Federal Websites

Department of Health & Human Services

HHS Operating Divisions

HHS Staff Divisions

Download A Document Viewer