The Bone, Exercise, Alendronate, and Caloric Restriction (BEACON) trial design and methods

Area of Science:

• Gerontology
• Bone Metabolism
• Obesity Research

Background:

• Intentional weight loss (WL) in older adults with obesity improves comorbidities but can decrease bone mineral density (BMD), increasing fracture risk.
• Optimizing WL interventions to preserve musculoskeletal health is crucial for this population.
• The Bone, Exercise, Alendronate, and Caloric Restriction (BEACON) trial addresses this by examining strategies to mitigate WL-associated bone loss.

Purpose of the Study:

• To compare the independent and combined effects of resistance training (RT) and bisphosphonate use on bone loss during a 12-month dietary WL intervention.
• To evaluate the impact of these interventions on skeletal integrity in older adults.

Main Methods:

• 308 older adults (≥60 years) with obesity and an indication for WL and bisphosphonate use participated.
• Participants received a group-mediated dietary intervention targeting 8-10% WL.
• Randomization to four groups: no RT + placebo, RT + placebo, no RT + bisphosphonate, or RT + bisphosphonate.

Main Results:

• Primary outcome: total hip areal BMD measured by DXA.
• Secondary outcomes: femoral neck and lumbar spine aBMD, HRpQCT bone assessments, and bone turnover biomarkers.

Conclusions:

• The BEACON trial will provide critical insights into optimizing skeletal integrity during weight loss in older adults.
• It investigates scalable interventions to maximize fat loss while minimizing harm to the musculoskeletal system.