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This method assumes lean mass, as the sum of all non\u2010bone and non\u2010fat tissue, is a reasonable proxy for muscle mass. In contrast, the D<jats:sub>3<\/jats:sub>\u2010creatine (D<jats:sub>3<\/jats:sub>Cr) dilution method directly measures whole body skeletal muscle mass, although this method has yet to be applied in the context of a geriatric WL trial. The purpose of this project was to (1) describe estimates of change and variability in D<jats:sub>3<\/jats:sub>Cr muscle mass in older adults participating in an intentional WL intervention and (2) relate its change to other measures of body composition as well as muscle function and strength.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The INVEST in Bone Health trial (NCT04076618), used as a scaffold for this ancillary pilot project, is a three\u2010armed, 12\u2010month randomized, controlled trial designed to determine the effects of resistance training or weighted vest use during intentional WL on a battery of musculoskeletal health outcomes among 150 older adults living with obesity. A convenience sample of 24 participants (<jats:italic>n<\/jats:italic>\u00a0=\u00a08\/arm) are included in this analysis. At baseline and 6\u00a0months, participants were weighed, ingested a 30\u00a0mg D<jats:sub>3<\/jats:sub>Cr tracer dose, provided a fasted urine sample 3\u20136\u00a0days post\u2010dosage, underwent DXA (total body fat and lean masses, appendicular lean mass) and computed tomography (mid\u2010thigh and trunk muscle\/intermuscular fat areas) scans, and performed 400\u2010m walk, stair climb, knee extensor strength, and grip strength tests.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Participants were older (68.0\u00a0\u00b1\u00a04.4\u00a0years), mostly White (75.0%), predominantly female (66.7%), and living with obesity (body mass index: 33.8\u00a0\u00b1\u00a02.7\u00a0kg\/m<jats:sup>2<\/jats:sup>). Six month total body WL was \u221210.3 (95% confidence interval, CI: \u221212.7, \u22127.9) kg. All DXA and computed tomography\u2010derived body composition measures were significantly decreased from baseline, yet D<jats:sub>3<\/jats:sub>Cr muscle mass did not change [+0.5 (95% CI: \u22122.0, 3.0) kg]. Of muscle function and strength measures, only grip strength significantly changed [+2.5 (95% CI: 1.0, 4.0) kg] from baseline.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Among 24 older adults, significant WL with or without weighted vest use or resistance training over a 6\u2010month period was associated with significant declines in all bioimaging metrics, while D<jats:sub>3<\/jats:sub>Cr muscle mass and muscle function and strength were preserved. Treatment assignment for the trial remains blinded; therefore, full interpretation of these findings is limited. Future work in this area will assess change in D<jats:sub>3<\/jats:sub>Cr muscle mass by parent trial treatment group assignment in all study participants.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jcsm.13322","type":"journal-article","created":{"date-parts":[[2023,9,5]],"date-time":"2023-09-05T09:53:44Z","timestamp":1693907624000},"page":"2350-2358","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Application of the D<sub>3<\/sub>\u2010creatine muscle mass assessment tool to a geriatric weight loss trial: A pilot study"],"prefix":"10.1002","volume":"14","author":[{"given":"Kristen M.","family":"Beavers","sequence":"first","affiliation":[{"name":"Department of Health and Exercise Science Wake Forest University  Winston\u2010Salem North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allison E.","family":"Avery","sequence":"additional","affiliation":[{"name":"Department of Health and Exercise Science Wake Forest University  Winston\u2010Salem North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahalakshmi","family":"Shankaran","sequence":"additional","affiliation":[{"name":"University of California  Berkeley California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William J.","family":"Evans","sequence":"additional","affiliation":[{"name":"University of California  Berkeley California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S. Delanie","family":"Lynch","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering Wake Forest School of Medicine  Winston\u2010Salem North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caitlyn","family":"Dwyer","sequence":"additional","affiliation":[{"name":"Department of Health and Exercise Science Wake Forest University  Winston\u2010Salem North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marjorie","family":"Howard","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Data Science Wake Forest School of Medicine  Winston\u2010Salem North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel P.","family":"Beavers","sequence":"additional","affiliation":[{"name":"Department of Statistical Sciences Wake Forest University  Winston\u2010Salem North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashley 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