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This secondary analysis evaluated changes in muscle area and density using computed tomography (CT) and lean and fat mass using dual-energy x-ray absorptiometry (DXA).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>One hundred fifty participants (50\/group) were randomized to 12-months of WL, WL + RT, or WL + VEST, undergoing CT and DXA scans at baseline, six- and 12-months. DXA measured lean and fat mass, while CT assessed muscle and intermuscular adipose tissue (IMAT) cross-sectional area (CSA) and density. Mixed linear models evaluated changes and treatment effects, and partial Pearson\u2019s correlations examined relationships between weight change and CT\/DXA outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Participants (66.4\u2009\u00b1\u20094.6\u2009years, 75% female, 69% white) were living with overweight (14.7%) or obesity (85.3%). All groups achieved similar and significant weight loss (\u223c10%). At 12-months, WL + RT increased mid-thigh muscle CSA (0.5%, p\u2009&amp;lt;\u2009.05), improved muscle density (3.7%-5.9%, p\u2009&amp;lt;\u2009.03), and reduced IMAT (20%-22%, p\u2009&amp;lt;\u2009.05) and fat masses (22%-26.8%, all p\u2009&amp;lt;\u2009.061). At the trunk, WL + VEST showed a trend toward muscle preservation and improved density (4.2%, p\u2009=\u2009.08) compared to WL, but had minimal impact on other measures. Differences between WL + VEST and WL were insignificant (all p\u2009&amp;gt;\u2009.05), but group comparisons showed improvements for WL + RT. Weight loss correlated with increased muscle density (r\u2009&amp;lt;\u20090, p\u2009&amp;lt;\u2009.001) but reduced muscle CSA and IMAT (r\u2009&amp;gt;\u20090, p\u2009&amp;lt;\u2009.001), indicating improved quality but reduced quantity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Our findings underscore the significance of weight loss-associated muscle loss, highlighting progressive RT as a minimally effective preservation strategy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/gerona\/glag062","type":"journal-article","created":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T12:42:40Z","timestamp":1772109760000},"source":"Crossref","is-referenced-by-count":0,"title":["Weighted vest use or resistance exercise to offset muscle loss in older adults: secondary findings from the INVEST in bone health 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