TODAY'S AJENDA #76

Every fitness trend promises to be the one. Right now, weighted vests are having a moment. This sleek, body-hugging gear reportedly transforms your daily walk into a bone-building, fat-melting miracle. 

But before you buy into the hype, let’s separate fact from fiction. 

Myth or Real: Weighted Vests Slow Osteoporosis 

Yes.* (But There’s a Catch.) 

As we get older, bone health becomes a real concern. The good news is that weight-bearing exercise is one of the most effective non-drug strategies for slowing bone loss. A weighted vest, in theory, strengthens bones by placing healthy stress on them (a process known as osteogenesis or bone formation). 

“What does the science say?” 

• A study followed 18 postmenopausal women for 5 years and found that those who did the weighted vest exercises maintained their bone density, while the control group lost theirs. 

• Another study found that after 12 weeks of weighted vest training, postmenopausal women reduced bone breakdown by 14.5% and gained 40% more ankle strength. 

But (and here’s the dose of honesty) these effects are modest and require consistency over months, sometimes years. Plus, both studies had structured exercise programs. It’s not like participants just strapped on a vest before hitting the farmer’s market. 

Even the Bone Health and Osteoporosis Foundation doesn’t endorse weighted vests yet, calling the evidence “uncertain” and stating that more research is needed. 

Myth or Real: Weighted Vests Boost Heart Health

Real. 

Slip on a weighted vest, and every movement is dialed up a notch. The heart pumps more blood to meet higher oxygen demands in the muscles. Over time, this can strengthen your cardiovascular system. 

• Science Says: A study of “normal-weight obese” women (normal BMI but high body fat) found that 8 weeks of weighted vest training reduced the rate of heart disease markers by 38% (I cover the study in more depth here). 

Even just 5% of your body weight will do the trick. For context, most vests range from 5-12%. Using a vest with more than 15% on a regular basis runs the risk of tilting the risk/benefit scale more to the risk range (of actually causing harm to the back, discs, etc).

Myth or Real: Weighted Vests Melt Fat

Myth. 

Anything promising to “melt fat” is selling you a fantasy. Fat loss doesn’t work this way. While weighted vests can help you burn more calories, the difference is small (around 10-20 extra calories per mile). 

However, a study done just this May found something interesting: 

• Science Says: People who wore weighted vests during a 6-month weight-loss program kept off 5 kg two years later. But those who dieted without vests regained most of the weight. 

The idea is that a weighted vest helps prevent the metabolic slowdown. Normally, when you lose weight, bones signal the brain to conserve energy and ramp up appetite. But the vest “tricks” your body into thinking it’s heavier, so it doesn’t react as strongly to the weight loss. 

• The Caveat: It was a tiny study (only 18 people), so we need bigger trials to confirm. 

Myth or Real: They’re Risk-Free

Myth. 

This is not a free lunch. More weight means more stress on joints, especially on your hips and knees. If you have arthritis or balance problems, that could mean a higher risk of pain or falls. 

To reduce the risk of injury: 

• Gradually Increase Weight → Start at 5-10% of your body weight to allow your body time to adapt. (For example, if you’re 120 pounds, your weighted vest shouldn’t be more than 12 pounds). 

• Get the Right Fit → Make sure your weighted vest is close to and sits high above your torso. Otherwise, it can strain your posture and irritate your joints. 

“Is there one kind you recommend?” Yes, the kind you like, and the kind you can afford. The idea is to add weight. It’s not to make a fashion statement. 

Bottom Line

So, are weighted vests worth it? Yes and no. They don’t hurt to try! But part of the weighted vest craze feeds into our desire for easy wins (e.g., wear this during your coffee run and watch the fat “melt away”). 

While the science does support bone density and cardiovascular benefits, think of it as a spice, not the main dish. The foundation is still regular weight-bearing exercise and adequate calcium and protein intake.

Transcendental Meditation (TM) sounds like something you’d do barefoot in the scented chambers of a reiki practitioner. But if I told you that there was a pill that could help lower your blood pressure, sleep better, and reduce stress, you’d want that prescription, right? 

Transcendental Meditation 101 

• The What: Transcendental Meditation is a meditation technique that activates alpha-1 wave activity in the brain, where you mentally repeat a word or phrase to reach a state of inner peace. 

• The How: Sit comfortably with your eyes closed and silently repeat a mantra (“om” or “so-hum” [Sanskrit for ‘I am that’]) for 20 minutes twice a day. 

Now for the interesting part: The Why. The science behind Transcendental Meditation’s benefits is pretty compelling. 

The Benefits of Transcendental Meditation 

A 2022 study tracked 80 healthcare workers for three months and found that TM helped improve chronic stress (insomnia and anxiety) significantly compared to usual wellness resources. 

But the cardiovascular benefits might be even more impressive. A 2024 systematic review analyzed 45 studies and found TM reduces blood pressure by about 3.3 points systolic and 1.8 points diastolic. 

• Zoom In: A 2012 study found that among African Americans with existing heart disease, TM practitioners were 48% less likely to have heart attacks or strokes over 5.4 years. 

TM may also improve insulin resistance (how well your body processes sugar). A 2006 study of 103 people (mostly men) with coronary heart disease found TM improved insulin sensitivity and blood pressure. (Though we definitely need this study replicated with women!)

The American Heart Association has also recognized TM as a potential therapy for hypertension. 

Tips For Getting Started

Transcendental Meditation needs to be taught in person, with 4 consecutive days of approximately 2-hour lessons. There is a cost involved, but that cost is based on someone’s ability to pay, so there are payment plans available and sliding fees to accommodate almost everyone’s financial situation. The fees go to paying the instructors, so that quality, credentialed experts can teach this practice.  

Insurance companies are now considering covering the costs of learning, since the clinical data regarding its benefits have been so impressive. 

We’ve also been discussing Transcendental Meditation in The Wellness Experiment. We hosted a live webinar with Bob Roth, author of Strength in Stillness, who has spent 50 years teaching this ancient technique to everyone from Oprah to Gwyneth Paltrow. 

My Experience With Transcendental Meditation

I’ll admit, I'm not as consistent as I’d like to be. I find that my best chances of success come when I do it first thing in the morning, when I can block off 20-30 minutes before the day takes over. 

And every single time I practice, the results are positive. Meditation makes me more mentally efficient, positive, calm, and focused. It’s as if I gain 2-3 hours extra in my day. Instead of feeling rushed, I feel like I finish my to-do list EARLY.  

There is no excuse for not being more consistent since I always feel so good when I do it. It is THAT powerful. And as the saying goes: ‘you don’t find the time, you make the time.’ 

Bottom Line

TM is not a magic bullet. But with prescriptions for anxiety, hypertension, and insomnia steadily climbing, maybe it’s time to consider this practice that’s been around for 5,000 years and has some real science behind it. 

If I could, I’d write “TM: 20 minutes twice a day” on a prescription pad and hand it to patients (especially women navigating the second half of life). But since I can’t do that, consider this my doctorly nudge to give it a shot. For more information on Transcendental Meditation, or to find an instructor near you, go to tm.org or check out davidlynchfoundation.org 

We’re all bracing for cold season. But September is also when ragweed comes out. A single plant can release 1 billion pollen grains and drift hundreds of miles. 

• Zoom In: That means you could live nowhere near ragweed and still deal with congestion, irritated skin, and a compromised immune system just as cold season ramps up. 

While we can’t stop ragweed outside, we can create cleaner air inside. I recommend Canopy’s Beside Humidifier* at home to help catch dust and other particles, providing more hydrated air that can help reduce allergies and possibly even the chances of getting sick. 

The cleaner, moist air can also lead to hydrated skin. And when you’re not dealing with a scratchy throat or runny/stuffy nose, you likely sleep better, which can improve other things (from skin to mood). 

I use Canopy’s Beside Humidifier to prepare for the winter season, but it’s great year-round (in the air conditioning or heat). I consider it part of my bedroom environment, which I try to optimize as much as possible. 

If you’re curious about a possible better night’s sleep and clearer skin, use the code Jen15 for 15% off. The code expires Wednesday, September 10, and is exclusively for Ajenda subscribers. 

Osteoporosis is the “silent thief” of bone. It can weaken your skeleton for years without causing pain, swelling, or any symptoms whatsoever, until an everyday mishap (stepping off the curb wrong) leads to a fracture.

One in two women over age 50 will experience an osteoporosis-related fracture in her lifetime. And these aren’t always minor fractures that heal with time:  

• Zoom In: Women have about a ⅙ chance of sustaining a hip fracture, which can lead to a sharp decline in survival and independence. 

That’s why drug therapy for osteoporosis exists. But like everything in medicine, the solution isn’t one-size-fits-all.

The Available Osteoporosis Medications 

Broadly, osteoporosis drugs fall into two camps: those that slow bone breakdown (anti-resorptives) and those that build new bone (anabolics).

Bisphosphonates like alendronate, risedronate, and zoledronic acid (Fosamax, Actonel, Boniva) are the go-to first choice. These medications stick to your bone surface and put the brakes on cells that resorb bone. 

• Science Says: Large studies show they can reduce vertebral fractures by 40–70% and hip fractures by 40–50%. 

Denosumab (Prolia) is a monoclonal antibody injection you get every six months that inhibits bone resorption. The FREEDOM trial found it reduced vertebral fractures by 68% and hip fractures by 40%. 

Then there are the bone-building medications. Teriparatide and abaloparatide (Forteo and Tymlos) actually stimulate your body to create bone rather than just preventing loss. They’re usually reserved for women at very high fracture risk.

Lastly, romosozumab (Evenity) is a newer option. It builds both bones and decreases resorption. 

Benefits vs. Risks

The benefits are clear: fewer fractures, less disability, improved quality of life. But nothing comes free.

Bisphosphonates can cause osteonecrosis of the jaw (bone death) and atypical femoral fractures. While serious, these side effects have received disproportionate attention given how rare they are (less than 1 per 100,000 patients a year). 

The bigger day-to-day concern for many women is gastrointestinal side effects. 

Then there’s denosumab (brand name Prolia). It works great, but coming off it is tricky. Stopping suddenly has been linked to rapid bone loss and a rebound in fracture risk, so patients need a careful “exit strategy.”

Anabolic therapies are expensive, require daily injections, and you can typically only use them for 18-24 months before the benefits plateau.

As for romosozumab? The FDA warns about the possible increased risk of heart attack and stroke, so it’s not used in women with recent cardiovascular events or who have had a stroke within the past year. 

The Bottom Line

The fracture reduction benefits usually outweigh the risks. But the decision must be individualized. There’s still so much we don’t know about osteoporosis medications: 

• Zoom In: That includes how long you can stay on a bisphosphonate or the optimal sequence of treatments. 

Find a doctor who is willing to dig deep. Don’t just ask: “Should I take a drug for osteoporosis?” but “Which drug, for how long, and what’s our plan to monitor?” 

There are doctors who specialize in metabolic bone disease and know the osteoporosis literature inside and out. If you can see one, definitely take advantage of that luxury.

Just remember that bone health doesn’t come from a prescription alone. Nutrition (adequate protein, calcium, and vitamin D), resistance training, balance work, and fall prevention are all equally important pillars. (Oh, and don’t forget, men get osteoporosis too!)

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ABOUT DR. JEN

In her former roles as chief medical correspondent for ABC News and on-air cohost of “GMA3: What You Need to Know,” Dr. Jennifer Ashton—”Dr. Jen”—has shared the latest health news and information with millions of viewers nationwide. As an OB-GYN, nutritionist, and board-certified obesity medicine specialist, she is passionate about promoting optimal health for “the whole woman.” She has authored several books, including the national best-seller, The Self-Care Solution: A Year of Becoming Happier, Healthier & Fitter—One Month at a Time. And she has gone through menopause…

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