Effect of an 18-month physical activity and weight loss intervention on body composition in overweight and obese older adults

Abstract Background: Optimization of intentional weight loss in obese older adults, through preferential fat mass reduction, is challenging, as the concomitant lean mass loss may exacerbate sarcopenia. Here, we assessed whether changes in within-day protein intake distribution are related to improvements in body composition in overweight/obese older adults during a hypocaloric and exercise intervention. Methods: Thirty-six community-dwelling, overweight-to-obese (BMI 28.0-39.9 kg/m2), sedentary older adults (aged 70.6±6.1 years) were randomized into either physical activity plus successful aging health education (PA+SA; n=15) or physical activity plus weight loss (PA+WL; n=21) programs. Body composition (by CT and DXA) and dietary intake (by three-day food records) were determined at baseline, 6-month, and 12-month follow-up visits. Within-day protein distribution was calculated as the coefficient of variation of protein ingested at breakfast [5:00–10:59], lunch [11:00–16:59] and dinner [17:00–1:00]. Secondary analysis was performed to determine associations between changes in protein intake distribution and body composition. Results: In both groups, baseline protein intake was skewed towards dinner. The pattern of protein intake changed towards a more even within-day distribution in PA+WL, but it remained unchanged in PA+SA. Transition towards a more even pattern of protein intake was independently associated with a greater decline in BMI (P<0.05) and abdominal subcutaneous fat (P<0.05) in PA+WL. However, changes in protein CV were not associated with weight loss in PA+SA. Conclusion: Our results show that mealtime distribution of protein intake throughout the day was associated with improved weight and fat loss under hypocaloric diet combined with physical activity.

Download Full-text

FEASIBILITY OF WEIGHTED VEST USE DURING A DIETARY WEIGHT LOSS INTERVENTION AND EFFECTS ON BODY COMPOSITION AND PHYSICAL FUNCTION IN OLDER ADULTS

Journal of Frailty & Aging ◽

10.14283/jfa.2018.17 ◽

2018 ◽

pp. 1-6

Author(s):

E. NORMANDIN ◽

D. YOW ◽

C. CROTTS ◽

J. KIEL ◽

K.M. BEAVERS ◽

...

Keyword(s):

Older Adults ◽

Weight Loss ◽

Body Composition ◽

Pilot Study ◽

Muscle Strength ◽

Lower Extremity ◽

Physical Function ◽

Weight Loss Intervention ◽

Dietary Weight Loss ◽

Weighted Vest

Background: While intentional weight loss in older adults with obesity yields clinically important health benefits there is a need to minimize the negative effects of weight loss on concomitant loss of muscle mass and strength. Data show wearing weighted vests during exercise improves lean mass and lower extremity strength, however the efficacy of wearing a weighted vest during a period of weight loss to mitigate muscle and strength loss is not known. Objectives: This study examined the feasibility of daily weighted vest use during a dietary weight loss intervention, and examined effects of vest use on body composition and physical function in well-functioning older adults with obesity. Design: Randomized, controlled pilot study. Setting: Wake Forest Baptist Medical Center in Winston-Salem, NC. Participants: 37 older (age=65-79 yrs), obese (BMI=30-40 kg/m2) sedentary men and women. Interventions: 22-week behavioral diet intervention (targeting 10% weight loss, 1100-1300 kcals/day) with (Diet+Vest; n=20) or without (Diet; n=17) weighted vest use (goal of 10 hours/day with weight added weekly according to individual loss of body mass). Measurements: Body composition by dual-energy x-ray absorptiometry and measures of physical function, mobility, and muscle strength/power. Results: Average weighted vest use was 6.7±2.2 hours/day and the vest-wear goal of 10 hrs/day was achieved for 67±22% of total intervention days. Five participants reported adverse events from wearing the vest (all back pain or soreness). Both groups lost a similar amount of weight (Diet= -11.2±4.4 kg; Diet+Vest = -11.0±6.3 kg; p<0.001), with no differences between groups (p=0.25). Fat mass, lean mass, and % body fat decreased significantly (p<0.0001), with no differences between groups. Compared to Diet+Vest, the Diet intervention resulted in greater decreases in leg power (p<0.02), with no other between group differences in physical function. Conclusion: This pilot study showed that vest use during dietary weight loss is feasible and safe in well-functioning older adults with obesity. Larger studies are needed to definitively determine whether external replacement of lost weight during caloric restriction may preserve lower extremity muscle strength and power.

Download Full-text

Behavioural mediators of reduced energy intake in a physical activity, diet, and sleep behaviour weight loss intervention in adults

Appetite ◽

10.1016/j.appet.2021.105273 ◽

2021 ◽

pp. 105273

Author(s):

Sasha Fenton ◽

Tracy L. Burrows ◽

Clare E. Collins ◽

Elizabeth G. Holliday ◽

Gregory S. Kolt ◽

...

Keyword(s):

Physical Activity ◽

Weight Loss ◽

Energy Intake ◽

Weight Loss Intervention ◽

Sleep Behaviour

Download Full-text

Efficacy of a Multi-Component m-Health Diet, Physical Activity, and Sleep Intervention on Dietary Intake in Adults with Overweight and Obesity: A Randomised Controlled Trial

Nutrients ◽

10.3390/nu13072468 ◽

2021 ◽

Vol 13 (7) ◽

pp. 2468

Author(s):

Sasha Fenton ◽

Tracy L. Burrows ◽

Clare E. Collins ◽

Anna T. Rayward ◽

Beatrice Murawski ◽

...

Keyword(s):

Physical Activity ◽

Weight Loss ◽

Randomised Controlled Trial ◽

Dietary Intake ◽

Controlled Trial ◽

Intervention Group ◽

Weight Loss Intervention ◽

Traditional Group ◽

Traditional Diet ◽

Randomised Controlled

This three-arm randomised controlled trial evaluated whether (1) a multi-component weight loss intervention targeting diet, physical activity (PA), and sleep was effective at improving dietary intake over six months and 12 months, compared with a control, and (2) the enhanced diet, PA, and sleep intervention was more effective at improving dietary intake than the traditional diet and PA intervention. A total of 116 adults (70% female, 44.5 years, BMI 31.7 kg/m2) were randomised to either traditional diet and PA intervention; enhanced diet, PA, and sleep intervention; or wait-list control. To examine between-group differences, intervention groups were pooled and compared with the control. Then, the two intervention groups were compared. At six months, the pooled intervention group consumed 1011 fewer kilojoules/day (95% CI −1922, −101), less sodium (−313.2 mg/day; 95% CI −591.3, −35.0), and higher %EI from fruit (+2.1%EI; 95% CI 0.1, 4.1) than the controls. There were no differences in intake between the enhanced and traditional groups at six months. At 12 months, the pooled intervention and control groups reported no significant differences. However, compared to the traditional group, the enhanced reported higher %EI from nutrient-dense foods (+7.4%EI; 95% CI 1.3, 13.5) and protein (+2.4%EI; 95% CI 0.1, 4.6), and reduced %EI from fried/takeaway foods (−3.6%EI; 95% CI −6.5, −0.7), baked sweet products (−2.0%EI; 95% CI −3.6, −0.4), and packaged snacks (−1.1%EI; 95% CI −2.2, −0.3). This weight loss intervention reduced total energy and sodium intakes as well as increased fruit intake in adults at six months. The enhanced intervention group reported improved dietary intake relative to the traditional group at 12 months.

Download Full-text

Breast cancer survivors’ experience of making weight, dietary and physical activity changes during participation in a weight loss intervention

Supportive Care in Cancer ◽

10.1007/s00520-016-3542-2 ◽

2016 ◽

Vol 25 (5) ◽

pp. 1455-1463 ◽

Cited By ~ 8

Author(s):

Caroline O Terranova ◽

Sheleigh P Lawler ◽

Kym Spathonis ◽

Elizabeth G Eakin ◽

Marina M Reeves

Keyword(s):

Breast Cancer ◽

Physical Activity ◽

Weight Loss ◽

Cancer Survivors ◽

Breast Cancer Survivors ◽

Weight Loss Intervention

Download Full-text

Weight Loss and High-Protein, High-Fiber Diet Consumption Impact Blood Metabolite Profiles, Body Composition, Voluntary Physical Activity, Fecal Microbiota, and Fecal Metabolites of Adult Dogs

Journal of Animal Science ◽

10.1093/jas/skab379 ◽

2021 ◽

Author(s):

Thunyaporn Phungviwatnikul ◽

Anne H Lee ◽

Sara E Belchik ◽

Jan S Suchodolski ◽

Kelly S Swanson

Keyword(s):

Physical Activity ◽

Weight Loss ◽

Body Composition ◽

Mass Loss ◽

Fat Mass ◽

Fecal Microbiota ◽

Restricted Feeding ◽

High Fiber ◽

Voluntary Physical Activity ◽

Over Time

Abstract Canine obesity is associated with reduced lifespan and metabolic dysfunction, but can be managed by dietary intervention. This study aimed to determine the effects of restricted feeding of a high-protein, high-fiber (HPHF) diet and weight loss on body composition, physical activity, blood metabolites, and fecal microbiota and metabolites of overweight dogs. Twelve spayed female dogs [age: 5.5±1.1 yr; body weight (BW): 14.8±2.0 kg, body condition score (BCS): 7.9±0.8] were fed a HPHF diet during a 4-wk baseline phase to maintain BW. After baseline (wk 0), dogs were first fed 80% of baseline intake and then adjusted to target 1.5% weekly weight loss for 24 wk. Body composition using dual-energy x-ray absorptiometry and blood samples (wk 0, 6, 12, 18, 24), voluntary physical activity (wk 0, 7, 15, 23), and fresh fecal samples for microbiota and metabolite analysis (wk 0, 4, 8, 12, 16, 20, 24) were measured over time. Microbiota data were analyzed using QIIME 2. All data were analyzed statistically over time using SAS 9.4. After 24 wk, dogs lost 31.2% of initial BW and had 1.43±0.73% weight loss per wk. BCS decreased (P<0.0001) by 2.7 units, fat mass decreased (P<0.0001) by 3.1 kg, and fat percentage decreased (P<0.0001) by 3.1 kg and 11.7% with weight loss. Many serum metabolites and hormones were altered, with triglycerides, leptin, insulin, C-reactive protein, and interleukin-6 decreasing (P<0.05) with weight loss. Relative abundances of fecal Bifidobacterium, Coriobacteriaceae UCG-002, undefined Muribaculaceae, Allobaculum, Eubacterium, Lachnospira, Negativivibacillus, Ruminococcus gauvreauii group, uncultured Erysipelotrichaceae, and Parasutterella increased (P<0.05), whereas Prevotellaceae Ga6A1 group, Catenibacterium, Erysipelatoclostridium, Fusobacterium, Holdemanella, Lachnoclostridium, Lactobacillus, Megamonas, Peptoclostridium, Ruminococcus gnavus group, and Streptococcus decreased (P<0.01) with weight loss. Despite the number of significant changes, a state of dysbiosis was not observed in overweight dogs. Fecal ammonia and secondary bile acids decreased, while fecal valerate increased with weight loss. Several correlations between gut microbial taxa and biological parameters were observed. Our results suggest that restricted feeding of a HPHF diet and weight loss promotes fat mass loss, minimizes lean mass loss, reduces inflammatory marker and triglyceride concentrations, and modulates fecal microbiota phylogeny and activity in overweight dogs.

Download Full-text

Regular Practice of Moderate Physical Activity by Older Adults Ameliorates Their Anti-Inflammatory Status

Nutrients ◽

10.3390/nu10111780 ◽

2018 ◽

Vol 10 (11) ◽

pp. 1780 ◽

Cited By ~ 9

Author(s):

Miguel Ferrer ◽

Xavier Capó ◽

Miquel Martorell ◽

Carla Busquets-Cortés ◽

Cristina Bouzas ◽

...

Keyword(s):

Physical Activity ◽

Older Adults ◽

Body Composition ◽

Healthy Aging ◽

The Body ◽

Moderate Physical Activity ◽

Metabolic Equivalents ◽

Inflammatory Status ◽

Anti Inflammatory ◽

Regular Practice

A chronic inflammatory state is a major characteristic of the aging process, and physical activity is proposed as a key component for healthy aging. Our aim was to evaluate the body composition, hypertension, lipid profile, and inflammatory status of older adults, and these factors’ association with physical activity. A total of 116 elderly volunteers were categorized into terciles of quantitative metabolic equivalents of task (MET). Subjects in the first and third terciles were defined as sedentary and active subjects, respectively. Anthropometric and biochemical parameters, hemograms, and inflammatory markers were measured in plasma or peripheral mononuclear blood cells (PBMCs). The active groups exercised more than their sedentary counterparts. The practice of physical activity was accompanied by lower weight, fat mass, body mass index, and diastolic blood pressure when compared to a more sedentary life-style. Physical activity also lowered the haematocrit and total leukocyte, neutrophil, and lymphocyte counts. The practice of exercise induced a decrease in the IL-6 circulating levels and the TLR2 protein levels in PBMCs, while the expression of the anti-inflammatory IL-10 was activated in active subjects. The regular practice of physical activity exerts beneficial effects on body composition and the anti-inflammatory status of old people.

Download Full-text

Group-Based Trajectory Analysis of Physical Activity Change in a US Weight Loss Intervention

Journal of Physical Activity and Health ◽

10.1123/jpah.2017-0484 ◽

2018 ◽

Vol 15 (11) ◽

pp. 840-846 ◽

Cited By ~ 1

Author(s):

Christopher C. Imes ◽

Yaguang Zheng ◽

Dara D. Mendez ◽

Bonny J. Rockette-Wagner ◽

Meghan K. Mattos ◽

...

Keyword(s):

Physical Activity ◽

Body Mass Index ◽

Weight Loss ◽

Body Mass ◽

Behavioral Treatment ◽

Group Membership ◽

Multinomial Logistic Regression ◽

Step Count ◽

Weight Loss Intervention ◽

Trajectory Group

Background: The obesity epidemic is a global concern. Standard behavioral treatment including increased physical activity, reduced energy intake, and behavioral change counseling is an effective lifestyle intervention for weight loss. Purpose: To identify distinct step count patterns among weight loss intervention participants, examine weight loss differences by trajectory group, and examine baseline factors associated with trajectory group membership. Methods: Both groups received group-based standard behavioral treatment while the experimental group received up to 30 additional, one-on-one self-efficacy enhancement sessions. Data were analyzed using group-based trajectory modeling, analysis of variance, chi-square tests, and multinomial logistic regression. Results: Participants (N = 120) were mostly female (81.8%) and white (73.6%) with a mean (SD) body mass index of 33.2 (3.8) kg/m2. Four step count trajectory groups were identified: active (>10,000 steps/day; 11.7%), somewhat active (7500–10,000 steps/day; 28.3%), low active (5000–7500 steps/day; 27.5%), and sedentary (<5000 steps/day; 32.5%). Percent weight loss at 12 months increased incrementally by trajectory group (5.1% [5.7%], 7.8% [6.9%], 8.0% [7.4%], and 13.63% [7.0%], respectively; P = .001). At baseline, lower body mass index and higher perceived health predicted membership in the better performing trajectory groups. Conclusions: Within a larger group of adults in a weight loss intervention, 4 distinct trajectory groups were identified and group membership was associated with differential weight loss.

Download Full-text

Body Composition in Community-Dwelling Older Adults Before and After SARS-CoV-2 Infection: A Longitudinal Prospective Study in a Rural Village Struck by the Pandemic

Journal of Primary Care & Community Health ◽

10.1177/21501327211047781 ◽

2021 ◽

Vol 12 ◽

pp. 215013272110477

Author(s):

Oscar H. Del Brutto ◽

Robertino M. Mera ◽

Denisse A. Rumbea ◽

Pedro Pérez ◽

Bettsy Y. Recalde ◽

...

Keyword(s):

Physical Activity ◽

Older Adults ◽

Body Composition ◽

Regression Models ◽

Community Dwelling ◽

The Body ◽

Study Results ◽

The Impact ◽

Community Dwelling Older Adults

Background: Information on the body composition of inhabitants of remote communities during the SARS-CoV-2 pandemic is limited. Using a longitudinal population-based study design, we assessed the association between SARS-CoV-2 infection and changes in body composition. Methods: Community-dwelling older adults living in a rural Ecuadorian village received body composition determinations before and 1 year after the pandemic as well as serological tests for detection of SARS-CoV-2 antibodies. The independent association between SARS-CoV-2 infection and abnormalities in body composition at follow-up was assessed by fitting linear mixed models for longitudinal data. Results: Of 327 enrolled individuals, 277 (85%) received baseline and follow-up body composition determinations, and 175 (63%) of them became SARS-CoV-2 seropositive. Overall, diet and physical activity deteriorated during the follow-up. Multivariate random-effects generalized least squares regression models that included the impact of time and seropositivity on follow-up body composition, showed that neither variable contributed to a worsening in body composition. Multivariate logistic regression models disclosed that the serological status at follow-up cannot be predicted by differences in body composition and other baseline covariates. Conclusions: Study results suggest no increased susceptibility to SARS-CoV-2 infection among older adults with abnormal body composition and no significant changes as a result of worse physical activity and dietary habits or seropositivity during the length of the study. Together with a previous study in the same population that showed decrease in hand-grip strength after SARS-CoV-2, results confirm that dynapenia (and not sarcopenia) is associated with SARS-CoV-2 infection in older adults.

Download Full-text

Impact of a randomized weight loss trial on breast tissue markers in breast cancer survivors.

Journal of Clinical Oncology ◽

10.1200/jco.2021.39.15_suppl.e12501 ◽

2021 ◽

Vol 39 (15_suppl) ◽

pp. e12501-e12501

Author(s):

Christina Marie Dieli-Conwright ◽

Maura Harrigan ◽

Brenda Cartmel ◽

Anees B. Chagpar ◽

Yalai Bai ◽

...

Keyword(s):

Breast Cancer ◽

Weight Loss ◽

Body Composition ◽

Cancer Survivors ◽

Breast Cancer Survivors ◽

Breast Tissue ◽

Serum Levels ◽

Serum Biomarkers ◽

Weight Loss Intervention ◽

Tissue Biomarkers

e12501 Background: Weight loss interventions are effective approaches to reduce body weight and alter serum biomarkers in breast cancer survivors, however the impact on breast tissue biomarkers is unknown. The Lifestyle, Exercise and Nutrition (LEAN) study was a randomized trial designed to test the effect of a weight loss intervention on body composition and breast tissue and serum biomarkers. Methods: Fifity-one women with a BMI ³ 25.0 kg/m2 diagnosed with breast cancer, who had completed chemotherapy and/or radiation therapy were randomized to weight loss intervention or usual care. Breast tissue biopsies from the unaffected breast, fasting serum samples, and body composition were measured at baseline and 6-months. Ki67, insulin receptor (IR), CD68 and CD163 were measured by Automated Quantitative Analysis (AQUA) method. Mean baseline to 6-month changes were compared using ANCOVA adjusting for baseline values. Results: Pre- and post-intervention biopsies were conducted in 49 and 42 women respectively, with both pre- and post- epithelial tissue available from 25 women; epithelial tissue was unavailable in the remaining 66 women. Women were 56.8 ± 8.9 years old, diagnosed 3.3 + 3.8 years prior, primarily Stage I breast cancer (54%), with a BMI of 32.8 ± 6.0 kg/m2. At baseline, breast tissue levels of IR were inversely associated with both percent body fat (r = -0.47, p = .03) and serum insulin levels (r = -0.45, p = .04); serum insulin levels were inversely associated with CD68 (r = -0.47, p = .03). Significant between-group biomarker changes are presented in Table 1. At month 6, loss in percent body fat was associated with increased IR (r = -0.42, p = .05). Increased CD68 breast tissue expression was associated with reductions in serum levels of CRP (r = -0.49, p=0.02). There was no significant effect of the intervention on IR expression or Ki67 (p>0.10). Conclusions: Breast tissue biopsies are feasible to collect in a clinical research setting among breast cancer survivors. A 6-month weight loss intervention led to decreased levels of CD163 in breast tissue and serum levels of leptin, and increased serum levels of adiponectin among breast cancer survivors. At baseline and month 6, changes in breast tissue biomarkers were favorably associated with serum biomarkers and body composition. Future confirmation is required to confirm the added benefit of tissue biomarkers beyond serum as an endpoint for lifestyle interventions among breast cancer survivors. Clinical trial information: NCT02110641. [Table: see text]

Download Full-text