Effect of Exercise Type During Intentional Weight Loss on Body Composition in Older Adults with Obesity

Abstract Background Observational research has identified several mortality biomarkers; however, their responsiveness to change is unknown. We tested whether the Healthy Aging Index (HAI) and other mortality biomarkers were responsive to intentional weight loss (WL), which is associated with lower mortality risk in recent meta-analyses. Methods Older adults (70.3 ± 3.7 years) with obesity were randomized into a 6-month WL (n = 47) or weight stability (WS: ±5% baseline weight; n = 48) program. Baseline and 6-month HAI score (0–10) was calculated from component sum (each 0–2: systolic blood pressure, forced vital capacity [FVC], creatinine, fasting blood glucose [FBG], Montreal Cognitive Assessment), and gait speed, grip strength, Digit Symbol Substitution Test, FEV1, Interleukin-6, C-Reactive Protein, and Cystatin-C were assessed at baseline and 6 months. Results Mean baseline HAI was 3.2 ± 1.6. By 6 months, WL participants lost 8.87 (95% CI: −10.40, −7.34) kg, whereas WS participants remained weight stable. WL group reduced HAI score (WL: −0.75 [95% CI: −1.11, −0.39] vs WS: −0.22 [95% CI: −0.60, 0.15]; p = .04), and components changing the most were FBG (WL: −3.89 [95% CI: −7.78, 0.00] mg/dL vs WS: 1.45 [95% CI: −2.61, 5.50] mg/dL; p = .047) and FVC (WL: 0.11 [95% CI: −0.01, 0.23] L vs WS: −0.05 [95% CI: −0.17, 0.08] L; p = .06). Among other biomarkers, only Cystatin-C significantly changed (WL: −2.53 [95% CI: −4.38, −0.68] ng/mL vs WS: 0.07 [95% CI: −1.85, 1.98] ng/mL; p = .04). Combining treatment groups, 1 kg WL was associated with a 0.07 (95% CI: 0.03, 0.12) HAI reduction (p < .01). Conclusion Intentional WL via caloric restriction reduced HAI score by 0.53 points, largely attributable to metabolic and pulmonary improvements.

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Changes in Cardiometabolic Risk Among Obese Older Adults After a 12-Month Exercise and Diet Intervention

Current Developments in Nutrition ◽

10.1093/cdn/nzaa063_010 ◽

2020 ◽

Vol 4 (Supplement_2) ◽

pp. 1612-1612

Author(s):

Anna Bragg ◽

Kristi Crowe-White ◽

Amy Ellis ◽

Julie Locher ◽

Jamy Ard ◽

...

Keyword(s):

Older Adults ◽

Weight Loss ◽

Cardiometabolic Risk ◽

Weight Maintenance ◽

Exercise Group ◽

Group Differences ◽

Intentional Weight Loss ◽

Time Interaction ◽

Weight Loss Group ◽

Syndrome Classification

Abstract Objectives Obesity imposes risk to cardiometabolic health; however, intentional weight loss in obese older adults remains controversial. Using data from the CROSSROADS Study (clinicaltrials.gov #NCT00955903), this ancillary study investigated effects of exercise with and without intentional weight loss on changes in cardiometabolic risk assessed by four risk-scoring tools. Methods Participants (n = 134, 39% male, 23% African American, 70.2 ± 4.7 y) were randomized to exercise (n = 48), exercise + nutrient-dense weight maintenance diet (n = 44), or exercise + nutrient-dense caloric restriction of 500 kcals/day (n = 42). The following risk scores were calculated using baseline and 12-month data: Framingham risk assessment, Cardiometabolic Disease Staging (CMDS), metabolic syndrome classification by the International Diabetes Federation (IDF), and metabolic syndrome classification by the National Cholesterol Education Program's Adult Treatment Panel (ATP III). Generalized Estimating Equations were employed to determine differences between groups with ethnicity, sex, and age as covariates. Results Group-time interaction was not significant in application of IDF or ATPIII. Group-time interaction was significant for Framingham and CMDS (P = 0.005 and 0.041, respectively). Upon post-hoc analysis, significant within-group improvements in Framingham scores were observed for exercise + weight maintenance (P < 0.001, r = −1.682) and exercise + weight loss (P = 0.020, r = −0.881). In analysis of between-group differences in Framingham scores, a significant decrease was observed in the exercise + weight maintenance group (P = 0.001, r = −1.723) compared to the exercise group. For CMDS, the exercise + weight loss group had significant within-group improvements (P = 0.023, r = - 0.102). For between-group differences in CMDS, the exercise + weight loss group showed significant risk score reduction (P = 0.012, r = −0.142) compared to the exercise group. Conclusions Risk assessment by Framingham and CMDS showed greater sensitivity to change in cardiometabolic risk factors. Results suggest obese older adults can lower cardiometabolic risk by engaging in exercise + weight maintenance or exercise + weight loss by moderate caloric restriction. Funding Sources R01AG033094 NIA, K07AG043588 NIA, P30DK056336 NIDDK.

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Obesity, intentional weight loss and physical disability in older adults

Obesity Reviews ◽

10.1111/j.1467-789x.2009.00679.x ◽

2010 ◽

Vol 11 (9) ◽

pp. 671-685 ◽

Cited By ~ 75

Author(s):

W. J. Rejeski ◽

A. P. Marsh ◽

E. Chmelo ◽

J. J. Rejeski

Keyword(s):

Older Adults ◽

Weight Loss ◽

Physical Disability ◽

Intentional Weight Loss

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TRANSITION TO A MORE EVEN DISTRIBUTION OF PROTEIN INTAKE IS ASSOCIATED WITH ENHANCED FAT LOSS IN OBESE OLDER ADULTS

Innovation in Aging ◽

10.1093/geroni/igz038.3097 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S841-S841

Author(s):

Samaneh Farsijani ◽

Jane A Cauley ◽

Adam J Santanasto ◽

Nancy W Glynn ◽

Robert M Boudreau ◽

...

Keyword(s):

Physical Activity ◽

Older Adults ◽

Weight Loss ◽

Body Composition ◽

Successful Aging ◽

Protein Intake ◽

Subcutaneous Fat ◽

Community Dwelling ◽

Protein Distribution ◽

Fat Loss

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.

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