Can Routine Clinical Tests for Protein Intake and Physical Function Predict Successful Weight Loss?

Abstract Objectives Obesity affects a growing number of older adults, contributing to poor physical and mental health outcomes; meanwhile, treatments to reduce obesity in older adults are complicated by a relatively limited treatment window and potential loss of lean mass. Furthermore, obesity's prevalence is unevenly distributed and highest among black and Hispanic older adults, thus contributing to ongoing health disparities. Recent research from our laboratory shows that higher protein intake (≥30 g/meal) enhances functional improvement during intentional weight loss but it is not yet known whether these effects are consistent across race. Methods In an ancillary pilot study, change in body weight, physical function (Short Physical Performance Battery), and cognitive function (Trail Making Test, TMT; Symbol Digit Modalities, SMD) was assessed among obese black and white older adults with mild to moderate functional impairment (n = 10) following 3 months of weight loss intervention at one of two protein intake levels (RDA 0.8 vs 1.2 g/kg/d and (≥30 g/meal) and moderate exercise. Results Significant weight loss (P = 0.009) and improvement in physical function (SPPB; P = 0.008) were observed at 3 months. While protein effects were not observed in this subset, trends toward race*time interactions showing greater weight loss among white participants (P = 0.062) and greater function improvement among black participants (P = 0.067) were observed. Additionally, cognitive assessment revealed a race*time interaction on TMT performance (TrailsB-A; P = 0.012), which correlated with changes in body weight and physical function. Conclusions These preliminary findings suggest that obesity reduction interventions benefited older adults across multiple health domains and underscore the need for further research to characterize potentially divergent benefits of intentional weight loss within these populations. Funding Sources This study was funded by the National Dairy Council and received additional support from the United States (U.S.) Department of Veterans Affairs Rehabilitation Research and Development Service Program and the National Institute of Aging.

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Predictors of successful weight loss with relative maintenance of fat-free mass in individuals with overweight and obesity on an 8-week low-energy diet

British Journal Of Nutrition ◽

10.1017/s0007114519001296 ◽

2019 ◽

Vol 122 (04) ◽

pp. 468-479 ◽

Cited By ~ 5

Author(s):

Thea Toft Hansen ◽

Mads Fiil Hjorth ◽

Karoline Sandby ◽

Sarah Vold Andersen ◽

Arne Astrup ◽

...

Keyword(s):

Weight Loss ◽

G Protein ◽

Protein Intake ◽

Overweight And Obesity ◽

Low Energy ◽

Fat Free Mass ◽

Rapid Weight Loss ◽

Successful Weight Loss ◽

Weight Loss Success ◽

Low Energy Diet

AbstractA low-energy diet (LED) is an effective approach to induce a rapid weight loss in individuals with overweight. However, reported disproportionally large losses of fat-free mass (FFM) after an LED trigger the question of adequate protein content. Additionally, not all individuals have the same degree of weight loss success. After an 8-week LED providing 5020 kJ/d for men and 4184 kJ/d for women (84/70 g protein/d) among overweight and obese adults, we aimed to investigate the relationship between protein intake relative to initial FFM and proportion of weight lost as FFM as well as the individual characteristics associated with weight loss success. We assessed all outcomes baseline and after the LED. A total of 286 participants (sixty-four men and 222 women) initiated the LED of which 82 % completed and 70 % achieved a substantial weight loss (defined as ≥8 %). Protein intake in the range 1·0–1·6 g protein/d per kg FFM at baseline for men and 1·1–2·2 g protein/d per kg FFM at baseline for women was not associated with loss of FFM (P = 0·632). Higher Three-Factor Eating Questionnaire (TFEQ) hunger at baseline and reductions in TFEQ disinhibition and hunger during the LED were associated with larger weight loss (all P ≤ 0·020); whereas lower sleep quality at baseline predicted less successful weight loss using intention to treat analysis (P = 0·021), possibly driven by those dropping out (n 81, P = 0·067 v. completers: n 198, P = 0·659). Thus, the protein intakes relative to initial FFM were sufficient for maintenance of FFM and specific eating behaviour characteristics were associated with weight loss success.

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Dietary Strategies for Weight Loss Maintenance

Nutrients ◽

10.3390/nu11081916 ◽

2019 ◽

Vol 11 (8) ◽

pp. 1916 ◽

Cited By ~ 6

Author(s):

Marlene A. van Baak ◽

Edwin C. M. Mariman

Keyword(s):

Systematic Review ◽

Weight Loss ◽

Protein Intake ◽

Weight Regain ◽

Randomized Clinical Trials ◽

Meta Analysis ◽

Weight Loss Maintenance ◽

Weight Loss Intervention ◽

Successful Weight Loss ◽

Dietary Strategies

Weight regain after a successful weight loss intervention is very common. Most studies show that, on average, the weight loss attained during a weight loss intervention period is not or is not fully maintained during follow-up. We review what is currently known about dietary strategies for weight loss maintenance, focusing on nutrient composition by means of a systematic review and meta-analysis of studies and discuss other potential strategies that have not been studied so far. Twenty-one studies with 2875 participants who were overweight or obese are included in this systematic review and meta-analysis. Studies investigate increased protein intake (12 studies), lower dietary glycemic index (four studies), green tea (three studies), conjugated linoleic acid (three studies), higher fibre intake (three studies), and other miscellaneous interventions (six studies). The meta-analysis shows a significant beneficial effect of higher protein intake on the prevention of weight regain (SMD (standardized mean difference) −0.17 (95% CI −0.29, −0.05), z = 2.80, p = 0.005), without evidence for heterogeneity among the included studies. No significant effect of the other strategies is detected. Diets that combine higher protein intake with different other potentially beneficial strategies, such as anti-inflammatory or anti-insulinemic diets, may have more robust effects, but these have not been tested in randomized clinical trials yet.

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Impact of Protein Intake during Weight Loss on Preservation of Fat-Free Mass, Resting Energy Expenditure, and Physical Function in Overweight Postmenopausal Women: A Randomized Controlled Trial

Obesity Facts ◽

10.1159/000514427 ◽

2021 ◽

pp. 1-12

Author(s):

Isabell Englert ◽

Anja Bosy-Westphal ◽

Stephan C. Bischoff ◽

Kathrin Kohlenberg-Müller

Keyword(s):

Weight Loss ◽

Energy Expenditure ◽

Physical Function ◽

Postmenopausal Women ◽

Protein Intake ◽

Resting Energy Expenditure ◽

Fat Free Mass ◽

The Impact ◽

Resting Energy

Introduction: Weight loss in old age increases the risk of sarcopenia caused by the age-related reduction of fat-free mass (FFM). Due to the strong correlation between FFM and resting energy expenditure (REE), the maintenance of this must also be considered. Besides, the physical function (PF) must be maintained. Objective: The impact of protein intake on changes in FFM, REE, and PF during weight loss in overweight postmenopausal women was investigated. Methods: Fifty-four postmenopausal women (BMI 30.9 ± 3.4; age 59 ± 7 years) were randomized into 2 groups receiving energy-restricted diets with either 0.8 g (normal protein; NP) or 1.5 g protein/kg body weight (high protein; HP) for 12 weeks, followed by a 6-month follow-up phase with an ad libitum food intake. FFM, REE, and PF (strength, endurance, and balance) were measured at baseline, after weight loss, and after follow-up. Results: Forty-six women completed the weight loss intervention and 29 were followed up. The weight loss was –4.6 ± 3.6 kg (HP) and –5.2 ± 3.4 kg (NP; both p < 0.001) and the weight regain during follow-up was 1.3 ± 2.8 kg (HP; p = 0.03) and 0.4 ± 2.5 kg (NP; p = 0.39), with no differences between groups. Similar decreases in FFM (–0.9 ± 1.1 [HP] vs. –1.0 ± 1.3 kg [NP]) and REE (–862 ± 569 [HP] vs. –1,000 ± 561 kJ [NP]; both p < 0.001) were observed in both groups. During follow-up, no changes in FFM were detected in either group, whereas in the NP group the REE increased again (+138 ± 296; p = 0.02). The main determinants of FFM loss were the energy deficit and the speed of weight loss. In the NP group, the Short Physical Performance Battery score improved with weight loss (+0.6 ± 0.8; p < 0.001) and handgrip strength decreased (–1.7 ± 3.4 kg; p < 0.001), whereas no changes were observed in the HP group. Conclusions: An HP weight-loss diet without exercise had no impact on preservation of FFM and REE but may help to maintain muscle strength in postmenopausal women.

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Successful weight loss reduces endothelial activation in individuals with severe obesity participating in a multimodal weight loss program

Obesity Research & Clinical Practice ◽

10.1016/j.orcp.2021.03.013 ◽

2021 ◽

Author(s):

Sabine J.M. Sag ◽

Christina Strack ◽

Judith Zeller ◽

Margareta Mohr ◽

Thomas Loew ◽

...

Keyword(s):

Weight Loss ◽

Severe Obesity ◽

Endothelial Activation ◽

Weight Loss Program ◽

Successful Weight Loss

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Assessment of Protein Intake in the First Three Months after Sleeve Gastrectomy in Patients with Severe Obesity

Nutrients ◽

10.3390/nu13030771 ◽

2021 ◽

Vol 13 (3) ◽

pp. 771

Author(s):

Lucrezia Bertoni ◽

Romina Valentini ◽

Alessandra Zattarin ◽

Anna Belligoli ◽

Silvia Bettini ◽

...

Keyword(s):

Weight Loss ◽

Sleeve Gastrectomy ◽

Protein Intake ◽

Severe Obesity ◽

Protein Supplementation ◽

Fat Free Mass ◽

The Third ◽

Total Protein Intake ◽

Dietary Record ◽

Protein Rich

An adequate protein intake prevents the loss of fat-free mass during weight loss. Laparoscopic sleeve gastrectomy (SG) jeopardizes protein intake due to post-operative dietary restriction and intolerance to protein-rich foods. The purpose of this study is to evaluate protein intake in the first three months after SG. We evaluated, 1 month and 3 months after surgery, 47 consecutive patients treated with SG. Protein intake, both from foods and from protein supplementation, was assessed through a weekly dietary record. Patients consumed 30.0 ± 10.2 g of protein/day on average from foods in the first month, with a significant increase to 34.9 ± 4.8 g of protein/day in the third month (p = 0.003). The use of protein supplementation significantly increased total protein intake to 42.3 ± 15.9 g protein/day (p < 0.001) in the first month and to 39.6 ± 14.2 g of protein/day (p = 0.002) in the third one. Compliance with supplement consumption was 63.8% in the first month and only 21.3% in the third month. In conclusion, both one and three months after SG, protein intake from foods was not sufficient. The use of modular supplements seems to have a significant impact on protein intake, but nevertheless it remains lower than recommended.

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