Weight loss and exercise differentially affect insulin sensitivity, body composition, cardiorespiratory fitness and muscle strength in older adults with obesity; a randomized controlled trial

2021 ◽  
Author(s):  
Andrea M Brennan ◽  
Robert A Standley ◽  
Steven J Anthony ◽  
Kory E Grench ◽  
Nicole L Helbling ◽  
...  
Keyword(s):  
Older Adults ◽  
Weight Loss ◽  
Body Composition ◽  
Adipose Tissue ◽  
Insulin Sensitivity ◽  
Lean Mass ◽  
Disease Risk ◽  
Controlled Trial ◽  
Statistical Significance ◽  
Intermuscular Adipose Tissue

Abstract Background Aging-related disease risk is exacerbated by obesity and physical inactivity. It is unclear how weight loss and increased activity improve risk in older adults. We aimed to determine the effects of diet-induced weight loss with and without exercise on insulin sensitivity, VO2peak, body composition, and physical function in older obese adults. Methods Physically inactive older (68.6 ± 4.5 years) obese (BMI 37.4 ± 4.9 kg/m 2) adults were randomized to: Health education control (HEC; n=25); Diet-induced weight loss (WL; n=31); or Weight loss and exercise (WLEX; n=28) for 6 months. Insulin sensitivity was measured by hyperinsulinemic euglycemic clamp, body composition by DXA and MRI, strength by isokinetic dynamometry, and VO2peak by graded exercise test. Results WLEX improved (p<0.05) peripheral insulin sensitivity (+75 ± 103%) vs. HEC (+12 ± 67%); WL (+36 ± 47%) vs. HEC did not reach statistical significance. WLEX increased VO2peak (+7 ± 12%) vs. WL (-2 ± 24%), and prevented reductions in strength and lean mass induced by WL (p<0.05). WLEX decreased abdominal adipose tissue (-16 ± 9%) vs. HEC (-3 ± 8%) and intermuscular adipose tissue (-15 ± 13 %) vs. both HEC (+9 ± 15%) and WL (+2 ± 11%) (p<0.01). Conclusions Exercise with weight loss improved insulin sensitivity and VO2peak, decreased ectopic fat, and preserved lean mass and strength. Weight loss alone decreased lean mass and strength. Older adults intending to lose weight should perform regular exercise to promote cardiometabolic and functional benefits, which may not occur with calorie restriction-induced weight loss alone.

scholarly journals Race affects the association of obesity measures with insulin sensitivity

2019 ◽  
Vol 111 (3) ◽  
pp. 515-525 ◽  
Author(s):  
Jeannie Tay ◽  
Amy M Goss ◽  
W Timothy Garvey ◽  
Mark E Lockhart ◽  
Nikki C Bush ◽  
...  
Keyword(s):  
Body Composition ◽  
Adipose Tissue ◽  
Insulin Sensitivity ◽  
African Americans ◽  
Lean Mass ◽  
Fat Distribution ◽  
Race Differences ◽  
Liver Fat ◽  
Abdominal Adipose Tissue ◽  
Caucasian Americans

ABSTRACT Background Race differences in body composition and fat distribution may in part explain the differences in insulin sensitivity and the disproportionate burden of type 2 diabetes in African Americans. Objective To determine if differences in body composition and fat distribution explain race differences in insulin sensitivity and identify obesity measures that were independently associated with insulin sensitivity. Methods Participants were 113 lean, overweight, and obese African-American and Caucasian-American adults without diabetes. Skeletal muscle insulin sensitivity was determined using a hyperinsulinemic-euglycemic clamp (SIClamp, insulin rate:120 mU/m2/min). Subcutaneous abdominal adipose tissue (SAAT), intra-abdominal adipose tissue (IAAT), and liver fat were measured by MRI; leg fat, total fat, and lean mass were measured by DXA. Results Race-by-adiposity interactions were significant in cross-sectional analyses utilizing multiple linear regression models for SIClamp (P < 0.05); higher BMI, fat mass, SAAT, leg fat, and liver fat were associated with lower SIClamp in Caucasian Americans but not African Americans. Race-by-IAAT interaction was not significant (P = 0.65). A central fat distribution (SAAT adjusted for leg fat) was associated with lower SIClamp in African Americans (β = −0.45, SE = 0.11, P < 0.001) but not Caucasian Americans (β = −0.42, SE = 0.30, P = 0.17). A peripheral fat distribution (leg fat adjusted for IAAT/SAAT) was associated with a higher SIClamp in African Americans (β = 0.11, SE = 0.05, P = 0.02) but lower SIClamp in Caucasian Americans (β = −0.28, SE = 0.14, P = 0.049). Lean mass was inversely associated with SIClamp in African Americans (β = −0.05, SE = 0.03, P = 0.04) but not Caucasian Americans (β = 0.08, SE = 0.05, P = 0.10) in the model for leg fat. Conclusions Measures of overall adiposity were more strongly associated with SIClamp in Caucasian Americans, whereas body fat distribution and lean mass showed stronger correlations with SIClamp in African Americans. Insulin sensitivity may have a genetic basis in African Americans that is reflected in the pattern of body fat distribution. These findings suggest a race-specific pathophysiology of insulin resistance, which has implications for the prevention of diabetes and related cardiometabolic diseases.

scholarly journals Impact of a Higher (Dairy) Protein Weight Loss Intervention on Function and Body Composition in Obese Older Adults with Limited Functional Performance

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 68-68
Author(s):  
Kathryn Porter Starr ◽  
Jamie Rincker ◽  
Stephan van Vliet ◽  
Dipa Patel ◽  
Shelley McDonald ◽  
...  
Keyword(s):  
Older Adults ◽  
Weight Loss ◽  
Body Composition ◽  
Lean Mass ◽  
Protein Intake ◽  
Exercise Intervention ◽  
Functional Performance ◽  
Cumulative Risk ◽  
Development Program ◽  
Age Related

Abstract Objectives The combination of obesity with age-related loss of muscle mass and strength creates a cumulative risk to function and the physical ability of older adults to sustain daily activities. The aim was to determine whether a higher protein intake can improve function and protect lean mass in older adults following a diet and exercise obesity intervention. Methods Obese (BMI ≥30 kg/m2) older (≥60 yrs) participants (female n = 50; male n = 15; 46% black) with functional limitations (Short Physical Performance Battery (SPPB) score = 9.1 ± 1.4 out of 12) were randomized to an RDA-level protein weight loss regimen (0.8 g/kg bw/d; Control; n = 33) or a higher protein arm (1.2 g/kg bw/d, with ≥30 g high quality protein (predominantly dairy) at each meal; Protein; n = 32). Both groups followed a hypo-caloric diet and participated in 2 supervised low-intensity chair exercise sessions per wk and 1 session/wk at home. Measurements at baseline, 3 and 6 months included body weight, SPPB, 6-minute walk time, 8-foot up and go test, and body composition (BODPOD). Results Mean baseline characteristics were BMI 35.0 ± 4.9 kg/m2 and age = 69.5 ± 6.2 yrs. At 6 months, weight loss and body fat reduction were significant (P < 0.001) in both Control (7.0% weight) and Protein (6.6% weight) with no group difference. The slight (<−1 kg) change in lean mass was not different between groups. At 3 and 6 months, SPPB scores significantly increased in both groups (P < 0.01) with no difference between groups. However, at 3 months, the Protein group had significantly greater improvements in distance walked in 6 minutes (Protein = 48.3 ± 71.7 m; Control = 3.4 ± 69.3 m; P = 0.01) and timed 8-foot up and go (Protein = −0.9 ± 1.0 s; Control = −0.3 ± 1.2 s; P = 0.04) compared to control; no difference between groups for either test at 6 months. Conclusions We found that a hypocaloric balanced, higher protein diet (predominantly low-fat dairy) improved distance walked in 6 minutes and 8-foot up and go times at the 3 month time point; this group difference was absent at 6 months, when the improvements in these tests, as well as SPPB were equal between groups. Further study is needed to assess the potential that higher protein intake accelerates function responses to a diet plus exercise intervention for obese older adults. Funding Sources The National Dairy Council and US Department of Veterans Affairs Rehabilitation Research and Development Program.

scholarly journals Olfaction and Changes in Body Composition in a Large Cohort of Older U.S. Adults

2020 ◽  
Vol 75 (12) ◽  
pp. 2434-2440
Author(s):  
Frank Purdy ◽  
Zhehui Luo ◽  
Joseph C Gardiner ◽  
Jayant M Pinto ◽  
Eric J Shiroma ◽  
...  
Keyword(s):  
Older Adults ◽  
Weight Loss ◽  
Body Composition ◽  
Fat Mass ◽  
Lean Mass ◽  
Total Mass ◽  
Total Body Mass ◽  
Adverse Health ◽  
The Difference ◽  
Underlying Mechanisms

Abstract Background Poor sense of smell in older adults may lead to weight loss, which may further contribute to various adverse health outcomes. However, empirical prospective evidence is lacking. We aimed to longitudinally assess whether poor olfaction is associated with changes in body composition among older adults. Methods A total of 2,390 participants from the Health ABC Study had their olfaction assessed using the Brief Smell Identification Test in 1999–2000. Based on the test score, olfaction was defined as poor (0–8), moderate (9–10), or good (11–12). Total body mass, lean mass, and fat mass were measured by dual-energy X-ray absorptiometry annually or biennially from 1999 to 2007. Results At baseline, compared to participants with good olfaction, those with poor olfaction weighed on average 1.67 kg less (95% CI: −2.92, −0.42) in total mass, 0.53 kg less (95% CI: −1.08, 0.02) in lean mass, and 1.14 kg less (95% CI: −1.96, −0.31) in fat mass. In longitudinal analyses, compared to participants with good olfaction, those with poor olfaction had a greater annual decline in both total mass (−234 g, 95% CI: −442, −26) and lean mass (−139 g, 95% CI: −236, −43). They also tended to have a greater annual loss of fat mass (−113 g, 95% CI: −285, 59), but the difference was not statistically significant. Conclusions Our results indicate poor olfaction is associated with lower body weight and greater weight loss in older adults. It is imperative for future studies to investigate potential underlying mechanisms and associated adverse health consequences.

The Weight Loss Effects of Branched Chain Amino Acids and Vitamin B6: A Randomized Controlled Trial on Obese and Overweight Women

2018 ◽  
Vol 88 (1-2) ◽  
pp. 80-89 ◽  
Author(s):  
Zahra Shakibay Novin ◽  
Saeed Ghavamzadeh ◽  
Alireza Mehdizadeh
Keyword(s):  
Amino Acids ◽  
Weight Loss ◽  
Body Composition ◽  
Vitamin B6 ◽  
Controlled Trial ◽  
Density Lipoprotein ◽  
Branched Chain Amino Acids ◽  
Model Assessment ◽  
Waist To Hip Ratio ◽  
Branched Chain

Abstract. Branched chain amino acids (BCAA), with vitamin B6 have been reported to improve fat metabolism and muscle synthesis. We hypothesized that supplementation with BCAA and vitamin B6 would result in more weight loss and improve body composition and blood markers related to cardiovascular diseases. Our aim was to determine whether the mentioned supplementation would affect weight loss, body composition, and cardiovascular risk factors during weight loss intervention. To this end, we performed a placebo-controlled randomized clinical trial in 42 overweight and obese women (BMI = 25–34.9 kg/m2). Taking a four-week moderate deficit calorie diet (–500 kcal/day), participants were randomized to receive BCAA (6 g/day) with vitamin B6 (40 mg/day) or placebo. Body composition variables measured with the use of bioelectrical impedance analysis, homeostatic model assessment, and plasma insulin, Low density lipoprotein, High density lipoprotein, Total Cholesterol, Triglyceride, and fasting blood sugar were measured. The result indicated that, weight loss was not significantly affected by BCAA and vitamin B6 supplementation (–2.43 ± 1.02 kg) or placebo (–1.64 ± 1.48 kg). However, significant time × treatment interactions in waist to hip ratio (P = 0.005), left leg lean (P = 0.004) and right leg lean (P = 0.023) were observed. Overall, supplementation with BCAA and vitamin B6 could preserve legs lean and also attenuated waist to hip ratio.

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

Obesity ◽  
2013 ◽  
Vol 22 (2) ◽  
pp. 325-331 ◽  
Author(s):  
Kristen M. Beavers ◽  
Daniel P. Beavers ◽  
Beverly A. Nesbit ◽  
Walter T. Ambrosius ◽  
Anthony P. Marsh ◽  
...  
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Weight Loss ◽  
Body Composition ◽  
Weight Loss Intervention

Whey protein and vitamin D supplementation in institutionalized older adults: A randomized trial

2021 ◽  
pp. 026010602110606
Author(s):  
Tamy Colonetti ◽  
Antônio Jose Grande ◽  
Franciani Rodrigues da Rocha ◽  
Eduardo Ronconi Dondossola ◽  
Lisiane Tuon ◽  
...  
Keyword(s):  
Older Adults ◽  
Vitamin D ◽  
Body Composition ◽  
Resistance Training ◽  
Whey Protein ◽  
Muscle Mass ◽  
Lean Mass ◽  
Vitamin D Supplementation ◽  
Relative Index ◽  
And Control

Background: The increase in life expectancy and in the number of individuals over 60 years old brings new demands to health professionals and services based on the physiological changes that occur in this population. The aging process results in changes in body composition, increasing body fat and reducing muscle mass, in addition to a reduction in bone mass. Aim: The aim of this study was to examine the effect of whey protein and vitamin D supplementation on body composition and skeletal muscle in older adults living in long-term care facilities. Methods: This study is a double-blind randomized controlled trial. Thirty older adults (>60 years old) were randomized and allocated in three groups: group receiving resistance training and supplementation receiving resistance training, whey protein and vitamin D; group received resistance and placebo training receiving resistance training and placebo, and control group without any intervention. Body composition was measured by dual-energy X-ray absorptiometry at baseline, 12 weeks, and 24 weeks. Results: The mean age was 74.87 (± 8.14) years. A significant difference ( p = 0.042) was observed between the group receiving resistance training and supplementation and control groups in relation to lean mass increase (kg) at 24 weeks. After 24 weeks of intervention, there was a significant increase in Relative index of muscle mass for the two groups that underwent resistance training, group received resistance and placebo training ( p = 0.042) and group receiving resistance training and supplementation ( p = 0.045), in relation to the control. Conclusion: Combined supplementation of whey protein and vitamin D with resistance training can significantly improve lean mass, total mass, and relative index of muscle mass in institutionalized older adults.

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