Effects of Obesity Reduction on Physical Function, Inflammation and Osteoarthritis in Older Adults

Abstract Age-related increases in chronic inflammation lead to reduced physical function via damage to muscle and joints and contribute to osteoarthritis (OA) risk. Obesity in older adults with OA further exacerbates inflammatory damage. Whether obesity reduction can lessen inflammation and improve OA is unknown; however, novel biomarkers may provide an answer. We completed a 6-mo. weight loss intervention (-500 kcal/day), studying blood biomarkers of inflammation and cartilage damage along with physical function in obese older adults with (OA+; n=39) and without an OA diagnosis (OA-; n=20). Participants were aged > 60 yrs (mean = 70.2±6.0) and obese (BMI =34.6±4.7 kg/m2). At endpoint, weight loss was -6.3±4.0% and -5.8±4.1% in OA+ and OA-, respectively, with no group difference. Change scores for function for OA+ and OA- were: Short Physical Performance Battery score (+1.7±1.3 and +2.1±1.5), 8 ft up and go (-0.7±1.0 and -0.9±1.12 sec) and 6 min walk (+31.4±105.1 and +39.5±57.4 meters). All improved from baseline (p<0.05), with no group difference. Concerning blood biomarkers, there was a decrease (p<0.05) in cartilage oligomeric matrix protein (COMP: OA biomarker), indicating a potential benefit for OA. Change in COMP also differed between groups; OA- had a greater (p<0.05) reduction than OA+. Pooled results showed improved adiponectin (p<0.05), with no group difference. There were no changes for CRP, CTX-1, IL-6 and TNF-α. Our novel findings link early intervention with better reduction of OA risk and inflammation in obese older adults and also show important benefits for improved physical function regardless of OA status.

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Effect of Weight Loss, Exercise, or Both on Undercarboxylated Osteocalcin and Insulin Secretion in Frail, Obese Older Adults

Oxidative Medicine and Cellular Longevity ◽

10.1155/2017/4807046 ◽

2017 ◽

Vol 2017 ◽

pp. 1-12 ◽

Cited By ~ 6

Author(s):

Georgia Colleluori ◽

Nicola Napoli ◽

Uma Phadnis ◽

Reina-Armamento Villareal ◽

Dennis T. Villareal

Keyword(s):

Older Adults ◽

Weight Loss ◽

Insulin Secretion ◽

Physical Function ◽

Exercise Group ◽

Diet Group ◽

Undercarboxylated Osteocalcin ◽

Age Related ◽

Long Term Effect ◽

Exercise Induced

Background. Obesity exacerbates age-related decline in glucometabolic control. Undercarboxylated osteocalcin (UcOC) regulates pancreatic insulin secretion. The long-term effect of lifestyle interventions on UcOC and insulin secretion has not been investigated. Methods. One hundred seven frail, obese older adults were randomized into the control (N=27), diet (N=26), exercise (N=26), and diet-exercise (N=28) groups for 1 year. Main outcomes included changes in UcOC and disposition index (DI). Results. UcOC increased in the diet group (36 ± 11.6%) but not in the other groups (P<0.05 between groups). Although similar increases in DI occurred in the diet-exercise and diet groups at 6 months, DI increased more in the diet-exercise group (92.4 ± 11.4%) than in the diet group (61.9 ± 15.3%) at 12 months (P<0.05). UcOC and body composition changes predicted DI variation in the diet group only (R2=0.712), while adipocytokines and physical function changes contributed to DI variation in both the diet (∆R2=0.140 and 0.107) and diet-exercise (∆R2=0.427 and 0.243) groups (P<0.05 for all). Conclusions. Diet, but not exercise or both, increases UcOC, whereas both diet and diet-exercise increase DI. UcOC accounts for DI variation only during active weight loss, while adipocytokines and physical function contribute to diet-exercise-induced DI variation, highlighting different mechanisms for lifestyle-induced improvements in insulin secretion. This trial was registered with ClinicalTrials.gov number NCT00146107.

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Feasibility and acceptability of a technology-based, rural weight management intervention in older adults with obesity

BMC Geriatrics ◽

10.1186/s12877-020-01978-x ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

John A. Batsis ◽

Curtis L. Petersen ◽

Matthew M. Clark ◽

Summer B. Cook ◽

David Kotz ◽

...

Keyword(s):

Older Adults ◽

Weight Loss ◽

Physical Function ◽

Weight Management ◽

Remote Monitoring ◽

Rural Areas ◽

Physical Therapist ◽

Anthropometric Measures ◽

Clinical Trial Registration ◽

Data Feedback

Abstract Background Older adults with obesity residing in rural areas have reduced access to weight management programs. We determined the feasibility, acceptability and preliminary outcomes of an integrated technology-based health promotion intervention in rural-living, older adults using remote monitoring and synchronous video-based technology. Methods A 6-month, non-randomized, non-blinded, single-arm study was conducted from October 2018 to May 2020 at a community-based aging center of adults aged ≥65 years with a body mass index (BMI) ≥30 kg/m2. Weekly dietitian visits focusing on behavior therapy and caloric restriction and twice-weekly physical therapist-led group strength, flexibility and balance training classes were delivered using video-conferencing to participants in their homes. Participants used a Fitbit Alta HR for remote monitoring with data feedback provided by the interventionists. An aerobic activity prescription was provided and monitored. Results Mean age was 72.9±3.9 years (82% female). Baseline anthropometric measures of weight, BMI, and waist circumference were 97.8±16.3 kg, 36.5±5.2 kg/m2, and 115.5±13.0 cm, respectively. A total of 142 participants were screened (n=27 ineligible), and 53 consented. There were nine dropouts (17%). Overall satisfaction with the trial (4.7+ 0.6, scale: 1 (low) to 5 (high)) and with Fitbit (4.2+ 0.9) were high. Fitbit was worn an average of 81.7±19.3% of intervention days. In completers, mean weight loss was 4.6±3.5 kg or 4.7±3.5% (p< 0.001). Physical function measures of 30-s sit-to-stand repetitions increased from 13.5±5.7 to 16.7±5.9 (p< 0.001), 6-min walk improved by 42.0±77.3 m (p=0.005) but no differences were observed in gait speed or grip strength. Subjective measures of late-life function improved (3.4±4.7 points, p< 0.001). Conclusions A technology-based obesity intervention is feasible and acceptable to older adults with obesity and may lead to weight loss and improved physical function. Clinical trial registration Registered on Clinicaltrials.gov #NCT03104205. Registered on April 7, 2017. First participant enrolled on October 1st, 2018.

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Systemic Proteomic Analysis Reveals Distinct Exosomal Protein Profiles in Rheumatoid Arthritis

Journal of Immunology Research ◽

10.1155/2021/9421720 ◽

2021 ◽

Vol 2021 ◽

pp. 1-11

Author(s):

Qiu Qin ◽

Ronghua Song ◽

Peng Du ◽

Chaoqun Gao ◽

Qiuming Yao ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Matrix Protein ◽

Complex Disease ◽

Protein Profiles ◽

Monocyte Differentiation ◽

Diagnosis And Prognosis ◽

Tnf Α ◽

Novel Biomarkers ◽

And Gender ◽

Amyloid P

Objective. Rheumatoid arthritis (RA) is a complex disease with unknown pathogenesis. In recent years, fewer have paid attention to the broad spectrum of systemic markers of RA. The aim of this study was to identify exosomal candidate proteins in the pathogenesis of RA. Methods. Totally, 12 specimens of plasma from 6 RA patients and 6 age- and gender-matched controls from the Chinese population were obtained for nanoscale liquid chromatography coupled to tandem mass spectrometry (nano-LC-MS/MS) analysis to identify exosomal profiles. Results. A total of 278 exosomal proteins were detected. Among them, 32 proteins were significantly upregulated ( FC ≥ 2.0 and P < 0.05 ) and 5 proteins were downregulated ( FC ≤ 0.5 and P < 0.05 ). Bioinformatics analysis revealed that transthyretin (TTR), angiotensinogen (AGT), lipopolysaccharide-binding protein (LBP), monocyte differentiation antigen CD14 (CD14), cartilage oligomeric matrix protein (COMP), serum amyloid P (SAP/APCS), and tenascin (TNC) can interact with each other. Subsequently, these cross-linked proteins may be mainly involved in the inflammatory-related pathways to mediate the onset of RA. Noteworthy, the LBP/CD14 complex can promote the expression of IL-8 and TNF-α, eventually leading to the development of RA. Conclusions. Our findings suggest distinct plasmatic exosomal protein profiles in RA patients. These proteins not only take important parts in the vicious circle in the pathogenic process of RA but also serve as novel biomarkers in RA diagnosis and prognosis.

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Group Lifestyle Phone Maintenance for Weight, Health, and Physical Function in Adults Aged 65–80 Years: A Randomized Clinical Trial

The Journals of Gerontology Series A ◽

10.1093/gerona/glaa229 ◽

2020 ◽

Author(s):

Elizabeth M Venditti ◽

Marsha D Marcus ◽

Rachel G Miller ◽

Vincent C Arena ◽

Susan L Greenspan ◽

...

Keyword(s):

Blood Pressure ◽

Older Adults ◽

Weight Loss ◽

Physical Function ◽

Community Dwelling ◽

Lipid Lowering ◽

Additional Risk ◽

Management Group ◽

Registration Number ◽

And Function

Abstract Background Group lifestyle sessions with phone maintenance could improve weight, health, and function in vulnerable older adults. Methods Community-dwelling adults (N = 322) with body mass index (BMI, kg/m2) ≥27 and additional risk factors received 12 one-hour in-person behavioral weight management group sessions then were randomized to 8 half-hour telephone sessions (n = 162) or newsletter control (n = 160) from 4 to 12 months with no treatment contact thereafter. Primary outcome was 0- to 12-month weight change. Cardiometabolic, short physical performance battery (SPPB), and self-reported activity changes were assessed at 12 and 24 months. Results At baseline, the mean (SD) age was 71.2 (4.3) and BMI was 33.8 (5.1). Participants were 77% women, 13% Black, 85% retired, averaging 4 medical conditions, and taking blood pressure (67.4%) and lipid-lowering (51.6%) medications. At 12 months, a greater proportion of the phone group (66.0%) achieved ≥5% weight loss compared with newsletter control (53.2%; p = .02). Mean (95% CI) weight loss was greater for phone (−6.6 kg [−7.5, −5.8]) than newsletter (−5.1 kg [−7.2, −3.0]); p = .01. Modest lipid, glucose, and blood pressure improvements were found, but did not differ significantly between groups. Small SPPB and activity improvements were maintained at 12 and 24 months in both groups. Conclusions Brief phone contacts compared to newsletters enhanced weight loss maintenance among older high-risk adults at 1 year, but not cardiometabolic outcomes. Modest functional improvements were observed in both. Lower-intensity maintenance contacts (phone or newsletter) for weight, health, and physical function in older adults warrant further study. Clinical Trials Registration Number NCT03192475

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Weight Loss, Exercise, or Both and Physical Function in Obese Older Adults

New England Journal of Medicine ◽

10.1056/nejmoa1008234 ◽

2011 ◽

Vol 364 (13) ◽

pp. 1218-1229 ◽

Cited By ~ 566

Author(s):

Dennis T. Villareal ◽

Suresh Chode ◽

Nehu Parimi ◽

David R. Sinacore ◽

Tiffany Hilton ◽

...

Keyword(s):

Older Adults ◽

Weight Loss ◽

Physical Function

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Weight Loss, Exercise, or Both and Physical Function in Obese Older Adults

Obstetrical & Gynecological Survey ◽

10.1097/ogx.0b013e3182352181 ◽

2011 ◽

Vol 66 (8) ◽

pp. 488-489 ◽

Cited By ~ 3

Author(s):

Dennis T. Villareal ◽

Suresh Chode ◽

Nehu Parimi ◽

David R. Sinacore ◽

Tiffany Hilton ◽

...

Keyword(s):

Older Adults ◽

Weight Loss ◽

Physical Function

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Aging With HIV: Inflammation Is Associated With Pain, Poorer Physical Function, and Frailty

Innovation in Aging ◽

10.1093/geroni/igaa057.1072 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 334-334

Author(s):

Heather Derry ◽

Carrie Johnston ◽

Chelsie Burchett ◽

Eugenia Siegler ◽

Marshall Glesby

Keyword(s):

Older Adults ◽

Physical Function ◽

Inflammatory Markers ◽

Smoking Status ◽

Well Being ◽

People Living With Hiv ◽

Cognitive Complaints ◽

Age Related ◽

Comorbidity Burden ◽

Ifn Γ

Abstract With advances in antiretroviral therapies, people living with HIV have life expectancies similar to their HIV-negative peers. Yet, they experience elevated multi-morbidity that can compromise quality of life as they age. Links between inflammation and accelerated aging may inform interventions, but these links are understudied in older adults with HIV. We investigated cross-sectional relationships between inflammation, well-being, and geriatric syndromes among 161 HIV-positive older adults. Participants provided fasting blood samples (for serum cytokines and CRP) and completed surveys (MOS-HIV; falls) and cognitive (MoCA) and frailty assessments (using Fried criteria). Adjusted linear and logistic regression models tested relationships between inflammatory markers and age-related health outcomes, controlling for age, gender, BMI, race, comorbidity burden, statin use, and smoking status. 93% had suppressed viral load. 11% had CRP levels suggesting possible acute illness (>10 mg/L) and were excluded from analyses. Participants with higher IFN-γ reported greater pain (p=0.003), greater cognitive complaints (p=.02), and worse physical function (p=0.04), than those with lower IFN-γ. Similarly, higher IL-6 levels were related to worse physical function (p=0.01) and slightly greater cognitive complaints (p=0.06), but were not significantly related to pain in adjusted models. Compared to those with lower IL-6, those with higher IL-6 levels were more likely to be frail (p=0.04). CRP was not significantly related to these outcomes. Six-month fall history and objective cognitive scores were not significantly related to the assessed inflammatory markers. Our results illustrate key, expected links between inflammatory processes, frailty, physical function, and pain among older adults with HIV.

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Balanced, Higher Protein at Meals in the Context of Obesity Intervention: A Diet Feasibility Study (P21-003-19)

Current Developments in Nutrition ◽

10.1093/cdn/nzz041.p21-003-19 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

Author(s):

Alissa Dix ◽

Kathryn Porter Starr ◽

Dipa Patel ◽

Richard Sloane ◽

Connie Bales ◽

...

Keyword(s):

Older Adults ◽

Weight Loss ◽

Physical Function ◽

Weight Reduction ◽

Health Concern ◽

High Risk Population ◽

Middle Aged ◽

High Quality ◽

Protein Meal ◽

High Quality Protein

Abstract Objectives Obesity is a major health concern in mid and later life; ≥40% of those ≥60 years are obese. However, the optimal approach for obesity reduction during the latter half of life has not been identified. Consuming balanced, liberal amounts of high quality protein at each meal is recommended for older adults and could help preserve lean mass and physical function. This study examined the feasibility and efficacy of this approach in the context of a weight reduction intervention for obese middle-aged and older adults. Methods This analysis combines findings on calorie and protein intakes of obese participants (mean BMI = 37.4 kg/m2; 88.7% female) aged ≥ 45 yrs (mean = 64.8 yrs) from two RCTs with similar protocols. Participants were randomized to hypo-caloric diets with either RDA level protein (0.8 g/kg bw; C-WL) or higher protein (1.2 g/kg bw; HP-WL) for 6 months. The HP-WL group was counseled to consume 30 g high quality protein/meal and provided lean beef or pork for 2 of 3 meals daily. Both groups had weekly group counseling and weigh-ins. Diet records (3-day) collected at 0, 3 and 6 months were analyzed (Food Processor; ESHA Research) for daily intakes of kcals and macronutrients. Results Both C-WL (n = 30) and HP-WL (n = 59) reduced their kcal intake and successfully reduced their body mass. At 6 months, weight loss was 5.8% and 7.0% for C-WL and HP-WL, respectively. Diet record analysis confirmed HP-WL participants achieved intakes of 30 g protein/meal. At 3 and 6 months respectively, mean ± SD protein intakes were 30.1 ± 9.9 g and 29.7 ± 12 g for breakfast; 37.5 ± 8.2 g and 35.6 ± 9.3 g for lunch; and 40.7 ± 13.7 g and 39.2 ± 8.1 g for dinner; daily protein intake was 1.2 ± 0.3 g/kg bw. In contrast, the C-WL protein intakes remained unchanged (0.8 g/kg bw). Conclusions These findings confirm the feasibility of a balanced, higher protein weight loss diet for obese middle-aged and older adults. HP-WL participants achieved notable weight reduction while also meeting meal protein goals. This practical dietary approach may offer superior long-term outcomes for physical function in this high-risk population; thus, further study of these potential benefits is warranted. Funding Sources Beef Checkoff and Pork Checkoff, North Carolina Pork Council, Smithfield Foods, NIH (T32 AG000029), and US Department of Veterans Affairs Rehabilitation Research and Development Service Program (CDA-2/IK2 RX002348).

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