Document Detail


Long-term maintenance of weight loss after lifestyle intervention in frail, obese older adults.
MedLine Citation:
PMID:  23299370     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: To determine if long-term weight loss with associated improvement in physical and metabolic health can be maintained after lifestyle intervention in frail, obese older adults.
DESIGN: Thirty-month follow-up pilot study of a 1-year lifestyle intervention trial.
SETTING: Community.
PARTICIPANTS: Sixteen frail, obese (body mass index=36±2 kg/m2) older (71±1 yr.) adults.
MEASUREMENTS: Body weight and composition, physical function, markers of the metabolic syndrome, glucose and insulin response to an oral glucose tolerance test, bone mineral density (BMD), liver and renal function tests, and food diaries.
RESULTS: At 30-month follow-up, weight (101.5±3.8 vs. 94.5±3.9 kg) and BMI (36.0 ±1.7 vs. 33.5±1.7 kg/m2) remained significantly below baseline (all p<0.05). No significant change in fat-free mass (56.7±2.1 vs. 56.9±2.2 kg) or appendicular lean mass (24.1±1.0 vs. 24.1±1.1kg, all p>0.05) occurred between 12 months (end of trial) and 30 months. Improvements in the physical performance test (PPT 27±0.7 vs. 30.2±0.6), insulin sensitivity (4.1±0.8 vs. 3.0±0.6), and insulin area under the curve (12484±2042 vs. 9270±1139 min.mg/dl) remained at 30 months compared to baseline (all p<0.05). Waist circumference (116±3 vs. 109±3 cm) and systolic blood pressure (134±6 vs. 123±5 mm HG) remained decreased at 30 months compared to baseline (all p<0.05). Whole body and lumbar spine BMD did not change; however, total hip BMD progressively decreased at 30 months compared to baseline (0.985±.026 vs. 0.941±.024 g/cm2; p<0.05). There were no adverse effects on liver or renal function. Food frequency questionnaire data showed lower overall caloric intake (-619±157 kcal/day) at 30 months compared to baseline (p<0.05).
CONCLUSION: These findings suggest that long-term maintenance of clinically important weight loss is possible in frail, obese older adults. Weight maintenance appears to be achieved through continued caloric restriction. Larger, long-term studies are needed to follow up on these findings and investigate mechanisms and behaviors underlying maintenance of weight loss and physical function.
Authors:
D L Waters; R Vawter; C Qualls; S Chode; R Armamento-Villareal; D T Villareal
Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The journal of nutrition, health & aging     Volume:  17     ISSN:  1760-4788     ISO Abbreviation:  J Nutr Health Aging     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-01-09     Completed Date:  2013-06-28     Revised Date:  2014-01-09    
Medline Journal Info:
Nlm Unique ID:  100893366     Medline TA:  J Nutr Health Aging     Country:  France    
Other Details:
Languages:  eng     Pagination:  3-7     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
African Americans
Aged
Blood Glucose
Body Composition
Body Mass Index
Bone Density
Caloric Restriction*
European Continental Ancestry Group
Female
Follow-Up Studies
Food Habits*
Glucose Tolerance Test
Humans
Insulin / blood
Insulin Resistance
Intervention Studies
Life Style*
Male
Metabolic Syndrome X / diet therapy*,  physiopathology
Obesity / diet therapy*,  physiopathology
Pilot Projects
Quality of Life
Questionnaires
Weight Loss*
Grant Support
ID/Acronym/Agency:
DK20579/DK/NIDDK NIH HHS; P60 DK020579/DK/NIDDK NIH HHS; R01 AG025501/AG/NIA NIH HHS; R01 AG031176/AG/NIA NIH HHS; R01 AG31176/AG/NIA NIH HHS; R01-AG025501/AG/NIA NIH HHS; UL1 RR024992/RR/NCRR NIH HHS; UL1-RR024992/RR/NCRR NIH HHS
Chemical
Reg. No./Substance:
0/Blood Glucose; 0/Insulin
Comments/Corrections

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