Weight Loss, Exercise, or Both and Physical Function in Obese Older Adults
Does weight loss combined with exercise improve physical function among obese older adults?
This was a randomized trial conducted over a 1-year period among patients over the age of 65 years who were obese. Subjects were randomly assigned to a weight management (diet) group, an exercise group, a combination diet and exercise group, or a control group from April 2005 to August 2009. The dietary intervention included weekly meetings with a dietitian, food records, and defined goals for a weight loss of 10% body weight. The exercise intervention included weekly group exercise sessions. The primary outcome was change in Physical Performance Test scores. Secondary outcomes included additional measures of frailty, body composition, bone mineral density, specific physical function measures, and quality of life.
A total of 93 participants (87%) completed the study (enrolled 107 participants). The median attendance at diet-therapy sessions was 83% among participants in the diet group and 82% among those in the diet/exercise group. The median attendance at exercise sessions was 88% among participants in the exercise group and 83% among those in the diet/exercise group. Larger improvements in Physical Performance Test scores were observed among those randomized to the diet/exercise group compared to the diet alone group or the exercise alone group (increases from baseline of 21% vs. 12% and 15%, respectively). Scores in all three intervention groups improved to a greater degree than the scores of the control group. Peak oxygen consumption improved more in the diet/exercise group than in the diet group or the exercise group (increases of 17% vs. 10% and 8%, respectively; p < 0.001). Scores for the Functional Status Questionnaire also increased to a greater degree in the diet/exercise group compared to the diet alone group (10% vs. 4%, p < 0.01). Body weight decreased by 10% in the diet alone group and by 9% in the diet/exercise group, but did not decrease in the exercise group or the control group (p < 0.001). Lean body mass and bone mineral density at the hip decreased less in the diet/exercise group than in the diet group (reductions of 3% and 1%, respectively, in the diet/exercise group vs. reductions of 5% and 3%, respectively, in the diet alone group; p < 0.05 for both comparisons). Strength, balance, and gait improved consistently in the diet/exercise group (p < 0.05 for all comparisons).
The investigators concluded that weight loss (i.e., diet) combined with exercise results in greater improvements in physical function among obese elderly patients.
Elderly adults who are obese are an increasing segment of the population. Efforts to improve overall physical function have significant public health implications.This study highlights the benefits of diet/exercise interventions. However, significant resources were required in the intervention, including dietitian time and group exercise sessions, all of which may limit the generalizability to a larger population.
Keywords: Weight Loss, Exercise, Body Weight, Obesity, Nutritionists, Diet
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