Calorie restriction in overweight older adults: Do benefits exceed potential risks?

Locher, Julie L.; Goldsby, TaShauna U.; Goss, Amy M.; Kilgore, Meredith L.; Gower, Barbara A.; Ard, Jamy D.

doi:10.1016/j.exger.2016.03.009

Cited by 48 publications

(43 citation statements)

References 40 publications

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“…Evidence-based data to guide treatment of older adults with obesity are limited 5,23,24 and tend to rely on studies involving younger adults. 2 Our study directly compared aerobic, resistance, and combined (aerobic and resistance) training during weight loss in obese older adults.…”

Section: Discussionmentioning

confidence: 99%

Aerobic or Resistance Exercise, or Both, in Dieting Obese Older Adults

et al. 2017

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BACKGROUND Obesity causes frailty in older adults; however, weight loss might accelerate age-related loss of muscle and bone mass and resultant sarcopenia and osteopenia. METHODS In this clinical trial involving 160 obese older adults, we evaluated the effectiveness of several exercise modes in reversing frailty and preventing reduction in muscle and bone mass induced by weight loss. Participants were randomly assigned to a weight-management program plus one of three exercise programs — aerobic training, resistance training, or combined aerobic and resistance training — or to a control group (no weight-management or exercise program). The primary outcome was the change in Physical Performance Test score from baseline to 6 months (scores range from 0 to 36 points; higher scores indicate better performance). Secondary outcomes included changes in other frailty measures, body composition, bone mineral density, and physical functions. RESULTS A total of 141 participants completed the study. The Physical Performance Test score increased more in the combination group than in the aerobic and resistance groups (27.9 to 33.4 points [21% increase] vs. 29.3 to 33.2 points [14% increase] and 28.8 to 32.7 points [14% increase], respectively; P=0.01 and P=0.02 after Bonferroni correction); the scores increased more in all exercise groups than in the control group (P<0.001 for between-group comparisons). Peak oxygen consumption (milliliters per kilogram of body weight per minute) increased more in the combination and aerobic groups (17.2 to 20.3 [17% increase] and 17.6 to 20.9 [18% increase], respectively) than in the resistance group (17.0 to 18.3 [8% increase]) (P<0.001 for both comparisons). Strength increased more in the combination and resistance groups (272 to 320 kg [18% increase] and 288 to 337 kg [19% increase], respectively) than in the aerobic group (265 to 270 kg [4% increase]) (P<0.001 for both comparisons). Body weight decreased by 9% in all exercise groups but did not change significantly in the control group. Lean mass decreased less in the combination and resistance groups than in the aerobic group (56.5 to 54.8 kg [3% decrease] and 58.1 to 57.1 kg [2% decrease], respectively, vs. 55.0 to 52.3 kg [5% decrease]), as did bone mineral density at the total hip (grams per square centimeter; 1.010 to 0.996 [1% decrease] and 1.047 to 1.041 [0.5% decrease], respectively, vs. 1.018 to 0.991 [3% decrease]) (P<0.05 for all comparisons). Exercise-related adverse events included musculoskeletal injuries. CONCLUSIONS Of the methods tested, weight loss plus combined aerobic and resistance exercise was the most effective in improving functional status of obese older adults. (Funded by the National Institutes of Health; LITOE ClinicalTrials.gov number, NCT01065636.)

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Section: Discussionmentioning

confidence: 99%

Aerobic or Resistance Exercise, or Both, in Dieting Obese Older Adults

et al. 2017

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“…137 For example, a recent research review explored the potential risks and benefits of calorie restriction among the elderly and urged caution as a result of mixed results from clinically based efficacy trials and a lack of effectiveness and community-based studies. 138 Most CVD prevention research has focused on younger adults; however, with the growing number of older adults and increases in the average life expectancy, more research on the nutrition behaviors of this group is warranted.…”

Section: Recommendations For Special Populationsmentioning

confidence: 99%

Meal Timing and Frequency: Implications for Cardiovascular Disease Prevention: A Scientific Statement From the American Heart Association

St‐Onge¹,

Ard²,

Baskin³

et al. 2017

Circulation

572

474

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Eating patterns are increasingly varied. Typical breakfast, lunch, and dinner meals are difficult to distinguish because skipping meals and snacking have become more prevalent. Such eating styles can have various effects on cardiometabolic health markers, namely obesity, lipid profile, insulin resistance, and blood pressure. In this statement, we review the cardiometabolic health effects of specific eating patterns: skipping breakfast, intermittent fasting, meal frequency (number of daily eating occasions), and timing of eating occasions. Furthermore, we propose definitions for meals, snacks, and eating occasions for use in research. Finally, data suggest that irregular eating patterns appear less favorable for achieving a healthy cardiometabolic profile. Intentional eating with mindful attention to the timing and frequency of eating occasions could lead to healthier lifestyle and cardiometabolic risk factor management.T he patterns of meal and snack eating behavior in American adults have changed over the past 40 years. Based on NHANES (National Health and Nutrition Examination Survey) data from 1971 to 1974 to 2009 to 2010 (n=62 298), women 20 to 74 years of age reported a decrease in 24-hour meal-derived total energy intake (TEI) from 82% in the 1970s to 77% in 2009 to 2010 and an increase in the proportion of TEI consumed from snacks from 18% to 23%.1 Similar trends were reported among men. The proportion of men and women who reported consuming all 3 standard meals declined over this period (from 73% to 59% in men; from 75% to 63% in women), 1 reflecting changes in eating patterns rather than changes in eating frequency. Indeed, the traditional breakfast-lunch-dinner pattern was not observed in a population of healthy, non-shift-working adults. 2 In that study, the number of eating occasions, defined as consumption of any food or beverage providing at least 5 kcal, was ≈4.2 times a day in the lowest decile and 10.5 times a day for the top decile. There were only 5 hours during the 24-hour day when <1% of all eating occasions occurred: between 1 and 6 am. This study clearly demonstrated that adults in the United States eat around the clock. Because feeding and fasting entrain clock genes, which regulate all aspects of metabolism, meal timing can have serious implications for the development of cardiovascular disease (CVD), type 2 diabetes mellitus, and obesity. 3,4 The circadian rhythms of the body are controlled by the central clock located in the suprachiasmatic nucleus of the hypothalamus but also by clocks of peripheral organs. Although the master clock is strongly entrained by light, clocks of peripheral organs are additionally responsive to food supply, and temporal restriction of food can reset clock gene rhythms. In mice, food given in the normal sleeping period can uncouple peripheral clocks from the master clock. 5 In fact, time-restricted feeding CLINICAL STATEMENTS AND GUIDELINESin mice alters the robustness and coherence of rhythmic gene transcripts, 6 which may be relevant for cardiom...

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“…In terms of waist girth, a combination of moderate caloric restriction and exercise has been recommended for weight loss in older adults to prevent the loss of bone density and skeletal muscle mass that occurs when only caloric restriction is instituted (Locher et al, 2016;Villareal & Shah, 2015;Waters, Ward, & Villareal, 2013). This combined approach has been found to be successful in achieving weight loss and improving physical function, cardiovascular, and metabolic outcomes in older adults (Beavers et al, 2014;Waters et al, The results of the present study indicate that including a focus on physical activity in weight loss programs has the potential to directly increase MVPA through the prescription of physical activity as a treatment and indirectly by facilitating the higher levels of activity that may ultimately result from reduced waist girth.…”

Section: Study Implicationsmentioning

confidence: 99%

Exploring Factors Associated With Physical Activity in Older Adults: An Ecological Approach

Rai

Jongenelis

Jackson³

et al. 2019

Journal of Aging and Physical Activity

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According to ecological models of behavior, the physical environment can influence physical activity engagement by a series of mediating and moderating processes. This study tested such a model to identify factors relevant to older adults' engagement in moderate-vigorous physical activity. Sociodemographic, psychological, physical, and environmental factors were assessed in 432 Western Australians aged 60 and older. Moderate-vigorous physical activity was measured objectively using accelerometers. No environmental variables were related to engagement in moderate-vigorous physical activity either directly or indirectly. However, various individual-level factors were significant, indicating that these may be more important than environmental factors in locations such as Australia that have generally conducive environments and ambient conditions.

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Calorie restriction in overweight older adults: Do benefits exceed potential risks?

Cited by 48 publications

References 40 publications

Aerobic or Resistance Exercise, or Both, in Dieting Obese Older Adults

Aerobic or Resistance Exercise, or Both, in Dieting Obese Older Adults

Meal Timing and Frequency: Implications for Cardiovascular Disease Prevention: A Scientific Statement From the American Heart Association

Exploring Factors Associated With Physical Activity in Older Adults: An Ecological Approach

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