Exercise's effect on mobility disability in older adults with and without obesity: The LIFE study randomized clinical trial

Abstract

ObjectiveSome data suggests that obesity blunts the benefits of exercise on mobility in older adults. We tested the homogeneity of the effect of a physical activity intervention on major mobility disability across baseline obesity classifications in the Lifestyle Interventions and Independence for Elders (LIFE) Study. LIFE randomized 1,635 sedentary men and women 70–89 years to a moderate intensity physical activity (PA) or health education (HE) program.MethodsMajor mobility disability (MMD), defined as the inability to walk 400m, was determined over an average follow up of 2.6 years. Participants were divided into 4 subgroups: 1) non-obese (BMI < 30 kg/m2; n=437); 2) non-obese with high waist circumference (WC >102 cm [men], >88 cm [women]; n=434); 3) class 1 obesity (30 kg/m2 ≤ BMI < 35 kg/m2; n=430); and 4) class 2+ obesity (BMI ≥ 35 kg/m2; n=312). Cox proportional hazard modeling was used to test an obesity by intervention interaction.ResultsThe PA intervention had the largest benefit in participants with class 2+ obesity (HR 0.69, 95% CI 0.48, 0.98). However, there was no statistically significant difference in benefit across obesity categories.ConclusionA structured PA program reduced the risk of MMD even in older adults with extreme obesity.

Association of metabolic syndrome with mobility in the older adults: a Korean nationwide representative cross-sectional study

“…High carbohydrate intake in Korean older adults leads to lower percentage of protein uptake in macronutrients. In addition, while exercise is well known to have positive effects on mobility decline 45 , a previous systematic review of seven controlled trials revealed that dynamic endurance training such as walking, jogging, and cycling, which are easily performed as home-based exercise, has a favourable effects on most of MetS features 46 . Therefore, for older Korean population, replacing carbohydrate with meat, fish, egg, bean, and performing endurance exercise is needed for prevention of both MetS and mobility decline.…”

The association between smoking and cardiometabolic risk among male adults with disabilities in Taiwan

“…Healthy lifestyle was determined as previously defined. 18,19,23,24 Participants were asked questions regarding four lifestyle habits, with responses categorized as “always,” “usually,” “seldom,” or “never.” For evaluation, responses were combined as usually/always and never/seldom. Regular exercise was determined according to whether participants usually/always exercised for >30 min, at least three times per week, or seldom/never engaged in exercise.…”

“…Healthy lifestyle was determined as previously defined. 18,19,23,24 Participants were asked questions regarding four lifestyle habits, with responses categorized as "always," "usually," "seldom," or "never." For evaluation, responses were combined as usually/always and never/seldom.…”

Therapeutic and lifestyle approaches to obesity in older persons

“…Exercise incorporating aspects of both aerobic endurance training (AT) and progressive resistance training (RT) does not result in significant weight loss in the absence of CR, but it does exert positive effects on body composition, improve physical function, increase strength, and positively affect quality of life in aging adults with obesity [6 ** ]. A recent study showed that even older adults with class 2+ obesity (BMI ≥ 35 kg/m 2 ) can safely perform moderate intensity physical activity and benefit in terms of mobility [14*]. While CR and exercise both individually improve physical function and quality of life, CR with concurrent exercise training yields better results than either modality alone [15].…”