Obesity in older adults: Effect of degree of weight loss on cardiovascular markers and medications

Abstract

Summary Obesity worsens the age‐related tendency towards cardiovascular disease and diabetes. Older adults are vulnerable to medication adverse effects. Intentional weight loss in older adults with obesity has been shown to improve cardiovascular and glycaemic markers. The effect of rapid weight loss induced by very‐low‐calorie diets (VLCDs) on these markers has not been evaluated in this group. In this 12‐week study, participants were randomized to one of healthy eating, hypocaloric diet or VLCD, all combined with three times weekly exercise (Ex/HE, Ex/Diet, Ex/VLCD, respectively). The effects of these interventions on weight, blood pressure, lipids, glucose and HbA1c, inflammatory markers and cardiovascular and diabetes medication changes were measured. Weight loss was 3.7%, 5.1% and 11.1% in Ex/HE, Ex/Diet and Ex/VLCD, respectively. There were significant improvements in HbA1c in all groups, but by the greatest degree in Ex/VLCD (0.18 ± 0.07%, 0.18 ± 0.06% and 0.59 ± 0.13%, respectively). Similar patterns were seen in total cholesterol (0.13 ± 0.15, 0.21 ± 0.11 and 0.53 ± 0.13 mmol/L, respectively, P = .047), triglycerides (0.35 ± 0.13, 0.20 ± 0.10 and 0.51 ± 0.09 mmol/L, respectively, P = .011) and systolic blood pressure (9 ± 2, 2 ± 3 and 14 ± 3 mmHg respectively, P = .025). There were no between‐group differences in fasting glucose, high‐density lipoprotein (HDL) cholesterol, LDL‐C and inflammatory markers. Reductions in anti‐hypertensive or diabetes medication were made in 4/29, 7/36 and 16/37 participants in Ex/HE, Ex/Diet and Ex/VLCD, respectively (P = .017). Significant weight loss achieved with a VLCD gave rise to improvements in multiple cardiovascular risk markers, despite reduction in medication. Weight loss is an under‐utilized method of cardiovascular risk management in this group.

Dietary weight-loss interventions for the management of obesity in older adults

“…In a recent systematic review, Haywood and Sumithran [52] included RCTs published until January 2018 examining the effects of any type of WL-intervention tested in persons aged 60 years and beyond with obesity (BMI ≥ 30 kg/ m 2 ). They identified two new small trials [53][54][55] actually testing VLCDs with an energy intake around 800-1000 kcal/d through meal replacements (Optifast program) over a relatively short period of time (3-6 months) in older adults without functional impairment or frailty at baseline (age range 65-85 years). One of them was partly industry-funded by Nestlé [53].…”

“…In both trials WL was greatest in the VLCD group, with comparable differences in the reduction of FM and WC. Haywood and colleagues in their trial also analysed changes in biomarkers of cardiovascular risk and found that improvements were more pronounced in the VLCD group [55]. However, the loss of LM and BMD was also greater in the VLCD group [54].…”

Overweight Effects on Metabolic Rate, Chronic Diseases, Time Perception, Aging, and Lifespan: a Systematic Review

“…Each disease is accompanied by weight loss. (13,55) Weight loss helps to recover. Simple restriction of food intake decreases MR by 45%.…”

“…Weightloss recovers from a lot of chronic diseases such as hypertension, gastric ulcer, psoriasis, diabetes, bronchial asthma, neoplasms, urolithiasis, gallstone disease, and etc. (13,(58)(59)(60)(61) Overeating at overweight deteriorates digestive; leads to malnutrition, metabolic intoxication, and immune stress. (62) Alimentary energy is energy expenditure for food intake, digestive, absorption, transport, storage, and eliminating.…”

“…Weight loss methods improve in multiple cardiovascular risk markers, reduce in medication, improve MR. (13,14) However, not every weight loss method can support metabolic health, reduce in energy expenditure, reduce oxidative damage, and delay age-associated declines in physiological function. (15) The impact of overweight on MR, health and diseases, aging and lifespan was separately investigated before, but all in conjunction was not studied, especially the impact of overweight and MR on TFP.…”