Diet and Exercise for Obese Older Adults

Posted by Graham McMahon • April 1st, 2011

In an Original Article this week, “Weight Loss, Exercise, or Both and Physical Function in Obese Older Adults,” Villareal et al. examined the independent and combined effects of weight loss and exercise in obese adults 65 years of age or older. The findings suggest that weight loss plus exercise provides greater improvement in physical function than either intervention alone.
Currently, approximately 20% of adults 65 years of age or older are obese, and the prevalence is likely to continue to rise as more baby boomers become senior citizens.

Clinical Pearls

What is the effect of obesity among older adults?

In older adults, obesity exacerbates the age-related decline in physical function, which causes frailty, impairs quality of life, and results in increases in nursing home admissions.

What was the effect of diet, exercise, or both on physical functioning in this study?

The mean scores on the Physical Performance Test increased more in the diet-exercise group than in the diet group or the exercise group: an increase of 5.4 points in the diet-exercise group (a 21% change from baseline), as compared with increases of 3.4 points in the diet group (a 12% change) and 4.0 points in the exercise group (a 15% change).

Figure 2. Mean Percentage Changes in Objective and Subjective Measures of Frailty during the 1-Year Intervention.

Morning Report Questions

Q: What was the effect of diet, exercise, both or neither on weight in this study?

A: There was a substantial decrease in body weight in the diet group (a weight loss of 9.7 kg, representing a 10% decrease from baseline) and in the diet-exercise group (a weight loss of 8.6 kg, representing a 9% decrease), but not in the exercise group (a weight loss of 1.8 kg, representing a 1% decrease) or the control group (a weight loss of 0.9 kg, representing <1% decrease).

Q: What was the effect of diet, exercise, both or neither on bone mineral density in this study?

A: Bone mineral density at the hip increased by 0.013 g per square centimeter (a 1.5% increase) in the exercise group. In contrast, bone mineral density at the hip decreased by 0.011 g per square centimeter (a decrease of 1.1% from baseline) in the diet-exercise group, and by 0.027 g per square centimeter (a decrease of 2.6%) in the diet group.

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