Diet versus Exercise in Obese Older Adults

Regular readers will recall a recent post on the issue of recommending weight loss in older individuals with obesity.

Now Dennis Villareal and colleagues from the Washington University School of Medicine, St. Louis, Missouri, in a paper published in the New England Journal of Medicine, examined the effect of weight loss, exercise, or both on physical function in obese older adults.

In this 1-year, randomized, controlled trial, 107 adults who were 65 years of age or older and obese were randomly assigned to a control group, a weight-management (diet) group, an exercise group, or a weight-management-plus-exercise (diet-exercise) group. A total of 93 participants (87%) completed the study.

The Physical Performance Test score, increased more in the diet-exercise group (21%) than in the diet group (12%) or the exercise group (15%) compared to scores in the control group (1%).

Perhaps surprisingly, the peak oxygen consumption (a measure of fitness) improved more in the diet-exercise group (17%) than in the diet group (10%) or the exercise group (8%).

The Functional Status Score, increased more in the diet-exercise group than in the diet or exercise groups.

Body weight decreased by 10% in the diet group and by 9% in the diet-exercise group, but did not decrease in the exercise group or the control group.

Lean body mass and bone mineral density at the hip decreased less in the diet-exercise group than in the diet group.

Strength, balance, and gait improved consistently in the diet-exercise group.

Adverse events included a small number of exercise-associated musculoskeletal injuries.

The authors conclude that a combination of weight loss and exercise provides greater improvement in physical function than either intervention alone in obese older individuals.

It is perhaps also worth noting that health status and physical functioning improved in all intervention groups compared to doing nothing (controls).

This study certainly lends support to the notion that a combination of diet and exercise may be best to improve both health and physical function in older individuals with excess weight.

AMS
Edmonton, Alberta

Hat Tip to Carla for drawing my attention to this study

Villareal DT, Chode S, Parimi N, Sinacore DR, Hilton T, Armamento-Villareal R, Napoli N, Qualls C, & Shah K (2011). Weight loss, exercise, or both and physical function in obese older adults. The New England journal of medicine, 364 (13), 1218-29 PMID: 21449785