(20-04-11) Weight loss, exercise, or both and physical function in obese older adults.

Villareal DT, Chode S, Parimi N, Sinacore DR, Hilton T, Armamento-Villareal R, Napoli N, Qualls C, Shah K.

Division of Geriatrics and Nutritional Science, Washington University School
of Medicine, St. Louis, USA. [email protected]
Abstract
BACKGROUND: Obesity exacerbates the age-related decline in physical function
and causes frailty in older adults; however, the appropriate treatment for
obese older adults is controversial.

METHODS: In this 1-year, randomized, controlled trial, we evaluated the
independent and combined effects of weight loss and exercise in 107 adults who
were 65 years of age or older and obese. Participants were randomly assigned to
a control group, a weight-management (diet) group, an exercise group, or a
weight-management-plus-exercise (diet-exercise) group. The primary outcome was
the change in score on the modified Physical Performance Test. Secondary
outcomes included other measures of frailty, body composition, bone mineral
density, specific physical functions, and quality of life.

RESULTS: A total of 93 participants (87%) completed the study. In the
intention-to-treat analysis, the score on the Physical Performance Test, in
which higher scores indicate better physical status, increased more in the diet-
exercise group than in the diet group or the exercise group (increases from
baseline of 21% vs. 12% and 15%, respectively); the scores in all three of
those groups increased more than the scores in the control group (in which the
score increased by 1%) (P<0.001 for the between-group differences). Moreover,
the peak oxygen consumption improved more in the diet-exercise group than in
the diet group or the exercise group (increases of 17% vs. 10% and 8%,
respectively; P<0.001); the score on the Functional Status Questionnaire, in
which higher scores indicate better physical function, increased more in the
diet-exercise group than in the diet group (increase of 10% vs. 4%, P<0.001).
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 (P<0.
001). Lean body mass and bone mineral density at the hip decreased less in the
diet-exercise group than in the diet group (reductions of 3% and 1%,
respectively, in the diet-exercise group vs. reductions of 5% and 3%,
respectively, in the diet group; P<0.05 for both comparisons). Strength,
balance, and gait improved consistently in the diet-exercise group (P<0.05 for
all comparisons). Adverse events included a small number of exercise-associated
musculoskeletal injuries.

CONCLUSIONS: These findings suggest that a combination of weight loss and
exercise provides greater improvement in physical function than either
intervention alone. (Funded by the National Institutes of Health;
ClinicalTrials.gov number, NCT00146107.).

Source: N Engl J Med. 2011 Mar 31;364(13):1218-29

News

---

In evidenza

"L'informazione presente nel sito serve a migliorare, e non a sostituire, il rapporto medico-paziente."

Per coloro che hanno problemi di salute si consiglia di consultare sempre il proprio medico curante.