Effect of Diet, Exercise, or Both on Biological Age and Healthy Aging in Older Adults with Obesity: Secondary Analysis of a Randomized Controlled Trial
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OBJECTIVES: To determine the effect of diet, exercise, and diet-exercise in combination on measures of biological age. DESIGN: Secondary analysis of a 1-year randomized, controlled trial. SETTING: University-based Medical Center. PARTICIPANTS: One-hundred-seven older (age≥65 yrs.) adults with obesity (BMI≥30 kg/m2) were randomized and 93 completed the study. Analyses used intention-to-treat. INTERVENTIONS: Participants were randomized to a control group, a weight-management (diet) group, an exercise group, or a weight-management-plus-exercise (diet-exercise) group. MAIN OUTCOME MEASURES: We calculated Klemera-Doubal Method (KDM) biological age, Homeostatic Dysregulation (HD) score, and Health Aging Index (HAI) score at baseline, and changes at 6- and 12-months. RESULTS: Diet and diet-exercise decreased KDM biological age more than exercise and control (-2.4±0.4, -2.2±0.3, -0.2±0.4, and 0.2±0.5, respectively, P<0.05 for the between group-differences). Diet and diet-exercise also decreased HD score more than exercise and control (-1.0±0.3, -1.1±0.3, 0.1±0.3, and 0.3±0.3 respectively, P<0.05). Moreover, diet-exercise decreased HAI score more than exercise, diet, or control (-1.1±0.2, -0.5±0.2, -0.5±0.2, and 0.0±0.2, respectively, P<0.05). CONCLUSIONS: These findings suggest that diet and diet-exercise are both effective methods of improving biological age, and that biological age may be a valuable method of assessing geroprotective interventions in older humans.
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One of the most common undesired effects of hypocaloric diets to lose weight in older people is an impairment in functioning due to the loss of skeletal muscle, with the highest impact in older people with sarcopenia and frailty.
“One of the most common undesired effects of the hypocaloric diets to lose weight in older people is an impairment in functioning due to the loss of skeletal muscle, with the highest impact in older people with sarcopenia and frailty [320,321].”
From Global consensus on optimal exercise recommendations for enhancing healthy longevity in older adults (ICFSR) (2025) · cites this paper as [321]
Energy restriction results in significant loss of muscle and bone.
“Importantly, energy restriction results in significant loss of muscle and bone [320,321].”
From Global consensus on optimal exercise recommendations for enhancing healthy longevity in older adults (ICFSR) (2025) · cites this paper as [321]
Hypocaloric diets for weight loss in older people commonly cause impaired functioning due to loss of skeletal muscle, with the highest impact in older people with sarcopenia and frailty.
“One of the most common undesired effects of the hypocaloric diets to lose weight in older people is an impairment in functioning due to the loss of skeletal muscle, with the highest impact in older people with sarcopenia and frailty [320,321].”
From Global consensus on optimal exercise recommendations for enhancing healthy longevity in older adults (ICFSR) (2025) · cites this paper as [321]
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References 32 · Cited by 45
- Authors
- Ho, E., Qualls, C., & Villareal, D. T.
- Affiliations
- Michael E. DeBakey VA Medical Center (US)
- University of New Mexico (US)
- Corresponding author
- Villareal, Dennis T.
- Venue
- The Journal of nutrition, health and aging
- Publisher
- Elsevier BV
- Published
- 2022-06
- Volume
- 26
- Issue
- 6
- Pages
- 552-557
- ISSN
- 1279-7707 (ISSN-L)
- PMC
- PMC9236175
- OpenAlex
- W4281711431
- Cited by
- 45
- References
- 32
- Citations by year
- 2026: 8 · 2025: 17 · 2024: 12 · 2023: 7 · 2022: 1
- FWCI
- 5.73
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- The journal of nutrition health & aging (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (7r01ag025501-06)
- National Institute on Aging (R01-AG025501, R01AG031176)
- National Institute of Diabetes and Digestive and Kidney Diseases (P30DK020579)
- Topics
- Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Health Sciences › Medicine › Geriatrics and Gerontology › Frailty in Older Adults
- Keywords
- biological age, healthy aging, older adults, obesity, physical activity, Klemera-Doubal method, homeostatic dysregulation, geroprotective interventions
- MeSH terms
- Healthy Aging, Aged, Aging, Diet, Reducing, Humans, Obesity, Weight Loss
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