Weight loss, exercise or both and cardiometabolic risk factors in obese older adults: results of a randomized controlled trial
Open accessAbstract
Background Obesity exacerbates the age-related decline in insulin sensitivity and is associated with risk for cardiometabolic syndrome in older adults; however, the appropriate treatment for obese older adults is controversial.Objective To determine the independent and combined effects of weight loss and exercise on cardiometabolic risk factors in obese older adults.Design One-hundred and seven obese (body mass index (BMI)≥30 kg m(-2)) older (≥65 years) adults with physical frailty were randomized to control group, diet group, exercise group and diet-exercise group for 1 year. Outcomes for this study included changes in insulin sensitivity index (ISI), glucose tolerance, central obesity, adipocytokines and cardiometabolic syndrome.Results Although similar increases in ISI occurred in the diet-exercise and diet groups at 6 months, the ISI improved more in the diet-exercise than in the diet group at 12 months (2.4 vs 1.2; between-group difference, 1.2; 95% confidence interval, 0.2-2.1); no changes in ISI occurred in both exercise and control groups. The diet-exercise and diet groups had similar improvements in insulin area under the curve (AUC) (-2.9 and -2.9 × 10(3) mg min dl(-1)), glucose AUC (-1.4 and -2.2 × 10(3)mg min dl(-1)), visceral fat (-787 and -561 cm(3)), tumor necrosis factor (-17.0 and -12.8 pg ml(-1)), adiponectin (5.0 and 4.0 ng ml(-1)), waist circumference (-8.2 and -8.4 cm), triglyceride (-30.7 and -24.3 g dl(-1)) and systolic/diastolic blood pressure (-15.9 and -13.1/-4.9 and -6.7 mm Hg), while no changes in these parameters occurred in both exercise and control groups. The cardiometabolic syndrome prevalence decreased by 40% in the diet-exercise and by 15% in the diet group. Body weight decreased similarly in the diet-exercise and diet groups (-8.6 and -9.7 kg) but not in the exercise and control groups.Conclusions In frail, obese older adults, lifestyle interventions associated with weight loss improve insulin sensitivity and other cardiometabolic risk factors, but continued improvement in insulin sensitivity is only achieved when exercise training is added to weight loss.
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The positive effects on circulating cytokines, adiponectin and TNF were due to diet and not exercise.
“the positive effects on circulating cytokines, adiponectin and TNF were due to diet and not exercise301”
From Sarcopenic obesity in older adults: aetiology, epidemiology and treatment strategies (2018) · cites this paper as [301]
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- Authors
- Bouchonville, M., Armamento-Villareal, R., Shah, K., Napoli, N., Sinacore, D. R., Qualls, C., & Villareal, D. T.
- Affiliations
- University of New Mexico (US)
- University of Rochester Medicine (US)
- Università Campus Bio-Medico (IT)
- Washington University in St. Louis (US)
- Corresponding author
- Villareal, D T
- Venue
- International Journal of Obesity
- Published
- 2013-07-04
- Volume
- 38
- Issue
- 3
- Pages
- 423-431
- ISSN
- 0307-0565 (ISSN-L)
- 1476-5497
- PMC
- PMC3835728
- OpenAlex
- W2028846462
- Cited by
- 163
- References
- 47
- Citations by year
- 2026: 12 · 2025: 6 · 2024: 9 · 2023: 15 · 2022: 13 · 2021: 18 · 2020: 10 · 2019: 7 · 2018: 11 · 2017: 11 · 2016: 23 · 2015: 13 · 2014: 10 · 2013: 4 · 2012: 1
- FWCI
- 13.04
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- International Journal of Obesity (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (5p60dk020579-35, UL1TR000448, 7r01ag025501-06)
- National Institute on Aging (R01-AG025501, R01AG031176)
- National Institute of Diabetes and Digestive and Kidney Diseases (DK20579, P60-DK-020579, P30DK056341, P30DK020579)
- National Center for Research Resources (UL1RR024992)
- National Center for Advancing Translational Sciences
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Health Sciences › Medicine › Epidemiology › Adipokines, Inflammation, and Metabolic Diseases
- Keywords
- obesity, older adults, weight loss, physical activity, diet, cardiometabolic syndrome, insulin sensitivity, insulin resistance, glucose tolerance, visceral fat, adiponectin, TNF-α, physical frailty, lifestyle intervention, blood pressure, triglycerides, waist circumference, abdominal obesity, adipokines, combined diet and exercise
- MeSH terms
- Aged, Blood Glucose, Blood Pressure, Body Weight, C-Reactive Protein, Cardiovascular Diseases, Combined Modality Therapy, Diet, Diet, Reducing, Female, Glucose Tolerance Test, Humans, Male, Obesity, Risk Factors, Time Factors, Weight Loss, Exercise, Treatment Outcome, Intra-Abdominal Fat, Adiponectin
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