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Older-adult Dieting Won't Lead To Reduced Physical Function, Research Suggests
ScienceDaily (May 8, 2007) — Unintentional
weight loss in older adults often leads to frailty, a decline in physical function and even death. So is it wise for older,
overweight women to embark on a weight loss program? New research from Wake Forest University Baptist Medical
Center suggests that these women are better off trying to lose weight
-- even if they regain some of it.
"Our results suggest that losing weight through
calorie cutting won't lead to increased disability in older women," said Jamehl Demons, M.D., lead investigator on a project
evaluating the effects of weight loss on physical performance.
And even when some of the weight was regained,
the women still came out ahead. "It looks like they are better off than if they had never tried to lose weight," said Mary
F. Lyles, M.D., lead investigator on an analysis exploring how dieting affected body composition.
The results of both projects -- which are
part of the larger Diet, Exercise and Metabolism in Older Women (DEMO) study -- are being presented today (May 4) at the annual
meeting of the American Geriatrics Society in Seattle.
It is well-known that weight loss -- whether
it is intentional or unintentional -- results in the loss of both muscle and fat. Because people naturally lose muscle as
they age, scientists have wondered whether it's safe for older adults to compound this effect by dieting.
"Weight loss without exercise is not widely
advocated for older adults because of the potential to lose muscle and reduce physical function," said Demons, an assistant
professor of internal medicine -- gerontology.
Her study evaluated 23 obese, postmenopausal,
sedentary women with a mean age of 58 who participated in the DEMO study. For five months, their meals and snacks were provided
by the study and contained 400 fewer calories than they needed to maintain their weight.
Participants' body composition and physical
function were measured before and after the five-month period. Tests of physical function measured knee strength, hand-grip
strength, walking speed, aerobic fitness and ability to quickly rise from a chair without using their arms. The women lost
an average of 25 pounds, with muscle representing about 35 percent of the total loss.
"Despite the large amount of muscle loss,
their aerobic fitness and their ability to rise from a chair showed a trend toward improvement," said Demons. "Their strength
and walking speed did not change. This suggests that their weight loss through dieting wouldn't be expected to lead to increased
Losing weight is only part of the equation,
however. Most individuals who successfully lose weight tend to regain most or all of it -- and little is known about whether
the regained weight is fat or muscle. In older adults, regaining a significant amount of fat could be risky because of the
potential to end up with less muscle than when they started.
Lyles' project evaluated 30 women from the
DEMO study to determine body composition when weight was regained. Body composition was measured before and after the five-month
period of calorie restriction. A third measurement was taken 12 months later.
The women lost an average of 25 pounds --
about 32 percent of the lost weight was muscle and 68 percent was fat. The women regained an average of 11 pounds. About 27
percent of the regained weight was muscle and 73 percent was fat.
"Weight regain in the year following an intensive
weight loss program is accompanied by gain of both fat and lean mass, with relatively more fat gain and less lean gain," said
She noted that during the 12 months, the women
had returned to their usual diet and exercise patterns, so researchers cannot conclude whether the shifts in body composition
were related to the weight loss -- or to some natural progression or aging change.
Co-researchers were Xeuwen Wang, Ph.D., Steve
Kritchevsky, Ph.D., Barbara Nicklas, Ph.D., and Leon Lenchik, M.D., all from Wake Forest, and Tongjian You, Ph.D., who is
now with the University of Buffalo.Adapted from materials provided by Wake Forest University Baptist Medical Center.
Snacking Can Benefit Older Adults
ScienceDaily (May 4, 2007) — A nationally
representative study of more than 2,000 people over age 65 found snacking is an "important dietary behavior" among older adults
that can help ensure they consume enough calories in their diets, according to researchers at Auburn University and the U.S.
Department of Agriculture.
Calorie consumption has been found to decrease
as people get older -- by as much as 1,200 calories per day for men and 800 calories per day for women at age 70 compared
to the consumption of 25-year-olds. Reasons for eating less include physical decline and illness, limited financial resources
and social factors such as living alone. While some research has investigated meal patterns among older adults, less has been
done on the role of snacks.
The researchers found 84 percent of the adults
in the study ate snacks daily, with an average of about 2.5 snacks per day. Those who ate snacks consumed significantly higher
amounts of calories, protein, carbohydrates and total fat than non-snackers. Snacks accounted for about one-quarter of all
the snackers' daily calories, about one-fifth of their fat intake and 14 percent of their protein.
"This study shows snacking is an important
dietary behavior, both in terms of the prevalence and the (calorie) contribution, among older adults," the researchers write.
"Whereas snacking may promote (calorie) imbalance resulting in obesity among other age groups, our results suggest snacking
may ensure older adults consume diets adequate in (calories).
Adapted from materials provided by American Dietetic Association.
Fitness Level, Not Body Fat, May Be Stronger Predictor Of Longevity For Older Adults
ScienceDaily (Dec. 5, 2007) — Adults
over age 60 who had higher levels of cardiorespiratory fitness lived longer than unfit adults, independent of their levels
of body fat, according to a new study.
Previous studies have provided evidence that
obesity and physical inactivity each can produce a higher risk of death in middle-aged adults. Whether this is also true for
older adults is uncertain, according to background information in the article.
Xuemei Sui, M.D., of the University of South
Carolina, Columbia, and colleagues examined the associations between cardiorespiratory fitness, various clinical measures
of adiposity (body fat) and death in older women and men. The study included 2,603 adults age 60 years or older (average age,
64.4 years; 19.8 percent women) enrolled in the Aerobics Center Longitudinal Study who completed a baseline health examination during 1979-2001.
Fitness was assessed by a treadmill exercise test and adiposity was assessed by body mass index (BMI), waist circumference,
and percent body fat. Low fitness was defined as the lowest fifth of the sex-specific distribution of treadmill exercise test
duration. There were 450 deaths during an average follow-up of 12 years.
The researchers found that those who died
were older, had lower fitness levels, and had more cardiovascular risk factors than survivors. However, there were no significant
differences in adiposity measures. Participants in the higher fitness groups were for the most part less likely to have risk
factors for cardiovascular disease, such as hypertension, diabetes, or high cholesterol levels. Fit participants had lower
death rates than unfit participants within each stratum of adiposity, except for two of the obesity groups. In most instances,
death rates for those with higher fitness were less than half of rates for those who were unfit.
Higher levels of fitness were inversely related
to all-cause death in both normal-weight and overweight BMI subgroups, in those with a normal waist circumference and in those
with abdominal obesity, and in those who have normal percent body fat and those who have excessive percent body fat.
"... we observed that fit individuals who
were obese (such as those with BMI of 30.0-34.9, abdominal obesity, or excessive percent body fat) had a lower risk of all-cause
mortality than did unfit, normal-weight, or lean individuals. Our data therefore suggest that fitness levels in older individuals
influence the association of obesity to mortality," the authors write.
"Our data provide further evidence regarding
the complex long-term relationship among fitness, body size, and survival. It may be possible to reduce all-cause death rates
among older adults, including those who are obese, by promoting regular physical activity, such as brisk walking for 30 minutes
or more on most days of the week (about 8 kcal/kg per week), which will keep most individuals out of the low-fitness category.
Enhancing functional capacity also should allow older adults to achieve a healthy lifestyle and to enjoy longer life in better
Journal reference: JAMA. 2007;298(21):2507-2516.
Adapted from materials provided by JAMA and Archives Journals.
Location Of Body Fat Associated With Cardiovascular Risk In Older Men And Women Even At Normal
ScienceDaily (Apr. 21, 2005) — CHICAGO
— The distribution of body fat in older men and women is associated with metabolic syndrome, a risk factor for cardiovascular
disease and diabetes, even in normal weight individuals, according to the April 11 issue of the Archives of Internal Medicine,
one of the JAMA/Archives journals.
Metabolic syndrome, a disorder that includes
dyslipidemia (elevated blood lipid levels), insulin resistance and high blood pressure, affects 22 percent of adults in the
U.S. and an even higher (42) percent of
older men and women, according to background information in the article. In addition to overweight and obesity, patterns of
fat distribution in middle-aged adults may confer additional risk for metabolic syndrome, but it is not known whether this
is true for older individuals.
Bret H. Goodpaster, Ph.D., of the University
of Pittsburgh Medical Center, and colleagues examined the association between the pattern of distribution of body fat and
metabolic syndrome in 3,035 men and women aged 70 to 79. The distribution of body fat was determined using computed tomography
(CT) scanning. Patients were examined and characterized as having metabolic syndrome if they met at least three of the following
criteria: waist circumference greater than about 40.2 inches in men or 34.7 inches in women; elevated blood triglyceride levels;
low high density lipoprotein (HDL) cholesterol levels; high blood pressure, treated or untreated; and elevated blood sugar
level, treated or untreated. Individuals were classified as normal weight, overweight or obese based on the basis of body
mass index (BMI, calculated as weight in kilograms divided by the square of height in meters) with a BMI of less than 25.0
considered normal weight, overweight was defined as a BMI of 25.0-29.9 and obese was defined by a BMI of greater than 29.9.
Visceral fat (fat found in the deeper tissues
and around the body's organs rather than just under the skin) was associated with metabolic syndrome in older men and women
whether they were normal weight, overweight or obese. Subcutaneous (under the skin) abdominal fat was associated with metabolic
syndrome only in normal weight men. Intermuscular fat was associated with the syndrome in normal and overweight men, the researchers
found. A surprising finding, according to the authors, was that subcutaneous thigh fat was inversely associated with metabolic
syndrome in obese men and women. Having more of this type of fat made an individual less likely to have metabolic syndrome.
"In conclusion, excess accumulation of either
visceral abdominal or muscle AT [adipose tissue or fat] is associated with a higher prevalence of metabolic syndrome in older
adults, particularly in those who are of normal body weight," the authors write. "This suggests that practitioners should
not discount the risk of metabolic syndrome in their older patients entirely on the basis of body weight or BMI. Indeed, generalized
body composition, in terms of both BMI and the proportion of body fat, does not clearly distinguish older subjects with the
(Arch Intern Med. 2005;165:777-783. Available
post-embargo at archinternmed.com)
Editor's Note: This study was supported by
grants from the National Institutes of Health, Bethesda, Md. Dr. Goodpaster was supported by a grant from the National Institute
Adapted from materials provided by Journal Of The American Medical Association.