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Diet plus exercise improves performance for obese seniors

Kathleen Blanchard's picture
Senior exercise

Combination of diet and exercise reduces frailty for obese seniors

Seniors who want to lose weight should combine diet and exercise suggests research from Washington University School of Medicine in St. Louis.

Findings published in the New England Journal of Medicine show diet and exercise both work to help seniors lose weight, but combing the two can help older people improve quality of life and maintain physical function and independence.

Dennis T. Villareal, MD, adjunct associate professor of medicine at Washington University School of Medicine in St. Louis explains obesity in older adults leads to declines in physical performance and frailty. The researchers wanted to separate the effects of dieting and exercise on obese seniors.

The study showed a combination of diet and exercise improved physical performance 21 percent for seniors, versus 12 percent for just dieting and 15 percent for those who exercised to improve obesity.

Villareal says, "Given the increasing prevalence of obesity even among older people, it is important to find ways to combat the problem and help seniors remain healthier and more independent."

Diet and exercise combination improves oxygen consumption for seniors

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The findings also showed seniors who exercised while dieting improve oxygen consumption. 17 percent from baseline during treadmill walking. For those who exercised, the improvement was 8 percent. Dieting alone improved oxygen consumption by 10 percent.

The study included 93 participants over age 65, with average age of 70. All of the seniors were obese, with body mass index greater than 30. The researchers used the Physical Performance Test that monitor progress. The test evaluates ability to perform tasks such as walking 50 feet, standing, climbing stairs, picking up a penny and lifting.

Greater improvements seen in quality of life

Four groups were compared - an exercise group, dieting alone, diet and exercise, and a group who made no lifestyle changes. Quality of life scores were measured after the study. Those who dieted and exercised had a 15 percent improvement. For the diet only group, quality of life improvement was 14 percent and for the exercise alone group, ten percent.

Villareal is now is head of geriatrics at the New Mexico Veterans Affairs Health Care System and professor of medicine at the University of New Mexico School of Medicine. He explains, “Combining exercise and weight loss isn’t designed so much to extend their life expectancy as it is to improve their quality of life during their remaining years and to help seniors avoid being admitted to a nursing home."

Seniors who diet also tend to lose muscle mass and bone density, putting them at risk for fractures. Villareal notes there has been some debate about whether weight loss is beneficial for elders. Dieting, combined with exercise was associated with a 3 percent loss of lean body mass and a 1 percent bone mineral loss in the hip area. Seniors who only dieted lost 5 percent of lean body mass and 3 percent of hip bone mineral density.

The study shows obese seniors do better when they combine exercise with diet. The findings showed overall improvements in strength, balance and gait for seniors given a diet and exercise program, compared to weight loss or exercise alone. The researchers note obesity is becoming more prevalent in older adults, making it important to find ways to help keep seniors healthy and independent.

"Weight Loss, Exercise, or Both and Physical Function in Obese Older Adults"
Dennis T. Villareal, M.D., Suresh Chode, M.D., Nehu Parimi, M.D., David R. Sinacore, P.T., Ph.D., Tiffany Hilton, P.T., Ph.D., Reina Armamento-Villareal, M.D., Nicola Napoli, M.D., Ph.D., Clifford Qualls, Ph.D., and Krupa Shah, M.D., M.P.H.
N Engl J Med 2011; 364:1218-1229March 31, 2011