Older adults with obesity and frailty is a growing public health problem. A series of RCTs were conducted to investigate if 10% weight loss is feasible in obese frail older adults and will improve physical function, body composition, and other health outcomes. This presentation will show results on physical function and body composition from two RCTs that DT Villareal was PI.
One-year trial of 107 older adults with obesity and frailty randomized to weight loss and exercise (combined aerobic and resistance), diet (DIET), exercise (EXER), diet-exercise (COMBO) or control (CON). Primary outcome was modified Physical Performance Test (PPT). Secondary outcomes were body composition, bone mineral density (BMD), specific physical functions. Body weight decreased 10% DIET, 9% COMBO, no decrease EXER or CON. LBM and hip BMD decreased less COMBO than DIET. Strength, balance, and gait improved in COMBO (P<0.05 all comparisons).
Next trial randomized 160 obese, frail older adults to 6-months weight loss plus aerobic exercise (AET), weight loss and resistance exercise (RET), weight loss and a combined aerobic and resistance training (COMBO) or control (CON) group. Similar primary and secondary outcomes. Body weight decreased 9% in all intervention groups and physical performance (PPT) increased more in COMBO than AET and RET. Lean mass decreased similarly and less in COMBO and RET than AET, as did total hip BMD g/cm3. Findings were similar for femoral neck, trochanter, and intertrochanter BMD. No significant changes in one-third radius, lumbar spine or whole body BMD. Peak VO2 (ml/kg/min) increased similarly and more in COMBO and AET compared to RET (P<0.001). Strength increased similarly and more in COMBO and RET than AET (P<0.001).
In conclusion, for older adults with obesity and frailty, resistance plus aerobic exercise, not aerobic exercise alone, should be prescribed to protect against skeletal muscle and bone loss during weight-loss therapy.