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American Journal of Clinical Nutrition, Vol. 82, No. 4, 872-878, October 2005
© 2005 American Society for Clinical Nutrition


ORIGINAL RESEARCH COMMUNICATION

Weight change and the conservation of lean mass in old age: the Health, Aging and Body Composition Study1,2,3

Anne B Newman, Jung Sun Lee, Marjolein Visser, Bret H Goodpaster, Stephen B Kritchevsky, Frances A Tylavsky, Michael Nevitt and Tamara B Harris

1 From the Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA (ABN, JSL, and BHG); the Institute for Research in Extramural Medicine, VU University Medical Center, and the Department of Nutrition and Health, Faculty of Earth and Life Sciences, Vrije Universiteit, Amsterdam, Netherlands (MV); the Division of Gerontology and Geriatric Medicine, Department of Internal Medicine, Wake Forest University School of Medicine, Winston Salem, NC (SBK); the Department of Preventative Medicine, University of Tennessee Health Science Center, Memphis, TN (FAT); the Prevention Sciences Group, University of California, San Francisco, CA (MN); and the Laboratory for Epidemiology, Demography and Biometry, National Institute on Aging, Bethesda, MD (TBH)

Background: Weight loss may contribute to the loss of lean mass with age.

Objective: The objective was to evaluate the relation between weight loss or weight gain and changes in lean mass and fat mass in older adults.

Design: We observed changes in weight and body composition during a 4-y period in 2163 men (47%) and women (53%) aged 70–79 y in the Health, Aging and Body Composition Study cohort. Whole-body and appendicular bone-free lean mass and fat mass were measured by using dual-energy X-ray absorptiometry.

Results: Weight loss and weight gain were common. In both weight losers and weight gainers, changes in lean mass as a percentage of initial lean mass were substantially smaller than changes in fat mass as a percentage of initial fat mass. However, the difference between the change in lean mass and that in fat mass was more pronounced with weight gain than with weight loss, especially in men. Small amounts of lean loss and fat gain were noted with weight stability. In multivariate models, weight loss was strongly associated with lean mass loss in both men and women, especially in men whose weight loss was concurrent with a hospitalization.

Conclusions: With weight change, a greater proportion of lean mass than of fat mass was conserved, but, especially in older men, significantly more lean mass was lost with weight loss than was gained with weight gain. These findings suggest that weight loss, even with regain, could accelerate sarcopenia in older adults.

Key Words: Body composition • sarcopenia • weight loss • older adults




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