AJCN Tufts Nutrition Symposium, Boston Sept 24-26
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American Journal of Clinical Nutrition, Vol. 84, No. 6, 1317-1323, December 2006
© 2006 American Society for Nutrition


ORIGINAL RESEARCH COMMUNICATION

Effect of lifestyle intervention on metabolic coronary heart disease risk factors in obese older adults1,2,3

Dennis T Villareal, Bernard V Miller, III, Marian Banks, Luigi Fontana, David R Sinacore and Samuel Klein

1 From Geriatrics and Nutritional Science and the Center for Human Nutrition, Washington University School of Medicine, St Louis, MO (DTV, BVM, MB, LF, DRS, and SK), and the Division of Food Science, Human Nutrition and Health, Istituto Superiore di Sanità, Rome, Italy (LF)

Background: Coronary heart disease (CHD) risk factors increase with age and body mass index (BMI; in kg/m2). However, whether lifestyle intervention ameliorates metabolic CHD risk factors in obese older adults is unknown.

Objective: The objective was to determine whether lifestyle intervention improves metabolic CHD risk factors in obese older adults.

Design: A 6-mo outpatient randomized controlled trial was conducted in obese (BMI ≥ 30) older (≥65 y) adults randomly assigned to diet and exercise therapy (treatment group; n = 17) or no therapy (control group; n = 10). The main outcomes were CHD risk factors.

Results: Body weight decreased by 8.4% (8.2 kg) in the treatment group; weight did not change significantly (0.7 kg) in the control group (P < 0.001 between groups). Changes between the control and treatment groups, respectively, in waist circumference (1 and –10 cm), plasma glucose (4 and –4 mg/dL), serum triacylglycerols (0 and –45 mg/dL), and systolic (–2 and –10 mm Hg) and diastolic (0 and –8 mm Hg) blood pressure were different (P < 0.05 for all). The number of subjects with the metabolic syndrome decreased by 59% in the treatment group but did not change significantly in the control group (P < 0.05). Serum free fatty acids increased by 10 µmol/L in the control group and decreased by 99 µmol/L in the treatment group (P < 0.05). Changes between the control and treatment groups, respectively, in C-reactive protein (0.8 and –2.5 mg/L) and interleukin 6 (1.6 and –2.4 pg/mL) were different (P < 0.05 for both).

Conclusions: Lifestyle intervention decreases multiple metabolic CHD risk factors simultaneously in obese older adults.

Key Words: Aging • obesity • metabolic syndrome • lifestyle intervention • atherosclerosis


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