Improved Function With Enhanced Protein Intake per Meal: A Pilot Study of Weight Reduction in Frail, Obese Older Adults.
Abstract
BACKGROUND: Obesity is a significant cause of functional limitations in older adults;
yet, concerns that weight reduction could diminish muscle along with fat mass have
impeded progress toward an intervention. Meal-based enhancement of protein intake
could protect function and/or lean mass but has not been studied during geriatric
obesity reduction. METHODS: In this 6-month randomized controlled trial, 67 obese
(body mass index ≥30kg/m(2)) older (≥60 years) adults with a Short Physical Performance
Battery score of 4-10 were randomly assigned to a traditional (Control) weight loss
regimen or one with higher protein intake (>30g) at each meal (Protein). All participants
were prescribed a hypo-caloric diet, and weighed and provided dietary guidance weekly.
Physical function (Short Physical Performance Battery) and lean mass (BOD POD), along
with secondary measures, were assessed at 0, 3, and 6 months. RESULTS: At the 6-month
endpoint, there was significant (p < .001) weight loss in both the Control (-7.5±6.2kg)
and Protein (-8.7±7.4kg) groups. Both groups also improved function but the increase
in the Protein (+2.4±1.7 units; p < .001) was greater than in the Control (+0.9±1.7
units; p < .01) group (p = .02). CONCLUSION: Obese, functionally limited older adults
undergoing a 6-month weight loss intervention with a meal-based enhancement of protein
quantity and quality lost similar amounts of weight but had greater functional improvements
relative to the Control group. If confirmed, this dietary approach could have important
implications for improving the functional status of this vulnerable population (ClinicalTrials.gov
identifier: NCT01715753).
Type
Journal articleSubject
FrailtyFunction
Obesity
Older adults
Protein
Weight loss intervention
Aged
Body Mass Index
Diet, Reducing
Dietary Proteins
Female
Frail Elderly
Geriatric Assessment
Humans
Male
Obesity
Pilot Projects
Treatment Outcome
Weight Loss
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https://hdl.handle.net/10161/15965Published Version (Please cite this version)
10.1093/gerona/glv210Publication Info
Porter Starr, Kathryn N; Pieper, Carl F; Orenduff, Melissa C; McDonald, Shelley R;
McClure, Luisa B; Zhou, Run; ... Bales, Connie W (2016). Improved Function With Enhanced Protein Intake per Meal: A Pilot Study of Weight Reduction
in Frail, Obese Older Adults. J Gerontol A Biol Sci Med Sci, 71(10). pp. 1369-1375. 10.1093/gerona/glv210. Retrieved from https://hdl.handle.net/10161/15965.This is constructed from limited available data and may be imprecise. To cite this
article, please review & use the official citation provided by the journal.
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Show full item recordScholars@Duke
Connie Watkins Bales
Professor in Medicine
Research in our laboratory focuses on the role of nutrition (particularly vitamins
and minerals) in the prevention and management of chronic diseases in older adults.
Previous studies have concerned trace elements and cardiovascular disease, calcium
and osteoporosis, and renal synthesis of vitamin D as it relates to bone health.
Some of our newest work emphasizes the role of micronutrients as antioxidants and
their interaction with the aging process. We are also working on various aspect
Shelley R McDonald
Associate Professor of Medicine
Martha Elizabeth Payne
Associate Professor in Psychiatry & Behavioral Sciences
This author no longer has a Scholars@Duke profile, so the information shown here reflects
their Duke status at the time this item was deposited.
Carl F. Pieper
Professor of Biostatistics & Bioinformatics
Analytic Interests. 1) Issues in the Design of Medical Experiments: I explore the
use of reliability/generalizability models in experimental design. In addition to
incorporation of reliability, I study powering longitudinal trials with multiple outcomes
and substantial missing data using Mixed models. 2) Issues in the Analysis of Repeated
Measures Designs & Longitudinal Data: Use of Hierarchical Linear Models (HLM) or Mixed
Models in modeling trajectories of multipl
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