Skip to main content
SpringerLink
Log in

Effects of changes in regional body composition on physical function in older adults: A pilot randomized controlled trial

  • Published:
The journal of nutrition, health & aging

Abstract

Background/Objective

Obesity exacerbates age-related physical disability; however, observational studies show that any weight loss in old age is associated with greater risk of mortality. Conversely, randomized controlled trials in older adults show that weight loss is beneficial. The discrepancy may be due to weight loss intention and differential changes to regional body composition. The purpose of this research was to evaluate the independent role of regional body composition remodeling in improving physical function.

Design

Pilot Randomized Controlled Trial.

Setting

Community based research center.

Participants

Thirty-six community dwelling, overweight to moderately obese (BMI 28.0–39.9 kg/m2) older adults (age 70.6±6.1 yrs).

Intervention

Physical activity plus weight loss (PA+WL, n=21) or PA plus successful aging (SA) education. PA consisted primary of treadmill walking supplemented with lower extremity resistance and balance training. The WL program was based on the Diabetes Prevention Project and aimed at achieving a 7% weight loss by cutting calories, specifically those from fat.

Measurements

At baseline, 6- and 12-months, body composition was measured using computerized tomography and dual x-ray absorptiometry. Abdominal visceral (VAT) and thigh intermuscular (IMAT) adipose tissue were quantified. Physical function was assessed using the short physical performance battery (SPPB).

Results

Separate multivariable linear regression models with both groups combined demonstrated that decreases in IMAT and VAT were significantly associated with improvements in SPPB (P<0.05) independent of change in total fat mass. PA+WL improved SPPB scores from baseline (0.8±1.4, P<0.05), whereas PA+SA did not; however no intergroup difference was detected. Of note, these effects were mainly achieved during the intensive intervention phase.

Conclusion

Decreases in IMAT and VAT are important mechanisms underlying improved function following intentional weight loss plus physical activity.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Al Snih S, Ottenbacher KJ, Markides KS, Kuo Y, Eschbach K, Goodwin JS. THe effect of obesity on disability vs mortality in older americans. Archives of internal medicine 2007;167:774–780. doi:10.1001/archinte.167.8.774

    Article  PubMed  Google Scholar 

  2. Villareal DT, Apovian CM, Kushner RF, Klein S. Obesity in older adults: technical review and position statement of the American Society for Nutrition and NAASO, The Obesity Society. Am J Clin Nutr 2005;82:923–934.

    CAS  PubMed  Google Scholar 

  3. Miller S, Wolfe R.The danger of weight loss in the elderly. J Nutr Health Aging 2008;12:487–491. doi:10.1007/bf02982710

    Article  CAS  PubMed  Google Scholar 

  4. Newman AB, Yanez D, Harris T, Duxbury A, Enright PL, Fried LP. Weight change in old age and its association with mortality. J Am Geriatr Soc 2001;49:1309–1318. doi:10.1046/j.1532-5415.2001.49258.x

    Article  CAS  PubMed  Google Scholar 

  5. Shea MK, Nicklas BJ, Houston DK, Miller ME, et al. The effect of intentional weight loss on all-cause mortality in older adults: results of a randomized controlled weight-loss trial. The American Journal of Clinical Nutrition 2011;94:839–846. doi:10.3945/ajcn.110.006379

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  6. Villareal DT, Chode S, Parimi N, Sinacore DR, et al. Weight Loss, Exercise, or Both and Physical Function in Obese Older Adults. New England Journal of Medicine 2011;364:1218–1229. doi:doi:10.1056/NEJMoa1008234

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  7. Waters DL, Ward AL, Villareal DT. Weight loss in obese adults 65 years and older: a review of the controversy. Exp Gerontol 2013;48:1054–1061. doi:10.1016/j.exger.2013.02.005

    Article  PubMed Central  PubMed  Google Scholar 

  8. Kuk JL, Lee S, Heymsfield SB, Ross R. Waist circumference and abdominal adipose tissue distribution: influence of age and sex. The American Journal of Clinical Nutrition 2005;81:1330–1334.

    CAS  PubMed  Google Scholar 

  9. Delmonico MJ, Harris TB, Visser M, Park SW, et al. Longitudinal study of muscle strength, quality, and adipose tissue infiltration. The American Journal of Clinical Nutrition 2009;90:1579–1585. doi:10.3945/ajcn.2009.28047

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  10. Schrager MA, Metter EJ, Simonsick E, Ble A, Bandinelli S, Lauretani F, Ferrucci L. Sarcopenic obesity and inflammation in the InCHIANTI study. Journal of Applied Physiology 2007;102:919–925. doi:10.1152/japplphysiol.00627.2006

    Article  PubMed Central  PubMed  Google Scholar 

  11. Goodpaster BH, Krishnaswami S, Resnick H, Kelley DE, et al. Association Between Regional Adipose Tissue Distribution and Both Type 2 Diabetes and Impaired Glucose Tolerance in Elderly Men and Women. Diabetes Care 2003;26:372–379. doi:10.2337/diacare.26.2.372

    Article  PubMed  Google Scholar 

  12. Goodpaster BH, Krishnaswami S, Harris TB, Katsiaras A, et al. Obesity, regional body fat distribution, and the metabolic syndrome in older men and women. Archives of internal medicine 2005;165:777–783. doi:10.1001/archinte.165.7.777

    Article  PubMed  Google Scholar 

  13. Park SW, Goodpaster BH, Strotmeyer ES, Kuller LH, et al. Accelerated loss of skeletal muscle strength in older adults with type 2 diabetes: the health, aging, and body composition study. Diabetes Care 2007;30:1507–1512. doi:10.2337/dc06-2537

    Article  PubMed  Google Scholar 

  14. Beavers KM, Beavers DP, Houston DK, Harris TB, et al. Associations between body composition and gait-speed decline: results from the Health, Aging, and Body Composition study. The American Journal of Clinical Nutrition, 2013. doi:10.3945/ajcn.112.047860

    Google Scholar 

  15. Addison O, Drummond MJ, Lastayo PC, Dibble LE, Wende AR, McClain DA, Marcus RL. Intramuscular fat and inflammation differ in older adults: The impact of frailty and inactivity. J Nutr Health Aging 2014;18:532–538. doi:10.1007/s12603-014-0019-1

    Article  CAS  PubMed  Google Scholar 

  16. Hilton TN, Tuttle LJ, Bohnert KL, Mueller MJ, Sinacore DR. Excessive Adipose Tissue Infiltration in Skeletal Muscle in Individuals With Obesity, Diabetes Mellitus, and Peripheral Neuropathy: Association With Performance and Function. Physical Therapy 2008;88:1336–1344. doi:10.2522/ptj.20080079

    Article  PubMed Central  PubMed  Google Scholar 

  17. Tuttle LJ, Sinacore DR, Mueller MJ. Intermuscular Adipose Tissue Is Muscle Specific and Associated with Poor Functional Performance. Journal of Aging Research 2012:7. doi:10.1155/2012/172957

  18. Goodpaster BH, Chomentowski P, Ward BK, Rossi A, et al. Effects of physical activity on strength and skeletal muscle fat infiltration in older adults: a randomized controlled trial. J Appl Physiol 2008;105:1498–1503. doi:10.1152/japplphysiol.90425.2008

    Article  PubMed Central  PubMed  Google Scholar 

  19. Santanasto AJ, Glynn NW, Newman MA, Taylor CA, Brooks MM, Goodpaster BH, Newman AB. Impact of Weight Loss on Physical Function with Changes in Strength, Muscle Mass, and Muscle Fat Infiltration in Overweight to Moderately Obese Older Adults: A Randomized Clinical Trial. Journal of Obesity 2011. doi:10.1155/2011/516576

    Google Scholar 

  20. Avila J, Gutierres J, Sheehy M, Lofgren I, Delmonico M. Effect of moderate intensity resistance training during weight loss on body composition and physical performance in overweight older adults. European Journal of Applied Physiology 2010;109:517–525. doi:10.1007/s00421-010-1387-9

    Article  PubMed  Google Scholar 

  21. Manini TM, Buford TW, Lott DJ, Vandenborne K, et al. Effect of Dietary Restriction and Exercise on Lower Extremity Tissue Compartments in Obese, Older Women: A Pilot Study. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 2013. doi:10.1093/gerona/gls337

    Google Scholar 

  22. Rejeski WJ, Fielding RA, Blair SN, Guralnik JM, et al. (The lifestyle interventions and independence for elders (LIFE) pilot study: Design and methods. Contemporary Clinical Trials 2005;26:141–154.

    Article  PubMed  Google Scholar 

  23. Borg G. Borg’s Perceived exertion and pain scales. Champaign, IL: Human Kinetics, 1998.

    Google Scholar 

  24. The Diabetes Prevention Program. Design and methods for a clinical trial in the prevention of type 2 diabetes. Diabetes Care 1999;22:623–634. doi:10.2337/diacare.22.4.623

    Article  Google Scholar 

  25. Newman AB, Bayles CM, Milas CN, McTigue K, et al. (2 The 10 Keys to Healthy Aging: Findings From an Innovative Prevention Program in the Community. Journal of Aging and Health 2010;22:547–566. doi:10.1177/0898264310363772

    Article  PubMed  Google Scholar 

  26. Stewart AL, Mills KM, King AC, Haskell WL, Gillis D, Ritter PL. CHAMPSphysical activity questionnaire for older adults: outcomes for interventions. Med Sci Sports Exerc 2001;33:1126–1141.

    Article  CAS  PubMed  Google Scholar 

  27. Guralnik JM, Simonsick EM, Ferrucci L, Glynn RJ, et al. A Short Physical Performance Battery Assessing Lower Extremity Function: Association With Self-Reported Disability and Prediction of Mortality and Nursing Home Admission. Journal of Gerontology 1994;49:M85–M94. doi:10.1093/geronj/49.2.M85

    Article  CAS  PubMed  Google Scholar 

  28. Visser M, Fuerst T, Lang T, Salamone L, Harris TB. Validity of fan-beam dualenergy X-ray absorptiometry for measuring fat-free mass and leg muscle mass. Health, Aging, and Body Composition Study-Dual-Energy X-ray Absorptiometry and Body Composition Working Group. J Appl Physiol 1999;87:1513–1520.

    CAS  PubMed  Google Scholar 

  29. Visser M, Goodpaster BH, Kritchevsky SB, Newman AB, et al. Muscle Mass, Muscle Strength, and Muscle Fat Infiltration as Predictors of Incident Mobility Limitations in Well-Functioning Older Persons. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences 2005;60:324–333. doi:10.1093/ gerona/60.3.324

    Article  Google Scholar 

  30. Fielding RA, Rejeski WJ, Blair S, Church T, et al. The Lifestyle Interventions and Independence for Elders Study: Design and Methods. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences 2011;66A:1226–1237. doi:10.1093/gerona/glr123

    Article  Google Scholar 

  31. Pahor M, Guralnik JM, Ambrosius WT, et al. Effect of structured physical activity on prevention of major mobility disability in older adults: The life study randomized clinical trial. JAMA, 2014. doi:10.1001/jama.2014.5616

    Google Scholar 

  32. Rejeski W, Brubaker PH, Goff DC, Jr, et al. Translating weight loss and physical activity programs into the community to preserve mobility in older, obese adults in poor cardiovascular health. Archives of internal medicine 2011;171:880–886. doi:10.1001/archinternmed.2010.522

    Article  PubMed Central  PubMed  Google Scholar 

  33. Murphy JC, McDaniel JL, Mora K, Villareal DT, Fontana L, Weiss EP. Preferential reductions in intermuscular and visceral adipose tissue with exercise-induced weight loss compared with calorie restriction. Journal of Applied Physiology 2012;112:79–85. doi:10.1152/japplphysiol.00355.2011

    Article  PubMed Central  PubMed  Google Scholar 

  34. Marcus R, Addison O, Kidde J, Dibble L, Lastayo P. Skeletal muscle fat infiltration: Impact of age, inactivity, and exercise. J Nutr Health Aging 2010;14:362–366. doi:10.1007/s12603-010-0081-2

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  35. Janssen I, Fortier A, Hudson R, Ross R. Effects of an Energy-Restrictive Diet With or Without Exercise on Abdominal Fat, Intermuscular Fat, and Metabolic Risk Factors in Obese Women. Diabetes Care 2002;25:431–438. doi:10.2337/ diacare.25.3.431

    Article  PubMed  Google Scholar 

  36. Chomentowski P, Dubé JJ, Amati F, Stefanovic-Racic M, Zhu S, Toledo FGS, Goodpaster BH. Moderate Exercise Attenuates the Loss of Skeletal Muscle Mass That Occurs With Intentional Caloric Restriction-Induced Weight Loss in Older, Overweight to Obese Adults. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences 2009;64A:575–580. doi:10.1093/gerona/glp007

    Article  Google Scholar 

  37. Miljkovic I, Zmuda JM. Epidemiology of myosteatosis. Curr Opin Clin Nutr Metab Care 2010;13:260–264. doi:10.1097/MCO.0b013e328337d826 [doi]

    Article  PubMed Central  PubMed  Google Scholar 

  38. Gallagher D, Kuznia P, Heshka S, Albu J, et al. Adipose tissue in muscle: a novel depot similar in size to visceral adipose tissue. The American Journal of Clinical Nutrition 2005;81:903–910.

    PubMed Central  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Center for Aging and Population Health, Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA

    A. J. Santanasto, A. B. Newman, E. S. Strotmeyer, R. M. Boudreau & Nancy W. Glynn

  2. Division of Endocrinology and Metabolism, Department of Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA

    B. H. Goodpaster

  3. Sanford Burnham Medical Research Institute, Metabolic Disease Program, Orlando, Florida, USA

    B. H. Goodpaster

  4. 130 DeSoto Street, A531 Crabtree Hall, Pittsburgh, PA, 15261, USA

    Nancy W. Glynn

Authors
  1. A. J. Santanasto
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. A. B. Newman
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. E. S. Strotmeyer
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. R. M. Boudreau
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. B. H. Goodpaster
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Nancy W. Glynn
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Nancy W. Glynn.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Santanasto, A.J., Newman, A.B., Strotmeyer, E.S. et al. Effects of changes in regional body composition on physical function in older adults: A pilot randomized controlled trial. J Nutr Health Aging 19, 913–921 (2015). https://doi.org/10.1007/s12603-015-0523-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12603-015-0523-y

Key words

Search

Navigation