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Effect of lifestyle intervention on metabolic coronary heart disease risk factors in obese older adults
Villareal DT, Miller BV III, Banks M, Fontana L, Sinacore DR, Klein S
The American Journal of Clinical Nutrition 2006 Dec;84(6):1317-1323
clinical trial
6/10 [Eligibility criteria: No; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: Yes; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

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 mmHg) and diastolic (0 and -8 mmHg) 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 mumol/L in the control group and decreased by 99 mumol/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.
Copyright by the American Society for Clinical Nutrition.

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