Abstract
BackgroundIntentional weight loss in obese older adults is a risk factor for accelerated muscle mass loss. We investigated whether a high protein diet and/or resistance exercise preserves fat free mass (FFM) during weight loss in overweight and obese older adults.MethodsWe included 100 overweight and obese adults (55–80 year) in a randomized controlled trial (RCT) with a 2 × 2 factorial design and intention-to-treat analysis. During a 10-week weight loss program all subjects followed a hypocaloric diet. Subjects were randomly allocated to either a high protein (1.3 g/kg body weight) or normal protein diet (0.8 g/kg), with or without a resistance exercise program 3 times/week. FFM was assessed by air displacement plethysmography.ResultsAt baseline, mean (±SD) BMI was 32 ± 4 kg/m2. During intervention, protein intake was 1.13 ± 0.35 g/kg in the high protein groups vs. 0.98 ± 0.29 in the normal protein groups, which reflects a 16.3 ± 5.2 g/d higher protein intake in the high protein groups. Both high protein diet and exercise did not significantly affect change in body weight, FFM and fat mass (FM). No significant protein*exercise interaction effect was observed for FFM. However, within-group analysis showed that high protein in combination with exercise significantly increased FFM (+0.6 ± 1.3 kg, p = 0.011).ConclusionA high protein diet, though lower than targeted, did not significantly affect changes in FFM during modest weight loss in older overweight and obese adults. There was no significant interaction between the high protein diet and resistance exercise for change in FFM. However, only the group with the combined intervention of high protein diet and resistance exercise significantly increased in FFM.Trial registrationDutch Trial Register, number NTR4556, date 05-01-2014.
Highlights
Intentional weight loss in obese older adults is a risk factor for accelerated muscle mass loss
Obesity in older adults is a serious health problem related with multiple chronic health conditions and plays an important role in non-fatal disability [2], which in turn may contribute to lower quality of life [2]
Strategies to reduce the loss of skeletal muscle mass during weight loss include resistance exercise and sufficient intake of high quality protein [6, 7]
Summary
Intentional weight loss in obese older adults is a risk factor for accelerated muscle mass loss. We investigated whether a high protein diet and/or resistance exercise preserves fat free mass (FFM) during weight loss in overweight and obese older adults. A potential drawback of weight loss in older adults is the accompanying loss of skeletal muscle mass [4], which in turn might accelerate the development of sarcopenia [5]. Strategies to reduce the loss of skeletal muscle mass during weight loss include resistance exercise and sufficient intake of high quality protein [6, 7]. Resistance exercise stimulates muscle protein synthesis, which in turn supports muscle mass preservation and muscle function [8]. In contrast to young adults, older adults might be resistant to anabolic stimuli from protein, which implies a blunted post prandial response [12, 13]
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