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/m2) 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).
Highlights
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
In the only investigation to date, Coker and colleagues [13] compared a conventional meal replacement to one with whey protein and essential amino acids in a short-term (8 week) study. They found no group difference in lean mass (LM) preservation; the supplemented group had increased rates of muscle protein synthesis and preferential loss of adipose tissue. Based on this and the acute studies of protein synthesis thresholds for older adults [15,16], we developed the MEASUR-UP (Measuring Eating, Activity and Strength: Understanding the Response-Using Protein) trial, which is the first to examine mealbased enhancement of protein intake (30 g high-quality protein per each of 3 meals) during a long-term (6 month) weight loss intervention (10% weight reduction goal) in obese older adults with functional limitations
Blocking by gender and marital and partner status, eligible participants were randomly assigned to a traditional weight loss (Control) or a protein-enhanced weight loss (Protein) study arm in a 1:2 allocation ratio using a computerized randomization scheme
Summary
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. Results: At the 6-month endpoint, there was significant (p < .001) weight loss in both the Control (−7.5 ± 6.2 kg) and Protein (−8.7 ± 7.4 kg) groups Both groups 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)
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