Abstract
Objectives Obesity-related physiological changes can limit improvements of obese subjects after training. The aim was to investigate obesity, muscular strength, and physical function in community-dwelling nonsarcopenic old adults. Methods Nonsarcopenic subjects (N=229, 73.7 ± 5.7 years; 21% normal weight, 42% overweight, and 37% obese based on body mass index (BMI)) participated in a 12-week resistance exercise program. Leisure time physical activity (LTPA), body composition (dual-energy X-ray absorptiometry), quadriceps strength (maximum voluntary isometric contraction; absolute and relative to body weight), and physical function in terms of 6-minutes-walk-for-distance (6MWD) and timed up and go (TUG) were measured baseline and endpoint. Results At baseline, normal weight participants had lower absolute quadriceps strength (−43 ± 22 N, P=0.015) than obese, but better quadriceps strength relative to body weight (1.4 ± 0.7 N/kg, P < 0.001), 6MWD (53 ± 27 m, P < 0.001), and TUG (−1.4 ± 0.7 sec, P ≤ 0.001). LTPA was positively associated with 6MWD and TUG (both P < 0.05), but based on general linear models, differences in LTPA between BMI categories did not explain differences in 6MWD and TUG between BMI categories. During the program, dropout (11.9%) and attendance (85%) were similar between BMI groups. After the intervention, body composition and physical function significantly improved in all three BMI categories; however, normal weight participants lost more body fat (−1.53 ± 0.78%, P=0.014), gained more lean mass (0.70 ± 0.36 kg, P < 0.001) and relative quadriceps strength (0.31 ± 0.16 N/kg, P=0.017), and improved more on the 6MWD (24 ± 12 m, P < 0.001) but gained less grip strength (−2.4 ± 1.3 N/kg, P=0.020) compared to obese. There were no differences in TUG or absolute quadriceps strength changes between the BMI strata. Physical function at baseline as well as training success of overweight participants was located between the normal weight and obesity groups. Conclusion Nonsarcopenic obese community-dwelling old adults have lower physical function than their normal weight counterparts. This difference is not explained by lower LTPA. A 12-week resistance exercise program improves body composition and physical function in normal weight, overweight, and obese old adults; however, obese participants experience less favorable changes in body composition and physical function than normal weight individuals. This trial is registered with NCT01074879.
Highlights
Obesity has been increasing for several decades in Western countries, and an increased prevalence has been observed in old adults [1]
Mean time of Leisure time physical activity (LTPA) was 342 ± 341 minutes/week, and the two most frequent activities reported were walking and gardening. Both normal weight and overweight participants exercised more than obese participants. ere were obvious differences in body composition between strata
Normal weight participants had lower quadriceps and grip strength when compared to obese, but better quadriceps strength relative to body weight, timed up and go (TUG), and 6MWD
Summary
Obesity has been increasing for several decades in Western countries, and an increased prevalence has been observed in old adults [1]. Unfavorable changes in body composition can be seen during ageing, i.e., body fat increases bit by bit while muscle mass decreases [7, 8]. As maintenance of muscular strength and physical function is a cornerstone of successful ageing, exercise has been widely recommended to fight the decrease in muscle mass in old adults and it possibly prevents obesity [9]. Several studies have indicated that various training programs, either alone or in combination with dietary interventions, are effective to improve body composition and physical function in old people [10,11,12]
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