Vitality after Intentional Weight Loss in Older Women is Associated with Exercise and Improved Sleep

Abstract

PURPOSE: Weight loss interventions do not consistently improve health-related quality of life (HRQOL), but some weight loss programs do improve vitality, a component of HRQOL defined as perceived increases in feelings of energy and reductions in fatigue. Behavioral and physiological factors most strongly associated with improvements in vitality during a weight loss intervention are poorly understood. The aim of this prospective study was to identify variables associated with improvements in vitality following an exercise and weight loss intervention in older women, known to be lower in vitality compared to male counterparts. METHODS: Eighty older women (66.9 ± 5.9 years; 97.1% White, BMI = 31.5 ± 5.4 kg/m2) completed a 6-month intervention designed to facilitate 10% loss of body weight that included randomization to either A) EX+D; three 75-minute sessions/week that integrated cardiorespiratory, resistance, balance and flexibility training and a recommendation to reduce energy intake by ~500 kcal/day (n = 60), or B) D; a recommendation to reduce energy intake by ~500 kcal/day alone (n = 20). Changes in outcomes of interest included vitality (SF-36 subscale; SF-36-VIT), sleep quality (Pittsburgh Sleep Quality Index; PSQI), speed of cognitive flexibility (Trail Making Test - B; TRAILS-B), physical function (6 Minute Walk Test; 6MWT), and a fasting serum measure of inflammation (IL-6). RESULTS: Both EX+D and D similarly (all p > .05 for group difference in change) improved (all p < .027) body weight (-7.7 ± 4.3 kg), SF-36-VIT (12.2 ± 16.3 units), 6MWT (53.3 ± 45.0 meters), PSQI (-0.6 ± 2.5 units), TRAILS-B (-8.7 ± 16.3 seconds) with no change in IL-6 (.40 ± 2.6; p = .31). Multiple linear regression analysis [F(7, 72) = 9.68, p <.001, adjusted R2= .485] indicated that change in SF-36-VIT was predicted from (standardized betas reported) baseline SF-36-VIT (-.521, p<.001), PSQI (-.380, p < .001), intervention group (EX+D or D; .285, p = .006), body weight (-.088, p = .304), TRAILS-B (-.166, p =.06), 6MWT (-.158, p = .138), and IL-6 (-.063, p = .488). CONCLUSIONS: Vitality is improved after intentional weight loss in older, overweight women and the change is independently predicted by low baseline vitality, if the weight loss program included exercise, and improved sleep quality.