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Randomized Controlled Trial
. 2017 Dec 12;73(1):73-80.
doi: 10.1093/gerona/glw237.

Effects of Calorie Restriction in Obese Older Adults: The CROSSROADS Randomized Controlled Trial

Jamy D Ard  1 , Barbara Gower  2 , Gary Hunter  2   3 , Christine S Ritchie  4 , David L Roth  5 , Amy Goss  2 , Brooks C Wingo  6 , Eric V Bodner  7 , Cynthia J Brown  7 , David Bryan  2   3 , David R Buys  8 , Marilyn C Haas  7 , Akilah Dulin Keita  9 , Lee Anne Flagg  10 , Courtney P Williams  7 , Julie L Locher  7
Affiliations
Randomized Controlled Trial

Effects of Calorie Restriction in Obese Older Adults: The CROSSROADS Randomized Controlled Trial

Jamy D Ard et al. J Gerontol A Biol Sci Med Sci. .

Abstract

Background: We lack a comprehensive assessment of the risks and benefits of calorie restriction in older adults at high risk for cardiometabolic disease. Calorie restriction may reduce visceral adipose tissue (VAT) but also have negative effects on lean mass and quality of life.

Methods: We conducted a 52-week, randomized controlled trial involving 164 older adults with obesity taking at least one medication for hyperlipidemia, hypertension, or diabetes. Interventions included an exercise intervention alone (Exercise), or with diet modification and body weight maintenance (Maintenance), or with diet modification and energy restriction (Weight Loss). The primary outcome was change in VAT at 12 months. Secondary outcomes included cardiometabolic risk factors, functional status, and quality of life.

Results: A total of 148 participants had measured weight at 12 months. Despite loss of -1.6% ± 0.3% body fat and 4.1% ± 0.7% initial body weight, Weight Loss did not have statistically greater loss of VAT (-192.6 ± 185.2 cm3) or lean mass (-0.4 ± 0.3 kg) compared with Exercise (VAT = -21.9 ± 173.7 cm3; lean mass = 0.3 ± 0.3 kg). Quality of life improved in all groups with no differences between groups. No significant changes in physical function were observed. Weight Loss had significantly greater improvements in blood glucose (-8.3 ± 3.6 mg/dL, p < .05) and HDL-cholesterol (5.3 ± 1.9, p < .01) compared with Exercise. There were no group differences in the frequency of adverse events.

Conclusions: While moderate calorie restriction did not significantly decrease VAT in older adults at high risk for cardiometabolic disease, it did reduce total body fat and cardiometabolic risk factors without significantly more adverse events and lean mass loss.

Keywords: Weight reduction; cardiometabolic risk; physical function; quality of life; visceral adipose tissue.

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Figures

Figure 1.
Figure 1.
Flow diagram of study participants throughout CROSSROADS trial. *Immediately following randomization and prior to receipt of intervention, three participants were diagnosed with cancer. Because cancer is an exclusion criterion and because we believe these participants very likely had undiagnosed cancer at the time of randomization, in the spirit of a controlled randomized trial and intention-to-treat, we do not include these three persons in any of our analyses. *Lost to follow-up and withdrew indicate those individuals for whom 12-month follow-up data were not collected.
Figure 2.
Figure 2.
Effect of intervention on weight (lbs) at follow-up assessments. Data are adjusted for baseline values and covariates including age, sex, and race.
Figure 3.
Figure 3.
Change in body composition by intervention group. Data are adjusted for baseline values and covariates.
See this image and copyright information in PMC

References

    1. Fakhouri TH, Ogden CL, Carroll MD, Kit BK, Flegal KM. Prevalence of obesity among older adults in the United States, 2007–2010. NCHS Data Brief. 2012;(106):1–8. - PubMed
    1. Federal Interagency Forum on Aging-Related Statistics. Older Americans 2012: Key Indicators of Well-Being http://www.agingstats.gov/agingstatsdotnet/main_site/default.aspx Accessed November 17, 2015.
    1. Villareal DT, Apovian CM, Kushner RF, Klein S; American Society for Nutrition; NAASO, The Obesity Society Obesity in older adults: technical review and position statement of the American Society for Nutrition and NAASO, The Obesity Society. Obes Res. 2005;13(11):1849–1863. doi:10.1038/oby.2005.228 - PubMed
    1. Jensen MD, Ryan DH, Apovian CM et al. . 2013 AHA/ACC/TOS guideline for the management of overweight and obesity in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the Obesity Society. Circulation. 2014;129(25 suppl 2):S102–S138. doi:10.1161/01.cir.0000437739.71477.ee - PMC - PubMed
    1. Jensen GL, Hsiao PY. Obesity in older adults: relationship to functional limitation. Curr Opin Clin Nutr Metab Care. 2010;13(1):46–51. doi:10.1097/MCO.0b013e32833309cf - PubMed

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