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. 2020 Dec:40:293-299.
doi: 10.1016/j.clnesp.2020.09.002. Epub 2020 Sep 19.

Intensive nutrition counseling as part of a multi-component weight loss intervention improves diet quality and anthropometrics in older adults with obesity

Rima Itani Al-Nimr  1 , K C S Wright  2 , Christina L Aquila  3 , Curtis L Petersen  4 , Tyler L Gooding  5 , John A Batsis  6
Affiliations

Intensive nutrition counseling as part of a multi-component weight loss intervention improves diet quality and anthropometrics in older adults with obesity

Rima Itani Al-Nimr et al. Clin Nutr ESPEN. 2020 Dec.

Abstract

Background and aims: Obesity significantly impacts older adults. Intensive nutrition counseling can aid in weight reduction and improve diet quality, but data are sparse in this population. The objective of this intervention is to determine how intensive nutrition counseling affects diet quality and anthropometric measures during a multi-component weight loss intervention in rural older adults with obesity.

Methods: A series of 12-week, single-arm feasibility pilots were conducted in fall 2017 and winter/spring 2018 in a community aging center in rural Northern New England. Adults were eligible if ≥ 65 years old with a Body Mass Index (BMI) ≥30 kg/m2. Exclusion criteria included dementia/cognitive impairment, uncontrolled psychiatric illness, weight-loss surgery, weight loss >5% in previous 6-months, life-threatening illness, palliative/hospice services, current participation in another weight-loss study/program, obesogenic medications, or presence of major chronic conditions. Participants received once-weekly nutrition counseling by a registered dietitian nutritionist (RDN), and twice-weekly exercise sessions by a physical therapist (PT). Primary outcomes were diet quality changes measured by total Rapid Eating and Activity Assessment for Patients-Short Version (REAP-S) and Automated Self-Administered 24-h dietary recall (ASA-24). Secondary outcome measures were changes in weight (kilograms) and waist circumference (centimeters). McNemar test was conducted for all paired categorical data while paired t-tests were conducted for all paired continuous data. All analyses were conducted in R; p-value<0.05 was significant.

Results: Total n = 23. Mean age was 72.2 (5.8) years (73.9% female); mean BMI was 35.9 ± 5.0 kg/m2. At 12 weeks, diet quality significantly improved. REAP-S scores increased by 3.53 ± 3.13 points (p < 0.001). Kilocalories, grams fat, grams saturated fat, milligrams sodium, grams added sugar, and grams alcohol via ASA-24 significantly decreased (all p < 0.05). Significant reductions in weight (-5.22 ± 3.13 kg) and waist circumference (-6.88 ± 5.67 cm) were observed (both p < 0.001).

Conclusion: Intensive nutrition counseling significantly enhances diet quality and reduces weight and waist circumference in rural older adults with obesity.

Keywords: Diet quality; Nutrition counseling; Obesity; Older adults; Weight loss intervention.

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Conflict of interest statement

Conflict of interest Dr. Batsis has consulted for Dinse, Knapp McAndrew LLC, legal firm for expert testimony, and received honoraria for grant review activities from the National Institute of Health, the European Research Foundation, and the Irish Medical Council. He has received honoraria for speaking at the Endocrine Society annual meeting and holds a preliminary patent #62/672,827 for a Bluetooth-enabled resistance exercise band.

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