Effect of lifestyle intervention on metabolic coronary heart disease risk factors in obese older adults

Effect of lifestyle intervention on metabolic coronary heart disease risk factors in obese older adults1,2,3 Dennis T Villareal, Bernard V Miller, III, Marian Banks, Luigi Fontana, David R Sinacore and Samuel Klein 1 From Geriatrics and Nutritional Science and the Center for Human Nutrition, Washington University School of Medicine, St Louis, MO (DTV, BVM, MB, LF, DRS, and SK), and the Division of Food Science, Human Nutrition and Health, Istituto Superiore di Sanit\ue0, Rome, Italy (LF) Background: Coronary heart disease (CHD) risk factors increase with age and body mass index (BMI; in kg/m2). However, whether lifestyle intervention ameliorates metabolic CHD risk factors in obese older adults is unknown. Objective: The objective was to determine whether lifestyle intervention improves metabolic CHD risk factors in obese older adults. Design: A 6-mo outpatient randomized controlled trial was conducted in obese (BMI 30) older (65 y) adults randomly assigned to diet and exercise therapy (treatment group; n =3D 17) or no therapy (control group; n =3D 10). The main outcomes were CHD risk factors. Results: Body weight decreased by 8.4% (8.2 kg) in the treatment group; weight did not change significantly (0.7 kg) in the control group (P < 0.001 between groups). Changes between the control and treatment groups, respectively, in waist circumference (1 and \u9610 cm), plasma glucose (4 and \u964 mg/dL), serum triacylglycerols (0 and \u9645 mg/dL), and systolic (\u962 and \u9610 mm Hg) and diastolic (0 and \u968 mm Hg) blood pressure were different (P < 0.05 for all). The number of subjects with the metabolic syndrome decreased by 59% in the treatment group but did not change significantly in the control group (P < 0.05). Serum free fatty acids increased by 10 \ub5mol/L in the control group and decreased by 99 \ub5mol/L in the treatment group (P < 0.05). Changes between the control and treatment groups, respectively, in C-reactive protein (0.8 and \u962.5 mg/L) and interleukin 6 (1.6 and \u962.4 pg/mL) were different (P < 0.05 for both). Conclusions: Lifestyle intervention decreases multiple metabolic CHD risk factors simultaneously in obese older adults. Key Words: Aging \u95 obesity \u95 metabolic syndrome \u95 lifestyle intervention \u95 atherosclerosis Related articles in AJCN: Public health success in recent decades may be in danger if lifestyles of the elderly are neglected Marleen A van Baak and Tommy LS Visscher AJCN 2006 84: 1257-1258. [Full Text