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Long-Term Effects of Randomization to a Weight Loss Intervention in Older Adults: A Pilot Study

Houston, Denise K., Miller, Michael E., Kitzman, Dalane W., Rejeski, W. Jack, Messier, Stephen P., Lyles, Mary F., Kritchevsky, Stephen B., Nicklas, Barbara J.
Journal of nutrition in gerontology and geriatrics 2019 v.38 no.1 pp. 83-99
body composition, death, elderly, exercise, interviews, long term effects, low calorie diet, weight loss, women
Randomized, controlled trials (RCTs) show intentional weight loss improves body composition and physical function in older adults; however, the long-term benefits (and risks) are unknown. We conducted a pilot study to assess the feasibility of recalling prior RCT participants to examine the long-term effects of intentional weight loss on body composition and physical function. A weighted, random sample of 60 older adults who were randomized to caloric restriction plus exercise (CR + EX) or exercise (EX) only in 5 prior RCTs (mean age at randomization, 67.3 years; 69% women, 80% white) were invited to participate. Follow-up was obtained on 89% (42 clinic visits, 10 phone interviews, 1 death) an average of 3.5 years (range, 2.2–5.8 years) after RCT completion. Despite greater weight, fat and lean mass loss during the RCT (mean difference in change (95% CI): −4.19 (−7.52, −0.86), −2.75 (−5.10, −0.40), and −2.32 (−3.69, −0.95) kg, respectively) in those randomized to CR + EX, long-term changes in weight (2.05 (−2.35, 6.45) kg) and body composition (1.80 (−1.56, 5.17) and 0.03 (−2.20, 2.26) kg for fat and lean mass, respectively) from baseline and physical function at long-term follow-up (mean difference in 400-m walk and SPPB (95% CI): 23.2 (−19.3, 65.6) sec and −0.03 (−1.02, 0.96) points, respectively) were similar in CR + EX and EX only. Although improvements in weight and body composition following intentional weight loss may not be sustained long-term, physical function does not appear to be negatively impacted. A larger study is needed to confirm these results.