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Researchers investigate whether diet, exercise decrease frailty in obese elderly

Washington University In St Louis : 19 July, 2006  (Company News)
Researchers at Washington University School of Medicine in St. Louis have found that obese elderly people can improve their physical function and lessen frailty by losing weight and exercising.
'We have known for a long time that exercise and weight loss can lower the risk of obesity-related problems in younger people, but until now there were not studies to determine if it has the same protective effects in older obese people,' says principal investigator Dennis Villareal, M.D., associate professor of medicine. 'This preliminary study shows that exercise and weight loss seem to provide these benefits, but we need to replicate these findings in a larger study.'

The findings were reported in the Archives of Internal Medicine.

Just as it has in younger people, the prevalence of obesity has increased in the elderly. About 20 percent of people 65 and older are obese. Elevated weight is known to be associated with impairments in daily living, limitations in mobility and an increased risk for functional decline.

'Obesity decreases survival, and many people don't reach old age due to the complications of obesity, such as diabetes and heart disease,' Villareal says. 'We think those who do reach older age might be resistant to some of the medical complications of obesity, but they are not immune to the functional complications. Obesity is a major cause of disability and frailty in this population, and we hope weight loss and exercise will reduce frailty and make it easier for these people to remain independent and have a good quality of life.'

In the pilot study, Villareal followed 27 people whose average age was 70. All were at least 40 pounds overweight. Participants were randomly assigned to either continue their current lifestyle or were placed into a group where they received six months of behavior therapy for weight loss, in conjunction with flexibility, aerobic and resistance-training exercises three times per week.

After six months, those in the diet and exercise group had less body fat and were stronger. They also improved walking speed and rated their own functional status higher on a questionnaire.

The research team hopes to replicate these findings over a longer time in a larger group of people. Villareal and his colleagues are recruiting volunteers between 65-80 who are at least 40 pounds overweight. Participants cannot have diabetes or heart disease.

Volunteers will receive physical exams, blood and urine tests, electrocardiograms and treadmill tests to see if they qualify for the study. They will also fill out questionnaires about quality of life, physical capabilities and limitations as well as cognitive function.

Those who qualify will receive a further round of tests, including an X-ray screening that helps determine total body fat; magnetic resonance imaging to measure fat in the abdomen, thighs and liver; and tests to measure flexibility, strength, balance and exercise endurance.

Qualified participants will be randomly divided into four groups: a control group that will continue with the same lifestyle; a group that will go on a weight-loss diet; one that will participate in a supervised exercise program and a fourth group that will both diet and take part in supervised exercise.

All subjects will receive medical screenings and assessments at the start of the study, after six months and at one year.

'We suspect the combined diet and exercise group will experience the biggest benefits in physical function and quality of life, but we won't know for sure until the study is completed,' Villareal says. 'It may turn out that simply losing weight or exercise alone also will decrease frailty in this population. What we know for sure is that obesity contributes to frailty, and we want to find ways to help these people remain independent and improve their quality of life.'
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