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Combined diet, exercise more beneficial in older obese adults than either intervention alone

Villareal DT. N Engl J Med. 2011;364:1218-1229.

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A combination of weight loss and exercise significantly improved the physical function of obese older adults compared with weight loss or exercise alone at 1 year, according to results of a randomized trial.

The trial included 107 obese participants who were aged at least 65 years. They were randomly assigned to a control group (n=27), a weight-management group (diet; n=26), an exercise group (n=26), or a diet-plus-exercise group (diet-exercise; n=28). Among these participants, 93 finished the study.

At 1 year, the researchers reported that the study’s primary outcome — change in Physical Performance Test score — was higher, thus indicating better physical status in individuals from the diet-exercise group (21%) vs. the diet (12%) or exercise (15%) alone groups, although all three were better than the control group (1%; P<.001 for between group differences).

Peak oxygen consumption was better in the diet-exercise group (increase of 17%) compared with the diet (10%) or exercise (8%) groups. Similarly, scores on the Functional Status Questionnaire were also better in the diet-exercise group vs. the diet alone group (increase of 10% vs. 4%; P<.001). Conversely, the greatest decrease in body weight was documented in the diet group compared with those in the diet-exercise group (10% vs. 9%; P=.67), whereas no decreases were found in either the control or exercise groups.

“Our findings suggest that weight loss alone or exercise alone improves physical function and ameliorates frailty in obese older adults; however, a combination of weight loss and regular exercise may provide greater improvement in physical function and amelioration of frailty than either intervention alone,” the researchers concluded. “Therefore, weight loss combined with regular exercise may be beneficial in helping obese older adults maintain their functional independence.”

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