Weight Loss and Physical Activity for Disease Prevention in Obese Older Adults: an Important Role for Lifestyle Management

Current Diabetes Reports

Volumn 14, Issue 10, 2014, Pages

  Valencia, Willy Marcos ^a,b   Stoutenberg, Mark ^b   Florez, Hermes ^a,b  

^a VETERANS AFFAIRS MEDICAL CENTER   (United States)

^b UNIVERSITY OF MIAMI MILLER SCHOOL OF MEDICINE   (United States)

Author keywords

Cardiorespiratory fitness; Diabetes; Disease prevention; Intentional weight loss; Lifestyle interventions; Obese older adult; Obesity paradox; Physical activity

Indexed keywords

CARDIOMETABOLIC RISK; CARDIORESPIRATORY FITNESS; CARDIOVASCULAR DISEASE; DIABETES MELLITUS; DYNAPENIA; FUNCTIONAL STATUS; HEALTH CARE SYSTEM; HEALTH ECONOMICS; HUMAN; LIFESTYLE MODIFICATION; MORTALITY; MUSCLE DISEASE; NON INSULIN DEPENDENT DIABETES MELLITUS; OBESITY; PHYSICAL ACTIVITY; PROPHYLAXIS; REVIEW; SARCOPENIA; WEIGHT CHANGE; WEIGHT REDUCTION; ADULT; ATTITUDE TO HEALTH; CARDIOVASCULAR DISEASES; DIABETES MELLITUS, TYPE 2; DYSPNEA; EVIDENCE BASED MEDICINE; EXERCISE; FITNESS; HEALTH PROMOTION; MOTOR ACTIVITY; PSYCHOLOGY; QUALITY OF LIFE; RISK REDUCTION; SEDENTARY LIFESTYLE;

ADULT; CARDIOVASCULAR DISEASES; DIABETES MELLITUS, TYPE 2; DYSPNEA; EVIDENCE-BASED MEDICINE; EXERCISE; HEALTH KNOWLEDGE, ATTITUDES, PRACTICE; HEALTH PROMOTION; HUMANS; MOTOR ACTIVITY; OBESITY; PHYSICAL FITNESS; QUALITY OF LIFE; RISK REDUCTION BEHAVIOR; SARCOPENIA; SEDENTARY LIFESTYLE; WEIGHT LOSS;

EID: 84906722201     PISSN: 15344827     EISSN: 15390829     Source Type: Journal    
DOI: 10.1007/s11892-014-0539-4     Document Type: Review

References (90)

1. WHO 10 facts on obesity. World Health Organization 2013. http://www.who.int/features/factfiles/obesity/en/. Accessed 25 Apr 2014.
2. CDC Overweight and obesity facts. Centers for Disease Control and Prevention. 2014. http://www.cdc.gov/obesity/data/adult.html. Accessed 21 April 2014.
3. TOS Obesity Writing Group, Allison DB, Downey M, Atkinson RL, et al. Obesity as a disease: a white paper on evidence and arguments commissioned by the council of The Obesity Society. Obesity. 2008;16:1161–77. This article, ahead of its time, allows the reader not only to better understand the definition and implications of defining obesity and disease, but also to incorporate language and concepts that will be extremely useful when discussing with patients about the definition of obesity as a disease.
4. AACE Position Statement, Mechanick JI, Garber AJ, Handelsman Y, Garvey WT. American association of clinical endocrinologists’ position statement on obesity and obesity medicine. Endocr Pract. 2012;18:642–8.
5. AMA News Room. AMA Adopts new policies on second day of voting at annual meeting. Obesity as a disease. American Medical Association 2013. http://www.ama-assn.org/ama/pub/news/news/2013/2013-06-18-new-ama-policies-annual-meeting.page. Accessed 21 Apr 2014
6. WHO Global strategy on diet, physical activity and health. Obesity and Overweight Facts. World Health Organization. 2003. http://www.who.int/dietphysicalactivity/media/en/gsfs_obesity.pdf. Accessed April 21, 2014.
7. TOS Obesity, bias and stigmatization. The Obesity Society 2014. http://www.obesity.org/resources-for/obesity-bias-and-stigmatization.htm. Accessed May 5, 2014.
8. Loef M, Walach H. Midlife obesity and dementia: meta-analysis and adjusted forecast of dementia prevalence in the United States and China. Obesity. 2013;21:E51–5.
9. Darmon P. Intentional weight loss in older adults: useful or wasting disease generating strategy. Curr Opin Clin Nutr Metab Care. 2013;16:284–9.
10. Jensen MD, Ryan DH, Apovian CM, et al. 2013 AHA/ACC/TOS obesity guideline. A report of the American College of Cardiology/American Heart Association Task Force on practice guidelines and The Obesity Society. Circulation 2013; 00:000–000.
11. AHA FACTS with a very heavy heart. Obesity and cardiovascular disease (CVD). American Heart Association 2013. http://www.heart.org/idc/groups/heart-public/@wcm/@adv/documents/downloadable/ucm_305059.pdf. Accessed 21 Apr 2014.
12. Reed JL, Chaput J-P, Tremblay A, Doucet E. The maintenance of energy balance is compromised after weight loss. Can J Diabetes. 2013;37:121–7.
13. DeFronzo RA, Abdul-Ghani MA. Preservation of β-cell function: the key to diabetes prevention. J Clin Endocrinol Metab. 2011;96:2354–66.
14. Kirkman S, Briscoe VJ, Clark N, et al. Diabetes in older adults: a consensus report. J Am Geriatr Soc. 2012;60:2342–56.
15. Alpert MA, Omran J, Mehra A, Ardhanari S. Impact of obesity and weight loss on cardiac performance and morphology in adults. Prog Cardiovasc Dis. 2014;56:391–400.
16. Chrostowska M, Szyndler A, Hoffmann M, Narkiewicz K. Impact of obesity on cardiovascular health. Best Pract Res Clin Endocrinol Metab. 2013;27:147–56.
17. Bastien M, Poirier P, Lemieux I, Després J-P. Overview of epidemiology and contribution of obesity to cardiovascular disease. Prog Cardiovasc Dis. 2014;56:369–81.
18. Kannel WB, Wilson PW, Nam BH, D’Agostino RB. Risk stratification of obesity as a coronary risk factor. Am J Cardiol. 2002;90:687–701.
19. McClain J, Hsu F, Brown E, et al. Pericardial adipose tissue and coronary artery calcification in the Multi-Ethnic Study of Atherosclerosis (MESA). Obesity. 2013;21:1056–63.
20. Labounty TM, Gomez MJ, Achenbach S, et al. Eur Heart J Cardiovasc Imaging. 2013;14:456–63.
21. Wassel CL, Laughlin GA, Araneta MR, et al. Associations of pericardial and intrathoracic fat with coronary calcium presence and progression in a multiethnic study. Obesity. 2013;21:1704–12.
22. Grabowski DC, Ellis JE. High body mass index does not predict mortality in older people: analysis of the longitudinal study of aging. JA GS. 2001;49:968–79.
23. Gruberg L, Weissman NJ, Waksman R, et al. The impact of obesity on the short-term and long-term outcomes after percutaneous coronary intervention: the obesity paradox? J Am Coll Cardiol. 2002;39:578–84.
24. Hainer V, Aldhoon-Hainerová I. Obesity paradox does exist. Diabetes Care. 2013;36 Suppl 2:S276–81.
25. Carnethon MR, De Chavez PJD, Biggs ML, et al. Association of weight status with mortality in adults with incident diabetes. JAMA. 2012;308:581–90.
26. Florez H, Castillo-Florez S. Beyond the obesity paradox in diabetes. Fitness, fatness and mortality. Editorial. JAMA. 2012;308:619–20.
27. Tobias DK, Pan A, Jackson CL, et al. Body-mass index and mortality among adults with incident type 2 diabetes. N Engl J Med. 2014;370:233–44.
28. Flegal KM, Kit BK, Orpana H, Graubard BI. Association of all-cause mortality with overweight and obesity using standard body mass index categories. A systematic review and meta-analysis. JAMA. 2013;309:71–82. This meta-analysis confirms the expected association between obesity and increased risk for all-cause mortality. The data was stronger in older adults, which is the focus of this review.
29. De Schutter A, Lavie CJ, Milani RV. The impact of obesity on risk factors and prevalence and prognosis of coronary heart disease—the obesity paradox. Prog Cardiovasc Dis. 2014;56:401–8.
30. Lavie CJ, McAuley PA, Church TS, Milani RV, Blair SN. Obesity and cardiovascular diseases: implications regarding fitness, fatness, and severity in the obesity paradox. J Am Coll Cardiol. 2014;63:1345–54.
31. Lavie CJ, Alpert MA, Arena R, Mehra MR, Milani RV, Ventura HO. Impact of obesity and the obesity paradox on prevalence and prognosis in heart failure. J Am Coll Cardiol HF. 2013;1:93–102.
32. McAuley PA, Beavers KM. Contribution of cardiorespiratory fitness to the obesity paradox. Prog Cardiovasc Dis. 2014;56:434–40.
33. Barry VW, Baruth M, Beets MW, Durstine JL, Liu J. Blair SN. Fitness vs fatness on all-cause mortality: a meta-analysis. Prog Cardiovasc Dis. 2014;56:382–90.
34. Banack HR, Kaufman JS. The obesity paradox: understanding the effect of obesity on mortality among individuals with cardiovascular disease. Prev Med. 2014;62:96–102.
35. Preston SH, Stokes A. Obesity paradox. Conditioning on disease enhances biases in estimating the mortality risks of obesity. Epidemiol. 2014;25:454–61.
36. Zheng H, Tumin D, Qian Z. Obesity and mortality risk: new findings from body mass index trajectories. Am J Epidemiol. 2013;178:1591–9.
37. Wildman RP, Muntner P, Reynolds K, et al. The obese without cardiometabolic risk factor clustering and the normal weight with cardiometabolic risk factor clustering. Prevalence and correlates of 2 phenotypes among the US populations (NHANES 1999–2004). Arch Intern Med. 2008;168:1617–24.
38. Hamer M, Stamatakis E. Metabolically healthy obesity and risk of all-cause and cardiovascular disease mortality. J Clin Endocrinol Metab. 2012;97:2482–8.
39. Hinnouho G-M, Czernichow S, Dugravot A, Batty GD, Kivimaki M, Singh-Manoux A. Metabolically healthy obesity and risk of mortality. Does the definition of metabolic health matter? Diabetes Care. 2013;36:2294–300.
40. Kramer CK, Zinman B, Retnakaran R. Are metabolically healthy overweight and obesity benign conditions? A systematic review and meta-analysis. Ann Intern Med. 2013;159:758–69. This systematic review offers a great insight to the suggested concept of healthy obesity, with results consistent with the prevalent need to address and manage obesity.
41. Stenholm S, Harris TB, Rantanen T, Visser M, Kritchevsky S, Ferrucci L. Sarcopenic obesity—definition, etiology and consequences. Curr Opin Clin Nutr Metab Care. 2008;11:693–700.
42. Jensen GL, Hsiao PY. Obesity in older adults: relationship to functional limitation. Curr Opin Clin Nutr Metab Care. 2010;13:46–51.
43. Kalyani RR, Corriere M, Ferrucci L. Age-related and disease-related muscle loss: the effect of diabetes, obesity, and other diseases. Lancet Diabetes Endocrinol 2014; Mar 6 [Epub ahead of print]. This review offers a great insight to the pathophysiology of sarcopenic obesity and the metabolic and endocrinologic issues of sarcopenia, age-related or disease-related.
44. Chung J-Y, Kang H-T, Lee D-K, Lee H-R, Lee Y-J. Body composition and its association with cardiometabolic risk factors in the elderly: a focus on sarcopenic obesity. Arch Gerontol Geriatr. 2013;56:270–8.
45. Manini TM, Clark BC. Dynapenia and aging: an update. J Gerontol A Biol Sci Med Sci. 2012;67A:28–40.
46. Visser M. Symposium 2: exercise and protein nutrition. Obesity, sarcopenia and their functional consequences in old age. Proc Nutr Soc. 2011;70:114–8.
47. Espeland MA, Rejeski WJ, West DS, et al. Intensive weight loss intervention in older individuals: results from the action for health in diabetes type 2 diabetes mellitus trial. J Am Geriatr Soc. 2013;61:912–22.
48. Gaesser GA, Angadi SS, Sawyer BJ. Exercise and diet, independent of weight loss, improve cardiometabolic risk profile in overweight and obese individuals. Phys Sports Med. 2011;39:87–97.
49. AHA. Treating obesity as a disease. American Heart Association. 2014. https://www.heart.org/HEARTORG/GettingHealthy/WeightManagement/Obesity/Treating-Obesity-as-a-Disease_UCM_459557_Article.jsp. Accessed April 21, 2014.
50. Tabák AG, Herder C, Rathmann W, Brunner EJ, Kivimäki M. Prediabetes: a high-risk state for diabetes development. Lancet. 2012;379:2279–90.
51. Tuomilehto J, Lindström J, Eriksson JG, et al. Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. N Engl J Med. 2001;344:1343–50.
52. Knowler WC, Barrett-Connor E, Flowler SE, et al. Reduction in the incidence of type 2 diabetes with lifestyle interventions or metformin. N Engl J Med. 2002;346:393–403.
53. Wing RR, Hamman RF, Bray GA, et al. Achieving weight and activity goals among diabetes prevention program lifestyle participants. Obes Res. 2004;12:1426–34.
54. Crandall J, Schade D, Ma Y, et al. The influence of age on the effects of lifestyle modification and metformin in prevention of diabetes. J Gerontol: Med Sci. 2006;61A:1075–81.
55. Davis N, Ma Y, Delahanty LM, et al. Predictors of sustained reduction in energy and fat intake in the Diabetes Prevention Program Outcomes Study intensive lifestyle intervention. J Acad Nutr Diet. 2013;113:1455–64.
56. Delahanty LM, Peyrot M, Shrader PJ, et al. Pretreatment, psychological, and behavioral predictors of weight outcomes among lifestyle intervention participants in the Diabetes Prevention Program (DPP). Diabetes Care. 2013;36:34–40.
57. Kowall B, Rathmann W, Heier M, et al. Impact of weight and weight change on normalization of prediabetes and on persistence of normal glucose tolerance in an older population: the KORA S4/F4 study. Int J Obes. 2012;36:826–33.
58. Church TS, LaMonte MJ, Barlow CE, Blair SN. Cardiorespiratory fitness and body mass index as predictors of cardiovascular disease mortality among men with diabetes. Arch Intern Med. 2005;165:2114–20.
59. Jakicic JM, Jaramillo SA, Balasubramanyam A, et al. Effect of a lifestyle intervention on change in cardiorespiratory fitness in adults with type 2 diabetes: results from the Look AHEAD study. Int J Obes. 2009;33:305–16.
60. Korytkowski MT. Lessons from the look action for health in diabetes study. Indian J Endocrinol Metab. 2013;17 suppl 3:S650–3.
61. Clark AL, Fonarow GC, Horwich TB. Obesity and the obesity paradox in heart failure. Prog Cardiovasc Dis. 2014;56:409–14.
62. Atkins JL, Whincup PH, Morris RW, Lennon LT, Papacosta O, Wannamethee SG. Sarcopenic obesity and risk of cardiovascular disease and mortality: a population-based cohort study of older men. J Am Geriatr Soc. 2014;62:253–60.
63. Brown CJ, Flood KL. Mobility limitation in the older patient. A clinical review. JAMA. 2013;310:1168–77.
64. Bouchonville MF, Villareal DT. Sarcopenic obesity: how do we treat it? Curr Opin Endocrinol Diabetes Obes. 2013;20:412–9.
65. Pahor M, Guralnik JM, Ambrosius WT, et al. Effect of structured physical activity on prevention of major mobility disability in older adults. The LIFE study randomized clinical trial. JAMA. 2014;311:2387–96.
66. Delahanty LM. The Look AHEAD study: implications for clinical practice go beyond the headlines. J Acad Nutr Diet. 2014;114:537–42.
67. Florez H, Pan Q, Ackerman RT, et al. Impact of lifestyle intervention and metformin on health-related quality of life: the Diabetes Prevention Program randomized trial. J Gen Intern Med. 2012;27:1594–601.
68. Ali MK, Echouffo-Tcheugui JB, Williamson DF. How effective were lifestyle interventions in real-world settings that were modeled on the Diabetes Prevention Program? Health Aff. 2012;31:67–75.
69. Harwell TS, Vanderwood KK, Hall TO, Butcher MK, Helgerson SD. The Montana Cardiovascular Disease and Diabetes Prevention Workgroup. Factors associated with achieving a weight loss goal among participants in an adapted Diabetes Prevention Program. Prim Care Diabetes. 2011;5:125–9.
70. West DS, Bursac Z, Cornell CE, et al. Lay health educators translate a weight-loss intervention in senior centers: a randomized controlled trial. Am J Prev Med. 2011;41:385–91.
71. Johnson JA, McIlroy WE, Papaioannou A, Thabane L, Giangregorio L. Feasibility study of walking for exercise in individuals living in assisted living settings. J Geriatr Phys Ther. 2013;36:175–81.
72. National Council on Aging. Center for aging. Enhance fitness. http://www.ncoa.org/improve-health/center-for-healthy-aging/enhance-fi.html. Accessed April 25, 2014.
73. Healthy Aging Regional Collaborative. http://www.healthyagingsf.org/. Accessed April 25, 2014.
74. MOVE! Weight Management Program. http://www.move.va.gov/. Accessed April 25, 2014.
75. Rejeski WJ, Ip EH, Bertoni AG, et al. Lifestyle change and mobility in obese adults with type 2 diabetes. NEJM. 2012;366:1209–17.
76. Villareal DT, Banks M, Siener C, Sinacore DR, Klein S. Physical frailty and body composition in obese elderly men and women. Obes Res. 2004;12:913–20.
77. Waters DL, Ward AL, Villareal DT. Weight loss in obese adults 65 years and older: a review of the controversy. Exp Gerontol. 2013;48:1054–61.
78. Blüher S, Markert J, Hergert S, et al. Who should we target for diabetes prevention and diabetes risk reduction? Curr Diabetes Rep. 2012;12:147–56.
79. Basu S, Seligman H, Winkleby M. A metabolic-epidemiological microsimulation model to estimate the changes in energy intake and physical activity necessary to meet the Health People 2020 obesity objective. Am J Public Health. 2014;104:1209–16.
80. Avenell A, Broom J, Brown TJ, et al. A systematic review of the long-term effects and economic consequences of treatments for obesity and implications for health improvement. Health Technol Assess. 2004;8:1–182.
81. Herman WH, Edelstein SL, Ratner R, et al. Effectiveness and cost-effectiveness of diabetes prevention among adherent participants. Am J Manag Care. 2013;19:194–202.
82. Krukowski RA, Lensing S, Love S, et al. Training of lay health educators to implement an evidence-based behavioral weight loss intervention in rural senior centers. The Gerontologist. 2012;53:162–71.
83. Krukowski RA, Pope RA, Love S, et al. Examination of costs for a lay health educator-delivered translation of the Diabetes Prevention Program in senior centers. Prev Med. 2013;57:400–2.
84. Prohaska T, Belansky E, Belza B, et al. Physical activity, public health, and aging: critical issues and research priorities. J Gerontol: Soc Sci. 2006;61:S267–73.
85. Barnes PM, Schoenborn CA. Physical activity among adults: United States, 2000: advance data from vital and health statistics. CDC Natl Cent Health Stat. 2003;333:15.
86. Wang F, McDonald T, Reffitt B, Edington DW. BMI, physical activity, and health care utilization/costs among medicare retirees. Obes Res. 2005;13:1450–7.
87. Biedenweg K, Meischke H, Bohl A, et al. Understanding older adults’ motivators and barriers to participating in organized programs supporting exercise behaviors. J Prim Prev. 2014;35:1–11.
88. Michael YL, Nagel CL, Gold R, Hillier TA. Does change in the neighborhood environment prevent obesity in older women? Soc Sci Med. 2014;102:129–37.
89. Chrysant SG, Chrysant GS. New insights into the true nature of the obesity paradox and the lower cardiovascular risk. J Am Soc Hypertens. 2013;7:85–94.
90. Swift DL, Johannsen NM, Lavie CJ, Earnest CP, Church TS. The role of exercise and physical activity in weight loss and maintenance. Prog Cardiovasc Dis. 2014;56:441–7.