Changes in Cardiometabolic Risk Among Older Adults with Obesity: An Ancillary Analysis of a Randomized Controlled Trial Investigating Exercise Plus Weight Maintenance and Exercise Plus Intentional Weight Loss by Caloric Restriction

dc.contributor.authorBragg, Anna E.
dc.contributor.authorCrowe-White, Kristi M.
dc.contributor.authorEllis, Amy C.
dc.contributor.authorStuder, Matthew
dc.contributor.authorPhillips, Frank
dc.contributor.authorSamsel, Steven
dc.contributor.authorParton, Jason
dc.contributor.authorLocher, Julie L.
dc.contributor.authorArd, Jamy D.
dc.contributor.otherUniversity of Alabama Tuscaloosa
dc.contributor.otherWake Forest University
dc.date.accessioned2023-09-28T19:36:22Z
dc.date.available2023-09-28T19:36:22Z
dc.date.issued2022
dc.description.abstractBackground Obesity imposes risk to cardiometabolic health; however, intentional weight loss among older adults with obesity remains controversial. Objective To explore the influence of exercise plus weight maintenance and exercise plus intentional weight loss by caloric restriction on changes in cardiometabolic risk among older adults with obesity assessed by four risk-scoring tools. Design Using longitudinal data from the Calorie Restriction and Changes in Body Composition, Disease, Function, and Quality of Life in Older Adults study (CROSSROADS) (ClinicalTrials.gov identifier: NCT00955903; May 2009 to October 2014), scores were calculated using baseline and 12-month data according to criteria from the International Diabetes Federation, National Cholesterol Education Program's Adult Treatment Panel, Framingham Risk Score, and Cardiometabolic Disease Staging. Participants and setting Participants (39% men, 23% African American, aged 70.2 +/- 4.7 years) were randomized to exercise (n = 48), exercise plus nutrient-dense weight main-tenance diet (n = 44), or exercise plus weight loss by moderate caloric restriction (n = 42). Main outcome measures To evaluate effects of exercise plus weight maintenance and exercise plus intentional weight loss on changes in cardiometabolic risk. Statistical analyses performed Generalized estimating equations were used to assess changes in risk with ethnicity, biological sex, and age as covariates. Results Group-time interaction was only significant for Framingham and Car-diometabolic Disease Staging (P = 0.005 and 0.041, respectively). Upon post hoc anal-ysis, significant within-group improvements in Framingham scores were observed for exercise plus weight maintenance (P < 0.001; r = -1.682) and exercise plus weight loss (P = 0.020; r = -0.881). In analysis of between-group differences in Framingham scores, significant decreases were observed in the exercise plus weight maintenance group (P = 0.001; r = -1.723) compared with the exercise group. For Cardiometabolic Disease Staging, the exercise plus weight loss group had significant within-group im-provements (P = 0.023; r = -0.102). For between-group differences in Cardiometabolic Disease Staging, the exercise plus weight loss group showed significant risk reduction (P = 0.012; r = -0.142) compared with the exercise group. Conclusions Among risk scores evaluated, Framingham and Cardiometabolic Disease Staging showed significantly greater sensitivity to change in cardiometabolic risk. Older adults with obesity can significantly lower cardiometabolic risk through exercise plus weight maintenance or exercise plus weight loss by moderate caloric restriction.en_US
dc.format.mediumelectronic
dc.format.mimetypeapplication/pdf
dc.identifier.citationBragg, A. E., Crowe-White, K. M., Ellis, A. C., Studer, M., Phillips, F., Samsel, S., Parton, J., Locher, J. L., & Ard, J. D. (2022). Changes in Cardiometabolic Risk Among Older Adults with Obesity: An Ancillary Analysis of a Randomized Controlled Trial Investigating Exercise Plus Weight Maintenance and Exercise Plus Intentional Weight Loss by Caloric Restriction. In Journal of the Academy of Nutrition and Dietetics (Vol. 122, Issue 2, pp. 354–362). Elsevier BV. https://doi.org/10.1016/j.jand.2021.07.009
dc.identifier.doi10.1016/j.jand.2021.07.009
dc.identifier.urihttps://ir.ua.edu/handle/123456789/11557
dc.languageEnglish
dc.language.isoen_US
dc.publisherElsevier
dc.subjectCardiometabolic risk
dc.subjectObesity
dc.subjectOlder adults
dc.subjectWeight loss
dc.subjectExercise
dc.subjectMETABOLIC SYNDROME
dc.subjectDEFINITION
dc.subjectSTATEMENT
dc.subjectWOMEN
dc.subjectMEN
dc.subjectNutrition & Dietetics
dc.titleChanges in Cardiometabolic Risk Among Older Adults with Obesity: An Ancillary Analysis of a Randomized Controlled Trial Investigating Exercise Plus Weight Maintenance and Exercise Plus Intentional Weight Loss by Caloric Restrictionen_US
dc.typeArticle
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