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Cutting just 250 calories a day with moderate exercise has reported greater rewards than exercise alone for older, obese adults. In obese older people, the combination of aerobic exercise with a moderate reduction in daily calories resulted in greater improvement in aortic stiffness (a measure of vascular health, which impacts cardiovascular disease), compared to exercise alone or with exercise plus a more restrictive diet, according to new research published today in the flagship journal of the American Heart Association Circulation.
Modifiable lifestyle factors such as a healthy diet and regular physical activity can help compensate for age-related increases in aortic stiffness. Although aerobic exercise generally has favorable effects on aortic structure and function, previous studies have shown that exercise alone may not be sufficient to improve aortic stiffness in obese older people.
“This is the first study to assess the effects of aerobic exercise with and without calorie reduction on aortic stiffness, which was measured by cardiovascular magnetic resonance (CMR) imaging to obtain detailed images of the aorta, “said Tina E. Brinkley, Ph .D., lead author of the study and associate professor of gerontology and geriatric medicine at the Sticht Center for Healthy Aging and Alzheimer’s Prevention at Wake Forest School of Medicine in Winston- Salem, North Carolina. “We investigated whether adding calorie restriction for weight loss would lead to greater improvements in vascular health compared to aerobic exercise alone in obese older adults.”
This randomized controlled trial included 160 sedentary adults, aged 65 to 79 years with obesity (BMI = 30-45 kg / m2). The average age of the participants was 69 years; 74% were women; and 73% were white. Participants were randomly assigned to one of three intervention groups for 20 weeks: 1) exercise only with their usual diet; 2) exercise plus moderate calorie restriction (reduction of about 250 calories / day); or 3) exercise plus more intensive calorie restriction (reduction of about 600 calories / day).
Both calorie-restricted groups were given lunches and dinners prepared with less than 30% calories from fat and at least 0.8 grams of protein per kg of ideal body weight, prepared under the direction of a registered dietitian. for study; they prepared their own breakfasts according to the menu approved by a dietitian. All study participants received supervised aerobic exercise training four days a week for the duration of the 20-week study at the Geriatric Research Center at Wake Forest School of Medicine.
The structure and function of the aorta was assessed by cardiovascular magnetic resonance imaging to measure the pulse wave speed of the aortic arch (the speed at which blood flows through the aorta) and distensibility, or the ability of the aorta to expand and contract. Higher PWV values and lower distensibility values indicate a stiffer aorta.
The results revealed that a weight loss of nearly 10% of total body weight or about 20 pounds over the five-month study period was associated with significant improvements in aortic stiffness – only in patients. participants assigned to the exercise plus moderate calorie restriction group. Additional results include:
- The exercise plus moderate calorie restriction group had a 21% increase in distensibility and an 8% decrease in PWV.
- None of the measures of aortic stiffness changed significantly in the exercise alone group or in the exercise plus more intensive calorie restriction group.
- Changes in BMI, total fat, body fat percentage, abdominal fat, and waist circumference were greater in the two calorie-restricted groups than in the exercise-only group.
- Weight loss was similar between the calorie restricted groups despite nearly half the calories (26.7% reduction in calories vs. 14.2% reduction in calories) in the intensive calorie restriction group.
“Our results indicate that lifestyle changes designed to increase aerobic activity and moderately decrease daily calorie intake may help reduce aortic stiffness and improve overall vascular health,” said Brinkley. “However, we were surprised to find that the group that reduced their calorie intake the most did not show any improvement in aortic stiffness, even though they experienced similar decreases in body weight and blood pressure as the participants with moderate calorie restriction. “
Brinkley added: “These results suggest that combining exercise with modest calorie restriction – as opposed to more intensive calorie restriction or no calorie restriction – likely maximizes vascular health benefits, while maximizing weight loss and fat loss. improvements in body composition and body fat distribution The finding that higher intensity calorie restriction may not be necessary or advised has important implications for weight loss recommendations to improve disease risk cardiovascular disease in obese elderly people.
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