Weight loss in obese adults 65years and older: a review of the controversy.
Weight loss in obese adults 65years and older: a review of the controversy.
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DOI：
10.1016/j.exger.2013.02.005
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发表时间：
2013-10
影响因子：
3.9
通讯作者：
Villareal, Dennis T.
中科院分区：
文献类型：
--
作者：
Waters, Debra L.;Ward, Aimee L.;Villareal, Dennis T.
老年人肥胖在许多发达国家普遍存在，并与各种负面健康后果有关，使其成为重要的公共卫生干预目标。然而，老年人肥胖的治疗方法仍然存在争议，因为人们担心随着年龄的增长而改变行为的难度，加剧与年龄相关的骨骼肌肉和骨骼的丧失，以及长期体重维持的可行性和相关的健康后果。这篇综述旨在系统地审查有关减肥干预措施的证据，重点是肥胖(体重指数30 kg/m2及以上)、老年人(65岁及以上)以及与运动和热量限制相关的一些拟议机制(生活方式干预)。我们的发现表明，这个年龄段的健康减肥可以通过长达一年的生活方式干预来实现。大多数综述的干预措施报告称，随着体重的减轻，瘦体重和骨密度都有所下降。矛盾的是，肌肉质量和身体功能都得到了改善。炎症分子和代谢标记物也有所改善，尽管运动和减肥在这些途径上的独立和相加效应还知之甚少。使用我们的综述纳入标准，在文献中只发现了一项调查长期体重维持和相关健康影响的小型先导性研究。未来关于肥胖老年人生活方式干预的研究应该解决骨丢失和瘦体重、炎症机制，并包括足够的随访以评估长期体重维持和健康结果。
Obesity in older adults is ubiquitous in many developed countries and is related to various negative health outcomes, making it an important public health target for intervention. However, treatment approaches for obesity in older adults remain controversial due to concerns surrounding the difficulty of behavior change with advancing age, exacerbating the age-related loss of skeletal muscle and bone, and the feasibility of long-term weight maintenance and related health consequences. This review serves to systematically examine the evidence regarding weight loss interventions with a focus on obese (body mass index 30 kg/m2 and above) older adults (aged 65 years and older) and some proposed mechanisms associated with exercise and caloric restriction (lifestyle intervention). Our findings indicate that healthy weight loss in this age group can be achieved through lifestyle interventions of up to a one-year period. Most interventions reviewed reported a loss of lean body mass and bone mineral density with weight loss. Paradoxically muscle quality and physical function improved. Inflammatory molecules and metabolic markers also improved, although the independent and additive effects of exercise and weight loss on these pathways are poorly understood. Using our review inclusion criteria, only one small pilot study investigating long-term weight maintenance and associated health implications was found in the literature. Future research on lifestyle interventions for obese older adults should address the loss of bone and lean body mass, inflammatory mechanisms, and include sufficient follow up to assess long-term weight maintenance and health outcomes.
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影响因子：
120.7
作者：
Flegal, Katherine M.;Carroll, Margaret D.;Curtin, Lester R.
通讯作者：
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影响因子：
3.3
作者：
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通讯作者：
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影响因子：
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作者：
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通讯作者：
Krumholz, HM
DOI：
10.1097/mco.0b013e3283331384
发表时间：
2010-01-01
影响因子：
3.1
作者：
Morley, John E.;Chahla, Elie;AlKaade, Saad
通讯作者：
AlKaade, Saad
DOI：
10.1093/gerona/55.6.m350
发表时间：
2000-06-01
影响因子：
5.1
作者：
Brown, M;Sinacore, DR;Kohrt, WM
通讯作者：
Kohrt, WM