EXERCISE INTERVENTIONS DURING VOLUNTARY WEIGHT LOSS IN OBESE OLDER ADULTS

肥胖老年人自愿减肥期间的运动干预

基本信息

批准号：
7661178
负责人：
DENNIS T. VILLAREAL
金额：
$ 54.31万
依托单位：
WASHINGTON UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2009
资助国家：
美国
起止时间：
2009-05-01 至 2009-08-11
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7661178
关键词：
Adverse effects Aerobic Aerobic Exercise Age Aging Attenuated Biological Preservation Biopsy Specimen Body Composition Body Weight decreased Body fat Bone Resorption Communities Control Groups Diet Dual-Energy X-Ray Absorptiometry Elderly Equilibrium Exercise Fasting Fatty acid glycerol esters Growth Factor Health Professional Hip region structure Inflammation Insulin-Like Growth Factor I Interleukin-6 Intervention Intramuscular Magnetic Resonance Imaging Measures Mediating Mediator of activation protein Muscle Muscle Proteins Obesity Osteogenesis Performance Physical Function Plasma Polymerase Chain Reaction Population Protein Biosynthesis Protein Isoforms Proteins Public Health Questionnaires Randomized Regression Analysis Resistance Risk Skeletal Muscle Societies System Techniques Testing Thigh structure Time Tracer Training Urine Vertebral column Western Blotting age related base bone mass bone turnover clinical practice cytokine feeding frailty functional loss functional outcomes functional status health care delivery improved mRNA Expression muscle form obesity management performance tests prevent programs public health relevance response sarcopenia stable isotope strength training

项目摘要

DESCRIPTION (provided by applicant): Obesity causes frailty in obese older adults by exacerbating the age-related decline in physical function. However, appropriate management of obesity in older adults is controversial. Weight loss without exercise could worsen frailty by accelerating the usual age-related decline in muscle and bone mass that leads to sarcopenia and osteopenia, respectively. Because of the important problem of frailty in obese older adults, it would be important to determine the most efficacious approach in reducing, or even reversing frailty in this population. The primary objective of this proposal is to evaluate which distinct type of physical exercise (resistance, aerobic, or combined) is most efficacious in preventing the weight-loss-induced reduction in muscle and bone mass and reversing frailty in obese older adults. A total of 160 obese older adults will be randomized to 1) 10% weight loss + resistance training, 2) 10% weight loss + aerobic training, 3) 10% weight loss + aerobic/resistance training, and 4) non-weight loss control group for 6 months. We hypothesize that 1) weight loss + resistance training will cause a greater improvement in physical function than weight loss + aerobic training and weight loss + aerobic/resistance training, 2) weight loss + resistance training will cause a greater preservation of muscle mass than weight loss + aerobic/resistance training, whereas weight loss + aerobic training will cause a decrease in muscle mass, 3) weight loss + resistance training will stimulate bone formation more than resorption compared to weight loss + aerobic/resistance training and, thus, preserve BMD, whereas weight loss + aerobic training will decrease bone turnover and attenuate the loss of BMD, and 4) weight loss + resistance training a) will cause a greater decrease in TNF-1 and IL-6 and a greater increase in MGF in skeletal muscles than aerobic and aerobic/resistance training and that b) these anabolic effects will correlate with preservation of muscle protein synthesis (MPS) and muscle mass during weight-loss therapy. Our overarching hypothesis across aims is that obesity and aging have additive adverse effects on body composition (sarcopenic obesity) and physical function (frailty), mediated by their additive adverse effects on inflammation and MPS, which will, thus, be significantly improved by weight loss + resistance training. Therefore, to test this central hypothesis in an integrated manner, we will use partial correlation and multiple regression analyses, to determine which of the body composition factors and/or the mechanistic skeletal muscle factors are the most important mediators for the observed changes in physical function. Obesity in older adults is a major public health problem. The number of obese older adults in our society will continue to increase, challenging existing health care delivery systems. The results of this proposed RCT will have important implications for preventing the loss of functional independence of obese older adults in our society and, therefore, will change current clinical practice for this rapidly growing segment of the population. PUBLIC HEALTH RELEVANCE: Obesity in older adults is a major public health problem that provides a challenge to health care professionals and our existing health care delivery systems. Obesity worsens the decline in physical function that occurs with age, and increases the risk for loss of independence in the community. This study will determine the most efficacious approach towards preventing the loss of functional independence of obese older adults in our society and will change current clinical practice for this rapidly increasing segment of the population.

描述（由申请人提供）：肥胖会加剧与年龄相关的身体机能下降，从而导致肥胖老年人脆弱。但是，对老年人的肥胖症进行适当的管理是有争议的。通过分别加速与年龄相关的肌肉和骨骼质量下降，分别导致肌肉减少症和骨质减少症的肌肉和骨骼肿块的通常下降，体重减轻可能会加剧脆弱性。由于肥胖老年人的脆弱问题，确定最有效的方法在减少甚至颠倒该人群中的脆弱方法非常重要。该提案的主要目的是评估哪种不同类型的体育锻炼（耐药性，有氧或合并）最有效地防止减肥诱导的肌肉和骨骼质量减少，以及肥胖老年人的脆弱性。总共160名肥胖老年人将被随机分为1）10％的体重减轻 +抵抗训练，2）10％体重减轻 +有氧训练，3）10％体重减轻 +有氧/抵抗训练，4）6个月的非重量损失对照组。我们假设1）体重减轻 +抵抗训练将导致身体机能的改善要比体重减轻 +有氧训练和体重减轻 +有氧/抵抗训练 +有氧/抵抗训练，2）体重减轻 +抵抗训练将导致肌肉质量更大会导致体重减轻 +体重/抵抗性训练，而体重/抵抗力训练比体重/抵抗训练会导致体重损失 +有氧运动 +有氧运动 +有氧运动的损失 +有氧运动的质量，3）是3），3）是肌肉的降低，3）有氧/抵抗训练，因此保留了BMD，而体重减轻 +有氧训练将减少骨骼的离职并减轻BMD的损失，4）4）体重减轻 +耐药训练a）将导致TNF-1和IL-6的降低更大，而在骨架上，MMGF的较高疗法和有氧运动的mus液位较大，而这些训练的液体较大，并且在这些骨骼的培训中，这些疗程的mus效果和无氧培训的效果将降低。减肥治疗期间蛋白质合成（MPS）和肌肉质量。我们各个目标的总体假设是，肥胖和衰老对人体成分（肌肉减少肥胖）和身体功能（脆弱）对炎症和MPS的添加不良影响介导的添加剂不利影响，从而通过体重损失 +抵抗力训练会显着改善。因此，为了以综合方式检验这一中心假设，我们将使用部分相关和多元回归分析来确定哪些身体组成因子和/或机械骨骼肌因子是观察到的身体功能变化的最重要的介体。老年人的肥胖是一个主要的公共卫生问题。我们社会中肥胖的老年人的数量将继续增加，挑战现有的医疗保健提供系统。该提出的RCT的结果将对防止肥胖老年人在我们社会中失去功能独立性的丧失具有重要意义，因此，将改变当前人口迅速增长的临床实践。公共卫生相关性：老年人的肥胖是一个主要的公共卫生问题，它为医疗保健专业人员和我们现有的医疗保健提供系统带来了挑战。肥胖使身体机能的下降恶化，随着年龄的增长，增加了社区失去独立性的风险。这项研究将确定防止肥胖老年人在我们社会中失去功能独立性的最有效的方法，并将改变当前人口的迅速增加的临床实践。