Miles D Witham1, Alison Avenell. 1. Section of Ageing and Health, University of Dundee, Ninewells Hospital, Dundee DD1 9SY, UK. m.witham@dundee.ac.uk
Abstract
PURPOSE: the prevalence of obesity is rapidly increasing in older adults. Information is required about what interventions are effective in reducing obesity and influencing health outcomes in this age group. DESIGN: systematic review and meta-analysis. DATA SOURCES: thirteen databases were searched, earliest date 1966 to December 2008, including Medline, CINAHL, PsycINFO, the Cochrane database and EMBASE. STUDY SELECTION: we included studies with participants' mean age > or = 60 years and mean body mass index > or = 30 kg/m(2), with outcomes at a minimum of 1 year. Data were independently extracted by two reviewers and differences resolved by consensus. DATA EXTRACTION: nine eligible trials were included. Study interventions targeted diet, physical activity and mixed approaches. Populations included patients with coronary artery disease, diabetes mellitus and osteoarthritis. RESULTS: meta-analysis (seven studies) demonstrated a modest but significant weight loss of 3.0 kg [95% confidence interval (CI) 5.1-0.9] at 1 year. Total cholesterol (four studies) did not show a significant change: -0.36 mmol/l (95% CI -0.75 to 0.04). There was no significant change in high-density lipoprotein, low-density lipoprotein or triglycerides. In one study, recurrence of hypertension or cardiovascular events was significantly reduced (hazard ratio 0.65, 95% CI 0.50-0.85). Six-minute walk test did not significantly change in one study. Health-related quality of life significantly improved in one study but did not improve in a second study. CONCLUSIONS: although modest weight reductions were observed, there is a lack of high-quality evidence to support the efficacy of weight loss programmes in older people.
PURPOSE: the prevalence of obesity is rapidly increasing in older adults. Information is required about what interventions are effective in reducing obesity and influencing health outcomes in this age group. DESIGN: systematic review and meta-analysis. DATA SOURCES: thirteen databases were searched, earliest date 1966 to December 2008, including Medline, CINAHL, PsycINFO, the Cochrane database and EMBASE. STUDY SELECTION: we included studies with participants' mean age > or = 60 years and mean body mass index > or = 30 kg/m(2), with outcomes at a minimum of 1 year. Data were independently extracted by two reviewers and differences resolved by consensus. DATA EXTRACTION: nine eligible trials were included. Study interventions targeted diet, physical activity and mixed approaches. Populations included patients with coronary artery disease, diabetes mellitus and osteoarthritis. RESULTS: meta-analysis (seven studies) demonstrated a modest but significant weight loss of 3.0 kg [95% confidence interval (CI) 5.1-0.9] at 1 year. Total cholesterol (four studies) did not show a significant change: -0.36 mmol/l (95% CI -0.75 to 0.04). There was no significant change in high-density lipoprotein, low-density lipoprotein or triglycerides. In one study, recurrence of hypertension or cardiovascular events was significantly reduced (hazard ratio 0.65, 95% CI 0.50-0.85). Six-minute walk test did not significantly change in one study. Health-related quality of life significantly improved in one study but did not improve in a second study. CONCLUSIONS: although modest weight reductions were observed, there is a lack of high-quality evidence to support the efficacy of weight loss programmes in older people.
Authors: Karen E Foster-Schubert; Catherine M Alfano; Catherine R Duggan; Liren Xiao; Kristin L Campbell; Angela Kong; Carolyn E Bain; Ching-Yun Wang; George L Blackburn; Anne McTiernan Journal: Obesity (Silver Spring) Date: 2011-04-14 Impact factor: 5.002
Authors: Jerome L Fleg; Daniel E Forman; Kathy Berra; Vera Bittner; James A Blumenthal; Michael A Chen; Susan Cheng; Dalane W Kitzman; Mathew S Maurer; Michael W Rich; Win-Kuang Shen; Mark A Williams; Susan J Zieman Journal: Circulation Date: 2013-10-28 Impact factor: 29.690
Authors: Michael D Jensen; Donna H Ryan; Caroline M Apovian; Jamy D Ard; Anthony G Comuzzie; Karen A Donato; Frank B Hu; Van S Hubbard; John M Jakicic; Robert F Kushner; Catherine M Loria; Barbara E Millen; Cathy A Nonas; F Xavier Pi-Sunyer; June Stevens; Victor J Stevens; Thomas A Wadden; Bruce M Wolfe; Susan Z Yanovski; Harmon S Jordan; Karima A Kendall; Linda J Lux; Roycelynn Mentor-Marcel; Laura C Morgan; Michael G Trisolini; Janusz Wnek; Jeffrey L Anderson; Jonathan L Halperin; Nancy M Albert; Biykem Bozkurt; Ralph G Brindis; Lesley H Curtis; David DeMets; Judith S Hochman; Richard J Kovacs; E Magnus Ohman; Susan J Pressler; Frank W Sellke; Win-Kuang Shen; Sidney C Smith; Gordon F Tomaselli Journal: Circulation Date: 2013-11-12 Impact factor: 29.690
Authors: A Perez-Cornago; L Brennan; I Ibero-Baraibar; H H M Hermsdorff; A O'Gorman; M A Zulet; J Alfredo Martínez Journal: J Physiol Biochem Date: 2014-01-09 Impact factor: 4.158
Authors: Dennis T Villareal; Suresh Chode; Nehu Parimi; David R Sinacore; Tiffany Hilton; Reina Armamento-Villareal; Nicola Napoli; Clifford Qualls; Krupa Shah Journal: N Engl J Med Date: 2011-03-31 Impact factor: 91.245