W Jack Rejeski1,2, Walter T Ambrosius3, Jonathan H Burdette4, Michael P Walkup3, Anthony P Marsh1. 1. Department of Health and Exercise Science, Wake Forest University, Winston-Salem, North Carolina. 2. Department of Geriatric Medicine. 3. Department of Biostatistical Sciences. 4. Department of Radiology, Wake Forest School of Medicine, Winston-Salem, North Carolina.
Abstract
BACKGROUND: Among older, overweight, and obese adults with either cardiovascular disease or the metabolic syndrome, reduced mobility and loss of leg strength are important risk factors for morbidity, disability, and mortality. It is unclear whether community-based approaches to weight loss may be an effective solution to this public health challenge. METHODS: An 18-month three-site, randomized controlled trial conducted by YMCA staff, with blinded assessors, enrolled 249 older, overweight, and obese adults with either cardiovascular disease or metabolic syndrome with randomization to three interventions: weight loss alone (WL), weight loss + aerobic training (WL + AT), and weight loss + resistance training (WT + RT). The dual primary outcomes were 400-m walk time in seconds and knee extensor strength in Newton meters. RESULTS: All groups lost weight from baseline: average baseline adjusted change of -6.1% (95% confidence interval [CI]: -7.5 to -4.7) for WL only, -8.6% (95% CI: -10.0 to -7.2) for WL + AT, and -9.7% (95% CI: -11.1 to -8.4) for WL + RT. Combined, the two physical activity + WL training groups had greater improvement in walk time than WL alone (mean difference 16.9 seconds [95% CI: 9.7 to 24.0], p < .0001). Baseline adjusted change in knee extensor strength was no greater with WL + RT than WL + AT (mean difference -3.6 Nm [95% CI: -7.5 to 0.3], p = .07). CONCLUSIONS: At risk, older, overweight and obese adults can achieve clinically significant reductions in body weight with community-based weight loss programs. The change in percent weight loss and improvements in mobility are significantly enhanced when either RT or AT is combined with dietary WL.
BACKGROUND: Among older, overweight, and obese adults with either cardiovascular disease or the metabolic syndrome, reduced mobility and loss of leg strength are important risk factors for morbidity, disability, and mortality. It is unclear whether community-based approaches to weight loss may be an effective solution to this public health challenge. METHODS: An 18-month three-site, randomized controlled trial conducted by YMCA staff, with blinded assessors, enrolled 249 older, overweight, and obese adults with either cardiovascular disease or metabolic syndrome with randomization to three interventions: weight loss alone (WL), weight loss + aerobic training (WL + AT), and weight loss + resistance training (WT + RT). The dual primary outcomes were 400-m walk time in seconds and knee extensor strength in Newton meters. RESULTS: All groups lost weight from baseline: average baseline adjusted change of -6.1% (95% confidence interval [CI]: -7.5 to -4.7) for WL only, -8.6% (95% CI: -10.0 to -7.2) for WL + AT, and -9.7% (95% CI: -11.1 to -8.4) for WL + RT. Combined, the two physical activity + WL training groups had greater improvement in walk time than WL alone (mean difference 16.9 seconds [95% CI: 9.7 to 24.0], p < .0001). Baseline adjusted change in knee extensor strength was no greater with WL + RT than WL + AT (mean difference -3.6 Nm [95% CI: -7.5 to 0.3], p = .07). CONCLUSIONS: At risk, older, overweight and obese adults can achieve clinically significant reductions in body weight with community-based weight loss programs. The change in percent weight loss and improvements in mobility are significantly enhanced when either RT or AT is combined with dietary WL.
Authors: Anthony P Marsh; Rachel M Vance; Tera L Frederick; Sarah A Hesselmann; W Jack Rejeski Journal: Med Sci Sports Exerc Date: 2007-06 Impact factor: 5.411
Authors: Anthony P Marsh; Jeffrey A Katula; Christina F Pacchia; Lara C Johnson; Kenneth L Koury; W Jack Rejeski Journal: Med Sci Sports Exerc Date: 2006-06 Impact factor: 5.411
Authors: Daniel E Kammire; Michael P Walkup; Walter T Ambrosius; Leon Lenchik; Sue A Shapses; Barbara J Nicklas; Denise K Houston; Anthony P Marsh; W Jack Rejeski; Kristen M Beavers Journal: Obesity (Silver Spring) Date: 2019-09-04 Impact factor: 5.002
Authors: Denise K Houston; Michael E Miller; Dalane W Kitzman; W Jack Rejeski; Stephen P Messier; Mary F Lyles; Stephen B Kritchevsky; Barbara J Nicklas Journal: J Nutr Gerontol Geriatr Date: 2019-03-08
Authors: John A Batsis; Curtis L Petersen; Matthew M Clark; Summer B Cook; Francisco Lopez-Jimenez; Rima I Al-Nimr; Dawna Pidgeon; David Kotz; Todd A Mackenzie; Stephen J Bartels Journal: J Gerontol A Biol Sci Med Sci Date: 2021-01-01 Impact factor: 6.053
Authors: John A Batsis; Curtis L Petersen; Summer B Cook; Rima I Al-Nimr; Dawna Pidgeon; Todd A Mackenzie; Stephen J Bartels Journal: J Nutr Gerontol Geriatr Date: 2020-09-09
Authors: W Jack Rejeski; Anthony P Marsh; Jason Fanning; Walter T Ambrosius; Michael P Walkup; Barbara J Nicklas Journal: Obesity (Silver Spring) Date: 2019-11 Impact factor: 5.002
Authors: Elizabeth M Venditti; Marsha D Marcus; Rachel G Miller; Vincent C Arena; Susan L Greenspan; Bonny Rockette-Wagner Journal: J Gerontol A Biol Sci Med Sci Date: 2021-01-18 Impact factor: 6.053
Authors: Jason Fanning; Michael P Walkup; Walter T Ambrosius; Lawrence R Brawley; Edward H Ip; Anthony P Marsh; W Jack Rejeski Journal: J Behav Med Date: 2017-11-22