Effects of a Hypocaloric, Nutritionally Complete, Higher Protein Meal Plan on Regional Body Fat and Cardiometabolic Biomarkers in Older Adults with Obesity

• Type of Material: Article
• Authors: Monica Serra, Emory University; Daniel P. Beavers, Wake Forest School of Medicine; Rebecca M. Henderson, Wake Forest School of Medicine; Jessica L. Kelleher, Emory University; Jessica R. Kiel, Medifast, Inc.; Kristen M. Beavers, Wake Forest University
• Language: English
• Date: 2019-02-12
• Publisher: Karger Publishers
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2019 S. Karger AG, Basel.
• Final Published Version (URL): http://dx.doi.org/10.1159/000497066
• Title of Journal or Parent Work: Annals of Nutrition and Metabolism
• ISSN: 0250-6807
• Volume: 74
• Issue: 2
• Start Page: 149
• End Page: 155
• Grant/Funding Information: This work was supported by an in-kind donation of the meal replacements used in the study and a grant from Jason Pharmaceuticals, Inc., a wholly owned subsidiary of Medifast, Inc., as well as the Wake Forest Claude D. Pepper Older Americans Independence Center (P30 AG21332), a National Institute on Aging supported career development award (K01 AG047921) to K.M.B., and US Department of Veterans Affairs Rehabilitation R&D Service career development award (IK2 RX-000944) to M.C.S.
• Keywords: Science & Technology; Life Sciences & Biomedicine; Nutrition & Dietetics; RISK; GLUCOSE; EXERCISE; SIZE; OVERWEIGHT; REDUCTIONS; Endocrinology & Metabolism; Body composition; LIPOLYSIS; GAIN; Obesity; Weight loss; WEIGHT-LOSS; INSULIN SENSITIVITY
• Research Categories: Health Sciences, Nutrition; Health Sciences, Public Health

Abstract

Background: Whether improvements in cardiometabolic health following weight loss (WL) are associated with changes in regional body fat distribution (gluteal vs. -android) is not well documented. Methods: Older (age: 70 ± 4 years; mean ± SD) adults with obesity were randomized to a 6-month WL program (WL; n = 47), accomplished using a hypocaloric, nutritionally complete, higher protein -(targeting ≥1.0 g/kg/day) meal plan, or a weight stability (WS; n = 49) program. Android, gynoid, visceral, and subcutaneous abdominal fat masses (via dual energy X-ray absorptiometry) and fasting glucose and lipid profiles were assessed at baseline and 6 months. Results: The WL group lost more body weight (WL: -8.6% vs. WS: -1.7%, p < 0.01), resulting in a reduction in fat mass at each region only following WL (all p < 0.05). The decline in the ratio of android/gynoid fat mass also was significant only following WL, resulting in greater declines than WS (mean [95% CI]; WL: -0.026 [-0.040 to -0.011] vs. WS: 0.003 [-0.012 to 0.019] g, p < 0.01). The change in the ratio of visceral/subcutaneous abdominal fat mass was not significant in either group and did not differ between groups (WL: 0.65 [-0.38 to 1.68] vs. WS: 0.05 [-1.00 to 1.10] g, p = 0.42). In general, the improvements in glucose and lipid profiles were associated with declines in fat mass at the gynoid and android regions (r's = 0.20-0.42, all p < 0.05), particularly the visceral depot but not the ratios. Conclusion: WL achieved via a hypocaloric, nutritionally complete, higher protein meal plan is effective in reducing body fat in the android, gynoid, and visceral depots, which relate to cardiometabolic improvements.