The World Health Organization (WHO) defines overweight and obesity as excessive fat accumulations, posing health risks. A Spanish survey indicated a significant increase in obesity (from 7.4 % to 17.4%.) between 1987 and 2017. Interestingly, it was observed that obesity is more prevalent in men than in women who are below 65 years of age. However, beyond the age of 65, obesity in women outnumbered men.
Study: Effectiveness of a Two-Year Multicomponent Intervention for the Treatment of Overweight and Obesity in Older People. Image Credit: Marian Weyo / Shutterstock
Background
Industrialization, food market globalization, economic development, and urbanization have substantially contributed to changes in the global population's eating habits. Some of these changes have led to an increase in the choice of low-nutrition foods, such as refined, processed, and high-fat foods. High consumption of these foods and sedentary lifestyles cause obesity. Obesity is regularly associated with several chronic diseases, including type II diabetes, high blood pressure, the development of neurodegenerative diseases, and cancer.
Obesity is primarily found in older people. Due to an increase in life expectancy and a reduction in birth rate, globally, a surge in the older population has been reported. In Spain, the number of individuals above the age of 64 reached 9.28 million in 2020.
Suitable interventions based on proper diet and exercise can successfully promote weight loss in older adults. Nevertheless, improper application of these interventions can adversely affect their muscles, nutrition levels, and bone health. In addition, low levels of essential vitamins and minerals can cause malnutrition, which might increase the risk of mortality and morbidity.
Aging alters body composition in older people, where lean mass decreases and fat mass increases. Therefore, improper weight loss interventions may aggravate the natural loss of muscle mass because weight loss causes not only a reduction of fat mass (FM) but also fat-free mass (FFM). Nevertheless, well-structured and supervised weight loss interventions are safe and effective for older people with positive health benefits.
Instead of single interventions, i.e., physical activity or dietary restrictions, a combination of both showed positive results. A recent Nutrients journal study evaluated the effectiveness of a two-year intervention program based on Mediterranean diet patterns for treating overweight older people and those with obesity.
About the Study
A total of 51 people above the age of 60 years and belonging to the Mediterranean city of Alicante (Spain) were included in this study. All participants' body mass index (BMI) was greater than 25 kg/m2. Participants were randomly assigned to two groups, i.e., the experimental and control groups, and they were matched at baseline for clinical variables.
Participants in the experimental group received personalized training for food education, weight management, and psychological support. The dietary–nutritional intervention was provided by a skilled dietician–nutritionist. The participants' weight loss was monitored, and their eating behavior was recorded. Every participant was evaluated 6, 12, and 24 months after the baseline evaluation.
Assessment of food consumption by the participants was carried out by the Food Frequency (MEDIS-FFQ) questionnaire, and the extent of adhering to the recommended diet was assessed through the Mediterranean Diet Prevention Group (PREDIMED) questionnaire. In addition, psychological evaluations, such as the severity of depression symptoms, were conducted through the PHQ-9 (Patient Health Questionnaire). The values in these questionnaires were recorded as scores.
Study Findings
A significant weight loss that included a decrease in fat mass, BMI, and reduction in waist circumference occurred in the experimental group after two years of dietary nutritional intervention. However, no difference was observed between the two groups concerning the hip circumference or waist-hip index.
Based on the analysis carried out over two years, the experimental and control groups reported improved scores related to the PHQ-9 questionnaire. However, over time, no significant improvement was observed in the PREDIMED and GAD-7 scores. The possible reason behind the lack of improvements in the GAD-7 scores could be that the time of intervention coincided with the coronavirus disease 2019 (COVID-19) lockdown. The national lockdown significantly reduced social interaction, which might have impacted anxiety levels. An improved PHQ-9 questionnaire score also reflects a reduced risk of chronic diseases.
No significant improvement in scores of both groups related to adherence to the Mediterranean diet was observed. However, it must be noted that the experimental group participants showed good adherence to MD at the start of the intervention, as evidenced by high initial scores.
Conclusions
The study has a few limitations, including a small sample size. Additionally, the generalization of the findings is limited because all participants belonged to a single city in Spain. However, the overall assessments of the two-year intervention based on the Mediterranean diet indicate that older people with obesity experience significant weight loss along with a reduction in BMI, percentage of fat mass, and waist circumference.
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