Houston Denise K, Miller Michael E, Kitzman Dalane W, Rejeski W Jack, Messier Stephen P, Lyles Mary F, Kritchevsky Stephen B, Nicklas Barbara J
a Sticht Center on Aging, Wake Forest School of Medicine , Winston-Salem , NC , USA.
b Department of Internal Medicine, Section on Gerontology and Geriatric Medicine , Wake Forest School of Medicine , Winston-Salem , NC , USA.
J Nutr Gerontol Geriatr. 2019 Jan-Mar;38(1):83-99. doi: 10.1080/21551197.2019.1572570. Epub 2019 Mar 8.
Randomized, controlled trials (RCTs) show intentional weight loss improves body composition and physical function in older adults; however, the long-term benefits (and risks) are unknown. We conducted a pilot study to assess the feasibility of recalling prior RCT participants to examine the long-term effects of intentional weight loss on body composition and physical function. A weighted, random sample of 60 older adults who were randomized to caloric restriction plus exercise (CR + EX) or exercise (EX) only in 5 prior RCTs (mean age at randomization, 67.3 years; 69% women, 80% white) were invited to participate. Follow-up was obtained on 89% (42 clinic visits, 10 phone interviews, 1 death) an average of 3.5 years (range, 2.2-5.8 years) after RCT completion. Despite greater weight, fat and lean mass loss during the RCT (mean difference in change (95% CI): -4.19 (-7.52, -0.86), -2.75 (-5.10, -0.40), and -2.32 (-3.69, -0.95) kg, respectively) in those randomized to CR + EX, long-term changes in weight (2.05 (-2.35, 6.45) kg) and body composition (1.80 (-1.56, 5.17) and 0.03 (-2.20, 2.26) kg for fat and lean mass, respectively) from baseline and physical function at long-term follow-up (mean difference in 400-m walk and SPPB (95% CI): 23.2 (-19.3, 65.6) sec and -0.03 (-1.02, 0.96) points, respectively) were similar in CR + EX and EX only. Although improvements in weight and body composition following intentional weight loss may not be sustained long-term, physical function does not appear to be negatively impacted. A larger study is needed to confirm these results.
随机对照试验（RCT）表明，刻意减肥可改善老年人的身体成分和身体功能；然而，其长期益处（和风险）尚不清楚。我们开展了一项试点研究，以评估召回既往RCT参与者以研究刻意减肥对身体成分和身体功能长期影响的可行性。我们邀请了60名老年人的加权随机样本，这些老年人在之前的5项RCT中被随机分配至热量限制加运动组（CR + EX）或仅运动组（EX）（随机分组时的平均年龄为67.3岁；69%为女性，80%为白人）。在RCT完成后平均3.5年（范围为2.2 - 5.8年），对89%的参与者进行了随访（42次门诊就诊、10次电话访谈、1例死亡）。尽管在RCT期间，随机分配至CR + EX组的参与者体重、脂肪和瘦体重下降幅度更大（变化的平均差异（95%CI）：分别为-4.19（-7.52，-0.86）、-2.75（-5.10，-0.40）和-2.32（-3.69，-0.95）kg），但从基线开始的长期体重变化（2.05（-2.35，6.45）kg）以及身体成分变化（脂肪和瘦体重分别为1.80（-1.56，5.17）和0.03（-2.20，2.26）kg）和长期随访时的身体功能（400米步行和简易体能状况量表（SPPB）的平均差异（95%CI）：分别为23.2（-19.3，65.6）秒和-0.03（-1.02，0.96）分）在CR + EX组和仅EX组中相似。尽管刻意减肥后体重和身体成分的改善可能无法长期维持，但身体功能似乎未受到负面影响。需要开展更大规模的研究来证实这些结果。
