减肥期间进行抗阻和冲击训练可改善肥胖老年人的身体机能和身体成分。
Resistance and Impact Training During Weight Loss Improves Physical Function and Body Composition in Older Adults With Obesity.
作者信息
Mesinovic Jakub, Gandham Anoohya, Cervo Mavil May, Jansons Paul, Glavas Costas, Braude Michael, Rodriguez Juan Pena, De Courten Barbora, Zengin Ayse, Beck Belinda R, Ebeling Peter R, Scott David
机构信息
Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Burwood, Victoria, Australia.
Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia.
出版信息
J Cachexia Sarcopenia Muscle. 2025 Apr;16(2):e13789. doi: 10.1002/jcsm.13789.
BACKGROUND
Weight loss achieved via energy restriction leads to significant losses in muscle and bone mass, potentially increasing risk for sarcopenia and osteoporosis. High-intensity resistance and impact training (HiRIT) might attenuate weight loss-induced musculoskeletal declines. Our objective was to compare changes in physical function and body composition in older adults with obesity undertaking dietary weight loss combined with HiRIT or aerobic training (AT).
METHODS
Sixty older adults (aged ≥ 60 years) with obesity (dual-energy x-ray absorptiometry determined body fat percentage ≥ 30% in men and ≥ 40% in women) and a mobility limitation (Short Physical Performance Battery [SPPB] score ≤ 11) were randomly assigned to either 12 weeks of supervised, centre-based HiRIT or self-directed, home-based AT while consuming a hypocaloric diet (750-1000 kcal/day reduction in energy intake). Changes in physical function (primary outcome: gait speed) and body composition were compared between groups.
RESULTS
A total of 49/60 randomised participants (mean age: 69.6 ± 6 years; 58% women; mean BMI: 32.9 ± 4.1 kg/m) completed the trial. Gait speed increased following HiRIT compared with AT (mean difference: 0.07 m/s [95% CI: 0.01, 0.13]). Chair stand times decreased in both groups (HiRIT: -1.3 s [95% CI: -2.1, -0.4] vs. AT: -0.8 s [95% CI: -1.6, -0.04]) and HiRIT, but not AT, increased handgrip strength (HiRIT: 2.2 kg [95% CI: 0.6, 3.9] vs. AT: 0.7 kg [95% CI: -0.9, 2.3]) and SPPB scores (HiRIT: 0.9 [95% CI: 0.4, 1.3] vs. AT: 0.4 [95% CI: -0.04, 0.8]). Similar decreases in total body mass (HiRIT: -5.1 kg [95% CI: -6.7, -3.4] vs. AT: -4.9 kg [95% CI: -6.5, -3.3]), fat mass (HiRIT: -3.6 kg [95% CI: -5.0, -2.2] vs. AT: -3.3 kg [95% CI: -4.7, -2.0]), visceral fat (HiRIT: -32.1 cm [95% CI: -47.4, -16.8] vs. AT: -31.4 cm [95% CI: -46.1, -16.8]) and appendicular lean mass (HiRIT: -0.8 kg [95% CI: -1.4, -0.2] vs. AT: -1.2 kg [95% CI: -1.8, -0.6]) were observed. HiRIT was well tolerated with only seven minor adverse events compared with five reported in those who completed AT.
CONCLUSION
HiRIT appears to be safe and more effective than AT for improving gait speed in older adults with obesity undertaking dietary weight loss. Additional trials with larger sample sizes and longer durations are warranted to explore whether HiRIT can attenuate weight loss-related muscle and bone mass declines.
TRIAL REGISTRATION
Australian New Zealand Clinical Trials: ACTRN12618001146280.
背景
通过能量限制实现的体重减轻会导致肌肉和骨量显著流失，可能增加肌少症和骨质疏松症的风险。高强度抗阻和冲击训练（HiRIT）可能会减轻体重减轻引起的肌肉骨骼衰退。我们的目的是比较肥胖老年人在进行饮食减肥的同时结合HiRIT或有氧训练（AT）时身体功能和身体成分的变化。
方法
60名年龄≥60岁的肥胖老年人（双能X线吸收法测定男性体脂百分比≥30%，女性≥40%）且存在行动能力受限（简短体能状况量表[SPPB]评分≤11），被随机分配至接受为期12周的、在中心进行的监督下的HiRIT或自主的、在家进行的AT，同时摄入低热量饮食（能量摄入减少750 - 1000千卡/天）。比较两组之间身体功能（主要结局：步速）和身体成分的变化。
结果
共有49/60名随机分组的参与者（平均年龄：69.6±6岁；58%为女性；平均BMI：32.9±4.1kg/m²）完成了试验。与AT相比，HiRIT后步速增加（平均差异：0.07m/s[95%CI：0.01，0.13]）。两组的椅子起立时间均减少（HiRIT：-1.3秒[95%CI：-2.1，-0.4] vs. AT：-0.8秒[95%CI：-1.6，-0.04]），且HiRIT增加了握力（HiRIT：2.2kg[95%CI：0.6，3.9] vs. AT：0.7kg[95%CI：-0.9，2.3]）和SPPB评分（HiRIT：0.9[95%CI：0.4，1.3] vs. AT：0.4[95%CI：-0.04，0.8]），而AT未增加。观察到两组在总体重（HiRIT：-5.1kg[95%CI：-6.7，-3.4] vs. AT：-4.9kg[95%CI：-6.5，-3.3]）、脂肪量（HiRIT：-3.6kg[95%CI：-5.0，-2.2] vs. AT：-3.3kg[95%CI：-4.7，-2.0]）、内脏脂肪（HiRIT：-32.1cm[95%CI：-47.4，-16.8] vs. AT：-31.4cm[95%CI：-46.1，-16.8]）和四肢瘦体重（HiRIT：-0.8kg[95%CI：-1.4，-0.2] vs. AT：-1.2kg[95%CI：-1.8，-0.6]）方面有相似程度的下降。HiRIT耐受性良好，仅有7例轻微不良事件，而完成AT的参与者报告有5例。
结论
对于进行饮食减肥的肥胖老年人，HiRIT在提高步速方面似乎比AT更安全、更有效。有必要进行更大样本量和更长持续时间的额外试验，以探讨HiRIT是否能减轻与体重减轻相关的肌肉和骨量下降。
试验注册
澳大利亚新西兰临床试验：ACTRN12618001146280。
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