Effects of Weight Loss vs Aerobic Exercise Training on Risk Factors for Coronary Disease in Healthy, Obese, Middle-aged and Older Men

Katzel, Leslie I.; Bleecker, Eugene R.; Colman, Eric; Rogus, Ellen M.; Sorkin, John D.; Goldberg, Andrew P.

doi:10.1001/jama.1995.03530240025035

Cited by 235 publications

(73 citation statements)

References 32 publications

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“…At least four studies [128][129][130][131] showed improvement in metabolic control with better glucose tolerance and increased insulin sensitivity associated with intentional weight loss. Hypocaloric diets were effective with weight loss of up to 10 kg or more.…”

Section: Fourth Question: Is Voluntary Weight Loss Beneficial In the mentioning

confidence: 99%

“…131 Katzel et al 129 compared the effects on cardiovascular risk factors of a 9-month hypocaloric diet and 9-month aerobic exercise training program in 170 obese men, mean age 61 y. Hypocaloric diet induced a 9-kg weight loss and better improvement of cardiovascular risk factors than did an exercise program. 129 Weight loss has also been tested in older people as a mean to lower the intensity of treatment for hypertension. 132 In a sample of old overweight subjects, who underwent a hypocaloric diet with a weight loss goal of 4.5 kg, those participants who reached 75% of this goal reduced their use of antihypertensive drugs; thus, these results suggest that even a small weight loss (more or less 3.5 kg) induces a significant improvement of blood pressure in old age and thus may be clinically relevant.…”

Section: Fourth Question: Is Voluntary Weight Loss Beneficial In the mentioning

confidence: 99%

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Health consequences of obesity in the elderly: a review of four unresolved questions

et al. 2005

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Obesity prevalence is growing progressively even among older age groups. Controversy exists about the potential harms of obesity in the elderly. Debate persists about the relation between obesity in old age and total or disease-specific mortality, the definition of obesity in the elderly, its clinical relevance, and about the need for its treatment. Knowledge of age-related body composition and fat distribution changes will help us to better understand the relationships between obesity, morbidity and mortality in the elderly. Review of the literature supports that central fat and relative loss of fat-free mass may become relatively more important than BMI in determining the health risk associated with obesity in older ages. Weight gain or fat redistribution in older age may still confer adverse health risks (for earlier mortality, comorbidities conferring independent adverse health risks, or for functional decline). Evaluation of comorbidity and weight history should be performed in the elderly in order to generate a comprehensive assessment of the potential adverse health effects of overweight or obesity. The risks of obesity in the elderly have been underestimated by a number of confounders such as survival effect, competing mortalities, relatively shortened life expectancy in older persons, smoking, weight change and unintentional weight loss. Identification of elderly subjects with sarcopenic obesity is probably clinically relevant, but the definition of sarcopenic obesity, the benefits of its clinical identification, as well as its relation to clinical consequences require further study. Studies on the effect of voluntary weight loss in the elderly are scarce, but they suggest that even small amounts of weight loss (between 5-10% of initial body weight) may be beneficial. In older as well as in younger adults, voluntary weight loss may help to prevent the adverse health consequences of obesity.

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Section: Fourth Question: Is Voluntary Weight Loss Beneficial In the mentioning

confidence: 99%

Section: Fourth Question: Is Voluntary Weight Loss Beneficial In the mentioning

confidence: 99%

Health consequences of obesity in the elderly: a review of four unresolved questions

et al. 2005

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Section: Study Characteristicsmentioning

confidence: 99%

“…Studies included-Of the 3750 citations reviewed, 21 met our inclusion criteria [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22]39,40]. However, we were unable to include two studies because of the inability to retrieve necessary data for HDL 2 -C [39,40]. Thus, our percent loss that met our inclusion criteria was approximately 9%, leaving us with a total of 19 studies for analysis [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22].…”

Section: Study Characteristicsmentioning

confidence: 99%

Aerobic exercise and HDL2-C: A meta-analysis of randomized controlled trials

Kelley

2006

Atherosclerosis

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Purpose-Use the meta-analytic approach to examine the effects of aerobic exercise on highdensity lipoprotein two cholesterol (HDL 2 -C) in adults.Study sources-(1) Computerized literature searches; (2) cross-referencing from retrieved articles; (3) hand-searching; and (4) expert review of our reference list.Study selection-(1) Randomized controlled trials; (2) aerobic exercise ≥8 weeks; (3) adults ≥18 years of age; (4) studies published in journal, dissertation, or master's thesis format; (5) studies published in the English-language between January 1, 1955 and January 1, 2003; and (6) assessment of HDL 2 -C in the fasting state.Data abstraction-All coding conducted by both authors, independent of each other. Discrepancies were resolved by consensus.Results-Nineteen randomized controlled trials representing 20 HDL 2 -C outcomes from 984 males and females (516 exercise, 468 control) were pooled for analysis. Using random-effects modeling and bootstrap confidence intervals (BCI), a statistically significant increase of approximately 11% was observed for HDL 2 -C (X̄ ± S.E.M., 2.6±0.9 mg/dl, 95% BCI, 1.0-4.4 mg/dl). With each study deleted from the model once, results remained statistically significant. Increases in HDL 2 -C were independent of decreases in body weight, body mass index (kg/m 2 ), and percent body fat.Conclusion-Aerobic exercise increases HDL 2 -C in adults.

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“…15 Consequently, it seems possible that both coffee and tea consumption may decrease diabetes risk by helping individuals control their body weight.…”

Section: Introductionmentioning

confidence: 99%

Coffee, tea and diabetes: the role of weight loss and caffeine

et al. 2005

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OBJECTIVE:To assess the effect of weight change on the relationship between coffee and tea consumption and diabetes risk. DESIGN: Prospective cohort study, using data from the First National Health and Nutrition Examination Survey Epidemiologic Follow Up Study. Survival analyses were conducted using 301 selfreported cases of diabetes and eight documented diabetes deaths during an 8.4-y follow-up. SUBJECTS: A total of 7006 subjects aged 32-88 y with no reported history of diabetes were included in the study. RESULTS: For all subjects combined, increases in consumption of ground-caffeinated coffee and caffeine at baseline were followed by decreases in diabetes risk during follow-up. There were significant statistical interactions between age and consumption of caffeine (P ¼ 0.02) and ground-caffeinated coffee (P ¼ 0.03). Age-stratified analysis showed that the decrease in diabetes risk only applied to r60-y-old subjects, for whom the decrease in diabetes risk also obtained for ground-decaffeinated coffee and regular tea. The multivariate hazard ratio (HR) and 95% confidence interval for a 2 cups/day increment in the intake of ground-caffeinated coffee, ground-decaffeinated coffee and regular tea was 0.86 (0.75-0.99), 0.58 (0.34-0.99) and 0.77 (0.59-1.00), respectively. The diabetes risk was negatively related to the consumption in a dose-response manner. There were strong statistical interactions between prior weight change and beverage consumption for r60-y-old subjects. Further analysis revealed that the decrease in diabetes risk only applied to those who had lost weight, and that there was a positive doseresponse relationship between diabetes risk and weight change. For example, the multivariate HR and 95% confidence interval for 40 vs 0 cups/day of ground-decaffeinated coffee was 0.17 (0.04-0.74), 0.52 (0.19-1.42), 0.77 (0.30-1.96) and 0.91 (0.39-2.14) for subgroups with weight change of r0, 0-10, 10-20 and 420 lbs, respectively. There was no significant association between diabetes risk and consumption of instant-caffeinated coffee, instant-decaffeinated coffee or herbal tea. Caffeine intake appeared to explain some, but not all, of the diabetes-risk reduction and weight change. CONCLUSION: The negative relationship between diabetes risk and consumption of ground coffee and regular tea, observed for all NHEFS subjects, actually only applied to nonelderly adults who had previously lost weight.

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Effects of Weight Loss vs Aerobic Exercise Training on Risk Factors for Coronary Disease in Healthy, Obese, Middle-aged and Older Men

Cited by 235 publications

References 32 publications

Health consequences of obesity in the elderly: a review of four unresolved questions

Health consequences of obesity in the elderly: a review of four unresolved questions

Aerobic exercise and HDL2-C: A meta-analysis of randomized controlled trials

Coffee, tea and diabetes: the role of weight loss and caffeine

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