Cutting 250 calories daily and exercising may improve heart health in
obese older adults

Date:
August 2, 2021
Source:
American Heart Association
Summary:
Among older adults with obesity, combining aerobic exercise
with moderate reductions in total daily calories led to greater
improvements in vascular health compared to exercise alone. Reducing
calorie intake by approximately 250 calories per day may lead
to significant weight loss and improve vascular health in older
adults with obesity.



FULL STORY ========================================================================== Cutting just 250 calories a day with moderate exercise reaped bigger
rewards than exercise alone for older, obese adults. Among older adults
with obesity, combining aerobic exercise with a moderate reduction in
daily calories resulted in greater improvements in aortic stiffness
(a measure of vascular health, which impacts cardiovascular disease),
compared to exercise only or to exercise plus a more restrictive
diet, according to new research published today in the American Heart Association's flagship journal Circulation.


========================================================================== Modifiable lifestyle factors such as a healthy diet and regular
physical activity may help offset age-related increases in aortic
stiffness. Although aerobic exercise generally has favorable effects on
aortic structure and function, previous studies have shown that exercise
alone may not be sufficient to improve aortic stiffness in older adults
with obesity.

"This is the first study to assess the effects of aerobic exercise
training with and without reducing calories on aortic stiffness, which
was measured via cardiovascular magnetic resonance imaging (CMR) to obtain detailed images of the aorta," said Tina E. Brinkley, Ph.D., lead author
of the study and associate professor of gerontology and geriatric medicine
at the Sticht Center for Healthy Aging and Alzheimer's Prevention at Wake Forest School of Medicine in Winston-Salem, North Carolina. "We sought to determine whether adding caloric restriction for weight loss would lead
to greater improvements in vascular health compared to aerobic exercise
alone in older adults with obesity." This randomized controlled trial
included 160 sedentary adults, ages 65-79 years with obesity (BMI=30-45
kg/m2). The average age of the participants was 69 years; 74% were
female; and 73% were white. Participants were randomly assigned to one
of three intervention groups for 20 weeks: 1) exercise only with their
regular diet; 2) exercise plus moderate calorie restriction (reduction
of approximately 250 calories/day); or 3) exercise plus more intensive
calorie restriction (reduction of approximately 600 calories/day).

The two calorie-restricted groups received pre-made lunches and dinners
with less than 30% of calories from fat and at least 0.8 grams of
protein per kg of their ideal body weight, prepared under the direction
of a registered dietitian for the study; they made their own breakfasts according to the dietitian- approved menu. Everyone in the study received supervised aerobic exercise training four days per week for the duration
of the 20-week study at the Geriatric Research Center at Wake Forest
School of Medicine.

The structure and function of the aorta were assessed with cardiovascular magnetic resonance imaging to measure aortic arch pulse wave velocity
(PWV) (the speed at which blood travels through the aorta) and
distensibility, or the ability of the aorta to expand and contract. Higher
PWV values and lower distensibility values indicate a stiffer aorta.

The results found that weight loss of nearly 10% of total body weight
or about 20 pounds over the five-month study period was associated
with significant improvements in aortic stiffness -- only in the
participants assigned to the exercise plus moderate calorie restriction
group. Additional findings include:
* The exercise plus moderate calorie restriction group had a 21%
increase
in distensibility and an 8% decrease in PWV.

* None of the aortic stiffness measures changed significantly in
either the
exercise-only group or the exercise plus more intensive calorie
restriction group.

* Changes in BMI, total fat mass, percent body fat, abdominal fat
and waist
circumference were greater in both of the calorie-restricted groups
compared to the exercise-only group.

* Weight loss was similar between the calorie-restricted groups
despite
nearly two times fewer calories (26.7% reduction in calories vs. a
14.2% reduction in calories) in the intensive calorie restriction
group.

"Our findings indicate that lifestyle changes designed to increase
aerobic activity and moderately decrease daily calorie intake may
help to reduce aortic stiffness and improve overall vascular health,"
said Brinkley. "However, we were surprised to find that the group that
reduced their calorie intake the most did not have any improvements
in aortic stiffness, even though they had similar decreases in body
weight and blood pressure as the participants with moderate calorie restriction." Brinkley added, "These results suggest that combining
exercise with modest calorie restriction -- as opposed to more intensive calorie restriction or no- calorie restriction -- likely maximizes
the benefits on vascular health, while also optimizing weight loss
and improvements in body composition and body fat distribution. The
finding that higher-intensity calorie restriction may not be necessary
or advised has important implications for weight loss recommendations
to improve cardiovascular disease risk in older adults with obesity." ========================================================================== Story Source: Materials provided by American_Heart_Association. Note:
Content may be edited for style and length.


========================================================================== Journal Reference:
1. Tina E. Brinkley, Iris Leng, Margie J. Bailey, Denise K. Houston,
Christina E. Hugenschmidt, Barbara J. Nicklas, W. Gregory Hundley.

Effects of Exercise and Weight Loss on Proximal Aortic Stiffness
in Older Adults With Obesity. Circulation, 2021; DOI: 10.1161/
CIRCULATIONAHA.120.051943 ==========================================================================

Link to news story: https://www.sciencedaily.com/releases/2021/08/210802140122.htm

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