Abstract :
Objectives: Physicians are often reluctant to advise older obese patients to lose weight for fear of
compromised nutrition and excessive loss of muscle mass and strength, all of which may lead to a loss of
independence and accelerate disability. Therefore, the purpose of this study was to examine nutrient intake in
older obese adults undergoing a weight loss intervention. Setting: The study setting was at a university research
facility. Participants: A total of 71 participants (age, 69.5 (SD = 5.8) yrs; 62% female; BMI, 34.6 (4.4) kg/m2)
were recruited. Design: Individuals were randomized into either a weight stable (WS) control group or an
intensive weight loss (WL) group. Intervention: The WL intervention was for 6 months and utilized partial meal
replacements (PMR) and a facility-based 3 d/wk, 60 min/session exercise training program encompassing both
aerobic and strength exercises. Weight loss goal for WL was 10% from baseline at 6-months. Measurements:
Variables were obtained at baseline and 6-months and included 3 day dietary records along with daily step counts
for 7 days. Total energy, macronutrients (g and % of energy), micronutrients (vitamins and minerals), as well as
use of PMR were assessed from the diet records. Body mass and body fat (g and % of body mass) were
determined at the 2 time points. Results: Estimated marginal means (SEM) for weight loss at 6-months was -8.8
(0.7)% for WL and -0.1 (0.7)% for WS. Daily energy intake at 6-months was lower for WL (1396 (64) kcals)
compared to WS (1817 (71) kcals). Additionally, those in the WL group (compared to WS) had lower intakes of
total fat (27.5 (1.2)%, WL vs. 36.1 (4.6)%, WS) and saturated fatty acids (8.5 (0.4)% vs. 10.8 (0.5)%), and had
higher levels of carbohydrates (57.6 (1.5)% vs. 49.0 (1.7)%), protein (18.4 (0.5% vs. 16.2 (0.6)%), and dietary
fiber (21.0 (0.9) g vs. 17.4 (1.0) g) at 6-months. Even with reduced total calorie intake, key micronutrients
(calcium, iron, vitamin D, vitamin E, vitamin C) were higher for WL vs. WS at 6-months. Total daily step counts
were higher for WL vs. WS at 6-months. Conclusion: A nutrition intervention to promote weight loss in older
obese adults was achieved using PMR as a primary strategy. Diet quality was improved for WL vs. WS in using
the nutrient fortified product, even with a reduction in total energy intake.
