Functional benefits of combined resistance training with nutritional interventions in older adults: A review

Effect of a 12-Week High-Calorie-Expenditure Multimodal Exercise Program on Health Indices in Women With Overweight: Protocol for a Randomized Controlled Trial

BACKGROUND

High-calorie-expenditure training is common among endurance athletes and is an effective strategy for weight loss. Although many training protocols include walking, running, cycling, and swimming according to a target heart rate, there is limited research on high-calorie-expenditure interventions with multimodal training programs using quantitative methods.

OBJECTIVE

The aims of this research protocol are to (1) develop a high-calorie-expenditure training program to cover target calorie expenditure according to the trainability of women classified as overweight (according to a BMI of 25-29.9 kg/m2); (2) determine the effect of high-calorie-expenditure workouts on conditioning, glycemic variables, and body composition; and (3) evaluate the implementation of the intervention and results in comparison with outcomes obtained under a standard-calorie-expenditure training program.

METHODS

This is a randomized controlled trial with a pretest-posttest design. Participants include 33 women with a BMI in the overweight range (25-29.9) allocated to three groups: two intervention groups and one control group. The intervention will be conducted for 12 weeks. Participants in the first group will be assigned an exercise program with high energy expenditure of approximately 3000-3500 kilocalories/week in the form of 5 sessions per week with an intensity of 50%-75% maximum oxygen rate (VO2 max) and 60%-80% target heart rate. The second group will be assigned an exercise program with a standard energy expenditure of approximately 1200-1500 kilocalories/week with 3 sessions per week at an intensity of 60%-75% VO2 max, according to The American College of Sports Medicine guideline. The effects of the multimodal training program with daily tasks will be compared to those of the standard-calorie-expenditure and control (no exercise) conditions with respect to changes in glycemic indices and body composition. Daily calories will be calculated through the International Physical Activity Questionnaire and using Nutrition 4 software.

RESULTS

Preliminary results show significant weight loss in both the high- and standard-calorie-expenditure groups (P=.003). Significant improvements were also found in muscle percentage (P=.05) and BMI (P=.05) for the high-calorie-expenditure group. Analyses are ongoing for glycemic indices, inflammation factors, and blood parameters.

CONCLUSIONS

High-calorie-expenditure training can cause further weight loss than standard exercise, which can eventually lead to greater fat mass reduction and improvement in glycemic indices. These results demonstrate that, in some cases, it may be necessary to increase the activity of women and use multimodal exercise programs with increased volume and intensity to increase the expenditure of exercise and daily activity. We found a net effect of exercise and daily activity at the individual level, whereas the daily lifestyle and physical behaviors of the participants remained constant.

TRIAL REGISTRATION

Iranian Registry of Clinical Trials IRCT20220202053916N1; https://tinyurl.com/c8jxfw36.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/51599.

[Socioeconomic inequalities in the food consumption of the elderly Brazilian population: National Health Survey, 2019]

Food consumption, when performed in an unhealthy manner, has consequences for the health of individuals, such as a higher incidence of excess weight and the exacerbation of pre-existing chronic diseases. The scope of this article was to assess summary inequalities in food consumption among the elderly population in Brazil. It involved a cross-sectional study, with data from the 2019 National Health Survey. The following outcomes were evaluated: consumption of beans, greens/vegetables, fruit, milk, meat, soda, candies and salt. The main exposure variable was education. An adjusted analysis was conducted and two indices were also used to measure inequality: the slope index (SII) and the concentration index (CIX). A total of 43,554 elderly people were investigated. It was identified that the more educated were 80% more likely to consume vegetables, fruit and milk, while the consumption of beans and meat was up to 50% lower among the less educated. The analyses of relative and absolute inequality reinforce the lower consumption of foods considered healthy among the less educated elderly individuals. The results reveal inequalities in food consumption among the elderly, with greater magnitude in food recognized as being healthy.

Healthy eating index in southern Brazilian older adults and its association with socioeconomic, behavioral and health characteristics

OBJECTIVE

The objective of this study was to assess factors associated with the diet quality of brazilian older adults.

DESIGN

Cross-sectional study.

SETTING

City of Carlos Barbosa, Brazil.

PARTICIPANTS

228 participants aged 60 and older.

MEASUREMENTS

A questionnaire with questions on socioeconomic and behavioral variables and health characteristics was used. The body mass index was calculated and the waist circumference was measured to provide information in respect to abdominal fat accumulation. Dietary data were collected via 24-hour recall and the diet quality was assessed using the Healthy Eating Index, an instrument that attributes scores to the diet according to the adequacy of intake of the main food and nutrient groups. Participants were divided into three categories, according to the Healthy Eating Index scores: under 51--poor diet; between 51 and 80--diet that needs improvement; over 80--good diet. The evaluation employed the analysis of variance, t test and non-conditional logistic regression to assess the association between the Healthy Eating Index and the other variables.

RESULTS

Most participants (80.9%) presented diet that needs improvement and the marital status showed an independent association with the Healthy Eating Index--married individuals showed higher odds of presenting good diet.

CONCLUSION

The results of this study suggest that, in general, the diet quality of this group needs improvement and that the marital status is a factor that can be considered for the development of activities to promote health and healthy food intake habits.

Effect of the Japanese preventive-care version of the Minimum Data Set--Home Care on the health-related behaviors of community-dwelling, frail older adults and skills of preventive-care managers: a quasi-experimental study conducted in Japan

AIM

To determine whether the Japanese preventive-care version of the Minimum Data Set-Home Care improves the health-related behaviors of older adults and the skills of preventive-care managers.

METHODS

Municipal preventive-care managers were instructed on the use of the Japanese preventive-care version of the Minimum Data Set--Home Care and asked to employ it in their interactions with clients during the intervention period (intervention group). The health-related behaviors of older adults (maintenance of self-care and consumption of a balanced diet) were assessed by self-rating methods. The skills of the preventive-care managers were assessed by considering the number of and variations in the needs of the clients, as reflected in the care plans formulated by the managers.

RESULTS

The clients' self-care levels were higher in the intervention group than in the control group (P < 0.05). A greater number of needs, as reflected in the care plans, were noted in the intervention group than in the control group (P < 0.05), and the variation in the assessed needs was greater in the former than in the latter.

CONCLUSION

This study suggests that the Japanese preventive-care version of the Minimum Data Set--Home Care may improve the skills of preventive-care managers, and consequently, the health-related behaviors of frail older clients.

Aging and inactivity—capitalizing on the protective effect of planned physical activity in old age

The paper discusses two parallel biocultural trends—aging and inactivity. The principle of economy in movement in modern society versus the dependency of human beings on movement for their development and health is described. The results of inactivity are sometimes mistakenly considered irreversible losses caused by aging, but in actual fact, inactivity accelerates the irreversible losses caused by the aging process. The paper then describes the contribution of physical activity in terms of increasing positive aspects or decreasing risks: increasing life expectancy or decreasing risk of mortality, increasing cardiovascular fitness or decreasing risk of cardiovascular disease, increasing muscle mass or decreasing falls and instability, improving cognitive performance or reducing cognitive decline and neurological disorders, and improving well-being or reducing depression. The optimal dose of physical activity is then described, followed by recommendations for further research on mechanisms determining physical activity behavior.

Combined effects of functionally-oriented exercise regimens and nutritional supplementation on both the institutionalised and free-living frail elderly (double-blind, randomised clinical trial)

Background

Consistently swelling proportion of the frail elderly within a modern society challenges the overstrained public health sector to provide both adequate medical care and comprehensive assistance in their multiple functional deficits of daily living. Easy-to-apply and task-specific ways of addressing this issue are being sought out, with a view to proposing systemic solutions for nationwide application.

Methods

The present randomised, double-blind, placebo-controlled, 7-week clinical trial aimed to determine whether specifically structured, intensive exercise regimens, combined with nutritional supplementation, might improve and help sustain individual muscle strength and mobility, and possibly enhance individual functional capabilities in an on-going quest for active prevention of care-dependency. Ninety-one frail elderly (F 71 M 20; mean age 79 years) were recruited from both nursing home residents and community dwellers and randomly split into four groups: Group I – progressive resistance exercises (PRE) + functionally-oriented exercises (FOE) + nutritional supplementation (NS), Group II – PRE + FOE + placebo, Group III – standard exercises (SE) + FOE + NS, Group IV – SE + FOE + placebo. Each group pursued a 45 min. exercise session 5 times weekly. The subjects' strength with regard to four muscle groups, i.e. hip and knee extensors and flexons, was assessed at 80% (1 RM) weekly, whereas their balance and mobility at baseline and at the end of the study.

Results

The study was completed by 80 subjects. Despite its relatively short duration significant differences in muscle strength were noted both in Group I and Group II (p = 0.01; p = 0.04; respectively), although this did not translate directly into perceptible improvement in individual mobility. Notable improvements in individual mobility were reported in Group III and Group IV (p = 0.002), although without positive impact on individual muscle strength.

Conclusion

Comprehensively structured, high-intensity regimen made up of diverse exercise types, i.e. functionally-oriented, progressive resistance and standard ones, preferably if combined with nutritional supplementation in adequate volume, demonstrates clear potential for appreciably improving overall functional status in the frail elderly in terms of individual walking capacity and muscle strength.

Trial registration

Central Register of Clinical Trials, Poland – CEBK180/2000.