title: Intentional weight loss in older adults: useful or wasting disease generating strategy?
abstract: OBJECTIVE
  Strategies for weight management in older adults remain controversial as overweight may protect them against mortality whereas weight loss may have harmful effects by promoting sarcopenia and bone loss. It has been suggested that weight management for obese older adults should focus more on maintaining weight and improving physical function than promoting weight loss. This review aims to specify whether intentional weight loss in older adults is a useful or a wasting disease generating strategy.
  
  
  RESULTS
  Recent randomized controlled studies have shown that a supervised, moderate caloric restriction coupled with regular exercise (both aerobic and resistance) in obese older adults do not increase mortality risk and may conversely reduce insulin resistance, metabolic complications, and disabilities without exacerbating lean mass and bone mineral density loss.
  
  
  CONCLUSIONS
  In obese older adults, moderate weight loss may have beneficial effects on comorbidities, functional performances, and quality of life provided that regular physical activity can be associated. An individual approach considering life expectancy, chronic comorbidities, functional status, personal motivation, and social support should be preferred. More research is needed to define the circumstances in which cautious dietary restrictions are reasonably justified in older adults. In any case, in the oldest (≥80 years) as in frail individuals, it seems reasonable to abstain from recommending weight loss.
authors: Department of Nutrition, Metabolic Diseases and Endocrinology, Sainte-Marguerite University Hospital, INRA UMR1260/INSERM UMR1062, Nutrition, Obesity and Risk of Thrombosis, Aix-Marseille University, Marseille, France. patrice.darmon@ap-hm.fr
authors: Patrice
authors: P
authors: Darmon
mesh_terms: D000368:Aged; D015992:Body Mass Index; D015519:Bone Density; D031204:Caloric Restriction / Q000379:methods*; D002318:Cardiovascular Diseases / Q000517:prevention & control; D002908:Chronic Disease; D015897:Comorbidity; D015444:Exercise; D006801:Humans; D007249:Inflammation / Q000517:prevention & control; D007333:Insulin Resistance; D008017:Life Expectancy; D018977:Micronutrients / Q000008:administration & dosage / Q000172:deficiency; D009765:Obesity / Q000178:diet therapy / Q000453:epidemiology*; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors; D019282:Wasting Syndrome / Q000178:diet therapy / Q000453:epidemiology*; D015431:Weight Loss
chemical_list: D018977:Micronutrients