title: Effect of dietary restriction and exercise on lower extremity tissue compartments in obese, older women: a pilot study.
abstract: BACKGROUND
  Accumulating evidence suggests that both dietary restriction and exercise (DR + E) should be incorporated in weight loss interventions to treat obese, older adults. However, more information is needed on the effects to lower extremity tissue composition-an important consideration for preserving mobility in older adults.
  
  
  METHODS
  Twenty-seven sedentary women (body mass index: 36.3±5.4kg/m(2); age: 63.6±5.6 yrs) were randomly assigned to 6 months of DR + E or a health education control group. Thigh and calf muscle, subcutaneous adipose tissue (SAT), and intermuscular adipose tissue (IMAT) size were determined using magnetic resonance imaging. Physical function was measured using a long-distance corridor walk and knee extension strength.
  
  
  RESULTS
  Compared with control, DR + E significantly reduced body mass (-6.6±3.7kg vs control: -0.05±3.5kg; p < .01). Thigh and calf muscle volumes responded similarly between groups. Within the DR + E group, adipose tissue was reduced more in the thigh than in the calf (p < .04). Knee extension strength was unaltered by DR + E, but a trend toward increased walking speed was observed in the DR + E group (p = .09). Post hoc analyses showed that reductions in SAT and IMAT within the calf, but not the thigh, were associated with faster walking speed achieved with DR + E (SAT: r = -0.62; p = .01; IMAT: r = -0.62; p = .01).
  
  
  CONCLUSIONS
  DR + E preserved lower extremity muscle size and function and reduced regional lower extremity adipose tissue. Although the magnitude of reduction in adipose tissue was greater in the thigh than the calf region, post hoc analyses demonstrated that reductions in calf SAT and IMAT were associated with positive adaptations in physical function.
authors.affiliation: Aging Rehabilitation Research Center, University of Florida, PO Box 112610, Gainesville, FL 32611. tmanini@ufl.edu.
authors.forename: Todd M
authors.initials: TM
authors.lastname: Manini
authors.forename: Thomas W
authors.initials: TW
authors.lastname: Buford
authors.forename: Donovan J
authors.initials: DJ
authors.lastname: Lott
authors.forename: Krista
authors.initials: K
authors.lastname: Vandenborne
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Daniels
authors.forename: Jeffrey D
authors.initials: JD
authors.lastname: Knaggs
authors.forename: Hetain
authors.initials: H
authors.lastname: Patel
authors.forename: Marco
authors.initials: M
authors.lastname: Pahor
authors.forename: Michael G
authors.initials: MG
authors.lastname: Perri
authors.forename: Stephen D
authors.initials: SD
authors.lastname: Anton
mesh_terms: D015992:Body Mass Index; D004038:Diet, Reducing / Q000379:methods*; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D035002:Lower Extremity / Q000503:physiopathology*; D008875:Middle Aged; D053580:Muscle Strength / Q000502:physiology*; D018482:Muscle, Skeletal / Q000503:physiopathology*; D009765:Obesity / Q000503:physiopathology / Q000628:therapy*; D010865:Pilot Projects; D016037:Single-Blind Method; D016138:Walking / Q000502:physiology*; D015431:Weight Loss
keywords: Aging; Body composition; Disability.; Obesity; Weight loss