title: Developing a new treatment paradigm for disease prevention and healthy aging.
abstract: An increasingly prevalent pattern of risk factors has emerged in middle-aged and older adults that includes the presence of type 2 diabetes or prediabetes, overweight or obese weight status with central obesity and very high body fat, low cardiorespiratory fitness (CRF), low strength, and a low lean-body-mass-to-body-fat ratio. Traditionally, these problems have been approached with a low-fat and low-calorie diet and with lower to moderate intensity activity such as walking. While the treatment has some clear benefits, this approach may no longer be optimal because it does not reflect more recent findings from nutrition and exercise sciences. Specifically, these fields have gained a greater understanding of the metabolic and functional importance of focusing on reducing body fat and central obesity while maintaining or even increasing lean body mass, a quality weight loss, and how to efficiently and effectively increase CRF and strength. Evidence is presented for shifting the treatment paradigm for disease prevention and healthy aging to include the DASH nutrition pattern but with additional protein, higher intensity, brief aerobic training, effort-based, brief resistance training, and structured physical activity. Recent interventions based on social cognitive theory for initiating and then maintaining health behavior changes show the feasibility and efficacy of the approach we are advocating especially within a multiple health behavior change format and the potential for translating the new treatment paradigm into practice.
authors.affiliation: Psychology Department, Virginia Tech, Blacksburg, VA 24061 USA.
authors.forename: Richard A
authors.initials: RA
authors.lastname: Winett
authors.affiliation: Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, VA 24061 USA.
authors.forename: Brenda M
authors.initials: BM
authors.lastname: Davy
authors.affiliation: Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, VA 24061 USA.
authors.forename: Elaina
authors.initials: E
authors.lastname: Marinik
authors.affiliation: Human Development, Virginia Tech, Blacksburg, VA 24061 USA.
authors.forename: Jyoti
authors.initials: J
authors.lastname: Savla
authors.affiliation: Personal Computer Resources, Inc., Blacksburg, VA 24060 USA.
authors.forename: Sheila G
authors.initials: SG
authors.lastname: Winett
authors.affiliation: Kinesiology Department, McMaster University, Hamilton, Ontario L8S 4 K1 Canada.
authors.forename: Stuart M
authors.initials: SM
authors.lastname: Phillips
authors.affiliation: Psychology Department, East Carolina University, Greenville, NC 27858 USA.
authors.forename: Lesley D
authors.initials: LD
authors.lastname: Lutes
keywords: Diabetes; Multiple health behaviors; Quality weight loss; Treatment paradigm