title: Improved Function With Enhanced Protein Intake per Meal: A Pilot Study of Weight Reduction in Frail, Obese Older Adults.
abstract: Obesity is a significant cause of functional limitations in older adults; yet, concerns that weight reduction could diminish muscle along with fat mass have impeded progress toward an intervention. Meal-based enhancement of protein intake could protect function and/or lean mass but has not been studied during geriatric obesity reduction.
  
  
  
  In this 6-month randomized controlled trial, 67 obese (body mass index ≥30kg/m(2)) older (≥60 years) adults with a Short Physical Performance Battery score of 4-10 were randomly assigned to a traditional (Control) weight loss regimen or one with higher protein intake (>30g) at each meal (Protein). All participants were prescribed a hypo-caloric diet, and weighed and provided dietary guidance weekly. Physical function (Short Physical Performance Battery) and lean mass (BOD POD), along with secondary measures, were assessed at 0, 3, and 6 months.
  
  
  
  At the 6-month endpoint, there was significant (p < .001) weight loss in both the Control (-7.5±6.2kg) and Protein (-8.7±7.4kg) groups. Both groups also improved function but the increase in the Protein (+2.4±1.7 units; p < .001) was greater than in the Control (+0.9±1.7 units; p < .01) group (p = .02).
  
  
  
  Obese, functionally limited older adults undergoing a 6-month weight loss intervention with a meal-based enhancement of protein quantity and quality lost similar amounts of weight but had greater functional improvements relative to the Control group. If confirmed, this dietary approach could have important implications for improving the functional status of this vulnerable population (ClinicalTrials.gov identifier: NCT01715753).
authors.affiliation: Center for the Study of Aging, Duke University Medical Center, Durham, North Carolina. Geriatric Research, Education, and Clinical Center, Durham VA Medical Center, North Carolina. kathryn.starr@dm.duke.edu.
authors.forename: Kathryn N
authors.initials: KN
authors.lastname: Porter Starr
authors.affiliation: Center for the Study of Aging, Duke University Medical Center, Durham, North Carolina. Department of Biostatistics and Bioinformatics.
authors.forename: Carl F
authors.initials: CF
authors.lastname: Pieper
authors.affiliation: Center for the Study of Aging, Duke University Medical Center, Durham, North Carolina.
authors.forename: Melissa C
authors.initials: MC
authors.lastname: Orenduff
authors.affiliation: Department of Medicine, and.
authors.forename: Shelley R
authors.initials: SR
authors.lastname: McDonald
authors.affiliation: Center for the Study of Aging, Duke University Medical Center, Durham, North Carolina.
authors.forename: Luisa B
authors.initials: LB
authors.lastname: McClure
authors.affiliation: Department of Biostatistics and Bioinformatics.
authors.forename: Run
authors.initials: R
authors.lastname: Zhou
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina.
authors.forename: Martha E
authors.initials: ME
authors.lastname: Payne
authors.affiliation: Center for the Study of Aging, Duke University Medical Center, Durham, North Carolina. Geriatric Research, Education, and Clinical Center, Durham VA Medical Center, North Carolina. Department of Medicine, and.
authors.forename: Connie W
authors.initials: CW
authors.lastname: Bales
mesh_terms: D000368:Aged; D015992:Body Mass Index; D004038:Diet, Reducing; D004044:Dietary Proteins / Q000008:administration & dosage*; D005260:Female; D016330:Frail Elderly; D015577:Geriatric Assessment; D006801:Humans; D008297:Male; D009765:Obesity / Q000517:prevention & control*; D010865:Pilot Projects; D016896:Treatment Outcome; D015431:Weight Loss
chemical_list: D004044:Dietary Proteins
keywords: Frailty; Function; Obesity; Older adults; Protein; Weight loss intervention