title: Calorie restriction in overweight older adults: Do benefits exceed potential risks?
abstract: The evidence regarding recommendations of calorie restriction as part of a comprehensive lifestyle intervention to promote weight loss in obese older adults has remained equivocal for more than a decade. The older adult population is the fastest growing segment of the US population and a greater proportion of them are entering old age obese. These older adults require treatments based on solid evidence. Therefore the purpose of this review is three-fold: 1) to provide a more current status of the knowledge regarding recommendations of calorie restriction as part of a comprehensive lifestyle intervention to promote weight loss in obese older adults, 2) to determine what benefits and/or risks calorie restriction adds to exercise interventions in obese older adults, and 3) to consider not only outcomes related to changes in body composition, bone health, cardiometabolic disease risk, markers of inflammation, and physical function, but, also patient-centered outcomes that evaluate changes in cognitive status, quality of life, out-of-pocket costs, and mortality. Seven randomized controlled trials were identified that examined calorie restriction while controlling for exercise intervention effects. Overall, the studies found that calorie restriction combined with exercise is effective for weight loss. Evidence was mixed regarding other outcomes. The risk-benefit ratio regarding calorie restriction in older adults remains uncertain. Greater long-term follow-up is necessary, and complementary effectiveness studies are needed to identify strategies currently used by obese older adults in community settings.
authors.affiliation: Department of Medicine, University of Alabama at Birmingham, Birmingham, AL 35294, United States; Department of Health Care Organization and Policy, University of Alabama at Birmingham, Birmingham, AL 35294, United States; Nutrition Obesity Research Center, University of Alabama at Birmingham, Birmingham, AL 35294, United States. Electronic address: jlocher@uab.edu.
authors.forename: Julie L
authors.initials: JL
authors.lastname: Locher
authors.affiliation: Nutrition Obesity Research Center, University of Alabama at Birmingham, Birmingham, AL 35294, United States; Office of Energetics, University of Alabama at Birmingham, Birmingham, AL 35294, United States.
authors.forename: TaShauna U
authors.initials: TU
authors.lastname: Goldsby
authors.affiliation: Nutrition Obesity Research Center, University of Alabama at Birmingham, Birmingham, AL 35294, United States; Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, AL 35294, United States.
authors.forename: Amy M
authors.initials: AM
authors.lastname: Goss
authors.affiliation: Department of Health Care Organization and Policy, University of Alabama at Birmingham, Birmingham, AL 35294, United States.
authors.forename: Meredith L
authors.initials: ML
authors.lastname: Kilgore
authors.affiliation: Nutrition Obesity Research Center, University of Alabama at Birmingham, Birmingham, AL 35294, United States; Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, AL 35294, United States.
authors.forename: Barbara
authors.initials: B
authors.lastname: Gower
authors.affiliation: Department of Epidemiology and Prevention, Wake Forest School of Medicine, Medical Center Boulevard, Winston Salem, NC 27157, United States.
authors.forename: Jamy D
authors.initials: JD
authors.lastname: Ard
mesh_terms: D000368:Aged; D001823:Body Composition / Q000502:physiology; D031204:Caloric Restriction; D005081:Exercise Therapy; D005260:Female; D006304:Health Status; D000070497:Healthy Lifestyle / Q000502:physiology; D006801:Humans; D008297:Male; D009765:Obesity / Q000178:diet therapy; D050177:Overweight / Q000178:diet therapy*; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors; D015431:Weight Loss / Q000502:physiology
keywords: Aerobic exercise; Calorie intake; Narrative review; Older adults