Effect of a high protein diet and/or resistance exercise on the preservation of fat free mass during weight loss in overweight and obese older adults: a randomized controlled trial.
BACKGROUND
Intentional weight loss in obese older adults is a risk factor for accelerated muscle mass loss. We investigated whether a high protein diet and/or resistance exercise preserves fat free mass (FFM) during weight loss in overweight and obese older adults.


METHODS
We included 100 overweight and obese adults (55-80 year) in a randomized controlled trial (RCT) with a 2 × 2 factorial design and intention-to-treat analysis. During a 10-week weight loss program all subjects followed a hypocaloric diet. Subjects were randomly allocated to either a high protein (1.3 g/kg body weight) or normal protein diet (0.8 g/kg), with or without a resistance exercise program 3 times/week. FFM was assessed by air displacement plethysmography.


RESULTS
At baseline, mean (±SD) BMI was 32 ± 4 kg/m2. During intervention, protein intake was 1.13 ± 0.35 g/kg in the high protein groups vs. 0.98 ± 0.29 in the normal protein groups, which reflects a 16.3 ± 5.2 g/d higher protein intake in the high protein groups. Both high protein diet and exercise did not significantly affect change in body weight, FFM and fat mass (FM). No significant protein*exercise interaction effect was observed for FFM. However, within-group analysis showed that high protein in combination with exercise significantly increased FFM (+0.6 ± 1.3 kg, p = 0.011).


CONCLUSIONS
A high protein diet, though lower than targeted, did not significantly affect changes in FFM during modest weight loss in older overweight and obese adults. There was no significant interaction between the high protein diet and resistance exercise for change in FFM. However, only the group with the combined intervention of high protein diet and resistance exercise significantly increased in FFM.


BACKGROUND
Dutch Trial Register, number NTR4556, date 05-01-2014.
Department of Nutrition and Dietetics, Faculty of Sports and Nutrition, Amsterdam University of Applied Sciences, Dr. Meurerlaan 8, 1067 SM, Amsterdam, Netherlands. a.verreijen@hva.nl.
Amely M
AM
Verreijen
Department of Nutrition and Dietetics, Faculty of Sports and Nutrition, Amsterdam University of Applied Sciences, Dr. Meurerlaan 8, 1067 SM, Amsterdam, Netherlands.
Mariëlle F
MF
Engberink
Department of Nutrition and Dietetics, Faculty of Sports and Nutrition, Amsterdam University of Applied Sciences, Dr. Meurerlaan 8, 1067 SM, Amsterdam, Netherlands.
Robert G
RG
Memelink
Department of Nutrition and Dietetics, Faculty of Sports and Nutrition, Amsterdam University of Applied Sciences, Dr. Meurerlaan 8, 1067 SM, Amsterdam, Netherlands.
Suzanne E
SE
van der Plas
Department of Health Sciences, Faculty of Earth and Life Sciences, VU University Amsterdam, De Boelenlaan 1085, 1081 HV, Amsterdam, Netherlands.|Department of Nutrition and Dietetics, Internal Medicine, VU University Medical Center, De Boelenlaan 1117, 1081 HV, Amsterdam, Netherlands.
Marjolein
M
Visser
Department of Nutrition and Dietetics, Faculty of Sports and Nutrition, Amsterdam University of Applied Sciences, Dr. Meurerlaan 8, 1067 SM, Amsterdam, Netherlands.|Department of Nutrition and Dietetics, Internal Medicine, VU University Medical Center, De Boelenlaan 1117, 1081 HV, Amsterdam, Netherlands.
Peter J M
PJ
Weijs
D000368:Aged; D000369:Aged, 80 and over; D001823:Body Composition; D015992:Body Mass Index; D031204:Caloric Restriction; D000073600:Diet, High-Protein; D004038:Diet, Reducing; D004041:Dietary Fats / Q000008:administration & dosage; D004044:Dietary Proteins / Q000008:administration & dosage; D005260:Female; D018737:Hand Strength; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000178:diet therapy*; D050177:Overweight / Q000178:diet therapy*; D010349:Patient Compliance; D055070:Resistance Training; D016896:Treatment Outcome; D055105:Waist Circumference; D015431:Weight Loss
D004041:Dietary Fats; D004044:Dietary Proteins
Fat free mass; High protein diet; Obesity; Older adults; Resistance exercise; Weight loss